Treatment of tibial insertion avulsion fracture of anterior cruciate ligament involving anterior root of lateral meniscus with multi-point fixation with anchor and suture / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of arthroscopic multi-point fixation with anchor and suture in the treatment of tibial insertion avulsion fracture of anterior cruciate ligament (ACL) involving the anterior root of lateral meniscus (LM).@*METHODS@#A retrospective analysis was conducted on the clinical data of 28 patients with tibial insertion avulsion fracture of ACL involving the anterior root of LM who were treated with arthroscopic multi-point fixation with anchor and suture between October 2017 and January 2023. There were 12 males and 16 females with the mean age of 26 years (range, 13-57 years). There were 20 cases of sports injury and 8 cases of traffic accident injury. In 2 cases of old fracture, the time from injury to operation was 45 days and 90 days, respectively; in 26 cases of fresh fracture, the time from injury to operation was 3-20 days (mean, 6.7 days). According to the Meyers-McKeever classification, there were 4 cases of type Ⅱ, 11 cases of type Ⅲ, and 13 cases of type Ⅳ. The preoperative Lysholm knee function score was 42.1±9.0, the International Knee Documentation Committee (IKDC) score was 40.0±7.3, and the Tegner score was 0.7±0.7.@*RESULTS@#All operations were successfully completed, and the incisions healed by first intention. All the 28 patients were followed up 5-60 months (mean, 20.4 months). During the follow-up, there was nocomplication such as infection, vascular or nerve injury, loosening or breakage of internal fixator, or stiffness of knee joint. Postoperative X-ray films showed satisfactory fracture reduction and firm fixation. All fractures healed clinically, and the healing time was 8-16 weeks (mean, 10.3 weeks). At last follow-up, Lachman test and anterior drawer test were negative. At last follow-up, Lysholm knee function score was 92.4±5.5, IKDC score was 91.6±4.4, and Tegner score was 5.2±1.1, which significantly improved when compared with preoperative scores ( t=-22.899, P<0.001; t=-29.870, P<0.001; t=-19.979, P<0.001).@*CONCLUSION@#Multi-point fixation with anchor and suture in the treatment of tibial insertion avulsion fracture of ACL involving the anterior root of LM can not only fix the LM, but also effectively reduce and fix the avulsion fracture, which can obtain good effectiveness.

A study on repair method of type Ⅱc injury in lateral meniscus popliteal tendon area of porcine knee / 中国修复重建外科杂志

OBJECTIVE@#To investigate the repair method of type Ⅱc injury in the lateral meniscus popliteal tendon area based on the porcine knee joint.@*METHODS@#Eighteen commercially available fresh porcine knee joints were randomly divided into 3 groups ( n=6). After preparing a type Ⅱc injury in the lateral meniscus popliteal tendon area, and the anterior (group A), posterior (group B), or anterior and posterior (group C) of the popliteal hiatus (PH) was sutured by vertical mattress. The tension meter was used to apply gradient tensions of 2, 4, 6, 8, and 10 N along the tibial plateau horizontally, respectively, to pull the midpoint of the lateral meniscus popliteal tendon area. The displacement values before modeling, after modeling, and after suture were recorded. The reduction value of lateral meniscus displacement and reduction rate after suture were calculated and compared between groups.@*RESULTS@#There was no significant difference between groups ( P>0.05) in the displacement values before modeling, after modeling, and after suture under different tensions. There was no significant difference between groups A and C ( P>0.05) in the reduction value of lateral meniscus displacement and reduction rate after suture under different tensions. The reduction value of lateral meniscus displacement and reduction rate after suture in group B were lower than those in groups A and C. The reduction value of lateral meniscus displacement under tension of 2 N and the reduction rates under tensions of 2, 4, and 6 N between groups A and B showed significant differences ( P<0.05). The reduction value of lateral meniscus displacement and the reduction rate under tensions of 2, 4, and 6 N between groups B and C showed significant differences ( P<0.05).@*CONCLUSION@#Suturing the anterior area of PH is the key to repairing type Ⅱc injury of lateral meniscus popliteal tendon area.

Fixation with S 2 alar iliac screws for unstable injury to posterior pelvic ring / 中华创伤骨科杂志

Objective:To explore the fixation with S 2 alar iliac screws (S 2AI) for unstable injury to the pelvic posterior ring. Methods:The clinical data of 18 patients were analyzed retrospectively who had been treated for unstable injury to the posterior pelvic ring by S 2AI screw fixation at Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University and at Department of Orthopaedics and Traumatology, The First Affiliated Hospital to University of South China from September 2017 to December 2020. They were 8 males and 10 females, with an average age of 40 years (from 20 to 64 years). According to Tile classification, there were 3 cases of type B2, 10 cases of type C1 and 5 cases of type C2. Sacral nerve injury was complicated in 3 patients (2 cases of Gibbons grade Ⅱ and one of Gibbons grade Ⅲ). Short-segment S 1-S 2AI fixation was used in 6 cases, contralateral S 1-S 2AI fixation in one case, lumbar-pelvic fixation in 5 cases, and sacroiliac triangle fixation in 6 cases. The accuracy of S 2AI placement was evaluated by CT after operation according to the Shillingford method; the reduction quality of pelvic fractures and complications were documented. Results:All the 18 patients were followed up for 19.8 months (from 12 to 36 months). Bony union was achieved in all fractures. A total of 21 S 2AI were implanted in the 18 patients without intraoperative neurovascular injury. Postoperative CT found penetration into the iliac cortex by S 2AI in 2 cases. According to the Matta criteria, the fracture reduction was excellent in 10 cases, good in 7 and fair in one. Of the 3 patients with preoperative sacral nerve injury, 2 with grade Ⅱ injury recovered to grade Ⅰ and one with grade Ⅲ injury recovered to grade Ⅱ after operation. Superficial infection occurred at the incision site in 2 patients after operation, and complications such as protrusion, rupture or loosening of implants were observed in none of the patients. Conclusion:S 2AI fixation can be flexibly applied to various types of posterior pelvic ring injury and can provide the pelvic ring and the lumbosacral junction with rigid fixation, leading to a low complication rate.

