RESUMO
This study was aimed to explore pharmacological effects of epimedium pubescen flavonoid (EPF) on biomechanical properties among ovariectomized rats. Sixty female Sprague-Dawley (SD) rats (aged 2-month-old) were randomly divided into six groups (n = 10), which were the sham control group (Group A), the model group (GroupB), the standard group (Group C), the treated 1 group (Group D), the treated 2 group (Group E), and the treated 3 group (Group F). Except the sham control group (Group A), rats in other groups had been ovariectomized. All rats were given the same feedstuff. Meanwhile, Group C was given calcium 75 mg·kg-1 combined with VitD3 21 IU·kg-1 by gastrogavage every day for 4 months; Group D was given EPF 75 mg·kg-1; Group E was given EPF 150 mg·kg-1;Group F was given EPF 300 mg·kg-1. At the end of the 4th month, all rats were sacrificed. Bones, which included tibia, femur and humerus of both sides and all lumbar vertebra bodies, had been taken out. Measurement was made on the elastic modulus, maximum loading capability, maximum stress, potential energy of deformation, and structural rigidity of biomechanical properties of the fourth lumbar vertebra body (LV4); the maximum loading capability, bone break load, potential energy of deformation, structural rigidity of the structural dynamics properties of the femur com-pact bone; the elastic modulus, maximum stress, maximum inherent strain, bone break stress, and bone break strain of the mechanical properties of a material of the femur compact bone in the experimental rats. The results showed that compared with Group B, the elastic modulus, maximum loading capability, maximum stress, potential energy of deformation, and structural rigidity of LV4; the maximum loading capability, bone break load, potential energy of de-formation, structural rigidity of the structural dynamics properties of the femur compact bone; the elastic modulus, maximum stress, maximum inherent strain, and bone break strain of the mechanical properties of a material of the fe-mur compact bone were obviously increased in Group A, D, E and F (P< 0.05). Group C had increasing tendency. There were no statistical differences among Group A, C, D, E and F. Group D, E, and F had increased with EPF dose-dependently. However, there were no statistical differences among them. There were no statistical differences on bone break strain of the mechanical properties of a material of the femur compact bone among Group A, C, D, E, and F. It showed that ovariectomization reduced the biomechanical properties of vertebra bodies, structural dynamics properties of the femur compact bone, and the mechanical properties of a material of the femur compact bone. The application of EPF can effectively prevent and treat the decreasing of biomechanical properties of ovariectomized rats, so as to keep them in a relatively higher level.
RESUMO
BACKGROUND:Active surgical treatments are preferred for elderly hip fractures. Individual fixation method is chosen according to fracture site, type, age and whether there are basic diseases in internal medicine, which plays an important role in the successful treatment of elderly hip fractures. OBJECTIVE:To explore the effects of optimized surgical treatment on osteoporotic hip fracture in the elderly. METHODS: Totally 176 patients with osteoporotic hip fracture were treated by different methods between January 2000 and January 2012, including 63 males and 113 females, with a mean age of (76.7±6.3) years. Out of the 84 cases of interchanteric fracture, seven cases were treated with conservative methods, 34 cases were treated with dynamic hip screw internal fixation, 18 cases were treated with cannulated screw internal fixation, seven cases were treated with anatomical plate internal fixation, 12 cases were treated with bipolar femoral placement, and six cases were treated with total hip arthroplasty. Out of the 92 cases with femoral neck fractures, 40 cases were treated with bipolar femoral placement, 37 cases were treated with total hip arthroplasty and 15 cases were treated with cannulated screw internal fixation. Modified Harris hip function scores were used to evaluate the therapeutic effects of different treatment methods. Complications were observed. RESULTS AND CONCLUSION:Seventy-six cases of interchanteric fractures and 85 cases of femoral neck fractures were fol owed-up for 8-26 months with an average of (5.7±1.3) months. Three cases suffered from post-operative infection, and one case died due to cardio-pulmonary failure in 10 days after operation. Both intraoperation and postoperative complications included femoral head cutting, intraoperative fracture, internal fixation and prosthetic loosening, postoperative fracture, avascular necrosis of femoral head, coxa vara, legs shorten, and delayed fracture healing. The incidence rates of complications in patients undergoing bipolar femoral placement and total hip arthroplasty were significantly lower than those treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P0.05). No significant differences were found in the incidence rate of complications and Harris scores between patients treated with bipolar femoral placement and total hip arthroplasty (P>0.05). These findings indicate that the treatment of osteoporotic hip fracture in the elderly can achieve satisfactory results if the comprehensive therapies are given. Bipolar femoral placement and total hip arthroplasty are preferred for elderly femoral neck fractures.
RESUMO
OBJECTIVE: To retrospectively evaluate the effect of locking compression plate (LCP) combined with scaled cancellous bone graft on postoperative nonunion of humeral shaft fracture. METHODS: A total of 19 cases with postoperative nonunion of humeral shaft fracture were collected from Department of Orthopaedics, Affiliated Hospital, Xiangnan University between August 2005 and January 2009. There were 12 males and 7 females, aging 28-59 years with the mean age of 36 years. All patients were treated with LCP fixation combined with scaled cancellous bone graft. The key points of the operation were as follows: beck-median or lateral approach, protection of the radial nerve and ulnar nerve, removal of the cicatrix, reopening of humeral canal, and limited periosteum striping. For minimally invasive plate osteosynthesis technique, length of LCP was appropriate, 3-4 locking screws at least were used on either stump, and double cortices were penetrated with locking screws and treated with scaled cancellous bone graft. RESULTS: All the fractures healed with a mean period of 7.2 months (from 6 to 8 months). Two cases showed temporary radial nerve palsy after the operation, which gradually recovered 3 and 6 weeks, respectively after appropriate treatment. Shoulder and elbow functions were somewhat impaired in 7 cases, but the dysfunction could not influence daily living. Infection, screw loosening, blade plate breakage, and other complications were not found. CONCLUSION:The integrity of locking screws and plate prevents screw breakage and plate loosening. The combination of autoallergic cancellous bone graft and scaled decorticating technique can improve healing of humeral shaft fracture.