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Objective:To investigate the effect of flap combined with 3D printed microporous titanium(tantalum)prosthesis in the treatment of lower extremity soft tissue defect with large bone defect.Methods:From January 2019 to December 2020, 2 patients with large soft tissue defects on dorsal foot together with large metatarsal bone defect and 4 patients with soft tissue defects of calf with large tibial bone defect were treated. The areas of soft tissue defect were 5.0 cm×8.0 cm-15.0 cm×10.0 cm. The length of the bone defect were 3.8 cm to 7.0 cm, 5.75 cm in average. In the first stage, metatarsal bone defect or tibial bone defect was filled with vancomycin blended bone cement, meanwhile, soft tissue defect was repaired with anterolateral femoral flap(ALTF) with vascular anastomosis in 2 cases of feet, and local fascia flap was trans-positioned in 4 cases of lower extremity defects. The sizes of repairing flap were 6.0 cm×8.5 cm-16.0 cm×11.0 cm. Two to 7 months after the initial surgery, the customer designed microporous titanium prostheses were used(5 cases with microporous titanium and 1 with microporous tantalum) to repair the bone defects. The wound healing, the integration of metatarsal and tibial fractures with 3D printed microporous titanium(tantalum) prostheses, and the walking condition were observed after surgery. The follow-up lasted from 6 to 25 months, with an average of 12.7 months.Results:The wound healing in 5 patients was good. The patients stood on the foot in 2 months after surgery, started to walk with the assistance of crutch in 3 months after surgery, and took walk without assistance in 5-6 months after surgery. Good osseous integration were achieved. One diabetic patient had infection of foot wound 3 months after surgery. After removal of microporous titanium prosthesis and replacement of vancomycin blended interstitial substance of bone cement, the wound healed and the patient resumed walking.Conclusion:It is an effective method to encourage the patients to take early ambulation after the surgery for lower extremity soft tissue defect with large bone defect that was repaired by a flap and 3D printed microporous titanium(tantalum)prosthesis. Further observations are required to investigate the long-term efficacy, and the reduction of prosthesis infection rate requires further exploration.
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Objective To explore the application of bridging-combined internal fixation for extremity fractures.Methods From May 2010 to August 2017,56 patients were treated by bridging-combined internal fixation for 58 different extremity fractures at Department of Orthopaedics,Military Orthopaedic Trauma Institute,Kunming General Hospital of PLA.They were 34 males and 22 females,aged from 16 to 83 years (average,48 years).There were 48 comminuted and 16 open fractures.The interval from injury to surgery ranged from one to 34 days (average,8 days).Early functional rehabilitation was encouraged for the patients.The therapeutic outcomes were evaluated in terms of fracture union time,postoperative infection,and postoperative functional recovery.Results Fifty-two of the patients were followed up for 12 to 28 months (average,16 months).The fractures united after 3 to 6 months (average,3.5 months).Comprehensive evaluation of the therapeutic outcomes resulted in 36 excellent,12 good,and 4 fair cases,yielding an excellent to good rate of 92.3％.Follow-ups revealed no postoperative infection,bone nonunion,loosening or breakage of the implants.Conclusion The bridging-combined internal fixation may lead to fine therapeutic outcomes for traumatic extremity fractures,because this system is flexible and easy to apply,and leads to fine reduction and limited postoperative complications.
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Objective:To compare and observe the different clearance effect of milk containing anti-Helicobacter pylori specific antibody. Methods:Four H. pylori strains were used to immune dairy cows to obtain milk containing anti-Helicobacter pylori specific antibody,of which,one was standardized strain and the other three were locally epidemic. Totally 148 people were screended,in which 72 were C-14 urea breath test positive, finally 39 meet the criteria. They were divided into two groups, the test group contained 21 subjects,were treated milk containing anti-Helicobacter pylori specific antibody;the 18 subjects in control group with common milk. The study was continued for 2 months. Results:Conducting the C-14 urea breath test,9 subjects in test group were negative,but no one was changed in control group. The effective clearance rate of the test group was 42. 86%,and there was no effective clearance in the control group,so there was significant difference in the two groups(P=0. 005,P<0. 05). Conclusion: The milk containing anti-Helicobacter pylori specific antibody is polyclonal and has higher valence,and could clear H . Pylori effectively.