[Treatment of old femoral neck and nonunion with free vascularized fibular grafting].

OBJECTIVE: To evaluate the clinical result of the treatment of old femoral neck fracture and nonunion with free vascularized fibular grafting. METHODS: From November 2000 to December 2005, 29 cases with old femoral neck fracture and nonunion had been treated by free vascularized fibular grafting with an average follow-up of 28.5 months. RESULTS: All the fracture were healed without any severe complications. And the healing time was 4-6 months (5.6 months on average). During the follow-up, the hips of 28 cases got well-function, and the average Harris hip score was 88.2. One case came about with osteonecrosis of femoral head after one year and finally accepted THA after 2 years. CONCLUSIONS: The free vascularized fibular grafting is a valuable procedure to treat old femoral neck fracture and nonunion.

[Periosteum construction in vitro by small intestinal submucosa combined with bone marrow mesenchymal stem cell].

OBJECTIVE: To investigate the practicability of periosteum construction in vitro by small intestinal submucosa (SIS) as a tissue scaffold with bone marrow mesenchymal stem cells (BMSC). METHODS: The bone marrow mesenchymal stem cells were cultivated by the conventional method in vitro, and then co-cultivated with SIS. The morphological feature of the complex material, the extracellular matrices, the adhesion and proliferation of BMSC were observed by optical microscope, electronic microscope, scanning electronic microscope and histologic evaluation respectively. RESULTS: BMSCs adhered and proliferated on SIS, secreted a great deal of extracellular matrices with active cellular function. BMSCs grew well there in layers, and the thickness became thicker as time passed, acting like a biological periosteum. CONCLUSION: Combined culture of SIS and BMSC in vitro can construct a tissue engineering periosteum similar to the natural one, thus providing a base for further study of its osteogenic regeneration in vivo.