RESUMO
BACKGROUND:There are many methods in the clinic to treat pelvic fractures, mainly conservative treatment, internal fixation and external fixation. Conservative treatment often causes complications due to poor reduction after fractures. Fixation has good effects on repair of unstable fractures, but fixation is seldom used for pelvic fractures. OBJECTIVE:To observe the effects of internal fixation on unstable pelvic fractures, and compare with conservative treatment and external fixation. METHODS:126 cases of unstable pelvic fractures from Longhua District People’s Hospital of Shenzhen City from January 2008 to June 2014 were divided into three groups:conservative treatment group, external fixation group and internal fixation group (n=42). After treatment, patients received X-ray examination. Lindahl imaging criteria were used as evidence. The quality of fracture reduction was evaluated. Patients were regularly fol owed up after treatment. The recovery of limb function was evaluated according to Majeed standard. Repair effects, the excel ent and good rates of fracture healing and cal us growth were evaluated in the last fol ow-up. RESULTS AND CONCLUSION:During the last fol ow-up, the total efficiency was 81%in the internal fixation group, 69%in the conservative treatment group, and 71%in the external fixation group, and results were significantly better in the internal fixation group than in the other two groups (P<0.05). The Lindahl and Majeed scores were significantly higher in the internal fixation group than in the other two groups (P<0.05). These results suggest that internal fixation for unstable pelvic fracture obtained better recovery effects and efficiency than conservative treatment and external fixation. Thus, the internal fixation is more suitable for patients with unstable pelvic fractures.
RESUMO
BACKGROUND:Study confirms that bone morphogenetic protein can induce osteogenesis;however the ultrastructure of periosteal cells induced by bone morphogenetic protein-7 remains poorly reported. OBJECTIVE:To study the bioactivity and ultrastructure of periosteal cells induced by bone morphogenetic protein-7 in vitro. METHODS:The primary periosteal cells isolated from adult tibial bone were in vitro cultured, and then divided into experimental group and control group. In the experimental group, cells were cultured with bone morphogenetic protein-7 and culture adjuvant;while cells in the control group were only cultured with the adjuvant. Three samples in each group were tested at 5, 10, 15 days, respectively. The general structure of cultured cells was observed using von Kossa staining, and the ultrastructure was observed under transmission electron microscopy. RESULTS AND CONCLUSION:The periosteal cells in the two groups grew wel in vitro, showing uniform morphology. Early cells were spindle-shaped, with strong three-dimensional sense and ful transparency;mitotic cells were short columnar or cubic shaped, there were a lot of rough endoplasmic reticulum and Golgi complex in osteoblasts under electron microscope. Later stage of cells developed from long fusiform into wide shuttle and irregular shape, there were a large number of matrix vesicles within the cells under the electron microscope. The membrane coating, alkaline phosphatase and calcium-binding protein in the cytoplasm, as wel as calcium crystals were found. The osteogenesis basement and lateral sides appeared projections, which were connected with adjacent bone cells. Induction of bone morphogenetic protein-7 in vitro promotes the osteoblasts proliferation, division and bone formation speed. The results suggest that bone morphogenetic protein-7 can significantly enhance the proliferation ability of osteoblasts in vitro.
RESUMO
BACKGROUND:The reports on bone morphogenetic protein-7 as a stimulating factor to induce osteogenic are relatively rare. OBJECTIVE:To study the expression of alkaline phosphatase of periosteal cel s after induced by bone morphogenetic protein-7 in vitro. METHODS:Periosteal cel s were obtained from adult tibial periosteum, and then the periosteal cel s were cultured by routine method in vitro. The cel s were divided into experimental group and control group, and then cultured with bone morphogenetic protein-7 plus osteoblast culture adjuvants and simple osteoblast culture adjuvants, respectively. The phase contrast microscope was used to observe the morphology and ultrastructure of periosteal cel s. Each group was observed at 7, 14 and 21 days, and three samples were observed at each time point. Alkaline phosphatase kit was used to detect the expression of osteoblast-specific markers alkaline phosphatase. RESULTS AND CONCLUSION:After cultured for 7 days, the proliferation of periosteal cel s in the experimental group and the control group was increased obviously, and the expression of alkaline phosphatase was detected but less. The cel s were spindle in shape, while the expression of alkaline phosphatase in the experimental group was higher than that in the control group. After cultured for 14 days, the proliferation of periosteal cel s in the experimental group and the control group was increased obviously, the cel morphology was changed from spindle-shaped to wide spindle-shaped, and the expression of alkaline phosphatase in the experimental group was increased significantly when compared with the control group. After cultured for 21 days, the proliferation of periosteal cel s was detected in the experimental group and the control group, and the proliferation in the experimental group was more significant than that in the control group, the cel morphology was wide spindle-shaped, and the number of alkaline phosphatase in the experimental group was higher than that in the control group. Statistical analysis showed that the positive rate of osteogenic markers alkaline phosphatase of bone morphogenetic protein-7 induced periosteal cel s in the experimental group was higher than that in the control group (Posteogenic and regeneration ability, the bone morphogenetic protein-7 could induce periosteal cel s, promote the expression of alkaline phosphatase, and could induce the periosteal cel s to transform into osteoblasts.