1.Development and validation of a wound registry form for use in a tertiary hospital in the Philippines
Philippine Journal of Surgical Specialties 2025;80(2):57-57
RATIONALE
Wound care practices are documented using wound registries to record wound types and characteristics, track wound status, assess impact of interventions, evaluate outcomes, and cost effectiveness. Data from wound registries may also be used for research in wound care and healthcare resource planning. However, a standardized wound registry in the Philippines is lacking, necessitating the creation and development of our own Wound Registry Form, tailored to our experience.
METHODSThis study involved the development and validation of a Wound Registry Form. An initial survey and focus group discussion with wound care practitioners were done to develop the items included in the form. The form underwent content validation with a panel of experts. Pilot data collection with 75 patients was performed to determine the interrater reliability between General Surgery (GS) and Plastic Surgery (PS) residents in a tertiary hospital when assessing patients with wounds.
RESULTSA Wound Registry Form containing 36 variables was developed. It demonstrated a high content validity index (1.0), and good interrater reliability. The General Surgery residents and Plastic Surgery residents did not differ significantly in describing the wound, and generally agree on the choice of wound dressing, and other treatment related characteristics –such as frequency of dressing changes, antibiotic use, and septic studies done. However there was a significant difference among the two groups in two aspects –1) wound exudate consistency, with majority of GS residents rating exudates to have high viscosity, while majority of PS residents rating the exudates as of low consistency (p < 0.01), and, 2) rationale for the type of dressing use – there is a higher percentage of GS residents considering price and availability primarily, whereas PS residents tend to weigh their dressing choices on the clinical indication for it (p < 0.01). No other significant differences were observed between the two groups in terms of other parameters.
CONCLUSIONThe Wound Registry Form demonstrated high content validity, and good interrater reliability. The form is a reliable data collection instrument that may be used in monitoringwound status and response to treatment, identifying trends in wound healing and management, analyzing interplay of patient and wound factors, determining effectiveness of wound care practices, and may contribute to wound care research and public health in the Philippines. Data from this tool may be used by multiple end users: by clinicians to provide evidence based wound care, by researchers who wish to explore factors contributing to the burden of wounds, by administrators who want to create an enhanced health record systems with standardized documentation of wound data, and by the public, including patients and their families, who wish to be more informed, and more proactive towards their healing.
Human ; Wounds And Injuries ; Wound Healing ; Surgery, Plastic ; General Surgery ; Exudates And Transudates ; Philippines
2.Three-dimensional binding treatment for avulsion fractures of inferior pole of patella utilizing suture anchor.
Hongqing HE ; Ningkai LI ; Meng LIU ; Jiating LIN ; Qiang WANG ; Yinchang ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):26-31
OBJECTIVE:
To explore the feasibility and effectiveness of suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique for avulsion fractures of the inferior pole of the patella.
METHODS:
A clinical data of 38 patients with avulsion fractures of the inferior pole of the patella, who met the selective criteria and were admitted between September 2021 and April 2023, was retrospectively analyzed. The fractures were treated with suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique in 18 cases (group A) and steel wire tension-band fixation in 20 cases (group B). There was no significant difference in terms of age, gender, cause of fracture, side of fracture, and disease duration between the two groups ( P>0.05). The length of incision, operation time, occurrence of complications, the range of motion of knee joint, and Böstman score of knee joint at last follow-up were recorded. The fracture healing was evaluated through X-ray films and the time of fracture healing was recorded.
RESULTS:
All incisions healed by first intention. The length of incision was significantly shorter in group A than in group B ( P<0.05). There was no significant difference in the operation time between the two groups ( P>0.05). All patients were followed up 12-24 months (mean, 16.1 months). X-ray films showed that all fractures healed and there was no significant difference in the healing time between the two groups ( P>0.05). At last follow-up, the range of motion and Böstman score of the knee joint in group A were significantly better than those in group B ( P<0.05). During follow-up, 1 patient (5.6%) in group A had one anchor mild prolapse and 3 patients (15.0%) occured internal fixation irritation in group B. But there was no significant difference in the incidence of complications between the two groups ( P>0.05).
CONCLUSION
For the avulsion fractures of the inferior pole of the patella, the suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique has advantages of reliable fixation, small incision, avoidance of secondary operation to remove internal fixator, and fewer complications, with definite effectiveness.
