BACKGROUND: With further understanding of deep venous thrombosis(DVT)following total hip replacement,reduction and prevention of DVT has become hot topic in clinical studies.The reports of DVT formation factors remain controversial due to small samples,little statistical significance,confusion of basic experimental and clinical results and lacks of science.OBJECTIVE: To explore the causes and factors for the early DVT following total hip replacement and summarize measures to prevent and treat early DVT to reduce incidence of complications.METHODS: A total of 1780 cases of primary total hip replacement operation were analyzed retrospectively.The statistical indexes included sex,age,body mass,other system disease,previous hip joint operation,anesthesia,operative time,prosthetic fixation,blood transfusion,postoperative functional exercise,antithrombotics,and complication.Standardized database was built and analyzed by SPSS(version 13).Regression analysis was performed using Binary Logistic Regression.RESULTS AND CONCLUSION: Of 1780 cases,136 had DVT.Age,other system diseases,anesthesia,prosthetic fixation,blood transfusion,postoperative functional exercise and antithrombotics were correlated with early DVT(P < 0.05).Old age,hypertension or diabetes,general anesthesia,fixation of bone cement,whole blood transfusion were the risk factors for early DVT following total hip replacement,while postoperative functional exercise and antithrombotics were the protective factors for DVT.The incidence rate of early complications can be reduced by the methods such as dealing with perioperative treatment carefully,effectively controlling the chronic diseases,efficient evaluation before surgery,precise manipulation,and the postoperative prophylactic treatment and nursing.

BACKGROUND:At present, the incidence rates of knee joint diseases such as knee osteoarthritis, knee joint degenerative are high. The major clinical treatment is total knee replacement in the clinic, so it is necessary to evaluate the changes in stress and bone mineral density of the regions surrounding the prosthesis after replacement. ＜br> OBJECTIVE:To explore periprosthetic stress and bone mineral density and to analyze their correlation after total knee arthroplasty. ＜br> METHODS:A total of 20 cases undergoing total knee arthroplasty were chosen.The hospital for special surgery scores were used to evaluate patients’ functional recovery at 12 months after total knee arthroplasty. The periprosthetic femur was divided into four regions of interest (ROI), respectively ROI 1-4;periprosthetic tibia was divided into three regions of interest, respectively ROI 5-7. Stress surrounding the prosthesis was analyzed using three-dimensional finite element analysis at 1, 3, 6 months, 1, 2, 3 years after replacement. Simultaneously, bone mineral density surrounding the prosthesis was measured using dual-energy X-ray absorptiometry. ＜br> RESULTS AND CONCLUSION:No patients affected infection or loosening of the prosthesis. At 12 months after replacement, the score of hospital for special surgery was (90.23±2.37), which showed significant differences as compared with before replacement (39.68±1.31) (P＜0.05). The level of stress shielding was highest in ROI 5 and lowest in ROI 3. Stress shielding rate of ROI increased with statistical difference at 6 months after operation (P＜0.05). At 1, 2, 3 years after operation, shielding rate in periprosthetic femoral stress in ROI 1 decreased. Compared with 1 month after operation, the difference was statistical y significant (P＜0.05). However, shielding rate of tibial periprosthetic stress in ROI 6 increased. Compared with 1 month after operation, the difference was statistical y significant (P＜0.05). Bone mineral density after 1 month after operation had no significant decrease (P>0.05). At 3 months after operation, bone mineral density began to decline significantly (P＜0.01). The decrease was most obviously in ROI 5 and the change was least in ROI 3. After 1 year of operation, bone mineral density did not change significantly. These data indicated that changes in bone mineral density were correlated with stress shielding after total knee arthroplasty. Monitoring two variations can provide theoretical data for preventing bone loss, which provides references for clinical rehabilitation guidance.

