BACKGROUND: Bioabsorbable materials have shown obvious advantages in clinical application for more than ten years, and have been widely used in many biomedical fields. OBJECTIVE: To review characteristics of bioabsorbable materials and their application in orthopedics. METHODS: The articles published in Wanfang, CNKI, VIP, and PubMed databases were searched by computer. The key words were “bioabsorbable materials, bioabsorbable metal materials, bioabsorbable inorganic materials, polymer materials, biocomposites” in Chinese, and “bioabsorbable/bioabsorbable material, metal material, polymer material, biocomposites” in English. RESULTS AND CONCLUSION: Absorbable metal materials have good mechanical properties. The corrosion mechanism of polymer materials is clear, which can predict the corrosion behavior and corrosion rate in vivo and in vitro, but its load-bearing performance is not as good as that of absorbable metal materials. After certain treatment, bioceramics have good biocompatibility, bone conductivity and osseointegration, but they are brittle and difficult to be formed. Biocomposites have the properties of component materials, and can also obtain new properties that single component materials do not have, so it has a wide application prospect.

OBJECTIVE: At present, many studies have proved that intramedullary nail and steel plate internal fixation is a better way to treat displaced midshaft clavicular fracture. However, there are relatively few comparative studies on the advantages and disadvantages of the two methods, and there are still many controversies. Through the meta-analysis of related literature, the efficacy and safety of intramedullary nail and steel plate in the treatment of adult displaced midshaft clavicular fracture were systematically evaluated. METHODS: Through computer retrieval of PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP databases from the inception to January 2020, the literature of randomized controlled trials meeting the inclusion and exclusion criteria of intramedullary nail and steel plate in the treatment of adult displaced midshaft clavicular fracture was collected and screened, and the quality evaluation and data extraction were carried out. The operation time, incision length and upper limb function score, Constant-Murley score, and fracture healing time were used as the evaluation indexes of meta-analysis. Meta-analysis was performed using ReMan 5.3 software. RESULTS: (1) Eight valuable articles were retrieved, among which 283 patients were treated with intramedullary nail and 271 patients were treated with steel plate internal fixation. (2) The meta-analysis results showed that the intramedullary nail group was superior to the steel plate group in terms of operation time [MD=-19.63, 95%CI(-22.72,-16.54)], incision length [MD=-3.31, 95%CI(-5.78,-0.85)], and fracture healing time [MD=-1.53, 95%CI(-2.73,-0.33)]. (3) No significant difference was found in upper limb function score [MD=-1.91, 95%CI(-5.48, 1.66)] and Constant-Murley score [MD=-0.58, 95%CI(-4.63, 3.47) between the intramedullary nail group and the steel plate group after surgery. CONCLUSION: The results of meta-analysis showed that intramedullary nail was superior to steel plate in the operation time, incision length and fracture healing time in the treatment of displaced midshaft clavicular fracture. The above results can provide evidence for clinical use of intramedullary nail instead of steel plate internal fixation in the treatment of displaced midshaft clavicular fracture.

