OBJECTIVE: To investigate the main point of long backbone fracture caused by blunt force in forensic clinical identification and to provide a reference for the inspection and appraisal practices of such injury. METHODS: Ninety-nine cases of adult long backbone fractures were collected from January 2006 to December 2013 in Gutian County of Fujian Province. According to the terms of fracture location, mode of injury, type, the data were summarized. RESULTS: In the 99 cases, there were 36 cases caused by hitting, kicking, and falling and 63 cases caused by vehicle collision. The majority of the former was ulna, and those of the latter were tibia and fibula. The types of fracture were transverse one, short oblique one, long oblique one, and spiral one. CONCLUSION Different types of long backbone fracture, not only causing stress load of fractures as well as structural differences related to each segment.
Fibula/pathology* ; Forensic Pathology ; Fractures, Bone/pathology* ; Humans ; Tibial Fractures/pathology*

The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress fractures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy.
Adult ; Female ; Fibula ; pathology ; transplantation ; Fractures, Stress ; pathology ; Humans ; Hypertrophy ; Male ; Middle Aged ; Tibia ; surgery ; Tibial Fractures ; surgery

OBJECTIVETo observe the effect of octyl-a-cyanoacrylate upon bone healing and its degradation in vitro after middle tibial transverse fracture in rabbitsì and to establish treatment of higher efficacy with the application of octyl-a-cyanoacrylate.

METHODSMiddle tibial transverse fracture model of New Zealand rabbits was established. In the experimental group, internal fixation with 2 mm Kirschner wires was performed and the broken ends were fixed with octyl-a-cyanoacrylate. In the control group, only internal fixation with 2 mm Kirschner wires was conducted. Animals were killed at preset time intervals of 2, 4, 6, 8, 10 and 12 weeks postoperatively and samples were harvested.

RESULTSTwo weeks after operation, clear fracture lines were observed in both the experimental and the control groups. Fibrous soft tissue connection was noted between the broken ends and there was soft tissue adhesion around the fracture site. There was no callus formation and the broken ends were surrounded by adhesive soft tissues. Obvious external callus formation was confirmed at 8 weeks after operation in both groups with partial disappearance of fracture lines. Ten and twelve weeks after the operation, fracture lines disappeared completely and there was obvious external callus formation and bone union. In the fourth week, fibrous cells and chondrocytes were found to grow into the colloid and surround it at the 6th week. The adhesive material was degraded and gradually absorbed at the 8th week. Chondrification was observed.

CONCLUSIONSTwo weeks after fixation for tibial fracture in rabbits, octyl-a-cyanoacrylate begins in vivo degradation. Chondrocytes and fibrocytes gradually grow into the degradation area and surround the adhesive material, which broke into pieces at 8 weeks. Complete degradation and disappearance of the adhesive material is present between 10 and 12 weeks. No barrier effect hampering fracture healing is noted.

Adhesives ; therapeutic use ; Animals ; Cyanoacrylates ; therapeutic use ; Rabbits ; Radiography ; Tibial Fractures ; diagnostic imaging ; pathology ; therapy

OBJECTIVETo compare the differences in damage degree, healing time and healing process between two animal models of defection fracture and provide the research data for the establishment of a new animal model.

METHODSSixty male SPF Spragur-Dawley rats were divided randomly into control group, sawing group and drilling hole group, with 20 rats in each group. Animals of drilling hole group were treated with hone drill and made an 1 mm hole on tibial plateau animals of sawing group were treated with saw and made an 3 mm defection on tibial plateau; nothing to do in animals of control group. The rats were respectively killed at 2nd, 4th weeks after operation, bone density, bone ash quantity, contents of bone Ca, P were detected.

RESULTSAt the 2nd week after operation, bone density, bone ash quantity, contents of bone Ca, P in drilling hole group and sawing group were significantly lower than that of the control group (P < 0.05 or P < 0.01). Two animal models of drilling hole group and sawing group were similar in X-ray films and pathology investigations. At the 4th week after operation, there were no significant defference in bone density and bone ash quantity among three groups (P > 0.05). Rats of sawing group showed more poroma and inflammatory infiltration in histological examination.

CONCLUSIONDrilling hole method and sawing method could be used to make animal model of defection fracture, two methods showed similar damage degree, healing time and healing process, hut drilling hole method have advantages of simple operation, easily control damage degree and less inflammatory infiltration and bone disunion.

