Objective To explore the clinical effect of lateral-rectus approach for treatment of acetabular fracture combined with ipsilateral pelvic fracture. Methods From January 2010 to February 2014, 24 patients with acetabular fracture combined with ipsilateral pelvic fracture were surgically managed through the lateral-rectus approach. Eighteen cases of merely anterior acetabular and pelvic fractures were treated with the lateral-rectus approach only, in the supine position. Six cases involving the posterior acetabular wall and posterior column were treated with the lateral-rectus approach combined lateral-rectus and posterior Kocher-Langenbeck approaches, in the floating position. The titanium reconstruction plates and cannulated screws were applied in these cases. Results The operation time was 70- 185 min and the intraoperative blood loss was 420-1 100 ml. Postoperative X-ray and CT exams showed excellent and good reduction. According to the postoperative Matta radiological evaluation, reduction of acetabular fracture was rated as anatomic in 13 cases, with satisfactory reduction in 8 cases and unsatisfactory in 3 cases. Injury to the sciatic nerve occurred in one case, and fat liquefaction at the abdominal incision in one case. All the patients were followed up for 13-30 months and the fractures healed after 10-16 weeks. According to the modified Merle d'Aubigne and Postel scoring system, 16 cases were excellent, 6 cases were good and 2 cases were fair 6 months after operation. Conclusions Surgical management of acetabular fractures through the lateral-rectus approach can provide adequate exposure and treatment for not only the acetabular fractures involving the anterior column and the quadrilateral surface, but also ipsilateral fractures involving the pubic superior ramus, iliac ala and sacroiliac joint, leading to fine outcomes.

Objective To summarize the experiences of the diagnosis and treatment of the intraspinal tumors. Methods One hundredand twenty-three cases of the intraspinal tumors were analyzed retrospectively. Results The intraspinal tumors in those patients included meningiomas/neurofibroma in 32 cases (19.5%), neurinoma in 32 cases (26.0%), ependymoma in 8 cases (6.5%), astrocytoma in 13 cases (10.6%), lipoma in 10 cases (8.1%), metastatic tumors and hemangioma each in 5 cases (4.1%), arachnoid cyst in 9 cases (7.3%), and others in 17 cases (13.8%). The extramedullary subdural, epidural and intramedullary tumors accounted for 56.9%, 21.1% and 22.8%. According to the locations, 30.1% tumors located at cervical region, 37.4% at thoracic region, 19.5% at lumbar region and 13.0% at sacral segments. The total removal rates of tumors were 69.1% (the total removal rates of extramedullary tumors were 70.1%, and the removal rates of intramedullary tumors were 60.7%).The improvement rates of different degree of movement, sense and sphincter function were 75.2%, 73.8% and 77.8%. Conclusion Most of the intraspinal tumors are benign, and the surgical outcome is satisfied. The keys of therapeutic efficacy were MRI and microsurgical techniques application. The spinal stability reconstruction is in the extreme need if spinal stability is breached in surgery.

BACKGROUND:With the increasing of aging, the incidence and mortality of osteoporotic hip fracture wil rise. It is of great significance to study the pathogenesis and preventing method. At present, finite element analysis can be used to judge fracture, only for the distribution trend of fracture failure in the starting point or section view, but it cannot completely reflect actual situation of fracture. OBJECTIVE:To build the fracture model of the femoral neck fracture caused by fal ing-induced external force based on the finite element analysis LS-DYNA software, and to evaluate the effect of rupture. METHODS:CT image data of one case of elderly femoral neck fracture were col ected. Using Mimics software, region growth of the contralateral area, cavity fil ing, editing, rebuilding the contralateral proximal femur model were conducted. Data were imported in Hypermesh and LS-DYNA software for meshing, and defining material properties. The failure parameters and interfacial properties were set. The load and force boundary constraints simulating the fal ing were simulated. The model of femoral neck fracture was calculated. Rupture effect was evaluated. RESULTS AND CONCLUSION:(1) The validity of contralateral proximal femur three-dimensional model was verified. Based on the finite element analysis software LS-DYNA, the femoral neck fracture model matched the actual fracture line to a degree of close to 83%. (2) Above results confirmed that based on the finite element analysis, LS-DYNA software can wel simulate the femoral neck fracture, which provides experimental basis to the exploration of femoral neck fracture classification mechanism caused by different fal ing-induced external forces.