Humans
;
Male
;
Female
;
Patella/surgery*
;
Suture Anchors
;
Fracture Fixation, Internal/instrumentation*
;
Adult
;
Retrospective Studies
;
Middle Aged
;
Fractures, Avulsion/surgery*
;
Treatment Outcome
;
Young Adult
;
Range of Motion, Articular
;
Fracture Healing
;
Adolescent
;
Suture Techniques
;
Knee Joint/physiopathology*
3.Short-term effectiveness of Gamma 3 U-Blade system for osteoporotic intertrochanteric fractures in the elderly.
Wenbin FAN ; Liu SHI ; Tian XIE ; Cheng ZHANG ; Xiangxu CHEN ; Hui CHEN ; Yunfeng RUI
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):47-52
OBJECTIVE:
To compare the short-term effectiveness between Gamma 3 intramedullary nails and Gamma 3 U-Blade system in the treatment of osteoporotic intertrochanteric fractures in the elderly.
METHODS:
A retrospective analysis was conducted on the clinical data of 124 elderly patients with osteoporotic intertrochanteric fractures, who were admitted between February 2020 and February 2023 and met the selection criteria. The fractures were fixed with Gamma 3 intramedullary nails in 65 patients (control group) and Gamma 3 U-Blade systems in 59 patients (UB group). The differences between the two groups were not significant in age, gender, body mass index, American Society of Anesthesiologists (ASA) classification, bone mineral density, time from injury to operation, fracture classification, and affected side ( P>0.05). The operation time, intraoperative blood loss, hospital stay, and fracture healing time were recorded; the tip-apex distance, fracture reduction quality, and lag screw position were evaluated on X-ray films at immediate after operation; the lag screw sliding distance and change value of neck-shaft angle were measured on X-ray films at last follow-up. Harris hip score at 1 year after operation and the occurrence of internal fixation-related complications were compared between the two groups.
RESULTS:
The operation time, intraoperative blood loss, and hospital stay in the UB group increased compared to the control group, but the differences were not significant ( P>0.05). All patients in both groups were followed up 12-24 months (mean, 17.1 months). At 12 months after operation, there was no significant difference in the Harris hip score between the two groups ( P<0.05). Radiological examination showed that there was no significant difference between the two groups ( P>0.05) in terms of tip-apex distance, fracture reduction quality, and lag screw position. Fractures healed in both groups, and there was no significant difference in healing time ( P>0.05). At last follow-up, the change value of neck-shaft angle and lag screw sliding distance in the UB group were significantly lower than those in the control group ( P<0.05). During follow-up, no related complications occurred in the UB group, while 6 cases (9.2%) in the control group experienced complications, and the difference in the incidence was significant ( P<0.05).
CONCLUSION
For the osteoporotic intertrochanteric fractures in the elderly, the Gamma 3 U-Blade system fixation can achieve good short-term effectiveness, with better imaging results compared to Gamma 3 intramedullary nails fixation.
Humans
;
Retrospective Studies
;
Hip Fractures/surgery*
;
Male
;
Female
;
Aged
;
Fracture Fixation, Intramedullary/methods*
;
Osteoporotic Fractures/surgery*
;
Bone Nails
;
Bone Screws
;
Aged, 80 and over
;
Treatment Outcome
;
Fracture Healing
;
Operative Time
;
Length of Stay
4.Treatment of irreducible intertrochanteric femoral fractures in elderly by novel bone hook combined with finger-guided technique.
Zenghui ZHANG ; Tichao HAN ; Wei LI ; Yangyang ZHOU ; Junjun LIU ; Nannan LI ; Tiantian REN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):53-58
OBJECTIVE:
To investigate the feasibility and effectiveness of the novel bone hook combined with finger-guided technique in the treatment of irreducible intertrochanteric femoral fractures in elderly.
