1.CLINICAL OBSERVATION AND EXPERIMENTAL STUDY ON EXTREMITY LENGTHENING
Medical Journal of Chinese People's Liberation Army 1981;0(06):-
When an extremity is being lengthened, the principle of the elasticity limitation of living tissues is always considered to be a guide fo avoid injuries to the nerves, blood vessels and periostium. It is generally believed that the lengthening should not exceed 10~15% of the original length of the bone. In order to attain a safe and large scale lengthening of a limb, the authors, under the condition of secure fixation of bone ends and early functional excercise of the diseased limb by using a specially des-gned external fixator, adopted a gradual lengthening with a slow speed of 1~1.25mm/d.Eighty cases of epiphysial distraction and 63 cases of metaphyseal osteotomy to lengthen extremities were studied. It was found that the expected lengthening in all the cases was achieved with a lengthening rate of 9~84.3% of the original length. It was 30~84.3% in 16 cases. The absolute lengthening was 6~16 cm in 69 cases. In one case, the femur and tibia were elongated at the same time, and a large shortening of 22 cm of the right lower limb was corrected in a one-stage operation (131 days).Experiments were performed on 15 goats. The lengthening rate of the tibia was 28.6~64.8% of the original length, with an average of 50.2%. In both the clinical and experimental studies, no nerve or blood vessel injury or non-union of the bone was found.The authors proposed a new concept different from the principle of elasticity limitation of livingissues. It is believed that nerves, blood vessels and periostium possess good adaptation capacity to slowand gradual lengthening. Low tension from traction can stimulate the tissues of the extremity to grow synchronously with the slow gradual lengthening and no injury will be inflicted to the structures and functions of the tissues concerned.
2.A study on the adaptive mechanism of peripheral nerve to gradual limb lengthening: observation on the perineurial barrier and vascular permeability
Chinese Journal of Orthopaedics 1996;0(10):-
Objective To evaluate the effect of limb lengthening on the perineurial barrier and vascular permeability of peripheral nerve. Methods Thirty-two rabbits with limb lengthening of 10% , 20% , 30% and 40% were used in this study; 8 animals were allocated in each group. Sixteen were employed for the electron microscopic(EM) observation and the others for the investigation of perineurial barrier and vascular permeability of the tibial nerves. Results Even if the elongation reached 40% of the original length of the tibia, both the perineurium and inner membrane of capillary was still intact, the perineurial barrier and vascular permeability maintained normal; however, EM examination revealed increase of a large number of vacuoles and the increase of the number of mitochondria in the cell of the perineurial membrane. Conclusion It is the gradual limb lengthing of
3.THE USE OF A MINIATURE EXTERNAL FIXATOR FOR THE COMPRESSION TREATMENT OF PATELLAR FRACTURE:A REPORT OF 60 CASES
Medical Journal of Chinese People's Liberation Army 1983;0(05):-
Sixty cases of different types of patellar fractures were treated from December 1986 to October 1990 by a self-designed miniature external fixator. The patients were followed-up for 6 months to 4 years, and there was not a single case of infection, prepatellar bursitis or early degeneration of the knee joint. The structure of the fixator is simple and the operation is easy. It is a versatile tool, because it can be used either for extension or for compression.since the pins are inserted without operation, it gives rise to little pain. Under the present treatment bone healing is rapid and the function of the knee joint is well preserved. The rate of excellent result reaches 98.2 per cent
4.Analysis of masticatory muscles electromyography of the patients with unilateral posterior crossbite
Qihong LI ; Dong LI ; Yinzhong DUAN
Journal of Practical Stomatology 1996;0(02):-
Objective:To study the effects of unilateral posterior crossbite on masticatory muscle functions pattern by using electromyography(EMG).Methods:20 subjects(11 males and 9 females)with unilateral posterior crossbite were selected.Subjects were instructed to stay mandibular postural position and to make maximum bite in intercuspal position(ICP)and bilateral chewing.EMG data of the left and right masseter and anterior temporalis muscles were recorded.Asymmetry index of masseter muscles(ASMM) and asymmetry index of temporalis muscles(ASTA)were calculated and compared.20 subjects with individual normal occlusion were used as control.Results:Compared to control group,masseter and temporal muscle activities in unilateral posterior crossbite group were lower in maximum bite and bilateral chewing;The activities of two muscles at crossbite side were lower than that at noncrossbite side.Under maximum bite and bilateral chewing,ASMM and ASTA in unilateral posterior crossbite group were significantly higher than those in control group;ASMM and ASTA in Subjects with one posterior tooth crossbite is lower than subjects with several teeth crossbite.Conclusion:It can be suggested that unilateral posterior crossbite may damage the function of mastication muscle.
