Objective To study the effect of thoraco-tumba fracture with pedicle scre system. Methods Forty-two cases with thorac-lumbar fractute treated with pedicle scre system were reviewed,their clinical featuers,x-ray and CT images before and after operation were analyzed. Results With follow-up of two months to three years after operntion,height of vertebra was completely restored on thirty-four cases,neurological function recovered in various degree according to the Frankel criteria in all cases. Conclusion Pedicle scre system is an effective method for treatment of thoraco-tumbar fracture.

OBJECTIVE: Assessed the feasibility of application of free fibular flap and clinical significance of pre-operational contrast enhanced CT angiography in functional reconstruction of oral and maxillofacial hard and soft tissue defects. METHOD: Eight cases with mandibular and soft tissue defects received a free fibula flap using arteriovenous anastomosis anastomosis method. The relationship between fibula flap design, size, repair parts and survival were analyzed. Preoperative enhanced CT angiography (CTA) examination was conducted to detect any abnormal blood vessels in fibula flap valve area. RESULT: Peroneal artery and posterior tibial artery variation was identified in one case of gums cancer, who used other muscle flap. Free fibula flap in the other 7 cases survived, which carried a skin island with an area ranging from 6 cm x 2 cm to 10.0 cm x 3.5 cm. Postoperative facial appearance, functionality, dental occlusion and voice function was normal. Lower limb function returned to normal from 2 weeks to 4 months after surgery. CONCLUSION CTA examination of the free vascularized fibula flap in the preoperative evaluation of the donor site is a valuable tool. Free fibula flap of bone, periosteum and bone marrow has a dual blood supply and are highly resistant to infection after transplantation. Personalized shaping osteotomy allowed for accurate recovery of mandibular alveolar patterns. Furthermore, the height and width of the fibula and the thickness of cortical bone is suitable for dental implants. Free fibula flap skin island can also be used to monitor the post-operative blood supply and is an ideal technique for mandible and soft tissue defects reconstruction as well as functional restoration.
Adult ; Aged ; Angiography ; methods ; Female ; Free Tissue Flaps ; blood supply ; Humans ; Male ; Maxillofacial Injuries ; surgery ; Middle Aged ; Mouth Neoplasms ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To explore the clinical effect of autogenous bone,allograft bone and BMP synthetic bone in the treatment of lum-bar spondylolisthesis,and provide more basis to choose transplant material.Methods A total of 96 patients with lumbar spondylolisthesis were chosen as research subjects,who were cured in our hospital from January 2014 to January 2015.They were divided into group A(who were treated with autogenous bone),group B(who were treated with allograft bone)and group C(who were treated with BMP synthetic bone), according to prospective study method.The indicators of the operation,postoperative adverse reactions,change of intervertebral disc height and bone graft fusion rate of three groups were compared.Results Difference of the operation indexes of three groups had no statistical sig-nificance(P >0.05).The incidences of adverse reactions in group A and group C had no statistically significant difference(P >0.05),but both less than that in group B,with statistically significant difference(P <0.05).The intervertebral disc height after 6,9,12 and 18 months in group A and group C had no statistically significant difference(P >0.05),but both more than that in group B,with statistically significant difference(P <0.05).Bone graft fusion rate of group C was faster than that of group A and goup B,and the graft fusion rate in 18 month in group A and C had no statistically significant difference(P >0.05).And the fusion rates of group A and C in each period were significantly higher than that of group B,with statistically significant difference(P <0.05).Total effective rate of neurologic improvement in group A and group C had no statistically significant difference(P >0.05),but both better than that of group B,with statistically significant difference (P <0.05).Conclusion BMP synthetic bone used in lumbar spondylolisthesis has the same clinical effect as autologous bone.But BMP synthetic bone has faster bone graft fusion rate than autologous bone.And it is beneficial to patients’recovery.