METHODS:
Between January 2021 and August 2023, 23 elderly patients with irreducible intertrochanteric femoral fractures were treated with the novel bone hook combined with finger-guided technique. There were 10 males and 13 females; the age ranged from 68 to 93 years (mean, 76.2 years). The time from injury to operation ranged from 36 to 76 hours (mean, 51.2 hours). According to the classification standard proposed by TONG Dake et alin 2021, there were 10 cases of typeⅠA, 1 case of typeⅠB, 6 cases of type ⅡA, 4 cases of type ⅡB, and 2 cases of type ⅡC. The operation time, intraoperative blood loss, intraoperative fluoroscopy frequences, and quality of fracture reduction were recorded. The fracture healing time and occurrence of postoperative complications were observed during follow-up. At last follow-up, the Harris scoring system was used to evaluate the hip joint function.
RESULTS:
The operation time was 42-95 minutes (mean, 52.1 minutes). The intraoperative blood loss was 40-420 mL (mean, 126.5 mL). Intraoperative fluoroscopy was performed 14-34 times (mean, 20.7 times). According to the criteria proposed by Chang et al, the quality of fracture reduction was rated as good in 20 cases and acceptable in 3 cases. All patients were followed up 6-20 months (mean, 10.2 months). X-ray film showed that all fractures healed with the healing time of 3.0-5.5 months (mean, 4.0 months). At last follow-up, the Harris score of the hip joint ranged from 82 to 97 points (mean, 90.4 points). Among them, 14 cases were rated as excellent and 9 cases as good. No complication such as coxa vara, cutting of the cephalomedullary nail, nail withdrawal, or nail breakage occurred during follow-up.
CONCLUSION
The treatment of elderly patients with irreducible intertrochanteric femoral fractures by using the novel bone hook combined with finger-guided technique can achieve high-quality fracture reduction and fixation, and has a good effectiveness.
Humans
;
Male
;
Female
;
Aged
;
Aged, 80 and over
;
Hip Fractures/diagnostic imaging*
;
Fracture Fixation, Internal/instrumentation*
;
Fracture Healing
;
Treatment Outcome
;
Operative Time
;
Fracture Fixation, Intramedullary/instrumentation*
;
Bone Nails
;
Postoperative Complications/epidemiology*
;
Feasibility Studies
;
Fingers
5.Comparison of effectiveness between two surgical methods for humeral lateral condyle fractures in children.
Hailong MA ; Qingjie WU ; Fang LIU ; Zhongtuo HUA ; Sicheng ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):64-69
OBJECTIVE:
To compare the effectiveness of ultrasound-guided closed reduction with Kirschner wire fixation and open reduction with Kirschner wire fixation in the treatment of humeral lateral condyle fracture (HLCF) in children.
METHODS:
A clinical data of 53 children with HLCF admitted between May 2020 and April 2023 and met selective criteria was retrospectively analyzed. Of these, 25 cases were managed with closed reduction and Kirschner wire fixation under ultrasound guidance (closed group), while 28 cases underwent open reduction and Kirschner wire fixation (open group). There was no significant difference between the two groups in terms of gender, age, cause of injury, fracture side, fracture classification, and time from injury to operation ( P>0.05). The following variables were recorded and compared between the two groups: operation time, intraoperative fluoroscopy frequency, fracture healing time, incidence of complications, and the Flynn elbow function score at last follow-up.
RESULTS:
In the closed group, the fractures were successfully reduced under ultrasound guidance, with no nerve damage reported in either group. The operation time and intraoperative fluoroscopy frequency were significantly less in the closed group than in the open group ( P<0.05). One case of infection (Kirschner wire irritation) was observed in the closed group, while 3 cases in the open group (2 of Kirschner wire irritation and 1 of incision infection). However, the difference in the incidence of infection between the two groups was not significant ( P>0.05). All patients in both groups were followed up 6-18 months (mean, 10.2 months). X-ray examinations confirmed that fractures had healed in both groups, with no significant difference in healing time ( P>0.05). During follow-up, 5 cases of lateral humeral process formation were observed in the closed group, compared to 12 cases in the open group, although this difference was not significant ( P>0.05). At last follow-up, the excellent and good rate of elbow joint function was evaluated as 96.0% (24/25) in the closed group and 92.9% (26/28) in the open group according to the Flynn scoring criteria, with no significant difference between the two groups ( P>0.05). Both groups showed no occurrence of ossifying myositis or elbow internal/external rotation.
