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Objective To compare the clinical outcome of shape memory alloy (SMA) embra-cing fixator and reconstruction plate fixation in treatment of displaced or comminuted midshaft clavicle fractures. Methods There were 65 patients with displaced or comminuted midshaft clavicle fractures surgically treated with either a SMA embracing fixator or a reconstruction plate. The patients were divided into two groups according to fixation methods, ie, SMA embracing fixator group (30 patients at average age of 28.1 years) and reconstruction plate group (35 patients at average age of 26.1 years). All pa-tients were followed up for mean 12 months and shoulder function was evaluated using shoulder score. Results Compared with reconstruction plate group, SMA embracing fixator had shorter operation time, smaller wound incision and less loss blood (all P < 0.05). However, there was no statistical difference in aspects of hospital stay, cost, JOA shoulder score and bone union rate between two groups (all P > 0.05). Conclusion The internal fixation with SMA embracing fixator is better than reconstruction plate fixation in treatment of midshaft clavicle fractures.
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Objective To discuss the matrix metalloproteinase ( MMP- 13 ) and insulin-like growth factor (IGF)-1 in knee osteoarthritis (OA) and Kashin-Beck disease (KBD) and to explore the mechanism of synovial lesions and their similarities and differences are compared. Methods Synovial fluid of 18 OA patients, 13 KBD patients, 6 normal controls were collected and their synovium were obtained at the same time.The synovium MMP-13 and IGF-1 were examined by immunohistochemistry, while those of the synovial fluid were tested by enzyme-linked immunosorbent assay (ELISA). One way ANOVA and LSD-t test were used for statistical analysis. Results The results of these 37 synovial tissue and synovial fluid samples showed that: ① The average optical density of the positive staining of the KBD synovial tissue (692±131,354±101, 415±62) was not statistically significant from that of the OA group (452±57, 366±65, 652±86)(P＞0.05) and the control group (541±98, 524±202, 379±94, P＜0.05). ②There was significant different between the expression of IGF-1 of synovial tissue in the KBD group (311±174, 235±95, 412±109) and the OA group (452±57, 652±75, 544±64) as well as the control group (251±29, 336±54, 388±76)(P＜0.05).③ Compared with the concentration of MMP-13 in the synovial fluid of the OA group (0.93±0.51), there was no significant difference between the OA and the KBD group (2.02±1.12) (P＞0.05); but, there was significant differences when compared with the control group (2.33 ±0.29, P＜0.05). ④ When compared the the concentration of IGF-1 in the synovial fluid in the KBD group [ (2.87±1.48) and the OA group (1.27±0.33)as well as that of the eontrol group (0.93±1.07)] the difference was significant. Conclusions ① Cartilagedegeneration and joint damage may be a part of the articular synovial lesions in KBD patients, just like that of the OA, and the may exist as a part of the pathogenesis. ② MMP-13 may be involved in the synovial damage,and is the major degenerating factors in cartilage extracellular matrix (ECM) in OA patients and KBD patients. ③ As one of the ECM synthesis factors, IGF-1 may play an important role in the synovial damage of OA and KBD disease, but the repair mechanism may be different between the two diseases.
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BACKGROUND:The non-steroidal antiinflammatory drugs (NSAIDs) were widely used to prevent heterotopic bone formation following total hip arthroplasty (THA),however,its efficacy and safety is poorly understood.OBJECTIVE:To determine the efficacy and safety of postoperative NSAIDs therapy in patients undergoing THA using Meta analysis.METHODS:The databases of PubMed,Embase,Cochrane Library,Chinese biomedical literature,CNKI,VIP as well as bibliographies of retrieved articles were researched for randomized controlled trials comparing NSAID versus control after THA,and the data were analyzed using Review Manager 5.0.RESULTS AND CONCLUSION:A total of 13 randomized controlled trials totaling 4706 participants were included.The result of meta analysis showed that low dose aspirin did not significantly affect the incidence of heterotopic bone formation (HBF) [RR=0.99,95% CI (0.87,1.14) rather than medium to high dose NSAIDs [RR=0.44,95% CI(0.30,0.64),there was no significant difference between two group in hip pain and physical function,the incidence of HBF was 16.0% in NSAID-group and 11.1% in 7 Gy group.Apart from low dose aspirin,medium to high doses of postoperative NSAIDs produce a substantial reduction in the incidence of HBF at the cost of minor high gastrointestinal side effect.Limited evidence showed there were no significant differences between the groups for improvements in hip pain and physical function,7 Gy fraction is more effective than use of NSAID.
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[Objective]To assess the efficacy and safety of low intensity pulsed ultrasonography for fractures.[Methods]According to Cochrane Systematic Review,Medline,EMBASE,Cochrane Library,CNKI and CBM were searched for RCTs,and gray literature were also searched.Furthermore,the bibliographies of retrieved papers and content experts were consulted for additional references.The quality of included studies was critically evaluated.Data analyses were performed with the Cochrane Collaboration's RevMan 5.0 software.[Results]Ten randomized controlled trials with total of 452 patients met the included criteria.The meta-analysis showed treatment with a low-intensity pulsed ultrasound signal can reduce healing time compared with the placebo group(RR=1.43,95% CI[1.15,1.79]P=0.001).[Conclusion]Treatment with a low-intensity pulsed ultrasound signal can reduce healing time.Some trials included in the review were of poor quality.Multi-center,large-scale randomized controlled trials of higher quality are needed to support our results.