Clinical outcomes of buttress plating in treating posterior Pilon fractures through modified posteromedial approach / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical outcomes of buttress plating in treating posterior Pilon fracture by amodified posteromedial approach.</p><p><b>METHODS</b>From July 2014 to January 2015, 10 patients with posterior Pilon fracture were respectively analyzed, including 7 females and 3 males, aged from 31 to 54 years old. One patient were type , 3 patients were type IIand 6 patients were type III according to classification of Pilon fracture by YU Guang-rong. All patients were treated by buttress plating through amodified posteromedial approach. Postoperative complications, fracture healing and reduction were observed, AOFAS score were used to evaluate function recovery at 1 year after operation.</p><p><b>RESULTS</b>All patients were followed up for 12 to 18 months with an average of(14.1±3.2) months. All incisions were primarily healed at stage I without wound complication, neurovascular injuries or musculus flexor contracture. According to Burwell-Charnley imaging scoring, 8 patients got anatomical reduction and 2 patients got moderate reduction. All fracture got healing from 12 to 16 weeks with an average of(13.2±1.8) weeks. According to AOFAS score at 1 year after operation, 8 got excellent results and 2 moderate. All patients returned to work at about(4.7±1.4) months (ranged from 3 to 6 months) after operation.</p><p><b>CONCLUSIONS</b>Buttress plating using a modified posteromedial approach in treating posterior Pilon fractures is an effective method, has less complications, and could recovery early weight-bearing functional exercise.</p>

Clinical efficacy of locked fibular nail for the treatment of lateral malleolus fractures in elderly patients with diabetes / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical outcome of locked fibular nail in treating lateral malleolus fractures in elderly patients with diabetes.</p><p><b>METHODS</b>From July 2012 to July 2014, clinical data of 22 diabetic patients with lateral malleolus fractures were respectively analyzed, including 15 females and 7 males, aged from 62 to 84 years old with an average of (69.3±13.7) years old. According to Danis-Weber classification, 2 cases were type A, 13 cases were type B, 5 cases were type C, and 2 cases were other type. All patients were reduced and fixed with Acumed locked fibular nail through a minimally invasive approach. Complication and fracture healing was recorded after operation. Clinical function was evaluated according to AOFAS.</p><p><b>RESULTS</b>All patients were followed up from 12 to 24 months with an average of (17.3±5.9) months. All incisions were healed at stage I. No wound complication, neurovascular or tendon injuries occurred. No fixation loss or discomfort of nail was reported. All patients achieved primary bone union, and healing time ranged from 8 to 14 weeks with an average of (10.3±3.9) weeks. AOFAS score was 87.4±5.2 at 1 year after operation 9 cases got excellent results and 12 cases good.</p><p><b>CONCLUSIONS</b>For elderly diabetic patients with lateral malleolus fractures, locked fibular nail has advantages of effective and stable fixation, high rate of bone healing, short healing time, less complication, and could obtain satisfied clinical effect.</p>

Osseous bridge resection for the treatment of adult talocalaneal coalitions without arthritis / 中国骨伤

<p><b>OBJECTIVE</b>To analyze clinical outcomes of osseous-bridge resection for the treatment of adult symptomatic talocalcaneal coalitions without arthritis.</p><p><b>METHODS</b>The clinical data of 12 patients (15 feet) with symptomatic talocalcaneal coalitions without arthtitis from January 2013 to June 2016 were respectively analyzed. All cases were secondary talocalcaneal coalition. There were 9 males (11 feet) and 3 females (4 feet) with a mean (26.6±3.3) years old (ranged, 18 to 33 years old). According to the Rozansky classification, there were 4 (6 feet) type I, 3 (3 feet) type II, 2 (2 feet) type III, 1 (1 feet) type IV, and 2 (3 feet) type V. All patients received coalition resection and interposition of fat graft. Complication, recurrence and range of motion was regularly recorded after operation. Clinical efficacy was evaluated according to the visual analogue scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot scale.</p><p><b>RESULTS</b>All patients were followed up for an average duration of (28.7±18.3) months (ranged, 12 to 48 months). All the incisions were primarily healed. There were no wound necrosis, infection, neurovascular or tendon injuries. Range of motion was improved in 13 feet. All patients returned back to work. Recurrence happened in 1 case 2 years after surgery, the patient received a secondary coalition resection. At the latest follow-up, VAS was 2.1±0.8 and AOFAS score was 82.7±7.2, were siginificantly improved when compared with the preoperative scores(8.2±0.7,=6.233,<0.01; 48.4±6.8,=5.747,<0.01).</p><p><b>CONCLUSIONS</b>For adult patients with symptomatic talocalcaneal coalitions without arthritis, simple coalition resection could provide good clinical outcomes with minimal complications.</p>

Long-term effects of TCV116 on cardiac function changes after myocardial infarction / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the long-term effects of TCV116 (candesartan cilexetil) on cardiac function changes after myocardial infarction.</p><p><b>METHODS</b>Myocardial infarction (MI) was induced by ligation of the left anterior descending coronary artery in rats. One week after the surgical performance,the surviving rats were randomly assigned to the following treatment groups: (1) MI rats with no therapy; (2) MI rats treated with TCV116 2 mg/kg per day; (3) Sham-operated control and (4) Sham-operated rats treated with TCV116 2 mg/kg per day. At 22 weeks, left ventricular function and cardiac histomorphometric parameters were measured, mRNA expression of cardiac genes such as beta myosin heavy chain, B-type natriuretic peptide, transforming growth factor beta1, collagen I and III quantified, and survival rates calculated.</p><p><b>RESULTS</b>Treatment with TCV116 significantly improved LV function, suppressed mRNA expression of cardiac genes,and extended the survival period compared with MI rats with no therapy (P<0.05).</p><p><b>CONCLUSION</b>Treatment with long-term angiotensin II type 1 receptor blocker may improve LV function and prolong the survival of rats after MI.</p>