ABSTRACT
The distal tibial epiphyseal fractures is a common type of fracture in adolescents.The distal tibia is adjacent to the ankle joint,where the epiphysis is fragile and easily damaged when the fracture occurs,resulting in ischemic necrosis of the epiphysis and impaired bone growth,and the degree of damage and treatment effect directly influence the shape and function of the ankle joint,seriously affect the prognosis and quality of life of adolescents.Therefore,anatomical reduction should be achieved after injury as much as possible to achieve stable fixation.For stable fractures of the distal tibial epiphysis(such as Salter-Harris type Ⅰ or Ⅱ fractures),the conservative treatment can be used;whereas for unstable fractures,especially Salter-Harris type Ⅲ and Ⅳ fractures with a high risk of displacement,surgical treatment is preferred.However,due to the physiological characteristics of the epiphysis of adolescents,the distal tibia grow and develop differently,the individualized treatment plans should be developed according to the situation of adolescents.3D printing technology combined with imaging technologies including CT and MRI can print complex shapes of geometric structures to meet individual needs,and play an important role in the surgical treatment of distal tibial epiphyseal fractures,especially Salter-Harris type Ⅲ and Ⅳ fractures,which can contribute to formulating individualized surgical plans,improving the success rate of surgery,reducing the incidence of long-term complications,and greatly improving the prognosis of adolescents.Based on the literature reports in the past decade,this paper reviews the research progress of the application of 3D printing technology in the diagnosis and treatment of distal tibial epiphyseal fractures in adolescents.
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Objective To explore the self-face recognition and its relationship to empathy in patients with schizophrenia.Methods Sixty-two schizophrenic patients and fifty -four healthy subjects were assessed with the self-face recognition task (SFRT) and the interpersonal reactivity index-C (IRI-C).Results The SFRT reaction time in the patients group( (2188 ± 1138) ms) was significantly longer than that in the control group( ( 1152 ± 326) ms) (P ＜ 0.01 ) ;the accuracy in the patients group ( (80 ± 16) ％ ) was significantly lower than that in the control group ( (88 ± 6) ％ ) (P ＜ 0.01 ).The IRI-C total scores,the subscores in perspective taking,the subscores in fantasy and empathic concern of IRI-C were significantly lower in the patients group(respectively(44.82 ± 10.50),(8.98 ± 3.56),( 11.87 ± 4.38 ),( 14.73 ± 4.00) ) than those in the control group ( respectively (49.85 ± 10.28),( 10.78 ± 3.86),( 14.98 ± 6.12),( 17.39 ± 4.56) ) ; the subscore in personal distress of IRI-C in the patients group(9.37 ± 5.12) was significantly higher than those in the control group(6.52 ± 3.89) ( P＜ 0.01 ).There was significant positive correlation between the accuracy for self-face recognition in SFRT and the subscore in fantasy of IRI-C ( r =0.322,P ＜ 0.05 ),the reaction time of SFRT had significantly positive correlation with the subscore in personal distress.Conclusion Schizophren patients have general impairments of self-face recognition and empathic abilities,and the self-face recognition is related to the empathic abilities.
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<p><b>OBJECTIVE</b>To compare therapeutic effects of three fixation methods with three Kirschner wires,and to find the best fixation method.</p><p><b>METHODS</b>From July 2008 to May 2009, 60 patients with humeral supracondylar fractures were treated. Among patients in Group A, 11 patients were male and 9 patients were female, ranging from 2 to 13 years old,with an average of (5.4 +/- 0.5)years;all the patients in Group A were fresh closed fractures without nerve and blood vessel injuries, 13 patients were type II and 7 patients were type III according to Gartland classification; and all the patients in Group A were treated by three Kirschner wires fixation with the third Kirschner different wire fixed through radial edge of coronoid fossa. Among patients in Group B, 13 patients were male and 7 patients were female,ranging from 2 to 11 years old, with an average of (6.1 +/- 0.4) years; all the patients in Group B were fresh closed fractures without blood vessel injuries, 11 patients were type II and 9 patients were type III according to Gartland classification, 2 patients had ulnar nerve injuries before treatment; and all the patients in Group B were treated by three Kirschner wires fixation with the third Kirschner different wire fixed through ulnar edge of coronoid fossa. Among patients in Group C, 8 patients were male and 12 patients were female, ranging from 3 to 14 years old, with an average of (7.4 +/- 0.6) years; all the patients in Group C were closed fresh fractures without blood vessel injuries, 7 patients were type II and 13 patients were type III according to Gartland classification, 2 patients had radial nerve injuries before treatment; and all the patients in Group C were treated by three Kirschner wires fixation with the third Kirschner different wire fixed through middle of coronoid fossa. After 1 year of treatment,the Carrying and Baumann angles were measured on the X-ray of all patients in the three groups, and the motion range of elbow joint was observed. The Flynn evaluation criteria were used to compare therapeutic effects among the three groups.</p><p><b>RESULTS</b>All the patients were followed up. The function loss of elbow joint were (14.04 +/- 3.25) degrees in Group A, (13.14 +/- 2.34) degrees in Group B, and (9.25 +/- 2.56) degrees in Group C. Changes of Carrying angle were (7.64 +/- 1.78) degrees in Group A; (7.38 +/- 1.68) degrees in Group B, and (5.27 +/- 1.13) degrees in Group C. Changes of Baumann angle were (28.55 +/- 3.23) degrees in Group A, (27.55 +/- 2.23) degrees in Group B, (21.45 +/- 1.73) degrees in Group C. According to Flynn criteria, there were 11 patients got excellent result, 4 good and 5 poor in Group A; in Group B, 12 patients got excellent result, 3 good and 5 poor; in Group C, 11 patients got excellent result, 6 good and 3 poor. The therapeutic effects of Group C was better than those of Group A and Group B.</p><p><b>CONCLUSION</b>There are different effects among three kinds of operative approaches for the humerus supracondylar fractures. The fixation method with one Kirschner wire through middle part of coronoid fossa is better than the other two fixation methods.</p>