CONCLUSION
The effectiveness of ultrasound-guided closed reduction and Kirschner wire fixation in the treatment of HLCF in children is comparable to open reduction and Kirschner wire fixation, but the former can reduce operation time and intraoperative fluoroscopy frequency, and obtain lower the incidence of complications.
Humans
;
Humeral Fractures/diagnostic imaging*
;
Bone Wires
;
Male
;
Female
;
Child
;
Retrospective Studies
;
Fracture Fixation, Internal/instrumentation*
;
Treatment Outcome
;
Child, Preschool
;
Open Fracture Reduction/methods*
;
Fracture Healing
;
Elbow Joint/surgery*
;
Adolescent
;
Closed Fracture Reduction/methods*
;
Fluoroscopy
;
Operative Time
6.Application of elbow skin fold extension line in extreme elbow flexion in ulnar Kirschner wire insertion of extended supracondylar humeral fractures in children.
Xu LIU ; Wei WU ; Yuzhou SHAN ; Guanghui YANG ; Ming CHEN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):70-74
OBJECTIVE:
To discuss the elbow skin fold extension line in Kirschner wire internal fixation of extended supracondylar humeral fractures in children.
METHODS:
The clinical data of 58 children with extended supracondylar fractures of the humerus who met the selection criteria between August 2021 and July 2024 were retrospectively analyzed. In 28 cases, needle placement of medial epicondyle of humerus was performed with the assistance of the elbow skin fold extension line (study group), and 30 cases were assisted by routine touch of the medial epicondyle of the humerus (control group). There was no significant difference in baseline data such as gender, age, side, cause of injury, Gartland type, Kirschner wire configuration, and time from injury to operation between the two groups ( P>0.05). The closed reduction rate, total operation time, time of medial humeral condyle pin placement, fluoroscopy times during medial pin placement, rate of one-time determination of medial entry point, ulnar nerve injury incidence, and fracture healing time were recorded and compared between the two groups. At the same time, the closed reduction rate of patients with the time from injury to operation ≤24 hours and >24 hours was compared. The elbow function was evaluated by Mayo elbow function score.
RESULTS:
The closed reduction rate of the study group was significantly higher than that of the control group ( P<0.05). Among all patients, the closed reduction rate of patients with the time from injury to operation ≤24 hours [73.3% (22/30)] was significantly higher than that of patients >24 hours [42.9% (12/28)] ( χ 2=5.545, P=0.019). The total operation time, medial needle placement time, and fluoroscopy times in the study group were significantly less than those in the control group, and the one-time determination rate of medial needle entry point in the study group was significantly higher than that in the control group ( P<0.05). There were 4 cases of ulnar nerve injury in the control group, and no ulnar nerve injury in the study group, but there was no significant difference in the incidence of ulnar nerve injury between the two groups ( P>0.05). All patients were followed up 6-12 months (mean, 8 months). There was no bone nonunion in both groups, and the fracture healing time of the study group was significantly shorter than that of the control group ( P<0.05). Volkmann ischemic contracture, heterotopic ossification, myositis ossificans, and premature epiphyseal closure were not observed after operation. No complications such as loosening or fracture of Kirschner wire occurred. At last follow-up, the Mayo elbow joint function score was used to evaluate function, and there was no significant difference between the two groups ( P>0.05).
CONCLUSION
In the treatment of extended supracondylar fractures of the humerus in children, the elbow skin fold extension line can help to quickly locate the medial epicondyle of the humerus, quickly insert Kirschner wire, and reduce the operation time and trauma.
Humans
;
Humeral Fractures/surgery*
;
Bone Wires
;
Male
;
Female
;
Fracture Fixation, Internal/instrumentation*
;
Retrospective Studies
;
Child
;
Elbow Joint/physiopathology*
;
Child, Preschool
;
Treatment Outcome
;
Fracture Healing
;
Ulnar Nerve/injuries*
;
Adolescent
;
Range of Motion, Articular
7.Effectiveness analysis of three internal fixation methods in treatment of avulsion fracture of tibial tubercle in adolescents.
Keyou DUAN ; Zhaodong WANG ; Yajun LIU ; Chen XU ; Zhonglian ZHU ; Jianzhong GUAN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):75-82
OBJECTIVE:
To analyze the effectiveness of three internal fixation methods, namely hollow screw combined with Kirschner wire tension band, hollow screw combined with anchor nail, and modified 1/3 tubular steel plate, in the treatment of avulsion fracture of tibial tubercle (AFTT) in adolescents.