Application of 3D printing technology in RGPCL simulation fitting.

The rigid gas permeable contact lens (RGPCL) is an ideal choice to improve the corrective vision of patients with a high degree of refractive error, keratoconus and corneal transplantation. However, RGPCL fitting is not an easy work for those patients with extremely irregular corneal surface. Technicians or doctors often need to try many times to determine the relatively satisfied lens customization parameters. This repeated try-on process not only increases discomfort of patients, but also will increase the risks of corneal epithelial shedding or corneal infection. In order to conduct RGP fitting in a faster and safer manner, a new method of simulating RGPCL fitting in 3D printing technology was assumed. The preliminary experimental results indicated that this method could effectively reduce the number of try-on and increase patient satisfaction, while decrease the risk of epithelial shedding or infection.

Biomechanical factors in the design of new femoral neck screw in children / 中国组织工程研究

BACKGROUND:As the epiphyseal plate has an important role in the growth and development of femur, the design of internal fixation should avoid the damage to the epiphyseal plate. Therefore, the positioning of pediatric femoral epiphyseal plate is particularly important. OBJECTIVE:To investigate the biomechanical property of the new femur neck screw internal fixation in treatment of children femoral neck fracture. METHODS:Twelve femurs were col ected from six fresh children cadavers provided by Dissecting Room of University of South China. After exclusion of bone disease with X-ray film, three new children femoral neck screws and three Kirschner wires with the diameter of 2.0 mm were used for fixation. The biomechanical tests were conducted to detect the axial compression and torsion stiffness. RESULTS AND CONCLUSION:In the children femoral neck screw group, the axial compression stiffness and torsion stiffness under the torsional torque of maximum 3 N?m were (190.74±20.88) N/mm and (0.18±0.045) N?m/° respectively;(138.95±15.19) N/mm and (0.120±0.036) N?m/° respectively in the Kirschner wire group;there were significant differences in the axial compression stiffness and torsion stiffness between two groups (P<0.05). The results showed that the compressive strength and torsional capacity of the children femoral neck screw were strong than those of Kirschner wire. The experiment suggested that the femoral neck screw for children is a new type of ideal internal fixation device which consist with the anatomical features of children proximal femur and can meet the requirement of children femoral neck fracture with good biomechanical property.

Clinical efficacy analysis and surgical treatment for tibial plateau fracture of Schatzker Ⅴ and Ⅵ / 中国矫形外科杂志

[Objective]To investigate the characteristics,treatment and prognosis of tibial plateau fracture of Schatzker type Ⅴ and Ⅵ and recommend the option of the surgical treatment.[Method]From May 2002 to March 2006,arthroscopically assisted double-plating fixation,locking plate with cannulated screws and external fixation with limited internal fixation were performed in 35 patients with tibial plateau fracture of Schatzker Ⅴ and Ⅵ.[Result]All patients were followed up from 12 to 35 months with an average time of 16.5 months.Bone union was achieved in all cases.According to Rasmussen's functional grading system,the excellent,good,fair and poor cases were 19,10,4 and 2,respectively.[Conclusion]CT 3D reconstruction,evaluation of soft tissues injury,suitable operation timing and approaches,anatomical reduction,bone transplantation,proper fixation and right rehabilitation training are all key factors to improve the therapeutic effects on tibial plateau fracture of Schatzker Ⅴ and Ⅵ.

Effects of polysaccharides from Gastrodia elata Blume on retina of ischemia reperfusion rats / 中国药理学通报

Aim To study the effect of polysaccharides from Gastrodia elata Blume(GEP) on levels of superoxide dismutase(SOD),malondialdehyde(MDA) and nitric oxide(NO);and the retinal morphology after rat retina ischemia reperfusion injury.Method Retinal ischemia was induced in SD rats by increasing the intraocular pressure to 16 kPa for 60 min via cannulation into the anterior chamber.SD rats were divided into five groups randomly: Small dose GEP group,Middle dose GEP group,Large dose GEP group,Vitamin E group and Negative contral group.At 60 min,24 h and 72 h after ischemia reperfusion,levels of SOD,MDA and NO in rat retinas were measured,and histopathologic changes were observed.Results At 60 min,24 h and 72 h after ischemia reperfusion,levels of SOD in rat retinas in middle,large dose GEP groups were significantly higher than that in negative control group(P

Histomorphological observation of PerioGlas implanted in muscle and osseous defects / 实用口腔医学杂志

0.05). In bone defects PeroGlas granales bond to bone and new bone formation were observed 4 weeks after operation. The bone defects were repa ired by new bone 12 weeks after PerioGlas implantation. Conclusion: PerioGlas may induce new bone formation in osseous defects.

On the Communication Methods and Skills between Doctors and Patients in the Department of Orthopedics / 中国医学伦理学

Patients in Orthopedics have different psychological features in the stages of before treatment,the stage of treatment,the stage of rehabilitation and the stage of post-discharge.The health care workers should use language and non-verbal skills to communicate with patients according to their psychological characteristics,and adopt different communication skills with different individuals.A good communication not only reduces the disputes between doctors and patients,but also promotes physiologic and psychological rehabilitation.