BACKGROUND:Currently, surgical treatment for Sanders III type, IV type fractures to restore damaged subtalar surface of the calcaneus and calcaneal shape, in order to reduce the incidence of traumatic arthritis has reached a consensus, and whether bone grafting is selected during surgery for calcaneal fractures has been a controversial issue. OBJECTIVE:To observe the clinical effect of Genex synthetic bone transplants and locking plate on comminuted calcaneal fractures. METHODS:Twenty-one cases of Sanders III type, IV type calcaneal fractures were retrospectively analyzed, including 16 males and 5 females, aged 22 to 55 years. After fracture reduction, a dough-like Genex bone graft was implanted into the defect region via lateral“L”shaped approach, and then the lateral wal of the bone was reset fol owed by internal fixation with the pre-curved locking plate. Fol ow-up observation was performed for fracture healing, Bolher angle and the Maryland Foot Score. RESULTS AND CONCLUSION:Total y 21 patients were fol owed up for 8-16 months. The fractures were healed without displacement, col apse and rejection. The bone graft was degraded within 6 months and completed absorbed after 1 year. According to Maryland Foot Score, the excellent rate was up to 86%, and the Bolher angle was increased from an average preoperative (5.3±3.35)° to postoperative (24.3±1.06)°. Genex artificial bone meal is a biomaterial that can be completely absorbed, has good plasticity and strong supporting force, and it is able to ful y fil bone defects, be easy to fracture reduction, induce bone formation, and promote fracture healing.

BACKGROUND: People have concerned with the effect of fibroblast growth factor biological protein sponge on the repairing effect of traumatic ulcer.OBJECTIVE: To observe the repairing effect of fibroblast growth factor biological protein sponge on the repairing effect of traumatic ulcer and its possible adverse reactionDESIGN: Grouping comparison observation.SETTING: Staff Room of Physiology, Medical College of Jinan University PARTICIPANTS: Totally 40 cases of traumatic ulcer accepted the treatment in the First Hospital of Jinan Univerity between March 2004 and May 2005 were recruited. Patients with diabetes mellitus and infection on the whole body were excluded. Traumatic ulcer lay in the shank. Patients were randomly divided into experimental group and control group with 20 in each group.INTERVENTIONS: In the experimental group (n=20), sterilized fibroblast growth factor biological protein sponge was used and in the control group (n=20), sterilized petrolatum gauze dressing was used on the wound.Change the gauze dressing once per day until the wound healed. Drugs,which affected wound growth, were not used on the whole body and at the local part. Wound healing status was evaluated 1, 2 and 3 weeks after changing the drugs (The secretion of a wound was divided into: nothing, a little, middling, a great deal. frontier reaction of wound was divided into:nothing, slight, middling, severe.). Pigment deposition and scar was recorded after wound healing.MAIN OUTCOME MEASURES: Healing time of ulcer, healing course of the wound and adverse reaction of the patients in the two groupsRESULTS: Totally 40 patients of the two groups entered result analysis.Wound healing status after treatment of the patients in the two groups: The rate of wound healing in 3 weeks in the experimental group was significantly higher than that in the control group [95% (19/20),55% (11/20),χ2=8.533,P ＜ 0.05]. Wound secretion and peripheral inflammatory reaction of the wound in the experimental group was obviously milder than that of the control group; there was no obvious adverse reaction and scar of the wound found in the two groups.CONCLUSION:FGF biological protein sponge can promote the healing of traumatic ulcer; shorten the healing time without scar and adverse reaction.This dressing is convenient, safe, and non-irritative.

Objective To compare the early effect of arthroscopic modified Mason-Allen(mMA)and suture-bridge technique for small and medium-size rotator cuff tear.Methods 60 patients with small and medium-size rotator cuff tear were divided into mMA group and suture bridge group,30 cases each.The mMA group was treated with mMA technique,and the suture bridge group was treated with suture-bridge technique.The operative time,the number of anchors used,blood loss,shoulder mobility,pain visual analogue scale(VAS),American Shoulder and Elbow Surgeons(ASES)scale,the Constant-Murley score and the rate of re-tear were compared between the two groups.Results The operative time and the number of anchors used in mMA group were less than those in suture bridge group(P<0.05),and there was no difference of blood loss between the two groups(P>0.05).After operation,the shoulder joint motion of two groups was increased compared with before operation(P<0.05),and there was no statistical difference between the two groups(P>0.05).After surgery,VAS of the two groups was lower than that before surgery,ASES scale and Constant-Murley scores were higher than those before surgery(P<0.05),there was no difference in VAS,ASES and Constant-Murley scores between the two groups(P>0.05).There was no difference in re-tear rate between the two groups(P>0.05).Conclusion Arthroscopic mMA is similar to suture-bridge technique in the treatment of small and medium-size rotator cuff tear,but operative time of mMA is shorter and it requires less anchors.