Objective To investigate the clinical results, indications and choices of surgical treatment of minimally invasive internal fixation by cannulated compression screws in the treatment of femoral neck fractures. Methods The authors retrospectively analyzed clinical data of 83 patients with femoral neck fractures treated by minimally invasive internal fixation by AO cannulated screws. Results According to the Garden classification, the patients comprised 12 cases of type I, 39 cases of type II, 23 type III and 9 type IV. The mean time from injury to surgery was 63.4 hours, the mean operation time was 65.7 min, the mean intraoperative blood loss was 64 ml and the mean hospital stay was 7.7 days. No wound infection, deep venous thrombosis of leg, pulmonary embolism or breakage of internal fixation occurred. No patients died. Follow-up observation ranged 12～48 months, with a mean of 31.3 months. Normal bone union was obtained in all the cases. Postoperatively, shortening of femoral neck took place in 4 patients (4/83, 4.8%) and different degrees of osteonecrosis happened in 7 patients (7/83, 8.4%). The mean postoperative Harris hip score was 94.6. Conclusions Minimally invasive internal fixation by cannulated compression screws for femoral neck fractures may be an effective alternative. This method is indicated for Garden I/II fractures without displacement in patients above 65 years old, or any types of femoral neck fractures in patients below 65 years old.

Objective To investigate the clinical results of minimally invasive plate fixation for tibial plateau fractures. Methods Minimally invasive plate fixation was adopted in 26 cases of tibial plateau fractures from January 2000 to June 2003. Results Follow-up for 6 months ～ 4 years (mean, 2 1 years) showed bone union in all the patients. The results of therapy were assessed according to the Merchant criteria as follows: excellent in 20, good in 5 and fair in 1. Conclusions Minimally invasive plate fixation in the management of tibial plateau fractures has advantages of minimal trauma, reliable fixation, early movement and fewer complications, being a valuable clinical alternative.

Objective To investigate the clinical results of limited exposure and indirect reduction in treatment of tibial plateau fractures. Methods 41 cases of tibial plateau fractures were treated with limited exposure and indirect reduction. According to Schatzker classification, there were 6 cases of type Ⅰ, 13 type Ⅱ, 11 type Ⅲ, 6 type Ⅳ, 3 type Ⅴand 2 type Ⅵ. Type I fractures were reduced in the close manner by applying large reduction forceps and fixed with percutaneous lag screws. Type Ⅱ, type Ⅲand Type Ⅳfractures were reduced by applying large reduction forceps and fixed by percutaneous plating after restoring joint surface and bone grafting. Type Ⅴand Type Ⅵfractures were reduced by applying fracture distracter and large reduction forceps before they were fixed with percutaneous plating. The clinical outcomes were assessed according to Rasmussens system. Results 36 patients were followed up from 6 to 60 months, with an average of 30.2 months. No deep vein thrombosis, infection, or compartment syndrome was found postoperatively. All the 36 fractures united. Overall, 25 (69%) patients were rated as excellent, 8 (22%) good, and 3 (9%) fair. Conclusion In treatment of tibial plateau fracture, limited exposure and indirect reduction has advantages of less dissection, stable fixation, early movement, better joint function and fewer complications.

Objective To discuss the feasibility,indications,surgical techniques,and outcome con- cerning the application of less invasive stabilization system (LISS) for complex proximal femoral fractures.Methods We treated 12 complex proximal femoral fractures using femoral LISS reversely from June 2005 to May 2006. They were five complex intertrochanteric fractures and seven subtrochanteric ones.By AO classification,two were type 31-A2.2,two type 31-A2.3,one type 31-A3.3,one type 32-A3.1,three type 32-B1.1,one type 32-B2.1, and two type 32-B3.I.The patients were treated with closed or indirect reduction and fixation with percutaneous LISS plate reversely.Results There were no major postoperative complications in this study.The mean operation time was 65 minutes (range,50 to 90 minutes),the mean intra-operative blood loss was 142 milliliters (range,50 to 400 milliliters),and the mean postoperative hospital stay was 9.3 days (range,6 to 15 days).All patients had a clinical follow-up;the mean follow-up time was 7.2 months (range,3 to 14 months).Ten cases healed clinically three months postoperatively,one periprosthetic fracture healed four months and one pathological fracture healed six months after operation.At the final radiographic follow-up,no collapse,varus deformity,cutting-out,hardware failure,or avascular necrosis was found.Conclusions Femoral LISS used reversely can provide secure fixation for proximal femoral fractures biomechanically and anatomically.It is also easy and safe.It is particularly suitable for old patients with intertrochanteric fractures complicated with disorders of internal organs and severe osteoporosis or patients with complex proximal femoral fractures.It is important to be skillful in indirect reduction and positioning of guide wire into hole A,and to avoid immediate weight-bearing postoperatively.

Objective To explore the surgical result of unilateral half-pin external fixation in the treatment of distal tibial fracture. Methods For type A fracture, two pins were inserted into the proximal fragment of tibia fracture and another two pins into the distal fragment; for type B and C fracture, distal pins were inserted into the talus and calcaneus. The fracture reduction was performed by distraction of external fixators. A limited open reduction was required in some difficult cases to restore the joint surface, with bone grafting and small fragments fixed with wires or screws. Meanwhile, fracture of fibula was fixed with plate and screws. Results The duration of external fixation was 3.5~8 months (mean, 5 months) in 22 patients. Bone union was achieved in all patients, without serious deep infection, osteomyelitis, or non-union. The patients were followed for 10~32 months (mean, 20 months). Functional exercise was carried out for more than 6 months after the removal of the external fixator. According to the Tornetta’s evaluation standard, excellent results were obtained in 11 patients, good in 7 patients, fair in 3, and poor in 1. Conclusions Unilateral half-pin external fixation combined with limited open reduction and internal fixation is a simple and effective minimally invasive method for the treatment of distal tibial fracture.

