ABSTRACT
Objective To compare extramedullary fixation (EF), intramedullary fixation (IF) and dipolar femoral replacement(DFR) in the treatment of intertrochanteric fractures in the elderly patients. Methods From July 1999 to December 2008, 172 old patients with intertrochanteric fractures were treated by either EF, or IF or DFR. The operative procedures, complications and therapeutic effects were compared between the 3 methods. Results The patients included in the present study were followed up for 8 to 36 months (average, 19. 6 months). There were significant differences ( P<0. 05) in incision length, operation time, intraoperative blood loss, functional recovery and complications between the 3 methods. IF had the shortest incision length and the least intraoperative blood loss. DFR had less blood loss than EF. IF had the least operation time, followed by DFR. DFR had the best functional recovery one year postoperatively. IF had shorter rehabilitation and healing time than EF. Conclusions EF is the first choice for intertrochanteric fractures of A 1.1, A 1.2, A 1.3 and A2. 1. IF is more appropriate for the aged and unhealthy patients with intertrochanteric fractures of A1. 1, A1. 2, A1. 3, A2. 1, A2. 2, A3. 1 and A3.2. DFR is fit for the elderly patients with severe comminuted fractures and osteoporosis.
ABSTRACT
BACKGROUND: Previous research reveals that, single-layer human amnion is effective to cure superficial bums, but it is still unsatisfactory.OBJECTIVE: To observe the effects of double-layer radiation-treated human amnion on the healing of deep second-degree burn wound.DESIGN, TIME AND SETTING: Randomized control study was performed at the Animal Experimental Center in the First Affiliated Hospital of Harbin Medical University (Harbin, Heilongjiang, China) from December 2006 to May 2007.MATERIALS: Fifty adult Wistar rats of clean grade were burned and then assigned into five groups at post-injury 4, 6, 8,10 and 12 days, with ten rats in each group. Subsequent to the chorion removal, the fresh human amniotic membrane was dried and prepared into double-layer films, which were aporate or porous. Human amnion was then radiated using γ-ray for further use.METHODS: Following dorsal skin epilatiou and the anesthesia, all the rats were immersed for 8 seconds in boiling water to induce rat models of deep second-degree burns. One side of the burn wound was applied human amnion, while the other side was applied oil gauze.MAIN OUTCOME MEASURES: Gross observation of the bum wound was carried out at post-injury 4, 6, 8, 10 and 12 days. Meanwhile, light microscope, scanning electron microscope and transmission electron microscope were employed to detect the histological changes of the burn wound, as well as bacteriological examination.RESULTS: Fifty rats were all involved in the result analysis. Sphacelism and crust were found in the burn wound treated with oil gauze, with the presence of focal ulcer at post-injury 12 days. Under light microscope, few hairs regenerated in dermis, especially hair follicle and hair root; Scanning electron microscope suggested a large amount of inflammatory exudates and leukocytes; Transmission electron microscope revealed an unclear structure of the cells. Bacteriological examination also indicated that the bacteria aecreted on the surface of burn wound. The treatment of double-layer radiation-treated human amniou healed the burn wound at post-injury 10 and 12 days, and the hairs grew with the same manner as that of normal skin. Epidermis tissues were proved to be normal skin at post-injury 12 days by means of light microscope, scanning electron microscope and transmission electron microscope. Bacteriology was detected to be negative.CONCLUSION: Double-layer radiation-treated human amnion plays a protective role on the burn wound in rats. It may facilitate epithelial growth, avoid wound infection and accelerate the healing of deep second-degree burn.
ABSTRACT
BACKGROUND:Better fusion of bone cement and bone interface can reduce prosthesis loosening rate.Marrow cavity is the place where bone cement fusion takes place,so its preparation is important to improve bone cement filling quality.OBJECTIVE:To evaluate bone cement-bone interface fusion in marrow cavity washed with high-pressure pulsed water syringe versus marrow cavity brushing.DESIGN,TIME AND SETTING:The comparative observation was performed at Animal Laboratory and Orthopaedic Laboratory of the First Hospital of Harbin Medical University from July 2002 to June 2003.MATERIALS:Forty fresh horse ulnas were randomly divided into 2 groups(n=20):washing group and control group.METHODS:The articular surfaces of the proximal ulna and cortex of horse ulnas were sawn to expose the trabecular bone,and only 15 cm proximal ulna was retained.The marrow cavity was opened with marrow cavity drilling and marrow cavity file along the line parallel to the longitudinal axis,proximal diameter 1.5 cm,5.5 cm deep,and self-developed marrow cavity bolt was put into the cavity until 5 cm deep.The marrow cavity of washing group was treated with high-pressure washing,1 000 mL fluid for each model,and the cavity was brushed once after washing with every 300 mL fluid for a total of 3 times.At the last time,100 mL water was used to clean the cavity following by wiping until the cavity was dry.The control group was not given any treatment.Both groups were infused with bone cement by the same method,and the models of each group were scanned by CT(interval 4 mm).MAIN OUTCOME MEASURES:Number of trabecular bone closely or not closely connected by bone cement section surrounding to calculate the rate of combination;condition of surfaces of marrow cavity and bone cement in the column by amplifier.RESULTS:CT scanning showed that interface connection rate of washing group was 64.47%,while the control group was 26.67%;the differences were statistically significant(P
