To investigate the effectiveness of T-locking plate in treating medial clavicle fracture so as to find out a therapy with safety and stabil ity. Methods Between October 2006 and January 2009, 13 patients with medial clavicle fracture were treated with open reduction and T-locking plate fixation. There were 9 males and 4 females, aged 18-68 years (mean, 47 years), including 7 cases of traffic accident injury, 4 cases of fall ing injury from height, and 2 cases of heavy object hit injury. The locations were left side in 5 cases and right side in 8 cases. All cases were closed fracture. The disease duration was 1 hour to 14 days. Results All incisions healed by first intention after operation. The X-ray films showed good reduction of fracture and internal fixation. All the 13 patients were followed up 12-18 months (mean, 15 months). The average fracture heal ing duration was 8 weeks (range, 6-12 weeks). No compl ication of infection, nerve or blood vessel injury, hemopneumothorax, or internal fixation loosening or failure occurred. The anatomical medial clavicle structure as well asappearances and functions were restored. According to Rockwood’s score method, the results were excellent in 11 cases and good in 2 cases. Conclusion The internal fixation of T-locking plate in treating medial clavicle fracture has the advantages of good stabil ity and low risk. Besides, the patients can do functional exercises early and the shoulder joint function can be improved in great degree.
ObjectiveTo evaluate the effectiveness of comprehensive management for early stage avascular necrosis of the femoral head (ANFH) by arthroscopic minimally invasive surgery by comparing with closed core decompression. MethodsBetween January 2007 and March 2010, 28 patients (33 hips) with early stage ANFH were treated with the procedure of arthroscopic core decompression combined with autogenous cancellous bone graft and bone morphogenetic protein (BMP) in 18 cases (21 hips, trial group) or with simple closed core decompression in 10 cases (12 hips, control group). No significant difference was found in gender, age, disease duration, etiology, and staging between 2 groups (P gt; 0.05). ResultsIncision healed primarily in all patients, and no infection occurred. All patients were followed up 2.5 years on average (range, 1-3 years). Pain relief and improvement of hip function were obtained in all patients at 6 months after operation. At last follow-up, the Harris scores were 85.67 ± 4.78 in trial group and 81.33 ± 7.03 in control group, showing significant difference between 2 groups (t= —2.10, P=0.04). Collapse of the femoral head was observed in 1 hip (Ficat stage II) of trial group, and in 2 hips (Ficat stage I ) and 2 hips (Ficat stage II) of control group; hip arthroplasty was performed. Significant difference in total effective rate was found between trial group and control group (95.24% vs. 66.67%; χ2=4.85, P=0.03). ConclusionArthroscopic core decompression combined with autogenous cancellous bone graft and BMP is more effective than traditional closed core decompression for treatment of early stage ANFH in pain relief, improvement of hip function, slowing-down the process of femoral head necrosis, reduction of hip joint replacement by accurate location of the lesions, and thoroughly debridement of necrotic bone.
Objective To explore the therapeutic effect of recombinant human epidermal growth factor (rhEGF) for burn wounds of degree II in the elderly patients. Methods From February 2003 to October 2008, 80 patientes with burn wounds of degree II were treated and randomly divided into two groups (n=40). In treatment group, there were 24 males and 16 females with an average age of 70 years (60-86 years), including 20 cases of superficial II degree and 20 cases of deep II degree.Burn wounds were caused by flame in 23 cases, by hot l iquid in 16 cases, and by electricity in 1 case. The mean time from injury to hospital ization was (2.87 ± 2.57) hours. The wounds were treated with silver sulfadiazine (SD-Ag) and rhEGF. In control group, there were 18 males and 22 females with an average age of 69 years (61-83 years), including 19 cases of superficial II degree and 21 cases of deep II degree. Burn wounds were caused by flame in 23 cases, by hot l iquid in 14 cases, by electricity in 2 cases, and by chemistry in 1 case. The mean time from injury to hospital ization was (3.39 ± 3.33) hours. The wounds were treated with SD-Ag. The dressing was changed every day until wounds heal ing. There were no significant differences in general data between two groups (P gt; 0.05). Results Wound did not heal in 1 case (deep II degree) of treatment group and in 5 cases (deep II degree) of control group over 40 days and free skin graft was used to repair wound. One case (superficial II degree ) in control group gave up treatment. One case (deep II degree) died of pulmonary infection in treatment group. These cases were excluded and 72 cases were analysed. No other side reactions were observed in teatment group except for flash stabbing pain (4 cases) and pruritus (2 cases). Wound infection occurred in 5 cases of the control group and in 3 cases of the treatment group, and wound healed after symptomatic treatment. The heal ing time of burn wound was (14.30 ± 1.26) days (superficial II degree) and (26.11 ± 2.97) days (deep II degree) in the treatment group, was (16.22 ± 1.40) days (superficial II degree) and (29.13 ± 4.99) days (deep II degree) in control group, showing significant difference between two groups (P lt; 0.05). Conclusion Incombined treatment, rhEGF can promote the heal ing of burn wounds of degree II in the elderly patients.
