A case report on a child with fracture and dislocation of the upper cervical spine accompanied by spinal cord injury.

RATIONALE: This study describes an 8-year-old boy with a C2 fracture and dislocation with a left C2-C3 articular process interlocking and spinal cord injury who underwent open reduction and internal fixation using the posterior cervical approach and achieved satisfactory results. PATIENT CONCERNS: An 8-year-old boy underwent an emergency transfer from a previous hospital after a car accident. DIAGNOSES: Axial fracture and dislocation with spinal cord injury (American Spinal Injury Association grade C), traumatic shock, brain contusion, intracranial hemorrhage, mandibular fracture, pulmonary contusion and hemorrhage, left vertebral artery stenosis, and multiple fractures throughout the body. Radiological examination revealed a fracture of the lower edge of the C2 vertebral body, fourth-degree anterior spondylolisthesis of the C2 vertebral body, interlocking of the left C2-C3 articular processes, widening of the C2-C3 vertebral space, and occlusion of the V1 and 2 segments of the left vertebral artery. INTERVENTIONS: The boy was immediately intubated and transferred to the pediatric intensive care unit for rescue treatment. However, the reduction was unsuccessful with 2 weeks of cranial traction. Thus, an open reduction was performed under general anesthesia. One month after the surgery, the boy was discharged from the hospital on foot after rehabilitation treatment. OUTCOMES: The boy was discharged from the hospital 1 month after surgery. At the 8-month follow-up, a radiological examination showed that the corrected C2 vertebral body fracture and dislocation were satisfactorily reduced, and the spinal cord was adequately decompressed. The internal fixation position was also good, and the spinal sequence had recovered well. In summary, except for the muscle strength of the right upper limb, which was slightly worse, the other clinical symptoms were significantly improved. LESSONS: In treating cervical fracture and dislocation with unilateral facet lock, the posterior open reduction of pedicle screw and lateral mass screw internal fixation achieved satisfactory results. Consequently, treating complex cervical spine injuries in children requires an accurate diagnosis and careful treatment strategy.

Functional Chitosan-based Materials for Biological Applications.

BACKGROUND: Bio-based materials, as the plentiful and renewable resources for natural constituents which are essential for biomedical and pharmaceutical applications, have not been exploited adequately yet. Chitosan is a naturally occurring polysaccharide obtained from chitin, which has recently attracted widespread attention owing to its excellent activity. This review shows the methods of extraction and modification of chitosan and provides recent progress of synthesis and use of chitosan-based materials in biological applications. METHODS: By consulting the research literature of the last decade, the recent progresses of functional chitosan-based materials for biological applications were summarized and divided into the methods of extraction chitosan, the chemical modification of chitosan, chitosan-based materials for biological applications were described and discussed. RESULTS: Chemical modification of chitosan broadens its applications, leading to developing numerous forms of chitosan-based materials with excellent properties. The excellent bioactivity of chitosan-based material enables it serves potential applications in biomedical fields. CONCLUSION: Chitosan-based materials not only exhibit the excellent activities of chitosan but also show other appealing performance of combined materials, even give the good synergistic properties of chitosan and its composite materials. Further studies are needed to define the ideal physicochemical properties of chitosan for each type of biomedical applications. The development of various functional chitosan-based materials for biological applications will be an important field of research, and this kind of material has important commercial value.