Application of one-third tubular steel plates and screws for fixation of medial column in pilon fractures.

Background: The present study sought to explore the efficacy of one-third tubular steel plates and screws for the treatment of medial column of pilon fractures. Methods: The present retrospective study comprised 40 subjects with Rüedi-Allgöwer type III pilon fractures that attended Northern Jiangsu People's Hospital from April 2016 to April 2019. Patients were assigned to 2 groups based on reconstruction and fixation components used on the medial column. The medial column of participants in the control group (n=20) was anchored using screws. The medial column for subjects in the treatment group (n=20) was reconstructed using a one-third tubular steel plate. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at 1, 2, 3, 6, 12 and 24 months after operation, intraoperative blood loss, fracture healing time, preoperative detumescence duration, operation time, postoperative weightbearing duration, and postoperative Burwell-Charnley radiological score of the 2 groups were compared. Results: The findings showed that intraoperative blood loss, preoperative detumescence time, and operation time for the treatment group were not statistically different relative to the control group (P>0.05). The fracture healing time and postoperative weightbearing time in the treatment group were 15.07±0.98 weeks and 6.91±0.61 weeks, respectively, while those in the control group were 15.84±0.59 weeks and 8.60±0.53 weeks, respectively (P<0.05). Patients in the treatment group showed markedly higher AOFAS scores relative to the AOFAS scores of subjects in the control group at month 1, 2, and 3 post-operation (P<0.05). AOFAS scores for the 2 groups were not significantly different at month 6, 12 and 24 post-operation. Subjects in the control group had a significantly lower Burwell-Charnley number radiology score relative to that of subjects in the treatment group (P<0.05). Conclusions: The present findings show that the medial column of subjects with Rüedi-Allgöwer type III pilon fracture can be repaired using a one-third tubular steel plate. Compared with simple screw fixation, the use of a one-third tubular steel plate allows earlier postoperative weightbearing, decreases the rate of postoperative reduction loss, and leads to better clinical effects and prognosis.

Total parathyroidectomy plus multi-point subcutaneous transplantation in the forearm may be a reliable surgical approach for patients with end-stage renal disease: A case report.

RATIONALE: We studied the feasibility of total arathyroidectomy(tPTX)+multi-point transplantation in the forearm for treatment of secondary hyperparathyroidism. Considering the controversial nature of the appropriate timing for and location of this type of surgery, relevant research is relatively rare. Our experience may be a relatively successful one. PATIENT CONCERNS: Our patient was a 28-year-old woman with end-stage renal disease (ESRD), who was on dialysis for 7 years, and a 2-year history of progressively aggravated bone pain. She also had hypercalcemia and hyperphosphatemia. DIAGNOSES: Given the patient's history of long-term dialysis, bone pain, high levels of intact parathyroid hormone(i-PTH) and hypercalcemia, we performed ultrasonography which showed solid nodules in the bilateral parathyroid glands. She was accordingly diagnosed with SHPT. INTERVENTIONS: The patient underwent tPTX+multi-point subcutaneous transplantation in the forearm. OUTCOMES: Her i-PTH level dropped to < 300 pg/mL, and the symptoms of bone pain markedly reduced after surgery. LESSONS: Total parathyroidectomy+multi-point subcutaneous transplantation in the forearm may be a reliable surgical approach for patients with ESRD.

Metastasis-associated lung adenocarcinoma transcript 1 promotes the proliferation of chondrosarcoma cell via activating Notch-1 signaling pathway.

BACKGROUND: Metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1) is identified to be overexpressed in several cancers. However, the role of MALAT-1 in chondrosarcoma is poorly understood. METHODS: The expression of MALAT-1 and Notch-1 signaling pathway was detected in chondrosarcoma tissues and chondrosarcoma cells by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot. 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay was performed to examine the cell viability of chondrosarcoma cells transfected with si-MALAT-1 or pcDNA-MALAT-1. Then the expression of Notch-1 signaling pathway was detected when MALAT-1 was upregulated or downregulated in chondrosarcoma cells. A subcutaneous chondrosarcoma cells xenograft model was used to confirm the effect of MALAT-1 on tumor growth in vivo. RESULTS: We found the increased expression of MALAT-1 and Notch-1 signaling pathway in chondrosarcoma tissue and cells. MALAT-1 promoted the proliferation of chondrosarcoma cells. In addition, MALAT-1 activated the Notch-1 signaling pathway at posttranscriptional level in chondrosarcoma cells. Meanwhile, overexpression of Notch-1 reversed the effect of si-MALAT-1 on the proliferation of chondrosarcoma cells. Finally, we found that MALAT-1 promoted the tumor growth in a subcutaneous chondrosarcoma cells xenograft model, which confirmed the promoted effect of MALAT-1 on the tumor growth in vivo. CONCLUSION: Taken together, our study demonstrated that MALAT-1 promoted the proliferation of chondrosarcoma cell via activating Notch-1 signaling pathway.