METHODS:
Between January 2018 and September 2023, 19 adolescent AFTT patients who met the selection criteria were admitted. According to different internal fixation methods, patients were divided into group A (8 cases, hollow screw combined with Kirschner wire tension band), group B (6 cases, hollow screw combined with anchor nail), and group C (5 cases, modified 1/3 tubular steel plate). There was no significant difference in the baseline data of age, gender, side, cause of injury, Ogden classification, and time from injury to operation among the three groups ( P>0.05). The range of motion (ROM), weight-bearing time, normal activity time of knee joint, and the hospital for special surgery (HSS) score at last follow-up were recorded and compared among the three groups. Recorded whether the fracture was displaced, whether the fracture line was blurred at 1 month after operation, whether there was epiphyseal dysplasia, and whether there was incision infection and other complications.
RESULTS:
There was no significant difference in hospital stay between the groups ( P>0.05). All patients were followed up 10-24 months, with an average of 14.3 months; there was no significant difference between the groups ( P>0.05). All the incisions healed well without soft tissue irritation or fracture nonunion, and no limb shortening deformity or epiphyseal dysplasia was found during follow-up. At 1 month after operation, the knee joint ROM and hospitalization expenses in group A were better than those in groups B and C, the fracture healing time, knee joint weight-bearing time, and normal activity time of knee joint were better than those in group C, and the hospitalization expenses in group C were better than those in group B, with significant differences ( P<0.05); there was no significant difference in the other indicators between the groups ( P>0.05). In group A, the fracture line was blurred 1 month postoperatively, the fracture ends were in close contact, and there was no fracture displacement; in groups B and C, the fracture line was clear in 2 cases, and 1 case in group C had slight fracture displacement; except for 1 case in group B, there was no fracture split in the other two groups. There was no significant difference in the incidences of blur of fracture line, fracture displacement, and intraoperative bone split between the groups at 1 month after operation ( P>0.05). At last follow-up, the HSS scores of knee joints in the three groups were excellent and good, and there was no significant difference between the groups ( P>0.05).
CONCLUSION
Hollow screw combined with Kirschner wire tension band technique is effective in treating adolescent AFTT, which has the advantages of stabilizing fracture, accelerating fracture healing and rehabilitation, early feasible knee joint functional exercise, and reducing hospitalization expenses.
Humans
;
Tibial Fractures/surgery*
;
Adolescent
;
Male
;
Fracture Fixation, Internal/instrumentation*
;
Female
;
Fractures, Avulsion/surgery*
;
Bone Wires
;
Bone Screws
;
Bone Plates
;
Treatment Outcome
;
Range of Motion, Articular
;
Bone Nails
;
Weight-Bearing
;
Fracture Healing
8.Molecular mechanism of magnesium alloy promoting macrophage M2 polarization through modulation of PI3K/AKT signaling pathway for tendon-bone healing in rotator cuff injury repair.
Xianhao SHENG ; Wen ZHANG ; Shoulong SONG ; Fei ZHANG ; Baoxiang ZHANG ; Xiaoying TIAN ; Wentao XIONG ; Yingguang ZHU ; Yuxin XIE ; Zi'ang LI ; Lili TAN ; Qiang ZHANG ; Yan WANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(2):174-186
OBJECTIVE:
To evaluate the effect of biodegradable magnesium alloy materials in promoting tendon-bone healing during rotator cuff tear repair and to investigate their potential underlying biological mechanisms.
