Modified medial minimally invasive double-plating osteosynthesis techniques for the treatment of distal third diaphyseal fracture of humerus.

The optimal surgical approach and placement of plates for the treatment of distal third diaphyseal fracture of the humerus are the subjects of debate. The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of modified medial minimally invasive plate osteosynthesis (MIPO) techniques using a double technique for the treatment of distal third diaphyseal fracture of the humerus. A total of 30 patients with a distal third diaphyseal fracture of the humerus were selected from our hospital. Patients were seen between January 2017 and October 2022. They were treated with a modified medial approach combined with MIPO using a double plate technique. Patient demographics, operation time, bleeding volume, union time, complications, the mean fracture length (FL) and distal cortical length (DCL), and the number of screws in the distal fragment were analyzed. The function of the shoulder and elbow was evaluated using Neer's assessment of the shoulder and Mayo's assessment of the elbow. The FL was 56.1 ± 7.2 mm and the DCL was 38.3 ± 5.3 mm. The mean operative time was 84.8 ± 13.4 min (range 60-110 min). The mean blood loss during surgical treatment was 46.5 ± 10.2 ml (range 30-60 ml). Bone healing was observed in all patients from 10 to 16 weeks (average 12.1 ± 1.7) postoperatively, and one case with poor surgical wound healing was recorded. All the patients had good function of both the shoulder and elbow. The maximum flexibility of the elbow ranged from 130° to 145° (average 138.1 ± 4.8°), with a maximum flexibility straightness ranging from 0° to 5° (average 2.2 ± 1.3°). The Mayo elbow joint function score was 80-100 (average 91.4 ± 5.0). The Neer shoulder joint function score ranged from 85 to 100 (average 92.5 ± 3.9). The modified medial approach was beneficial it did not cause any iatrogenic radial nerve or ulnar nerve injuries. The anterior and the medial side plates are fixed perpendicular to the distal humerus and provide excellent stability at the same time producing better shoulder and elbow joint function.

Survivin and vascular endothelial growth factor are associated with spontaneous pulmonary metastasis of osteosarcoma: Development of an orthotopic mouse model.

The high rate of pulmonary metastases of osteosarcoma (OS) presents a therapeutic challenge in the field of orthopedics. Therefore, there is a marked requirement to establish a spontaneous pulmonary metastasis animal model of OS, within which potential antitumor agents may be evaluated for their ability to inhibit the growth and pulmonary metastasis of OS, as well as to identify potentially associated biomarkers of OS metastasis. In the present study, rodent OS cells (UMR106-01) were injected into the right tibia of athymic nude mice. The mice were sacrificed weekly by cervical dislocation at one to five weeks following inoculation. The orthotopic mice developed tumor masses in the right tibia one week following inoculation. At three weeks, multiple nodules were observed in the lungs. The expression of survivin and vascular endothelial growth factor (VEGF) was analyzed in the tumors and lungs via immunohistochemistry. The positive expression of survivin and VEGF was identified in the local tumor and lung tissue of the orthotopic mice, however was not observed in the tissues of the healthy control mice. The orthotopic model established in the current study presents a valuable tool for the investigation of factors that promote or inhibit OS growth and/or metastasis. In addition, it was identified that survivin and VEGF may be significant in the lung metastasis of OS.