BACKGROUND:For depressed skul fractures in children, retaining their skul and narrowing surgical incision meet the concept of minimaly invasive surgery as important as ensuring the surgical safety and therapeutic effects, which is also the requirement of children’s parents. OBJECTIVE:To explore the curative effects of in suit replantation of free bone fragments based on a smal incision in children with depressed skul fractures. METHODS: Fifteen patients with depressed skul fractures, aged 3-16 years, were selected and subject to CT examination and manual examination of the scalp at fractured site under general anesthesia for labeling fracture range. Then, one or two bone fragments corresponding to the fracture site and size were selected. A smal incision with a length equal to the outer edge of bone fragments removed. Postoperative folow-up was employed for observation of clinical effects. RESULTS AND CONCLUSION:An incision, 5-7 cm in length, were made, and one bone fragment was removed from six cases, and two bone fractures were removed from nine cases. Intraoperatively, there were six cases of epidural hematoma, three cases of subdural hematoma, six cases of brain contusion and bleeding. For fracture fixation, one skul lock was used in eight cases, two skul locks in six cases, and three bone plates in one cases. Postoperative CT showed 12 cases of good fracture reduction displayed basic symmetry with the contralateral skul; 3 cases showed partialy depressed bone fragments that were less than 0.5 cm; 6 cases had a little skul defects with a diameter < 1.0 cm; 6 cases had mild epidural hematoma or effusion which was eliminated after conservative treatment. Eleven of 15 cases were folowed for 2 month to 3 years, and showed no changes in skul shape on CT films compared with those at discharge and presented with good stability. In addition, there were one case of mild limb paralysis, one case of mild language barriers, and one case of mild seizures, but al these cased were wel controled by drugs. These findings indicate that in situ replantation of partialy free bone fragments is suitable for depressed skul fractures in children.

Sarcopenia is an age-related disease that mainly involves decreases in muscle mass, muscle strength and muscle function. At the same time, the body fat content increases with aging, especially the visceral fat content. Adipose tissue is an endocrine organ that secretes biologically active factors called adipokines, which act on local and distant tissues. Studies have revealed that some adipokines exert regulatory effects on muscle, such as higher serum leptin levels causing a decrease in muscle function and adiponectin inhibits the transcriptional activity of Forkhead box O3 (FoxO3) by activating peroxisome proliferators-activated receptor-γ coactivator -1α (PGC-1α) and sensitizing cells to insulin, thereby repressing atrophy-related genes (atrogin-1 and muscle RING finger 1 [MuRF1]) to prevent the loss of muscle mass. Here, we describe the effects on muscle of adipokines produced by adipose tissue, such as leptin, adiponectin, resistin, mucin and lipocalin-2, and discuss the importance of these adipokines for understanding the development of sarcopenia.
Humans ; Adipokines ; Leptin ; Adiponectin ; Sarcopenia ; Muscles