RESUMO
BACKGROUND:It is stil disputed at present about the treatment selection for clavicle fractures, operative or conservative treatment. OBJECTIVE:To evaluate the effects of operative and non-operative (conservative) treatment for clavicle fractures with the method of meta-analysis. METHODS: We retrieved PUBMED, EMBASE, OVID, Cochrane library, Science Direct, Springer Link, China National Knowledge Infrastructure and Wanfang Database for articles on treatment of clavicle fractures published from January 2000 to December 2013. According to specific inclusion and exclusion criteria, relevant literatures about treatments of clavicle fractures were searched for data source extraction, which were used for meta-analysis using Review Manager 5.0 software. RESULTS AND CONCLUSION:Six randomized controled trials were included, including 570 patients. Meta-analysis results demonstrated that for clavicle fractures, implant fixation could decrease nonunion rate [RR=0.16, 95%CI(0.07, 0.38),P < 0.000 1], malunion rate [RR=0.15, 95%CI(0.07, 0.34),P < 0.000 01], delayed union rate [RR=0.20, 95%CI(0.06, 0.70),P=0.01] and the incidence of residual pain at 1 year after treatment [RR=0.24, 95%CI(0.12, 0.51),P=0.000 2], could elevate Constant Score [MD=3.68, 95%CI(1.61, 5.76),P=0.000 5]. However, it was not concluded that fixation could reduce the incidence of neurological complications [RR=0.63, 95%CI(0.06, 0.70),P=0.22]. It is suggested that implant fixation for clavicle fractures obtained good clinical effects. However, due to the disadvantages of the included literatures, we stil needed high-quality multicenter randomized controled trials to further verify conclusions, and should pay more attention on patients’ individual conditions when the therapeutic methods for clavicle fractures were selected in the clinic.
RESUMO
BACKGROUND:The in vivo degradation process of chitosan/hydroxyapatite composite porous scaffolds is not very clear. Research on the effects of rat osteoblasts and degradation products is less. OBJECTIVE:To analyze the biocompatiblity of rat osteoblasts with degradation products of chitosan/hydroxyapatite composite porous scaffolds. METHODS:The second generation of cultured rat osteoblasts were respectively cultured in the extract of degradation products of chitosan/hydroxyapatite composite scaffolds (experimental group) and Dulbecco’s modified Eagle’s medium containing 10%fetal bovine serum (control group). At 2, 4, 6, 8, 10 days of culture, cel counting was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Alkaline phosphatase activity was measured by the recommended method of determination of the Federation, and total protein was determined by BCA method. RESULTS AND CONCLUSION:The proliferation speed, alkaline phosphatase activity, total cel ular protein synthesis and ratio of alkaline phosphatase to total protein in rat osteoblasts cultured in the experimental group were significantly higher than those in the control group (P<0.05). This experiment showed that the degradation products of chitosan/hydroxyapatite composite porous scaffolds cannot only promote rat osteoblast adhesion, growth and proliferation, but also enhance its ossification function, with good biocompatibility.