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@#Objective To analyze and compare the treatment of HeppleⅤ talus osteochondral injury(OLT)with autologous periosteal iliac bone graft and allogeneic bone powder combined with platelet rich gel(PRP).Methods Totally 62 HeppleⅤOLT patients admitted to our hospital from October 2018 to October 2022 were selected as the research subjects.They were divided into a transplantation group(31 patients received autologous periosteal iliac bone transplantation treatment)and a combination group(31 patients received allogeneic bone powder combined with PRP treatment)based on their treatment methods.Conduct a 12 month postoperative outpatient follow-up study on patients,evaluate and compare the treatment effectiveness,ankle joint range of motion(ROM),American Society of Orthopedic Foot and Ankle Surgeons(AOFAS)ankle posterior foot score,pain score,satisfaction,and incidence of complications between the two groups of patients at 12 months after surgery.Results The total effective rate of the transplantation group(96.77%)was not significantly different from that of the combination group(93.55%,P>0.05).At 12 months after surgery,the ROM and AOFAS scores of both groups improved(P<0.05),and there was no statistically significant difference between the groups(P>0.05).At 1 month,3 months,6 months,and 12 months after surgery,the pain scores of both groups decreased compared to before surgery(P<0.05).The subjective overall satisfaction of patients in the transplantation group(77.42%)was lower than that in the combination group(96.77%,P<0.05).The total incidence of complications in the transplantation group(19.35%)was significantly higher than that in the combination group(3.23%,P<0.05).Conclusion Allogeneic bone powder combined with PRP can avoid additional surgical incisions,increase patient subjective satisfaction,and increase the incidence of postoperative complications.
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Spinocerebellar ataxias are a high clinically and genetically heterogeneous group of neurodegenerative disorders, usually belongs to autosomal dominant hereditary cerebellar ataxia. Spinocerebellar ataxia type 5 (SCA5) is one of the extremely rare subtypes and caused by heterozygous mutation of SPTBN2 gene. A case of infant-onset SCA5 patient is reported, mainly manifested as global developmental delay, ataxia and dysarthria, carrying the heterozygous missense variant c.1438C>T (p. Arg480Trp) in the SPTBN2 gene. This mutation may have an important impact on functional regions of the β-Ⅲ spectrin, leading to the occurrence of disease.
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Objective To analyze and summarize the risk factors of failed internal fixation for intertrochanteric fracture.Methods From April 2008 to April 2011,267 patients with intertrochanteric fractures in 4 hospitals were treated with internal fixation.The relationship between the failure of internal failure and possible factors as age,gender,hypertension,diabetes,the abuse of alcohol and tobacco,use of glucocorticoid,the degree of osteoporosis and fractures type were studied.According to the surgical risk assessment table,the patients were divided into low-risk,mid-risk,and high-risk group.The rate of internal fixation failure was compared in the 3 groups.Results We found 42 cases which showed radiographic failures.The internal fixation failure directly related with advanced age,diabetes,severe osteoporosis,unstable type fracture,but not gender,hypertension,the abuse of alcohol and tobacco,use of glucocorticoid.Risk factors of internal fixation failure included diabetes,osteoporosis degree,and fracture stability.Failed intertrochanteric fracture fixation mainly occurred in the mid-risk and high-risk groups.Conclusion Severe osteoporosis,unstable fracture,diabetes are risk factors of failure of intertrochanteric fracture fixation.These factors will affect the quality of surgery.For the patient with intertrochanteric fractures in the low-risk groups,internal fixation should be the first choice for treatment.For the patients in the mid-risk and high-risk group,internal fixation should be applied cautiously.For the aged patients in high-risk groups,hip arthroplasty is a wise option.