OBJECTIVE: Electroacupuncture has been commonly used in clinical practice for pain after total knee arthroplasty, but its effects and safety remain controversial. The efficacy and safety of electroacupuncture in the treatment of pain after total knee arthroplasty were systematically evaluated. METHODS: PubMed, Embase, Cochrane Library, SinoMed, CNKI, VIP and Wanfang databases were searched to collect randomized controlled trials on electroacupuncture in the treatment of pain after total knee arthroplasty from inception to December 31, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed by RevMan 5.3 software. RESULTS: (1) A total of six studies involving 304 patients were included. (2) The results of meta-analysis showed that compared with control group, the experimental group had significantly lower visual analogue scale scores at 3 days [MD=-0.67, 95%CI(-1.01 to-0.33), P < 0.001], 7 days [MD=-0.60, 95%CI (-0.88 to-0.33), P < 0.001), 14 days [MD=-0.97, 95%CI(-1.74 to-0.21), P < 0.05) and end point of clinical trial (MD=-0.67, 95%CI(-1.04 to-0.30), P < 0.001), respectively, after total knee arthroplasty. There were no significant differences in visual analogue scale scores at 1 day after total knee arthroplasty [MD=-0.12, 95%CI(-0.64, 0.40), P >0.05). (3) The incidence of postoperative vertigo was significantly lower in the trial group than that in the control group [OR=0.28, 95%CI(0.10, 0.78), P < 0.05]. (4) The incidence of postoperative vomiting was not significantly different between the trial and control groups [OR=0.83, 95%CI(0.37, 1.87), P > 0.05]. CONCLUSION: Electroacupuncture has obvious advantages in the treatment of pain after total knee arthroplasty, which can significantly relieve the pain reaction of patients at 3, 7, 14 days and the end point of clinical trial, and can reduce the incidence of postoperative vertigo, but it cannot reduce the incidence of postoperative vomiting and pain at 1 day after total knee arthroplasty. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.

OBJECTIVETo investigate surgical skills and clinical effects of manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures.

METHODSFrom May 2013 to October 2016, 35 patients with grade IV supination-external rotation ankle fractures were treated with percutaneous Kirschner wire internal fixation, involving 22 males and 13 females with an average age of 38.2 years ranged from 18 to 65 years old. The time from injury to operation ranged from 2 h to 10 d with an average of 5 d. Reduction quality was assessed by Burwell-Charnley radiological criteria. Baird-Jackson ankle scoring system was used to assess clinical effects.

RESULTSThirty-three patients were followed up from 10 to 28 months with an average of 14 months. Fracture healing time ranged from 10 to 18 weeks with an average of 12 weeks. According to Burwell-Charnley radiological criteria, 30 cases were obtained anatomic reduction, 3 cases moderate. According to Baird-Jackson ankle scoring system, total score was 93.8±5.4, 17 cases got excellent result, 12 good, 2 fair and 2 poor.

CONCLUSIONSManipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures has advantages of reliable efficacy, less complications. But higher require techniques were required for closed reduction. It is not suitable for severe crushed fracture and compressive articular surface fracture.

OBJECTIVE: To evaluate the safety and accuracy of Renaissance robot navigation system in minimally invasive surgery for thoracolumbar fracture. METHODS: The clinical data of patients with thoracolumbar fracture who underwent posterior minimally invasive pedicle screw internal fixation from July 2016 to July 2019 was retrospectively analyzed. And the patients were divided into robot group and artificial group. Robot navigation assisted screw placement was used in robot group, and traditional unarmed screw placement was used in artificial group. There were 20 patients in robot group, including 13 males and 7 females, aged from 23 to 69 years old with an average of(45.05±11.81)years old, one case was T₁₁ fracture, 2 cases were T₁₂, 10 cases were L₁, 6 cases were L₂ and 1 case was L₃. There were 20 patients in artificial group, including 11 males and 9 females, aged from 26 to 65 years old with an average of(43.40±11.22)years old, 2 cases were T₁₁ fractures, 7 cases were T₁₂, 10 cases were L₁, and 1 case was L₃. The numbers of fluoroscopy, operation time and intraoperative blood loss were observed. The screw position was evaluated by Neo method. RESULTS: A total of 126 screws were implanted in robot group and 124 screws were implanted in artificial group. The operation time, fluoroscopy times, intraoperative blood loss were(115.75±14.26) min, (7.95±0.89) times and (132.50±29.36) ml in robot group and (129.50±10.50) min, (14.40±2.56) times and(182.50±23.14) ml in artificial group, respectively, there was significant difference between the groups(P<0.05). According to Neo classification method, there were 122 screws at grade 0, 4 screws at grade 1 in robot group, and there were 108 screws at grade 0, 9 screws at grade 1 and 7 screws at grade 2 in artificial group. The accuracy of the robot group was better than that of artificial group(P<0.05). CONCLUSION Compared with free hand screw placement, Renaissance robot navigation system can effectively improve the accuracy of pedicle screw placement, reduce the number of fluoroscopy times and intraoperative blood loss, thereby improving the safety of operation.
Adult ; Aged ; Female ; Fracture Fixation, Internal/methods* ; Humans ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Pedicle Screws ; Retrospective Studies ; Robotics ; Spinal Fusion ; Young Adult