5.Biomechanical test of suture fixation strength at ligament-tendon free end which used in cruciate ligament reconstruction
Chunli ZHANG ; Qihong LI ; Liu YANG
Chinese Journal of Tissue Engineering Research 2003;7(20):2806-2807
Aim To test the strength of Kraekow bilateral locking stitchfor tendon or ligament free end fixation and evaluate the stitch which wasused in reconstruction of cruciate ligament or secure fixation of soft tissue tobone. Methods Twenty-four specimens of patellar tendon free end, whichwere divided into 3 groups according 2 or 3 stitches and 6 subgroups ac-cording No1 Ethilon or 0.4 mm diameter stainless steel wire different suturematerials, fixed with Krackow locking stitch, were undertaken the tensiletest respectively, so as to find out the least stitches and efficient suture pat-tern. Results 2 Krackow locking stitches had more strength than that of0.4 mm diameter stainless steel wire, the fixation strength of 2 stitcheswhich used No1 Ethilon was more than 80 N, superior to the failure strengthof material itself, it still maintained the same strength if the first stitch wasacross the tendon tissuetransversely. There was no significant differencebetween 2 and 3 Krackow locking stitches in suture strength statistically, thefixation strength was superior to the suture material, it could reduce the'suture exposure when the first stitch is across the tendon tissue while main-tains a comparable strength to other suture. Conclusion If attempt to makea higher strength of suture, we should focus on selecting a stronger materialsor adding the suture materials in number rather than the stitch number.
6.Expression of BMP and TGF-β1 in Regenerative Gap During Tibial Lengthening by Metaphyseal Osteotomy of Rabbits
Fei DAI ; Meiying WU ; Qihong LI
Orthopedic Journal of China 2001;8(3):265-267
To study the expression of bone morphogetic protein(BMP) and transforming growth factor β1(TGF-β1) in regenerative gap during lengthening period. Method: The right tibia of 14 mature rabbits were lengthened using metaphyseal osteotomy. Distraction was started on the 4th day postoperatively, 1mm per day and conducted twice each day. The expression of endogenesis BMP and TGF-β1 in regeneraive gap were observed during ten weeks after distraction by histology and immunohistochemisty. Results: The result showed that bone morphogetic protein(BMP) and transfoming growth factor β1(TGF-β1) were expressed in chondrocytes, osteoblasts, and fibroblasts. The expression of BMP was at a high level in initial two weeks after distraction while the expression of TGF-β1 was increased step by step. Then both of them decreased alonged with lengthening proceeding. Two weeks after distracting stopped, the expression of BMP could not being observed. But the expression of TGF-β1 could being observed all stage after distraction stopped. Conclusion: BMP and TGF-β1 were expressed persistently in regenerative gap during bone lengthening.
