[An analysis of failure factors in treatment of femoral shaft fracture with interlocking intramedullary nailing].

OBJECTIVE: To analyze the failure factors treating femoral shaft fracture with interlocking intramedullary nailing, and to offer the measures for prevention. METHODS: From April 1999 to September 2002, among the 213 cases of femoral shaft fracture treated by interlocking intramedullary nailing, 18 were failure. The data of these cases were analyzed. RESULTS: The failure cases were divided into 6 types: 3 cases with nail break-down, 7 with distal screw backing out, 3 with proximal screw backing out, 3 with fibrous ankylosis of knee, 2 with late infection. Failure relative factors were regarded to operation technique, incorrect rehabilitation choice of operative indication, quality of interlocking intramedullary nailing. CONCLUSIONS: An appropriate indication should be chosen as using interlocking intramedullary nailing for femoral shaft fracture. The skills should be mastered well. The suitable materials should be chosen carefully. And the rehabilitation exercises should be directed properly. All these are important measures for prevention.

Study of gelatinized marrow stroma osteoblasts and true bone ceramic active bone.

OBJECTIVE: To investigate a new method to construct tissue-engineering bone that will be applicable clinically. METHODS: The cultured 5th generation rabbit bone marrow stroma osteoblasts (MSO) was dissolved in 3% sodium alginate solution (the final concentration of sodium alginate in the solution being 1%, and MSO, 5x10(6)/L), and then inoculated into prepared true bone ceramic (TBC) and gelatinized the bone by dribbling with calcium gluconate. The standard bone defect models were made in 48 adult New Zealand rabbit's both radius. Among the 48 rabbits, 24 were in Groups A and B, in which the left radius was implanted with gelatinized MSO-TBC (Group A) and right radius implanted with autograft-bone (Group B); and the other 24 were in control group whose left radius was implanted with non-gelatinized MSO-TBC (Group C) and right radius implanted with gelatinized TBC (Group D). Outcomes of the implanted bones were assessed by radiology, pathological histology, osteogenetic quantitative analysis, and biomechanics at 2, 4, 8, 12 weeks postoperatively. RESULTS: In Groups A and B, a satisfactory bone reparation and bony union was noted within 12 weeks. In Groups C and D, bone reparation was not satisfied compared with Group A in terms of ostogenetic quantity and biomechanics. CONCLUSIONS: Gelatinized MSO-TBC is an ideal artificial active bone that overcomes TBC shortcomings of fragileness and smooth surface that is not eligible for seed cell's adhesion. It is promising to put into clinical use extensively.

[Effects of Shenggu injection on mRNA expression of vascular endothelia growth factor in rat osteoblasts in vitro].

OBJECTIVE: To study the effects of Shenggu injection (SGI) on mRNA expression of vascular endothelia growth factor (VEGF) in rat osteoblasts in vitro and to explore its possible molecular mechanisms in promoting fracture healing. METHODS: Rat osteoblasts cultured in vitro were stimulated with SGI according to the protocol. The expression levels of VEGF mRNA in the cells in every group were examined by reverse-transcriptase ploymerase chain reaction (RT-PCR). RESULTS: When osteoblasts were stimulated with different concentrations of SGI for 5 days, the expression of VEGF mRNA peaked with 1 mg/ml SGI on the 5th day. When treated with 1 mg/ml SGI from the 1st to the 5th day, the expression of VEGF mRNA increased gradually with the increase of culturing time. CONCLUSION: SGI could promote significantly the expression of VEGF mRNA in rat osteoblasts in vitro. The levels of expression of VEGF mRNA changed along with different concentrations and stimulating time of SGI.