Animals ; Bone Density ; Disease Models, Animal ; Male ; Rats ; Rats, Sprague-Dawley ; Tibia ; pathology ; Tibial Fractures ; etiology

The healing pattern of medial and lateral cortical gap in open transverse or short oblique tibial fractures were retrospectively reviewed in 2 groups; In group A, 16 patients were treated by Judet external fixator in rigid mode. In group B, 6 patients were treated in biocompressive mode, which allowed predominantly longitudinal axial motion. The characteristic healing pattern in group A was gap healing without or with minimal periosteal callus. The healing time and time for consolidation per 1mm gap were significantly longer in medial cortices than lateral ones (p< 0.036, p< 0.024 respectively). In group B, the fractures were healed with periosteal callus. There was no difference in the healing time and the time for consolidation per 1mm gap between the two cortices. The consolidation time per 1mm gap in the medial cortices was significantly longer in group A than group B (p< 0.020). The longitudinal axial motion in open transverse tibial fractures seems to shorten the healing time effectively in the medial cortex.
Adolescent ; Adult ; Comparative Study ; Fracture Fixation ; Fracture Healing ; Fractures, Open/pathology/*surgery ; Human ; Male ; Middle Age ; Retrospective Studies ; Tibial Fractures/pathology/*surgery

BACKGROUNDPrevious studies have shown that prostaglandins (PGs) dramatically stimulate healing processes in bone. However, the effect of prostaglandin I2 (PGI2) on fracture healing remains unclear. To investigate the effect of PGI2, a study on fracture healing process in closed tibia fractures was designed.

METHODSThirty-six Sprague-Dawley male rats were randomized into two groups. On the first day, their right tibias were fractured by three-point bending technique. The study group (n = 18) received a single injection of 10 µg/kg iloprost for 5 days, while the control group (n = 18) received saline solution in the same way. On the 7th, 14th and 28th days following the fracture, six rats were sacrificed and their right legs were harvested in each group. The progression of fracture healing was assessed for each specimen by the scores of radiography (by Lane-Sandhu) and histology (by Huo et al).

RESULTSOn the 7th day, the radiographic and histologic scores were equal. On the 14th day radiographic total score was 6 and histologic total score was 23 in the iloprost group, whereas radiographic total score was 11 and histologic total score was 33 in the control group. On the 14th day radiographic and histologic scores were significantly decreased in the iloprost group compared to the control group (P < 0.05). On the 28th day radiographic total score was 12 and histologic total score was 37 in the iloprost group, whereas radiographic total score was 15 and histologic total score was 40 in the control group. On the 28th day although there was a decrease in radiographic and histologic scores of the iloprost group acording to control group, it was not statistically significant (P > 0.05).

CONCLUSIONIloprost delays fracture healing in early stage in rats.

Animals ; Epoprostenol ; pharmacology ; Fracture Healing ; drug effects ; Fractures, Bone ; pathology ; Iloprost ; pharmacology ; Male ; Rats ; Rats, Sprague-Dawley ; Tibial Fractures ; pathology ; Wound Healing ; drug effects

Adolescent ; Child ; Female ; Fractures, Stress ; diagnostic imaging ; pathology ; physiopathology ; Humans ; Male ; Tibial Fractures ; diagnostic imaging ; pathology ; physiopathology ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo explore the therapeutic effectiveness of Ilizarov technique in treatment of infected tibial defects combined with overlaying skin defects.

METHODSTwenty-one cases with infected tibial defects combined with skin defects were treated between 2001 and 2008 includeing 18 males and 3 females with an average age of 31 years ranging from 19 to 43 years. The length of bone defect ranged from 3 to 13 cm (means 6 cm). Skin defect area was from 3 cm x 3 cm to 6 cm x 10 cm; 11 cases combined with drop foot, 5 cases with arthrocleisis of knee. Preoperative X-ray of the affected limb was performed and zone of skin necrosis was marked, then the point and length of osteotomized bone, and scope of bone and soft tissue need for removing were determined. The internal fixation were removed. Opening irrigation, vacuum sealing drainage (VSD), and dressing changing were appllied. The skin was fixed with Kirschner wire and bone was transferred with Ilizarov technique in all patients. The lengthening of bone and skin was carried out for 4 to 7 days after surgery, 1/6 to 1/4 mm once, 4 to 6 times a day. The clinical effectiveness was determined mainly through wound and lengthening of skin.

RESULTSAll patients were followed up for from 6 to 62 months (means 49.5 months). Fourteen of 21 cases received one stage treatment, there was still secretion from end of bone in 3 patients whose bone healed after debridement, the other 4 patients were cured via trimming end of bone and compression fusion. The defects of bone were extended to full length in 18 patients. Abutting end was slightly absorbed and became rattailed in 2 cases, there was lack of blood supply to abutting ends in one patient who was cured via bone graft from iliac bone. Skin defects was cured in 18 patients with one stage treatment, the other 3 patients were cured after infection was controlled. The deformity of drop foot were corrected in 11 patients, and function of knee was improved in five patients. The external fixator was removed at 1.2 to 2.6 years after surgery. At last, bone infections were cured, defects of bone and skin recovered in all patients.

CONCLUSIONOne stage treatment of infected tibial defects combined with skin defects using Ilizarov technique has minimal invasion with less complex surgeries, could reduce the time and expense of treatment.

Adult ; Female ; Fractures, Open ; surgery ; Humans ; Ilizarov Technique ; Male ; Necrosis ; Postoperative Complications ; surgery ; Skin ; pathology ; Soft Tissue Injuries ; surgery ; Tibia ; surgery ; Tibial Fractures ; pathology ; surgery

Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; pathology ; physiopathology ; surgery ; therapy ; Treatment Outcome

Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Minimally Invasive Surgical Procedures ; methods ; Recovery of Function ; Tibial Fractures ; pathology ; physiopathology ; surgery ; Young Adult