7.Arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joint tuberculosis
Yonghua CHEN ; Kanglai TANG ; Qihong LI
Chinese Journal of Orthopaedics 2000;0(02):-
Objective To investigate the clinical experiment of arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis. Methods From January 2001 to April 2005, 6 patients (4 males and 2 females), with a mean age of 33 years old (range, 28 to 44 years old) and mean duration of 13 months, received arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator. All patients had received at least 3 weeks standard drug treatment for tuberculosis before the operation. After thoroughly debridement under arthroscopy using anterolateral and anteromedial approaches, a half-ring sulcated external fixator was used to fix the ankle joint at the neutral position. 4 days (2-7 days) after the operation, patients could walk with partially weight bearing. All patients replied to our questionnaire and the average follow-up was 21.3 months, with a range of 6-42 months. Patients returned for a clinical and radiolographic evaluation every week before the tibiotalar joints union. The external fixator apparatus were removed after the joint fused. Results Fusion occurred in all patients, the average time to clinical and radiographic union was 12.5 weeks (9-17 weeks). 3 patients were graded as excellent: no pain with a stable fusion. The others were graded as good: mild pain, occasional limp with a stable fusion. There were no sinus or other complications occurred. Conclusion There are considerable advantages using arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis without serious bone defect, include: limited invasion, quickly recovery, thoroughly debriding the tuberculose focus. And the half-ring sulcated external compression fixator could achieve stable and elastic fixation with adjustable rigidity. And patients can walk earlier to promote ankle fusion and decrease related complications.
8.Morphologic changes of arthrodial cartilage of tibial platuea during tibiae lengthening
Xuquan WANG ; Qihong LI ; Jianzhong XU
Chinese Journal of Orthopaedics 1999;0(07):-
Objective To investigate the adaptation of metabolism of arthrodial cartilage for limb lengthening. Methods Thirty New Zealand rabbits were randomized into two groups, limb lengthening group (group A) and delay observation group (group B). Every group was subdivided into three sub-groups according to distraction degree: 10%, 20% and 40%. Upper-tibia metaphysis lengthening was adopted at 1 mm/d rate of distraction and iconography changes of knee joint were observed with X-ray, the morphologic changes of chondrocyte and cartilago articularis on tibial flat were observed with light and electric microscope. The changes of cartilage surface were observed with scanning microscope. Results 1) There was no obvious iconography change of knee at every time phase in each group. 2) Pale of cartilage on tibial flat were just noted in group A40 and B40. 3) The arrangement of chondrocyte was disorder in A40, some degenerating and generating chondrocytes were found in the same group. The number of chondrocytes increased, and the volume was expanded in group B20 or B40, the degenerating chondrocytes were not found in the same group. 4) Low-grade expansion of endoplasmic reticulum and swelling of chondrosome were found in part of chondrocyte in group B40 contrasting with the other groups. The numbers of endoplasmic reticulum and matrix alveolus increased in chondrocyte. The same changes were observed in group A. 5)The cartilage surface lost its smoothness during distraction, and this kind of changes were more severe when distraction increased. Conclusion The articular cartilage showed certain adaption to stimulation of distraction during low degree distractions. To greater distraction degrees some abnormality in metabolism of arthrodial cartilage may occure.
9.Observation on vascularization of big segmental bone defect repaired by heterogeneous deproteinized bone
Yuekui JIAN ; Qihong LI ; Lei LIU
Orthopedic Journal of China 2006;0(10):-
0.05).[Conclusion]Composite of heterogeneous deproteinized bone+autogeneous MSCs+rhBMP2 has the same ability of autogeneous bone graft to repair big experimental segmental tibia defect,thus it can be used as a scaffold in tissue engineering and for further study of immunogenicity and ossification ability.
10.Effect of Pulsed Electromagnetic Fields Stimulation on the Repair of Peripheral Nerve
Aimin WANG ; Qihong LI ; Zuyan JIANG
Chinese Journal of Orthopaedics 1998;0(12):-
Aim: To study the effect of pulsed electromagnetic fields(PEMF) stimulation on the repair of rats grafted sciatic nerve. Methods: One hundred Wistar rats were classified randomly into two groups, a control group (group A, n = 50) and a PEMF group(group B, n = 50). The biological effect of the grafted nerve, the relative lumbar spinal cord and one of the ending organs - triceps muscle was studied at the same time. Results: The neuron's vitality in lumber spinal cord had been stimulated in the PEMF- treated rats. The Wallerian degeneration of the nerve distal to the grafted was accelerated after PEMF stimulation. The increased regeneration of the nerve was found throughout 16 weeks recovery period in PEMF group. Application of PEMF had decreased the atrophy of the triceps muscle caused by denervation and promoted its functional recovery. Conclusion: PEMF stimula- tion may enhance the regeneration of the injured peripheral nerve.