Adult ; Craniocerebral Trauma ; complications ; Diagnosis, Differential ; Female ; Humans ; Hyponatremia ; diagnosis ; etiology ; therapy ; Inappropriate ADH Syndrome ; diagnosis ; Male ; Middle Aged

OBJECTIVE: To compare the efficacy between vesselplasty and percutanous kyphoplasty (PKP) in the treatment of Kümmell disease. METHODS: The clinical data of patients with Kümmell disease from July 2018 to December 2019 were retrospectively analyzed. According to the different therapeutic methods, the patients were divided into vesselplasty group and PKP group. There were 20 patients in vesselplasty group, including 2 males and 18 females, aged from 54 to 83 years with an average of (67.40±7.44)years, 1 case of T₁₀ fracture, 3 cases of T₁₂ fracture, 9 cases of L₁ fractures, 5 cases of L₂ fractures and 2 cases of L₃ fractures. There were 20 patients in PKP group, including 3 males and 17 females, aged from 56 to 81 with an average of(67.20±7.01) years, 2 cases of T₁₀ fracture, 1 case of T₁₁ fracture, 6 cases of T₁₂ fracture, 10 cases of L₁ fracture and 1 case of L₃ fracture. Visual analogue scale(VAS), Cobb angle, anterior vertebral height were recorded before operation, 1 day after operation and 1 year after operation. Oswestry Disability Index(ODI) was recorded before operation, 1 month after operation and 1 year after operation. And bone cement leakage rate was compared between two groups after operation. RESULTS: All the patient were followed up for more than 1 year. In vesselplasty group, VAS score was 1.20±0.41, ODI was(13.50±3.10)%, Cobb angle was(17.20±3.12)° and anterior vertebral height was(20.20±1.35) mm at 1 year after operation. In PKP group, VAS score was 1.15±0.40, ODI was (13.20±3.00)%, Cobb angle was (17.10±3.19)° and anterior vertebral height was (20.10±1.37) mm at 1 year after operation. These index was significantly better than pre-operation through intra-group comparison(P<0.05), and there was no statistically difference between the two groups(P>0.05). There were 20 cases (20 vertebrae) in vesselplasty group, of which 1 case had bone cement leakage at the upper endplate, with a leakage rate of 5%(1/20). In PKP group, there were 20 cases (20 vertebrae), 3 cases of upward endplate leakage(3/7), 1 case of downward endplate leakage(1/7), 1 case of leakage to the front of the vertebral body(1/7), 2 cases of leakage to the side of the vertebral body(2/7), with a leakage rate of 35% (7/20). The difference between two groups was statistically significant(P<0.05). CONCLUSION Vesselplasty in the treatment of Kümmell disease can better reduce leakage rate of bone cement and reduce complications.
Bone Cements ; Female ; Fractures, Compression/surgery* ; Humans ; Kyphoplasty/methods* ; Male ; Osteoporotic Fractures/surgery* ; Retrospective Studies ; Spinal Fractures/surgery* ; Spondylosis ; Treatment Outcome ; Vertebroplasty

Adult ; Arm Injuries ; drug therapy ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Elbow Joint ; drug effects ; injuries ; surgery ; External Fixators ; Female ; Fracture Fixation ; Humans ; Internal Fixators ; Male ; Middle Aged

Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Clavicle ; injuries ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged

Adult ; Aged ; Bone Nails ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Radiography ; Radius Fractures ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Skin ; Treatment Outcome