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METHODSFrom February 2005 to February 2010,5 patients with forearm fractures who were treated with titanium elastic nailing (TEN) were identified to fulfill the criteria of having developed a delayed union or nonunion of the ulna. The causes of delayed union or nonunion were investigated according to mechanism of injury, fracture location, treatments methods and postoperative management. All patients were male and the age was 3 to 14 years old with an average of 9.4 years. All fractures were located on the mid-third part of forearm. Two cases had a re-fracture. Among them, 3 cases caused by high-energy injury and 2 cases by falling down. Open reduction were performed in 4 cases while the other one was treated with closed reduction. Four patients were immobilized in an above-elbow cast, postoperatively.

RESULTSAll patients were followed up from 7 to 19 months with an average of 11.4 months. There were 4 delayed union and 1 nonunion. Three patients healed after the removal of the nail and avoidance of weight-bearing. Two patients healed by replacing another fixation. No patients had soft-tissue irritation or nail-entry-site infections.. The clinical effect was evaluated according to Daruwalla and Price scores with 3 excellent and 2 good of the results.

CONCLUSIONSUsing titanium elastic nailing for the treatment of pediatric both-bone forearm fractures is a good method. However,strict indication selection should be followed to avoid delayed union or nonunion.

Adolescent ; Child ; Child, Preschool ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Retrospective Studies ; Ulna Fractures ; physiopathology ; surgery

6.Effects of FOLFOX regimen chemotherapy on immunity of patients with colorectal cancer

Xiuying XIAO ; Baohua YU ; Xiaoyan YANG ; Xianzhi GUO ; Chen YU ; Xiang DU

China Oncology 2009;19(10):770-773

Background and purpose: Anti-tumor chemotherapy compromises normal immune function of the patients. There were many reports that chemotherapy for advanced colorectal cancer often inhibit the cellular immune function. The effect of FOLFOX regimen chemotherapy on immunity of the patients with colorectal cancer before and after therapy was studied, and healthy people were used as a control. Methods: Eighty colorectal cancer patients were treated by FOLFOX regimen, which consisted of 2-hour infusion of oxaliplatin(85 mg/m~2) and 2-hour infusion of leucovorin (CF)(200 mg/m~2) on Day 1, followed by 5-fluorouracil(5-FU) bolus (400 mg/m~2) on Day 1 and 46-hour infusion (2 400 mg/m~2). FOLFOX regimen was repeated at 2-week intervals. Two treatments of the above regimen were defined as one cycle. Flow cytometry was used to detect T lymphocyte subsets and NK cells in blood samples from patients with colorectal cancer before and after therapy. Data obtained fi'om healthy people was used as control. Results: CD3~+, CD4~+ T cells, NK cells and CD4~+/CD8~+ ratio in blood samples were not significant before and after chemotherapy in first day, second week and fourth week(P0.05). Lower CD3~+, CD4~+ T cells, NK cells and CD4~+/CD8~+ ratio were detected in blood samples from cancer group than that from the healthy control(P<0.05). CD8~+ T lymphocyte were reverse. This change was related to the TNM pathological stage. Conclusion: FOLFOX regimen was effective for patients with coloreetal cancer, which can improve patients' life quality and did not impact on the immune function of the patients. The immune function of lymphocytes in peripheral blood of the patients with colorectal cancer was low, and even worse in the patients with late TNM stage. It is valuable for estimating the function of cell immune of the patients, patients prognosis and the role of immune therapy in the treatment of the patients by detecting T lymphocyte subset and NK cell.