[Objective]To evaluate long term curative effect on treatment of developmental dislocation of hip(DDH) in children between 18~36 months old by combined close-reduction method of adductor-cut,close-reduction and frog type plaster fixation.[Method]One hundred and fifty-six children(232 hips) treated by combined close-reduction method in 1993 to 2001 were followed-up with mean follow-up time of 9.2(5.5~14.5) years.There were 77 hips of grade Ⅰ dislocation,95 hips of grade Ⅱ,and 60 hips of grade Ⅲ according to Zhou Yongde grading criteria.Periodical imaginological and hip joint function examinations were evaluated and analyzed.[Result]One hundred and ninety-five hips obtained satisfactory concentric reduction with excellent and good rate of 84.05% according to Zhou Yongde criteria.There were 9 hips with femoral head necrosis at follow-up.Mean preoperative acetabular index(AI) of successful reduction hips was(35.34?5.96)%,and that of failure reduction hips was(44.51?5.32)%.The excellent and good rate were 84.41% in cases of grade Ⅰ hips,85.21% in grade Ⅱ hips,and 81.67% in grade Ⅲ hips.[Conclusion]Combined method of adductor-cut,close-reduction and frog type plaster fixation is an effective way for treatment of DDH of children between 18~36 months old.Preoperative AI but not degree of dislocation is the criteria to determine whether close-reduction is necessary or not.

BACKGROUND:Bone marrow mesenchymal stem cels play an osteogenic role under the assistance of scaffold materials. The scaffold cannot only deliver the cels to the bone defect area, but also act as a new bone growth framework. Colagen-chitosan composite is one of ideal scaffold materials in bone tissue engineering, which has osteoinductive ability and better osteogenic ability than conventional scaffolds. Bone transport technology has been widely used in the clinical repair of long bone defects, but it has some deficiencies, such as slow osteogenesis, long time for external fixation and nonunion. How to further accelerate bone formation and reduce complications has become the current problem to be solved. Here, it is hypothesized that bone marrow mesenchymal stem cels/ colagen/chitosan composite scaffold can increase the therapeutic effect of bone transport in the repair of tibial bone defects.
METHODS/DESIGN:This study is a randomized controled animal experiment, includingin vitro andin vivo tests.In vitro test: Bone marrow mesenchymal stem cels are isolated from the bone marrow of New Zealand rabbits aged 1-2 months, and passaged to the third generation. Then, cel suspension is added onto the colagen-chitosan scaffold to construct the bone marrow mesenchymal stem cels/colagen/chitosan composite scaffold.In vivo test: Twenty-four New Zealand rabbits at 3-4 months are selected and randomly assigned to receive bone transport, scaffold implantation, bone transport+scaffold implantation, respectively. The primary outcome measures are the growth of implant materials and bone defect interface, X-ray detection of bone defect repair, hematoxylin-eosin staining and scanning electron microscope observation of bone formation in the bone defect region, immunohistochemical detection of type I colage expression in the osteogenic region, scanning electron microscope observation of interface bonding between implant materials and host bone, ultrastructure and bone formation.
DISCUSSION:The results from this animal experiment wil help to determine the feasibility of bone marrow mesenchymal stem cels/colagen/chitosan composite scaffold to accelerate bone repair during bone defect repair using bone transport technology.

Objective: To evaluate the clinical efficacy of proximal femoral nail antirotation (PFNA) in treatment of elderly incompleted inner wall type intertrochanteric fracture. Methods:The medical records of 33 patients with incompleted inner wall type intertrochanteric fractures were analyzed retrospectively. The incision length,blood loss,operative time,volume of drainage,start standing time,fracture healing time,abnormal rate of femur and complications were summarized,and the clinical effects were also evaluated according to Harris standard. Results:A total of 31 patients achieved complete follow-up data. The fracture healing time and clinical excellent rates were (12.5 ± 3.5) weeks and 90.3%. The abnormal rate of femur operative time, incision length, blood loss, operative time, volume of drainage, and start standing time were 12.9%,(4.3 ± 2.7) cm,(50.2 ± 35.0) ml,(40.3 ± 12.7) min,(30.5 ± 9.6) ml and (10.3 ± 5.7) d. Conclusion:PFNA fixation is an ideal method for treatment of elderly incompleted inner wall type intertrochanteric fractures, with small incision, shorter operative time, shorter fracture healing time, shorter bed rest time and less complications.

BACKGROUND:Pulsed electromagnetic field is a non-invasive and non-radiative treatment method.Clinical use of pulsed electromagnetic fields in the treatment of orthopedic diseases has achieved certain results. OBJECTIVE:To review the current clinical application of the pulsed electromagnetic field in the treatment of orthopedic diseases,providing a scientific theoretical basis for the clinical treatment of orthopedic diseases. METHODS:The first author used a computer to search PubMed,CBM,Cochrane Library,CNKI,and WanFang Data for related studies on the pulsed electromagnetic field in the treatment of orthopedic diseases,using the keywords of"pulsed electromagnetic field,orthopedics,osteoarthritis,osteoporosis,bone healing,electromagnetic navigation"in English and Chinese.For the literature related to the same content,recent publications were selected.A total of 69 articles were selected from the search results for review. RESULTS AND CONCLUSION:Pulsed electromagnetic field has a definite curative effect on fracture healing.It can be used in the treatment of osteomyelitis by antibacterial,bactericidal,anti-inflammatory and promoting bone healing,and can inhibit osteoporosis and its progress.In addition,the treatment of early osteoarthritis,femoral head necrosis and postoperative rehabilitation of late joint replacement through various ways can become a treatment for orthopedic diseases.However,the therapeutic mechanism of the pulsed electromagnetic field for a variety of orthopedic diseases is still unclear,and most of the research is still in the primary stage.In the future,it is still necessary to obtain more reliable evidence from high-quality research and clinical trials to provide a more perfect basis for the clinical treatment of orthopedic diseases.