Biocompatibility of bio-derived xenograft bone with bone marrow mesenchymal stem cells / 中国组织工程研究

BACKGROUND:Bio-derived xenograft bone has natural pore structure of the bone, low immunogenicity, and good cytocompatibility. OBJECTIVE:To verify the biocompatibility of bio-derived xenograft bone with bone marrow mesenchymal stem cel s. METHODS:Fresh pig femoral bone was col ected to prepare bio-derived bone. Scanning electron microscope was used to observe the material structure. Passage 3 rabbit bone marrow mesenchymal stem cel s at a density of 2×109/L were inoculated into the cancel ous bone surface of the bio-dervied bone and cultured for 7 days. Cel growth was detected using scanning electron microscope. After culture for 8 days, cel number was counted. RESULTS AND CONCLUSION:The bio-derived bone had rough surface and irregularly interconnected pores constructing a mesh-like structure. After 3 days of compound culture, cel s had irregular shapes and adhered to the surface of bio-derived bone;after 5 days of culture, cel s were closely interconnected to form a layered growth;after 7 days of culture, cel s exhibited multilayered growth and the extracel ular matrix secreted local y. Under compound culture, the former 2 days were latent period, 3-6 days were logarithmic phase, and from the 6 th day, the cel growth curve became smooth gradual y and the cel proliferation decreased and entered into the plateau period. These findings indicate that the bio-derived xenograft bone has good biocompatibility with bone marrow mesenchymal stem cel s.

Materials biocompatibility in the internal fixation of pelvic fracture combined with acetabular fracture / 中国组织工程研究

BACKGROUND:Pelvic fractures combined with acetabular fractures are mostly caused by high-energy violence, often accompanied by severe complications and high mortality, and surgical fixation is preferred in most cases. OBJECTIVE:To investigate the internal fixation of pelvic fracture combined with acetabular fracture and to analyze the material biocompatibility. METHODS:A computer-based search of Wanfang, CNKI and PubMed databases was performed for articles related to the internal fixation of pelvic fracture combined with acetabular fracture and material biocompatibility published from 2005 to 2014. The keywords were“pelvis fractures, acetabulum fractures, internal fixators, materials”in Chinese and English, respectively. Articles published in authoritative journals or recently were preferred, and final y 29 articles were enrol ed in result analysis. RESULTS AND CONCLUSION:Steel plate reconstruction or screw internal fixation is often used for clinical treatment of pelvic fracture combined with acetabular fracture. Titanium plate is often chosen with similar elastic modulus to the bone and good biocompatibility. The titanium plate is pre-bended before implantation to match the bone surface of the fracture site. Absorbable screws have good histocompatibility and non-toxic side effects, which can avoid the electrolysis and corrosion of metal screws and maintain certain strength in early period of internal fixation;over time, the fracture is gradual y healed, the material strength gradual y decreases, and the material is final y degraded into water and carbon dioxide to achieve good clinical outcomes. It is difficult and high-risk for treatment of pelvic fracture combined with acetabular fractures, and active treatment and damage control are recommended as soon as possible. A reasonable treatment plan can be developed based on the type of fracture. Plate internal fixation and minimal y invasive fixation developed by the three-dimensional reconstruction techniques show a great progress in fracture treatment, which have broad clinical application prospects.

Acute single-stage reconstruction of multiligament knee injuries using the ligament advanced reinforcement system

The purpose of the study was to report our early outcome in the management of multiligament knee injuries with the ligament advanced reinforcement system [LARS]. Between 2007 and 2010, 9 of 11 patients operated on for multiligament knee injuries were included in this study; 2 patients were excluded due to complicated neurovascular injuries, open knee dislocations and severe comorbidities. All patients were managed acutely [<3 weeks] by reconstructions of the cruciate and collateral ligaments with LARS ligament and were followed up for an average of 30 months [18-46 months]. The mean Lysholm score of the 9 patients at final follow-up was around 90 [range 88-94] with an average Tegner activity score of 5.5. The postoperative function of 1 case of KD-11 and 2 cases of KD-111 was rated as 'A,' while the remaining cases were rated 'B'. At final follow-up, minor osteoarthritic degeneration was detected in 1 case of KD-III and 2 cases of KD-IV. Superficial infection developed in 1 case, and no cases of knee synovitis and premature osteoarthritis were recorded. A creditable outcome at mean of 30 months' follow-up was obtained in acute single-stage reconstruction of uncomplicated multiligament knee injuries with LARS ligament

Special operative techniques for intertrochanteric fractures without lesser trochanter fracture / 中华骨科杂志

