Complicated Bosworth fracture-dislocation: A case report and review of the literature / 中华创伤杂志(英文版)

Bosworth fracture and dislocation is relatively rare, accounting for about 1% of ankle fractures. It is characterized by the proximal fibula fracture embedded in the posterolateral distal tibia. Due to an insufficient understanding of this fracture, it is easy to cause missed diagnosis and misdiagnosis in clinical practice. Due to the insertion of the fracture, it is challenging to perform closed reduction, and improper treatment is easy to cause complications. Surgical treatment is recommended for this type of fracture. In order to improve the understanding of orthopedic surgeons about Bosworth fracture and dislocation, this paper reports the diagnosis and treatment of 2 cases of Bosworth fracture and dislocation, and reviews the literature on Bosworth fracture's mechanism, diagnosis, classification, complications, and treatment options in recent years.

Biomechanical application of finite element method in upper cervical spine / 中国骨伤

Biomechanics plays an important role in the pathogenesis of upper cervical spine disease. Traditional biomechanical test, such as animal experiment, physical experiment and vitro experiment exists many problems. Finite element method, a new biomechanical method, can repeat in sustainability study, change quality and quantity, provide the manifestation of local and internal region and make up the deficiency of current methods. The paper summaries the biomechanical application of finite element method in upper cervical spine, including the finite element modeling, pathophysiological mechanism of upper cervical spine and biomechanical analysis of internal fixation devices.

Clinical application of centerpiece titanium plate fixation in open door laminoplasty / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical application of Centerpiece titanium plate fixation in open door laminoplasty.</p><p><b>METHODS</b>From January 2009 to December 2010,25 patients with cervical spinal stenosis were treated by open door laminoplasty with Centerpiece titanium plate fixation. There were 16 males and 9 females,with a mean age of (57.2 +/- 6.7) years (ranged, 44 to75 years). There were multilevel cervical myelopathy in 8 cases, posterior longitudinal ligament ossification in 12 cases and congenital cervical spinal stenosis in 5 cases. According to Japanese Orthopedic Association (JOA) score to evaluate nerve function and calculate improvement rate. X-ray and CT were used to evaluate postoperative spinal canal enlargement and bone fusion at the hinge side. The sagittal diameter of C5 spinal canal on the lateral X-ray was measured before operation and 6 months after operation respectively, and the expansion rate of spinal canal was calculated [(postoperative sagittal diameter-preoperative sagittal diameter)/(preoperative sagittal diameter) x 100%].</p><p><b>RESULTS</b>The operative time and intraoperative blood loss were respectively (165.5 +/- 35.6) min and (325.0 +/- 75.1) ml. All patients were followed up from 6 to 18 months with an average of (7.3 +/- 3.8) months. The JOA score increased from 9.3 +/- 1.1 before operation to 14.7 +/- 2.1 at 6 months after operation (t = 4.12, P < 0.05), and the improvement rate was (64.5 +/- 10.2)%. Radiographic data showed spinal canal enlarged perfectly, bone fusion at hinge side and no cervical spinal stenosis was found. The sagittal diameter of C5 spinal canal improved from (9.0 +/- 1.5) mm before operation to (14.3 +/- 2.0) mm at 6 months after operation (t = 7.61, P < 0.05), and the expansion rate was (67.6 +/- 11.8)%.</p><p><b>CONCLUSION</b>Clinical application of Centerpiece titanium plate fixation in open door laminoplasty is safe and effective. While vertebral plate is elevated to obtain instantly stability, at the same time, the integrity of spinal canal is also recovered.</p>

Study on the feasibility of posterior thoracic transarticular screw fixation / 中国骨伤

<p><b>OBJECTIVE</b>To study the feasibility and technical parameters of posterior transarticular screw fixation in the thoracic spine.</p><p><b>METHODS</b>Since September 2009 to December 2009, 20 thoracic cadaveric spines (12 males and 8 females) were dissected. The lateral masses and pedicles were exposed carefully. After the entrance point of transarticular screws was determined, posterior transarticular screws implantation was performed under direct visualization into T(1,2), T(5,6) and T(9,10). Then CT scan was performed. On the CT scan,the angle and length of the transarticular screw trajectory were measured.</p><p><b>RESULTS</b>The thoracic transarticular screw trajectory were caudal tilting in the sagittal plane and lateral tilting in the coronal plane with successful placement. There was little differences between different segmental of thoracic vertebrae of the angle, but without significance (P > 0.5). The average angles of the screws were (52.6 +/- 5.9) degrees caudal tilting in the sagittal plane and (12.4 +/- 2.9)0 lateral tilting in the coronal plane. The average trajectory lengths were (22.5 +/- 1.9) mm. There was significant differences statistically among T(1,2), T(5,6) and T(9,10) (P < 0.01).</p><p><b>CONCLUSION</b>Posterior transarticular screw fixation is feasible. Transarticular screw fixation in the thoracic spine affords an alternative to standard pedicle screw placement for thoracic stabilization.</p>