Experience With Immediate Internal Fixation Combined With Primary Wound Closure in Gustilo-Anderson Type IIIA Open Ankle Fractures.

Open ankle fractures, especially Gustilo-Anderson type III fractures are challenging to manage with controversy over the "best" or "superior" treatment strategy. This study aimed to evaluate the treatment outcome of immediate internal fixation combined with primary wound closure in the management of Gustilo-Anderson type IIIA open ankle fractures. We retrospectively assessed the outcomes of thirty-two patients treated using immediate internal fixation combined with primary wound closure with a minimum follow-up of twenty-four months. At the median follow-up of 38 months, the mean American Orthopaedic Foot and Ankle Society scale score was 87.22 ± 4.05. The physical component summary score of Short-Form 36 Health Status Survey was 66.63 ± 11.42 and the mental component summary score was 67.31 ± 7.20. Range of motion of Ankle/Foot injured side was 64.56 ± 4.30 degrees, and range of motion of Ankle/Foot uninjured side was 72.31 ± 3.12 degrees. Visual analog pain scale score was 1.5 ± 0.88 at rest and 3.09 ± 1.17 during activity. According to American Orthopaedic Foot and Ankle Society scale score, the rate of excellent and good outcomes was 90.6%. Postoperative complications were documented, comprising 2 (6.4%) cases of infection, 5 (15.6%) cases of wound skin necrosis, 1 (3.2%) case of postoperative ankle traumatic arthritis, and 1 (3.2%) case requiring reoperation due to suboptimal fibula fracture reduction. The study results demonstrated that immediate internal fixation combined with primary wound closure for Gustilo-Anderson type IIIA open ankle fractures achieve good functional outcomes and lower complication rates.

Hsa_circ_0001982 promotes the proliferation, invasion, and multidrug resistance of osteosarcoma cells.

BACKGROUND: Osteosarcoma (OS) is the most common bone cancer mostly seen in people aged 10-25 years. This research aims to clarify the function of hsa_circ_0001982 in osteosarcoma (OS) and its effect on drug resistance, preliminarily exploring its mechanism. METHODS: The expression of hsa_circ_0001982 and miR-143 in OS clinical tissues and cells was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR), MTT, colony formation assay, and transwell assay assessed cell proliferation, colony formation, migration, and invasion, respectively. The targeted relationship of hsa_circ_0001982 and miR-143 was verified by a dual-luciferase reporter assay. RESULT: The expression of hsa_circ_0001982 was significantly increased in OS tissues and cells (MG63), as in well as chemoresistant OS tissues and cells (MG63/Dox). Overexpression of hsa_circ_0001982 promoted proliferation, colony formation, migration, invasion, and multidrug resistance in MG63 cells. By contrast, knockdown of hsa_circ_0001982 markedly reduced the resistance of MG63/Dox cells to doxorubicin (IC50 evidently reduced). Bioinformatic prediction showed that miR-143 was a target miRNA of hsa_circ_0001982, and a dual-luciferase reporter assay proved this. Further experiments revealed that miR-143 expression was notably downregulated in OS tissues, chemoresistant OS tissues, and MG63/Dox cells. Moreover, miR-143 was negatively correlated with hsa_circ_0001982 in OS cells and tissues. CONCLUSION: The regulation of malignant behaviors such as proliferation, invasion, migration, and multidrug resistance of OS cells by hsa_circ_0001982 may be achieved by targeting miR-143. Moreover, hsa_circ_0001982 is a potential target for early diagnosis and targeted therapy of OS.

Perioperative prevalence of deep vein thrombosis in patients with percutaneous kyphoplasty: A retrospective study with routine ultrasonography.

In recent years, deep venous thrombosis (DVT) after spine surgery has received extensive attention, but perioperative prevalence of DVT in patients undergoing percutaneous kyphoplasty (PKP) is lacking.To assess the perioperative prevalence of deep vein thrombosis (DVT) in patients undergoing PKP with routinely applied ultrasonography.We reviewed 1113 consecutive patients undergoing PKP from January 2014 to August 2017. The surgical procedure was bilateral PKP. All patients were routinely examined with ultrasonography when admitted to the hospital and on the first post-operative day. Clinical signs of DVT were checked and recorded before examination.Forty (3.6%) out of 1113 patients were diagnosed with DVT by ultrasonography. Of the 40 detected cases of DVT, only six (0.54%) patients presented with clinical signs of DVT, demonstrating that there were 34 (3.05%) asymptomatic cases. No patient presenting with clinically suspected pulmonary embolism (PE) was observed. Gender, body mass index (BMI), operative time, hypertension, diabetes, heart disease, and lower limb fracture were not significant risk factors for DVT (P > .05). In contrast, patient age, oncologic conditions, DVT history, and paraplegia appeared to be significant risk factors for DVT (P < .01). There was no significant difference in the incidence of DVT found between the three PKP surgical levels (P > .05).The total incidence of perioperative DVT diagnosed with ultrasonography in patients undergoing PKP was 3.6%, of which only 0.54% was symptomatic cases. It is necessary to assess DVT using ultrasonography during the perioperative procedure of PKP, especially for high-risk patients.Level of evidence: Level IV.