Objective To explore the operative techniques for AO/OTA type 31-A3.1 and 31-A3.2 intertrochanteric fractures fixed with intrameduallary nail.Methods Seventy-four cases of unstable intertrochanteric fracture (AO/OTA type 31-A3.1 and 31-A3.2) from January 2007 to December 2010 were analyzed retrospectively.There were 33 males and 41 females,aged from 36-87 years (mean,71 years).The right hip was involved in 34 patients and the left in 40 patients.The mechanism of injury was traffic injuries in 27 cases,fall damage in 43 cases,injury by falling in 3 case and crush injury in 6 cases.Percutaneous joystick technique,Homann retractor technique,clamp technique and mini-incision was applied to aid reduction during the surgery.All cases were fixed with proximal intrameduallary nail.Clinical and radiographic outcomes were recorded.The postoperative hip function was evaluated using Harris score.Results With the aid of C-arm,closed reduction was performed in 73 cases.Only one patient experienced open reduction because of failure of closed reduction.Sixty-five cases were followed up for 8 to 23 months (mean,14.5 months).Bone union was observed in all cases with the average time of 7.4 months (range,8-23).The operation time,blood loss,the frequency of X-ray exposure was 75±4 minutes,135±5 ml and 24±3 times,respectively.At final follow-up,29 cases were classified as excellent,31 as good,and 5 as fair.The mean Harris hip score was 91.4 points (range,87-95).The overall rate of excellent or good result was 92.3％.Conclusion It is difficult to perform close reduction for unstable intertrochanteric hip fracture (AO/OTA type 31-A3.1and 31-A3.2),especially in relatively young patients.Special operative skills are necessary in some cases.

Supracetabular external fixation in treating pelvic fractures associated with injuries of abdominal organs / 中华骨科杂志

ObjectiveTo evaluate the technique and clinical outcomes of supra-acetabular external fixation in treating pelvic fractures associated with injuries of abdominal organs.MethodsThere were 17 cases of pelvic fractures associated with injuries of abdominal organs.Nine were males and 8 were females,with the average age of 42 years(range,21-75 years).The injury was caused by traffic accident in 9 cases,fall-down from height in 4,and crush by heavy objects in 6.According to Tile classification of pelvic fractures,7 were type B1,3 were type B2,2 were type B3,4 were type C1 and 1 was type C2.Fifteen cases suffered with hemorrhagic shock,2 with perineal injury and 12 with fractures of the limbs.All patients were treated with supra-acetabular external fixation and the outcomes were evaluated by Cole's clinical scoring,Matta and Tornetta's radiographic standards.ResultsAll 17 cases were followed up with the mean period of 6.5 months (range,2-18 months).The average time of operation was 15 min (range,9-25 min).The mean blood loss was 17 ml(range,5-25 ml).All fractures healed and the mean healing period was 9.2 weeks (range,8-12 weeks).Three had transient palsy of lateral femoral cutaneous nerve.Five had soft tissue infection while the bony structures were not involved.According to Cole's scoring for pelvic fractures,15 cases were excellent,1 case was good and 1 case was fair,with the good-excellent rate of 94.12％.According to Matta and Tornetta's standards of fracture reduction,12 were excellent,3 were good and 2 were fair,with the good-excellent rate of 88.24％.ConclusionSupra-acetabular external fixation is a minimal invasive and convenient method for treating pelvic fractures with abdominal organs injury which is mechanically stronger than traditional external fixation via iliac crest.

Treatment of traumatic anterior sternoclavicular joint dislocation with Fastin anchors / 中华创伤骨科杂志

Objective To discuss the treatment of traumatic anterior sternoclavicular joint disloca-tion with Fastin anchors. Methods A retrospective analysis was done for 14 patients with traumatic anterior sternoclavicular joint dislocation who had been treated with Fastin anchors from March 2006 to April 2008. They were 9 males and 5 females, with an average age of 35 years (range, 21 to 46 years) . Their diagnoses were confirmed by X-ray and CT scan. After reduction and temporary Kirschner wire fixation of the sternoclavicular joint, the anchor was driven into the manubrium sterni, with the suture at the end of the anchor securely knotted after passing through the internal extremity of clavicle. The Kirschner wire was re-moved after 3 weeks. Results All the patients were followed up for 12 to 22 months (average, 17 months). The results were excellent in 11, good in 3 according to Rockwood scale. There was no loss of re-duction or implant loosening. Conclusion Fastin anchor can fix the sternoclavicular joint reliably, avoiding potential risk of Kirschner wire migration and ensuring fine functional recovery of the joint.

Comparison of external fixation and locking compression plate for intra-articular distal radial fractures / 中国矫形外科杂志

[Objective]To compare the results of external fixation and locking compression plate(LCP) in the treatment of intra-articular distal radius fractures.[Method]A retrospective analysis was done for 62 cases of intra-articular distal radius fractures treated from May 2006 to September 2008.Twenty-seven cases were treated with external fixation,and 35 with LCP.The study analyzed the differences between the two groups in Sarmiento scale and functional recovery of wrist.[Result]All the patients were followed up for 13 to 40 months(average,17 months).There was no significant difference in the Sarmiento scale and range of motion 1 year later,and the grip strength was significantly higher in external fixation group.Two cases in external fixation group had pintract infection.One case had tendon irritation in LCP group.[Conclusion]External fixation and LCP can be used reliably to treat intra-articular fractures about the wrist.It is essential that the surgeon have a complete understanding of the injury pattern before operation.