Objective To study the biological characteristic of rabbit bone marrow mesenchymal stem cells (BMSCs) double-labeled by PKH26 and BrdU in vitro, and to construct tissue engineered cardiac patch in vitro. Methods The BMSCs were harvested from 6-month-old New Zealand rabbits and labeled with PKH26 and BrdU. The growth and fluorescent intensitywere observed by inverted phase contrast microscope, fluorescent microscope, flow cytometry, and MTT detection. Thecharacteristics of double-labeled BMSCs differentiating into osteoblasts and adipocytes, respectively, in vitro were identified by alkal ine phosphatase (ALP) staining, Al izarin red staining, Oil red O staining, immunocytochemical technique of collagen type I, and osteocalcin expression. The labeled BMSCs were seeded on the small intestinal submucosa (SIS) and co-cultured for 5-7 days to construct tissue engineered cardiac patch. The patches were tested by inverted phase contrast microscope, fluorescent microscope, scanning electron microscope, and HE staining to observe the cell prol iferation. Results The double-labeled cells grew well and showed red fluorescence. There was no significant difference in the growth characteristic between the labeled and unlabeled cells. There was no significant difference in the expression of stem cell specific surface antigen between before lebel ing and after lebel ing. After osteogenic induction of labeled BMSCs, ALP staining and Al izarin red staining were positive, and the cells expressed collagen type I and osteocalcin. After adipocytes induction, l ipid droplets could be observed in cytoplasm by Oil red O staining. After the co-culture in vitro for 5-7 days, the double-labeled cells grew well, showing a multi-layer cellular structure on the surface of SIS. Conclusion Rabbit BMSCs can be double-labeled with PKH26 and BrdU stably. The labeled cells still have the potential of self-renewal abil ity and multipotent differentiation abil ity; tissue engineered cardiac patch can be constructed by co-culturing labeled BMSCs and SIS in vitro.
Objective To summarize the effectiveness of bone cement combined with screws for repairing tibial plateau defect in total knee arthroplasty (TKA). Methods Between March 2013 and March 2016, 30 patients were treated with TKA and bone cement combined with screws for repairing tibial plateau defect. Of the 30 patients, 8 were male and 22 were female, with an average age of 64.7 years (range, 55-71 years). And 17 cases were involved in left knees and 13 cases in right knees; 22 cases were osteoarthritis and 8 cases were rheumatoid arthritis. The disease duration ranged from 9 to 27 months (mean, 14 months). Knee Society Score (KSS) was 41.63±6.76. Hospital for Special Surgery Knee Score (HSS) was 38.10±7.00. The varus deformity of knee were involved in 19 cases and valgus deformity in 11 cases. According to the Rand classification criteria, tibial plateau defect were rated as type Ⅱb. Results All incisions healed by first intention, without infection or deep vein thrombosis. All the patients were followed up 27.5 months on average (range, 10-42 months). At last follow-up, HSS score was 90.70±4.18 and KSS score was 93.20±3.75, showing significant differences when compared with preoperative values (t=–58.014, P=0.000; t=–60.629, P=0.000). Conclusion It is a simple and safe method to repair tibial plateau defect complicated with varus and valgus deformities with bone cement and srews in TKA.
Objective To provide an ideal seed cell for tissue engineered urinary bladder and urethra by serially culturing canine smooth muscle cells from urinary bladder in vitro and compare biological characteristics of different passagesof cells. Methods Bladder smooth muscle cells of 12-month-old male dogs weighing 10-12 kg were isolated from adult dogs’ urinary bladders by collagenase and trypsin digestion and serially cultured in DMEM medium supplemented with 10% serum of newborn bovines. Morphology and prol iferation of the cells were observed and the serially-cultured cells were identified with the transmission electron microscope and immunohistochemistry. Results The cells appeared spindle in parallel rows when they grew to the degree of subconfluence, and showed the “peak-valley” structure under the inverted phase contrast microscope. The cells could be prol iferated serially to the 12th passage in vitro. The growth curve showed the cells before the 7th passage had the similar prol iferation characteristics and the growth cycle was about 40 hours. The TEM showed myofilament and the dense body in cytoplasm of smooth muscle cells. Smooth muscle actin was positive by immunohistochemical staining. After the 7th passage, the cells’ growth became slow, and myofilament and the dense body in cytoplasm vanished. Conclusion The canine smooth muscle cells from urinary bladder can be serially cultured in vitro and highly purified and largely prol iferated by the appropriate method. The cells before the 7th passage can be used as optimal seed cells for tissue engineered urinary bladder and urethra.