METHODS:
Forty-eight 8-week-old Sprague Dawley rats were taken and randomly divided into groups A, B, and C. Rotator cuff tear models were created and repaired using magnesium alloy sutures in group A and Vicryl Plus 4-0 absorbable sutures in group B, while only subcutaneous incisions and sutures were performed in group C. Organ samples of groups A and B were taken for HE staining at 1 and 2 weeks after operation to evaluate the safety of magnesium alloy, and specimens from the supraspinatus tendon and proximal humerus were harvested at 2, 4, 8, and 12 weeks after operation. The specimens were observed macroscopically at 4 and 12 weeks after operation. Biomechanical tests were performed at 4, 8, and 12 weeks to test the ultimate load and stiffness of the healing sites in groups A and B. At 2, 4, and 12 weeks, the specimens were subjected to the following tests: Micro-CT to evaluate the formation of bone tunnels in groups A and B, HE staining and Masson staining to observe the regeneration of fibrocartilage at the tendon-bone interface after decalcification and sectioning, and Goldner trichrome staining to evaluate the calcification. Immunohistochemical staining was performed to detect the expressions of angiogenic factors, including vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2), as well as osteogenic factors at the tendon-bone interface. Additionally, immunofluorescence staining was used to examine the expressions of Arginase 1 and Integrin beta-2 to assess M1 and M2 macrophage polarization at the tendon-bone interface. The role of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway in tendon-bone healing was further analyzed using real-time fluorescence quantitative PCR.
RESULTS:
Analysis of visceral sections revealed that magnesium ions released during the degradation of magnesium alloys did not cause significant toxic effects on organs such as the heart, liver, spleen, lungs, and kidneys, indicating good biosafety. Histological analysis further demonstrated that fibrocartilage regeneration at the tendon-bone interface in group A occurred earlier, and the amount of fibrocartilage was significantly greater compared to group B, suggesting a positive effect of magnesium alloy material on tendon-bone interface repair. Additionally, Micro-CT analysis results revealed that bone tunnel formation occurred more rapidly in group A compared to group B, further supporting the beneficial effect of magnesium alloy on bone healing. Biomechanical testing showed that the ultimate load in group A was consistently higher than in group B, and the stiffness of group A was also greater than that of group B at 4 weeks, indicating stronger tissue-carrying capacity following tendon-bone interface repair and highlighting the potential of magnesium alloy in enhancing tendon-bone healing. Immunohistochemical staining results indicated that the expressions of VEGF and BMP-2 were significantly upregulated during the early stages of healing, suggesting that magnesium alloy effectively promoted angiogenesis and bone formation, thereby accelerating the tendon-bone healing process. Immunofluorescence staining further revealed that magnesium ions exerted significant anti-inflammatory effects by regulating macrophage polarization, promoting their shift toward the M2 phenotype. Real-time fluorescence quantitative PCR results demonstrated that magnesium ions could facilitate tendon-bone healing by modulating the PI3K/AKT signaling pathway.
CONCLUSION
Biodegradable magnesium alloy material accelerated fibrocartilage regeneration and calcification at the tendon-bone interface in rat rotator cuff tear repair by regulating the PI3K/AKT signaling pathway, thereby significantly enhancing tendon-bone healing.
Animals
;
Rotator Cuff Injuries/metabolism*
;
Rats, Sprague-Dawley
;
Signal Transduction
;
Wound Healing/drug effects*
;
Alloys/pharmacology*
;
Rats
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Rotator Cuff/metabolism*
;
Macrophages/metabolism*
;
Magnesium/pharmacology*
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Vascular Endothelial Growth Factor A/metabolism*
;
Male
;
Biocompatible Materials
;
Bone Morphogenetic Protein 2/metabolism*
9.Effect of autologous osteochondral tissue and periosteum transplantation on tendon-bone healing of rotator cuff in rabbits.
Sen FANG ; Mingtao ZHANG ; Xudong YANG ; Cairang DAOJI ; Mingchun LI ; Zhixuan NIAN ; Junwen LIANG ; Xiangdong YUN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(2):187-192
OBJECTIVE:
To investigate the effect of autologous osteochondral tissue and periosteum transplantation on tendon-bone healing of rotator cuff in rabbits.
METHODS:
Twenty-four male New Zealand white rabbits were randomly divided into autologous osteochondral tissue and periosteum transplantation group (experimental group, n=12) and simple suture group (control group, n=12). Both groups were subjected to acute supraspinatus tendon injury and repaired with corresponding techniques. At 4, 8, and 12 weeks after operation, 4 specimens from each group were taken from the right shoulder joint for histological examination (HE staining, Masson staining, and Safranin O-fast green staining), and the left shoulder was subjected to biomechanical tests (maximum tensile load and stiffness).
