Clinical observation of anterior cruciate ligament reconstruction with tibial-remnant preserving technique using hamstring autograft / 中国骨伤

<p><b>OBJECTIVE</b>To observe the outcome of ACL reconstruction with tibial-remnant preserving technique using hamstring autograft.</p><p><b>METHODS</b>From January 2007 to June 2009,18 patients, including 11 male and 7 female with an average age of 28.2 years (from 18 to 42 years), received ACL reconstruction in Kunshan traditional Chinese medicine hospital, Jiangsu province. All cases were confirmed that the remnant of torn ACL were more than 1/3 by arthroscopic observation. The gracillis and semitendinosus tendons harvested from the patient were folded and weaved as a graft, which was pulled into the femoral and tibia tunnel through the sheath formed by the remnant preserved carefully, then fixed by Rigidfix at femoral side and Intrafix at tibial side respectively. The Lysholm scores were recorded at the last follow-up to evaluate the postoperative knee function. The knee stability, range of motion (ROM), and proprioception were evaluated by physical examination.</p><p><b>RESULTS</b>The average duration of follow-up of all 18 patients was 17.3 months (ranged from 15 to 24 months), no synovitis, graft tear, and ROM limitation were found. The average postoperative Lysholm score was (91.56 +/- 4.60) improved from preoperative (49.43 +/- 2.85) (P < 0.05). There were no differences between bilateral knees on the knee flexion (P > 0.05).</p><p><b>CONCLUSION</b>To preserve the tibial remnant of torn ACL during ACL reconstruction had good outcomes, and contributed to recovery of knee proprioceptive function.</p>

Expansive pedicle screws fixation combined with Wright artificial bone implantation for treatment of thoracolumbar burst fracture of the elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effects of expansive pedicle screws fixation combined Wright artificial bone implantation in treating thoracolumbar burst fracture of the elderly.</p><p><b>METHODS</b>From March 2007 to July 2009, 12 patients with thoracolumbar burst fractures were treated with surgery in the study. There were 7 males and 5 females, with an average age of 62.3 years (from 56 to 71 years). Nerve functions of all patients were ASIA classified grade E. According to TLICS score system, 6 points were in 5 cases and 7 points were in 7 cases. Expansive pedicle screw system was used and Wright artificial bone was injected into the injuried vertebrae. The anterior border height of vertebral body and Cobb angle were observed at the preoperation, postoperation and final follow-up.</p><p><b>RESULTS</b>All patients were followed up from 10 to 15 months with an average of 12 months. Wounds healed well, pain in the chest-back abated, no the expansive pedicle screws loosened or broke down. The anterior border height of vertebral body increased from (32.3 +/- 9.1)% preoperatively to (95.3 +/- 3.2)% postoperatively; and the Cobb angle decreased from (31.6 +/- 6.8) degrees preoperatively to (4.5 +/- 3.2) degrees postoperatively. There was significant difference between two groups (P<0.01). After 3 months, the anterior border height of vertebral body was (94.7 +/- 3.3)% and the Cobb angle was (4.6 +/- 3.4) degrees; at the final follow-up, the anterior border height of vertebral body was (93.2 +/- 3.6)% and the Cobb angle was (5.3 +/- 3.7) degrees. There was no significant difference between the two data (P>0.05).</p><p><b>CONCLUSION</b>The combination of expansive pedicle screws fixation and Wright artificial bone injection is a good treatment for thoracolumbar burst fracture, with advantages such as easy operation and good effect, which mainly applied to patients with no obvious nerve injuries.</p>