A new strategy to fix posterolateral depression in tibial plateau fractures: Introduction of a new modified Frosch approach and a "Barrel hoop plate" technique.

AIMS: The articular congruity of tibial plateau has been stressed to be associated with the long-term function outcomes. Approach selection and fixation pattern to manipulate the posterolateral (PL)-depression of tibial plateau are both key issues which trauma surgeons should focus on. In order to provide a strong purchase of PL-depression, we developed a new modified Frosch approach and a "Barrel hoop plate" technique to provide bony reconstruction of PL-depression. MATERIALS AND METHODS: Eleven consecutive patients of tibial plateau fractures involved in PL-depression were surgically treated at our single level-I trauma center. Our newly designed "Barrel hoop plate" was used to fix the PL-depression via a modified Frosch approach. The demography and treatment information were summarized of all the patients. X-ray and CT-scan of the knee joint were used to assess the reduction after operation. Besides evaluation of the HSS knee score, medial tibial plateau angle(mTPA), posterior slope angle(PSA) and articular step-off were measured to assess the malreduction degrees. RESULTS: The average operation time was 123 ± 20 min. The mean blood loss was 148 ± 45 mL. The fractures were healed radiographically at 13 ± 1 weeks post-operation. After 15 ± 2 months follow-up, all the patients were pain-free with full range of motion and stable knees. Radiologically, good fracture reduction was achieved in all cases. According to the final assessment, the mTPA, m-PSA and l-PSA were 85° ± 2°, 11° ± 5° and 10° ± 6°, respectively. The average range of motion was 128° ± 10°in flexion and 4° ± 4° in extension, and the average HSS score was 91 ± 3. CONCLUSION: Our new approach is a modification of the Frosch approach with a decreased soft tissue exposure and a low risk of neurovascular vessel injury. The concurrent application of the "Barrel hoop plate" technique could not only provide a reconstruction of the PL tibial plateau, but also hoop the ruptured tibia plateau rim and secure the depression as a raft. This new technique prevented the PL-tibial plateau reduction loss and the made the patients' early range of motion come true.

Silencing of Glucose Transporter Protein-1 by RNA Interference Inhibits Human Osteosarcoma Mg63 Cells Growth in vivo.

While knock-down of glucose transporter protein 1 (GLUT-1) inhibited various human cancer cell growth in vitro and in vivo, including osteosarcoma cell growth in vitro, there has been no report on whether knock-down of GLUT-1 by siRNA may inhibit osteosarcoma cell growth in vivo. We hypothesized that siRNA may inhibit osteosarcoma cell growth in vivo. We introduced siRNA-GLUT-1 by lentivirus into MG63 osteosarcoma cells which were xenograted into nude mice. Immunohistochemical staining, Western blot and reverse transcriptase quantitative (RT-qPCR) were used to determine GLUT-1 protein and mRNA expression of the tumor cells. The results showed the tumor volume of GLUT-1-siRNA-MG63 cells xenorafted nude mice was significantly less than that of siGFP-MG63 or MG63 cells xenografted nude mice (P < 0.05), suggesting that silencing of GLUT-1 inhibited tumor formation and growth of osteosarcoma cells in vivo. Our findings suggest that the lentiviral-mediated siRNA interference against GLUT-1 may be a valuable tool for gene therapy for osteosarcoma.