RESULTS:
Both groups of animals survived until the completion of the experiment after operation. At 4 weeks after operation, both groups showed less collagen fibers and disorder at the tendon-bone junction. At 8 weeks, both groups showed reduced inflammation at the tendon-bone junction, with more organized and denser collagen fibers and chondrocytes. The experimental group showed better results than the control group. At 12 weeks, the experimental group showed typical tendon-bone transition structure, with increased generation of collagen fibers and chondrocytes, and the larger cartilage staining area. Both groups showed an increase in maximum tensile load and stiffness over time ( P<0.05). The stiffness at 4 weeks and the maximum tensile load at 4, 8, and 12 weeks in the experimental group were superior to control group, and the differences were significant ( P<0.05). There was no significant difference in stiffness at 8, 12 weeks between the two groups ( P>0.05).
CONCLUSION
Autologous osteochondral tissue and periosteum transplantation can effectively promote the fiber and cartilage regeneration at the tendon-bone junction of rotator cuff and improve the biomechanical effect of shoulder joint in rabbits.
Animals
;
Rabbits
;
Male
;
Wound Healing
;
Transplantation, Autologous
;
Periosteum/transplantation*
;
Rotator Cuff Injuries
;
Rotator Cuff/surgery*
;
Tendons/surgery*
;
Biomechanical Phenomena
;
Chondrocytes/transplantation*
;
Tendon Injuries/surgery*
;
Tensile Strength
10.Short-term effectiveness of expert adolescent lateral femoral nail fixation for femoral shaft fractures in older children and adolescents.
Xiaozhang HE ; Tao WANG ; Guoxin NAN ; Jundong WANG ; Peng LIAO ; Shaolin XU ; Kailong YU
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(3):290-295
OBJECTIVE:
To investigate short-term effectiveness of using expert adolescent lateral femoral nail (EALFN) in treating femoral shaft fractures in older children and adolescents.
METHODS:
A retrospective analysis was conducted on the clinical data of 17 patients with femoral shaft fractures who met the inclusion criteria and were admitted between July 2020 and June 2024. All fractures were fixed with EALFN after reduction. There were 11 males and 6 females, with a mean age of 13.3 years (range, 11-16 years). The average body weight was 51.2 kg (range, 40-84 kg), and the average height was 162.1 cm (range, 150-172 cm). The causes of injury included traffic accidents ( n=9), falling from height ( n=1), and simple falls ( n=7). One patient had an open fracture treated with an external fixator and experienced delayed fracture healing. The remaining patients were closed fractures, with an average time from injury to operation of 5.8 days (range, 2-10 days). Operation time and postoperative hospital stay were documented. During follow-up, X-ray films were taken to observe the fracture healing, and the bilateral femoral length, femoral neck-shaft angle, widest femoral neck diameter (FND), and articular trochanteric distance (ATD) were measured at last follow-up. Hip function was assessed using the Harris score. The differences in the all indicators between the healthy and affected sides were compared.
RESULTS:
The operation time ranged from 65 to 130 minutes (mean, 94.1 minutes). Postoperative hospital stay ranged from 5 to 40 days (mean, 16.7 days). All patients were followed up 7-36 months (mean, 14.4 months). One patient exhibited delayed fracture healing during follow-up. The distal locking nail was removed at 6 months after operation, and partial weight-bearing was initiated following dynamic fracture stabilization. The fracture healing was achieved, and the intramedullary nail was removed at 24 months after operation. The other fractures healed with the healing time of 6-20 months (mean, 9.6 months), and the intramedullary nails were removed. During follow-up, no femoral fracture, abnormal development of the greater trochanter, or ischemic necrosis of the femoral head occurred. At last follow-up, there was no significant difference in femoral length, femoral neck-shaft angle, FND, ATD, or Harris score between the affected and healthy sides ( P>0.05).
CONCLUSION
For older children and adolescents with femoral neck fractures, the application of EALFN fixation aligns more closely with the principles of intramedullary central fixation and rapid rehabilitation. This approach is associated with fewer complications and superior short-term effectiveness.
Humans
;
Male
;
Femoral Fractures/surgery*
;
Female
;
Child
;
Adolescent
;
Retrospective Studies
;
Bone Nails
;
Fracture Fixation, Intramedullary/instrumentation*
;
Fracture Healing
;
Treatment Outcome


Result Analysis
Print
Save
E-mail