Clinical observation of C3-type patellar fractures treated by operation methods with or without a turned-over patella.

OBJECTIVE: To evaluate the clinical efficacy of operation methods with or without a turned-over patella for treatment of C3-type patellar fractures. METHODS: A total of 68 patients with C3-type patellar fractures undergoing open reduction and internal fixation were retrospectively selected and treated with a turned-over patella surgery (turned-over patella group, n = 30) or conventional therapy without turning over the patella (conventional group, n = 38). The intraoperative and postoperative indicators of the two groups were assessed and comparatively analyzed. RESULTS: The bedridden time was significantly shorter in the turned-over patella group than in the conventional group (P = 0.002), while the range of motion (ROM) of knee joint was significantly higher in the turned-over patella group (P = 0.044). The Lysholm score was slightly higher in the turned-over patella group than in the conventional group, but the difference was not statistically significant (P = 0.055). No significant difference was observed between the two groups in terms of the operation time (P = 0.096), intraoperative blood loss (P = 0.543), time of weight bearing (P = 0.312), fracture healing time (P = 0.272), or complications (P = 1). CONCLUSION: The turned-over patella operation method exhibited some superiority to conventional reduction-fixation approach for treatment of C3-type patellar fractures in terms of efficacy and safety by enlarging the ROM of the knee joint and promoting functional recovery.

Effect of c-erbB2 overexpression on prognosis in osteosarcoma: evidence from eight studies.

C-erbB2 (HER-2/neu) plays an important role in the progression of several types of cancer by increasing tumor growth, migration, invasion, and metastasis and is associated with poor disease prognosis. Numerous studies examining the relationship between c-erbB2 expression and prognostic impact in patients with osteosarcoma have yielded inconclusive results. We therefore conducted a meta-analysis to provide a comprehensive evaluation of the prognostic role of c-erbB2 expression on 5-year survival, which compared the positive and negative expression of c-erbB2 in patients of the available studies. A detailed search was made in PubMed for relevant original articles published in English. Finally, a total of eight studies with 411 osteosarcoma patients were involved to estimate the relationship between c-erbB2 expression and 5-year overall survival. Positive expressions of c-erbB2 predicted poorer survival in osteosarcoma with the pooled RR of 1.53 (95 % CI 1.20-1.94, P = 0.0006). In conclusion, the findings from this present meta-analysis suggest that c-erbB2 overexpression is related to poor prognostic of osteosarcoma and can be a useful clinical prognostic factor for those patients.

Pedicle screw fixation with translaminar facet joint screws for the treatment of thoracolumbar fracture.

OBJECTIVE: To evaluate the efficacy of Cotrel-Dubeusset (CD) instrumentation combined with translaminar facet joint screw (TLS) in the treatment of thoracolumbar fracture. METHODS: A total of six L(2)-L(4) spines were used to establish unstable fracture model with three-dimensional range of motion (ROM) of the spines measured. Fixation with CD and fixation with CD combined with translaminar facet joint screw were achieved to compare their stability. Thirty cases of thoracolumbar fracture, in whom the anterior edge of vertebral body was compressed to 59% and the posterior edge compressed to 88%, were treated by pedicle screw fixation combined with TLS. Among them, 19 received posterolateral or anterior-posterior bone grafting. RESULTS: There was significant difference in ROM between the two techniques except that in extension. In Group CD+TLS, ROM was 5.38% lower, lateral bending 4.91% lower and axial rotation 11.85% lower than those in Group CD respectively. In the clinical group, the average anterior edge restored to 97% and posterior edge to 98%. The duration of follow-up was 5-24 months (mean, 10 months). The rate of correction loss on the anterior edge was 4.5%. Among the 19 cases of bone grafting, all of them achieved bony fusion (mean fusion time, 4.3 month) with a correction loss rate of 3.4%. CONCLUSIONS: In the treatment of thoracolumbar fracture, pedicle screw fixation combined with TLS can strengthen the stability of pedicle screws, especially anti-rotation stability and enhance fusion rate and reduce correction loss.