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BACKGROUND:Bone transport has been used for a variety of reasons in bone defects with good clinical results.However,various complications have also attracted the attention of practitioners and the avoidance of non-healing of the docking point has become a common concern for doctors and patients. OBJECTIVE:To explore effective methods of avoiding non-healing of the docking point in the treatment of tibial bone defects by bone transport so as to shorten the treatment period and reduce the pain of patients. METHODS:The clinical data of 21 patients with unilateral tibial bone defect admitted to the No.910 Hospital of Joint Logistics Support Force of Chinese PLA from January 2018 to January 2021 were retrospectively analyzed,including 16 males and 5 females,aged(32.8±10.3)years,with an average bone defect length of 10.2 cm.All 21 patients received bone transport surgery,during which the bone defect area was filled with bone cement to reduce the adverse factors affecting the healing of the docking point.The Association for the Study and Application of the Methods of Ilizarov,healing index and incidence of adverse reactions were evaluated during postoperative follow-up. RESULTS AND CONCLUSION:The 21 patients were followed up for 15 to 24 months after surgery,and the extended area was all well mineralized and had no malformations,and no refractures occurred during treatment.Among them,one patient had foot drop,which could not be completely corrected after surgical release of the Achilles tendon and wearing foot and ankle orthotics.19 patients had different degrees of needle tract infection,and no deep infection occurred after timely needle tract nursing.The healing rate of the docking point was 100%;the healing index was 36-45 d/cm and the average was 38 d/cm.The Association for the Study and Application of the Methods of Ilizarov showed that bone healing was excellent in 17 cases(81%)and poor in 4 cases(19%).The results of limb function were excellent in 18 cases(86%)and good in 3 cases(14%).These findings show that bone cement segmental filling during bone transport is an effective method to solve the non-healing of the docking point,shorten the patient's treatment period and reduce the patient's pain.
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Objective To evaluate the treatment effects of minimal invasive plate technique on tibial shaft fractures.Methods A retrospective case-control study was made on 120 patients with tibial shaft fractures treated from September 2012 to February 2015.There were 70 males and 50 females,with age range of 21 to 61 years [(42.18 ± 10.76)years].There were 65 cases injured in traffic accidents,28 in fall from height,and 27 in sports crashes.The time from injury to operation was 1 to 5 days [(2.49 ± 1.30)days].All fractures were type C2 by AO classification.The patients were assigned to minimally invasive plate fixation (minimal invasion group) and traditional reduction and internal fixation (tradition group),according to the treatment difference.The amount of intraoperative bleeding,operation time,hospitalized time,fracture union time,visual analogue scale (VAS) and Johner-Wruhs function score were recorded.Results Minimal invasion group showed significant differences from tradition group in aspects of amount of intraoperative bleeding [(63.26 ± 6.84) ml vs.(187.46 ± 25.47) ml],operation time [(58.37±6.21)minvs.(90.30±8.47)min],hospitalized time [(7.24±1.29)daysvs.(8.63± 1.42) days] and fracture union time [(10.26 ± 1.82) weeks vs.(13.24 ± 2.07) weeks] (P ＜ 0.05).There were significant differences between minimal invasion group and tradition group in VAS at postoperative 1,3,and 5 days [(4.03 ±0.65)points vs.(4.98 ±0.72)points;(2.92 ±0.51)points vs.(3.93 ± 0.60) points;(1.84 ± 0.32) points vs.(3.01 ± 0.48) points] (P ＜ 0.05).The excellence rate by Johner-Wruhs function scale was 93.3％ (36 cases as excellent,20 good,three fair,and one poor)in minimal invasion group and 81.7％ (16 cases as excellent,33 good,eight fair,and three poor) in tradition group (P ＜0.01).Conclusion Minimally invasive plate technique can effectively decrease trauma and perioperative pain,and is beneficial for bone union in tibial shaft fractures.
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Objective To design a new lumbosacral anterior plate by statistical analysis for the numerical value of the anatomic structure in Chinese.Methods The numerical value of lumbosacral angle and height of lumbosacral vertebrae,and discus intervertebralis were measured in 350 orthotropia and lateral view X-ray pictures of lumbosacral vertebrae of adult normal individuals.According to the acquired amplitude of lumbosacral vertebrae in Chinese,we designed the modified lumbosacral anterior plate,and then tested the plate in 4 different states of working condition on 8 fresh spinal columns to assay biomechanical data,and the results were compared with those of lumbosacral anterior secure plate(PACH).Results The amplitude of lumbosacral angle were 125 to 135,the heights of anterior border L5 and S1 vertebrae were(27.06?2.30) and(22.3?2.8)mm,the height of L5S1 discus intervertebralis was(8.2?0.3)mm.The flex bias and the compression rigidity had significant deviation for the vertebral column fixed the modified plate [flexation(4.706?0.012)mm,extension(4.549?0.298)mm,lateral bending(5.412?0.384)mm,average value of rigidity in 400 N(105.8?7.6)N/mm] and PACH[flexation(5.241?0.113) mm,extension(5.662?0.246)mm,lateral bending(6.767?0.017)mm,and average value of rigidity(87.4?4.2)N/mm] respectively,with statistical significance among them(P
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Objective To investigate the requirement of water in Hemsleya zhejiangensis during the culture process. Methods The chlorophyll content, the gas exchange, and chlorophyll fluorescence parameter in H. zhejiangensis were measured after treatment with drought stress for different time. Results With decreasing of relative soil water content, the net photosynthetic rate (Pn) in H. zhejiangensis was increased before the 15 d and than was decreased. The stomatal conductance (Gs) and transpiration rate (E) were decreased under drought stress for 5 d, while the intercellular CO2 concentration (Ci) was increased. The efficiency of energy conversion of open PSⅡ (Fv′/Fm′) maintained rather stable, while its electron transport rate (ETR), actual PSⅡ efficiency (?PSⅡ), photochemical quenching (qP), and non-photochemical quenching (NPQ) were increased after the 10 d of drought stress, and then was decreased, which was consistent with the change in Pn. Conclusion The growth of H. zhejiangensis is promoted under slight drought stress condition, which is probably associated with the dissipation of excess light energy.