3D printing combined with anteroposterior cannulated screws for the treatment of posterolateral tibial plateau fracture.

PURPOSE: This study aimed to compare the effects of conventional surgery and three-dimension (3D) printing technology-assisted surgery in the treatment of posterolateral tibial plateau fractures (PTPF). METHODS: A cohort of 61 patients afflicted with PTPF, spanning from June 2015 to October 2021, was enrolled. They were divided randomly into two groups: 31 cases of 3D printing group, 30 cases of conventional group. The personalized 3D-printed models were used to simulate the surgical procedures in 3D printing group. The demographic characteristics and clinical data were recorded, encompassing operation duration, intraoperative blood loss, intraoperative fluoroscopy shoots and fracture union time. The radiographic outcomes were gauged, encompassing tibiofemoral angle (FTA), tibial plateau angle (TPA), posterolateral slope angle (PSA) and Rasmussen's anatomical score. The functional outcomes were assessed at the 12-month postoperative juncture, encompassing range of motion, Hospital for Special Surgery (HSS) score and Rasmussen's functional score. Furthermore, fracture complications were evaluated,, encompassing infections, traumatic osteoarthritis, and delayed union. RESULTS: The 3D printing group exhibited the operation time of 95.8 ± 30.2 min, intraoperative blood loss of 101.1 ± 55.3 ml, and intraoperative fluoroscopy shoots of 6.3 ± 2.3 times, while the conventional group recorded respective values of 115.5 ± 34.0 min, 137.0 ± 49.2 ml and 9.13 ± 2.5 times. Noteworthy disparities were evident between the conventional and 3D printing groups (p < 0.05). Furthermore, in comparison to the conventional group, the 3D printing group exhibited commendable radiological and functional outcomes both immediately and 12 months post-surgery, although statistical significance was not attained. Moreover, the 3D printing group experienced a paucity of complications compared to the conventional group, although without achieving statistical significance. CONCLUSION: This study demonstrated the clinical feasibility of 3D printing combined with anteroposterior cannulated screws for the treatment of posterolateral tibial plateau fracture.

Exploration of MRI T2 Mapping Image Application in Articular Disc Displacement of the Temporomandibular Joint in Adolescents.

PURPOSE: To explore the application of magnetic resonance imaging (MRI) T2 mapping technique in clinical practice through morphological and quantitative analysis of T2 mapping sequences in adolescents with temporomandibular disorders (TMDs) and control groups comprising healthy participants. PATIENTS AND METHODS: A total of 45 and 63 patients, who had articular disc displacement with and without reduction, respectively, were assigned to the experimental groups, and 57 participants with normal articular discs of the temporomandibular joint were considered as the control group. All participants in the three groups underwent MRI. T2 mapping was performed in the oblique sagittal plane. The regions of interest (ROIs) for the T2 relaxation time maps of the disc were selected manually. The performance of morphological and structural changes and quantitative parameters in MRI T2 mapping image artifacts were statistically compared. RESULTS: In the control group, the mean T2 value was 39.284 ±5.634 ms, in the group of disc displacement with reduction, the mean T2 value was 33.634 ±4.235 ms, and in the group of disc displacement without reduction, the mean T2 value was 30.982 ±3.205 ms. The T2 mapping values of the experimental groups, together with different morphological structures, were significantly lower than were those of the control group. CONCLUSION: MRI T2 mapping enables a more accurate evaluation of TMD severity. Sequentially, it helps provide a more reliable medical imaging basis for classifying diagnosis and evaluation in clinical practice.

Influence of Gonadotropin Hormone Releasing Hormone Agonists on Interhemispheric Functional Connectivity in Girls With Idiopathic Central Precocious Puberty.

Purpose: The pubertal growth suppressive effects of gonadotropin hormone releasing hormone agonists (GnRHa) are well-known, although it remains unclear if long-term GnRHa treatment influences the brain function of treated children. The present study investigated the differences in the homotopic resting-state functional connectivity patterns in girls with idiopathic central precocious puberty (ICPP) with and without GnRHa treatment using voxel-mirrored homotopic connectivity (VMHC). Methods: Eighteen girls with ICPP who underwent 12 months of GnRHa treatment, 40 treatment-naïve girls with ICPP, and 19 age-matched girls with premature thelarche underwent resting-state functional magnetic resonance imaging using a 3T MRI. VMHC method was performed to explore the differences in the resting-state interhemispheric functional connectivity. The levels of serum pubertal hormones, including luteinizing hormone (LH), follicular-stimulating hormone, and estradiol, were assessed. Correlation analyses among the results of clinical laboratory examinations, neuropsychological scales, and VMHC values of different brain regions were performed with the data of the GnRHa treated group. Results: Significant decreases in VMHC of the lingual, calcarine, superior temporal, and middle frontal gyri were identified in the untreated group, compared with the control group. Medicated patients showed decreased VMHC in the superior temporal gyrus, when compared with the controls. Compared to the unmedicated group, the medicated group showed a significant increase in VMHC in the calcarine and middle occipital gyrus. Moreover, a positive correlation was observed between basal LH levels and VMHC of the middle occipital gyrus in medicated patients. Conclusions: These findings indicate that long-term treatment with GnRHa was associated with increased interhemispheric functional connectivity within several areas responsible for memory and visual process in patients with ICPP. Higher interhemispheric functional connectivity in the middle occipital gyrus was related to higher basal LH production in the girls who underwent treatment. The present study adds to the growing body of research associated with the effects of GnRHa on brain function.