[Summary] With the increasing global aging population, osteoporosis vertebral compression fracture ( OVCF) is getting more attention as a big challenge for orthopedic surgeons.Current therapeutic options include conservative treatment, traditional open reduction and internal fixation, percutaneous vertebroplasty (PVP), and percutaneous kyphoplasty (PKP).Due to excellent clinical results on pain relief and function improvement, PVP and PKP, as minimally invasive surgical techniques, now increasingly become more popular for painful OVCF.The review focused on a brief introduction of the current status of the two procedures and a discussion of the future trends of the two techniques.

Objective To study the effect of low-level 84 disinfection solution on reproductive physiology of mice . Methods 72 KM mice were randomly divided into three groups :0.5%84 disinfection solution group ( group A) , 2.0%84 disinfection solution group (group B) and saline solution group (group C).12 males and 12 females in each group. Corresponding medicine was given once a day by intragastric gavage for 9 weeks.The estrous cycle of female mice was observed by exfoliative cytology of vagina .After 9 weeks, The sperm abnormality test was performed , Serum samples were taken for sex hormone test by ELISA, and the histological change of testis (or ovary), heart, liver, lung and kidney were observed.Results Compared with group C , No significant difference was observed in the weight variation and serum sex hormone level in group A and B (P >0.05).The difference of the estrous cycle of female mice was not significant (P >0.05).No histopathological abnormality was observed .Compared with group C, There was no significant difference in the rate of sperm abnormality in group A ( P >0.05 ) , but the rate in group B was significantly increased ( P <0.05 ) . Conclusion 0.5% 84 disinfection solution has no significant effect on reproductive physiology of mice , The concentration of disinfection solution must be strictly controlled when used .

Humans ; Papillomavirus Infections ; therapy ; Respiratory Tract Infections ; therapy

Objective To investigate outcomes of different operations in treatment of cervical spinal fracture in patients with ankylosing spondylitis and summarize experiences and bases in selection of operation.Methods A retrospective study was done on 19 patients with cervical spinal fracture following ankylosing spondylitis treated between 2005 and 2011 and received complete follow-up.Among them,nine patients were treated with combined anterior and posterior surgical approach (combined treatment group),seven with single posterior surgical approach (posterior approach group) and three with single anterior surgical approach (anterior approach group).Clinical data,follow-up data and image outcome of the patients were collected and compared.Results All patients received average 14 months of follow-up (range,12-20 months).In combined treatment group,the fracture was healed at postoperative 4-6 months.One patient had palsy of recurrent laryngal nerve but was recovered at postoperative three months.Seven patients with incomplete spinal cord injury had at least one level improvement in neurological function according to American Spinal Injury Association (ASIA) classification.No implant loosening or shifting were found in internal fixation.In posterior approach group,fracture was healed at postoperative 4-6 months,with no surgical complications,loosening or shifting of implants.Five patients with incomplete spinal cord injury had at least one level improvement in neurological function according to ASIA classification.In anterior approach group,an additional operation for implant loosening was performed in one patient at postoperative four weeks.The other two patients obtained fracture healing at postoperative four and five months respectively,without implant loosening.Condusions Combined anterior and posterior approaches can not only be the first choice for treatment of cervical spinal fracture following ankylosing spondylitis,but also be used for patients with bone defect at fracture site or separation at fracture end,with no necessity of postoperative external fixation.Single posterior reduction and fixation can be considered in patients with transvertebral fracture in the absence of bone defect,separation at fracture end,displacement or slight displacement,with necessary postoperative external fixation.However,single anterior fixation takes risk of implant failure and needs postoperative external fixation.

Objective To evaluate the role of the short-segment transpedicular instrumentation and fusion in the treatment of thoracic and lumbar spine unstable fractures. Methods We reviewed 121 patients of thoracic and lumbar vertebral fractures treated by short-segment transpedicular instrumentation (attachment of one level above the fracture to one level below the fracture) by using an AO Universal Spine System (USS), plus posterolateral fusion by using autogenous iliac crest bone graft. Results Out of the 121 cases, 104 had been followed clinically, radiographically, and functionally for 12 to 72 months (mean 31.3 months). Follow-up observations showed that, 101 patients (97.1%) had neurological function improvement more than one Frankel grade (3 no change), the average loss of vertebral body height basically reversed to normal (mean 58.3% preoperatively versus mean 3.2% postoperatively, with mean loss of 2.1% in follow-up), and the kyphotic angles were basically corrected (mean 29?preoperatively versus mean 3.4?postoperatively, with mean loss of 3.4?in follow-up). Conclusions The short-segment transpedicular instrumentation and fusion can provide excellent reduction and fixation, indirect decompression, and stabilization for unstable thoracic and lumbar fractures. The USS may be effectively employed in the short-segment fixation of thoracic and lumbar fractures.[