Bone Nails ; adverse effects ; Bone Plates ; adverse effects ; Hip Fractures ; physiopathology ; surgery ; therapy ; Humans ; Prostheses and Implants ; adverse effects

The terrible triad of elbow is a kind of complex elbow fracture dislocation, after reduction, it should get a concentric circles joint reduction and elbow stability, if radial and coronoid process fractures is less piece, the conservative treatment can be performed, but regularly follow up is mandatory. If surgical treatment was chosen, radial head fractures and the lateral collateral ligament complex must be repaired. Single lateral approach can be used and also can be combined with anteromedial approach in surgery. Some problems are still controversial in the treatment of coronoid process fracture with Morry type I and type II, such as fixation or not, whether additional external fixation and repair of the medial collateral ligament injury at the same time.

Surgery is the preferred method for the treatment of spinal canal disease, surgical method involves laminectomy and laminoplasty. The ideal spinal surgery not only should fully expose the spinal canal, completely resect the occupied position and remove the spinal cord compression, but also should maintain the stability of spinal biomechanics. Because of the different realization of clinician to safeguard and rebuild the spinal stabilization during opertion of spinal canal disease, and choice of surgical method and how to maintain the stability of spine biomechanics has become a hot of research in this field. Many scholars have studied it in order to reduce the influence of laminectomy on the spinal stability. Laminoplasty can directly relieve the nerve roots compression caused by increasing or reconstruction of vertebral canal volume, and allow the migration of spinal cord to dorsum and depart from disc and vertebral body. Laminoplasty not only can fully expose and decompress during operative, but also may prevent the postoperative spinal instability. In addition to these condition of extensive disease, severe bone destruction or combined with osteoporosis, the laminoplasty is the most ideal method for single spinal canal disease in theoretically.

Arthroplasty, Replacement, Knee ; adverse effects ; rehabilitation ; Humans ; Postoperative Complications ; prevention & control ; Recovery of Function

Aseptic loosening, ascribes to particle induced osteolysis, is the most common reason for total joint arthroplasty failure. Wear particles, liberated from the surface of prostheses, mediate the expression of inflammatory cytokines in macrophages and increase the osteoclastogenesis. However, it remains unclear how macrophages can recognize wear particles and be induced by wear particles. Recently, a number of studies have demonstrated that Toll like receptors and inflammasome may play a critical role in osteolysis. However, the mechanism of activation of Toll like receptors and the relationship between TLR pathway and downstream signaling pathways still remain unclear. It will be beneficial to understand the pathogenesis of aseptic loosening by exploring these mechanisms. This article highlights the role of Toll like receptors and inflammasome in aseptic loosening, which is helpful to the development of therapies that prevent wear particle induced aseptic loosening.

OBJECTIVETo investigate the opportune time of secondary definitive surgery for patients with multiple injuries from earthquakes based on the acute physiology and chronic health evaluation II (APACHE II) score and the principles of damage control.

METHODSTwenty-one patients with critical earthquake injuries were treated with damage control strategies, followed by medical support and surgical intervention to restore their physical potential in the intensive care unit (ICU). Successive APACHE II scoring was adopted to evaluate the patients'physiological status, and then, internal fixation of fractures and other definitive operations were performed.

RESULTSAll the patients were effectively treated with few complications, low deformity rate and no death.

CONCLUSIONSAppropriate evaluation of patients?physiological potential, right decision on surgical time and proper operative method can reduce the rates of complications, disability and death for patients with critical earthquake injuries.

APACHE ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; Disasters ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; surgery

Arthroplasty, Replacement, Hip ; Humans ; Postoperative Care ; Postoperative Complications

OBJECTIVE: To compare the clinical effects of total hip arthroplasty(THA) with non-osteotomy and subtrochanteric osteotomy in the treatment of Crowe type IV hip dysplasia (DDH) in adults. METHODS: Data of 35 Crowe type IV DDH patients who underwent THA were analyzed retrospectively, the patients were divided into two groups:15 cases of non-osteotomy and 20 cases of subtrochanteric osteotomy. There was no significant difference in age, gender, body mass index between two groups (>0.05). The operative time, bleeding volume, hospitalization duration, Harris hip score and the limb length discrepancy (LLD) were evaluated. RESULTS: All of the patients were followed up for 12 to 48 months, no prosthesis loosening or infection occurred by the end of follow-up. In non-osteotomy group, 1 case had occurred by sciatic nerve injury and 1 case developed cutaneous branch injury of the femoral nerve, both of which were spontaneously recovered completely without treatment after 3 months. One case of dislocation occurred in subtrochanteric osteotomy group, after closed reduction, dislocation did not recur; three cases had proximal femoral crack fractures and received steel plate fixation; no reoperation was needed. There was significant difference in operation duration, bleeding volume, and hospitalization days between two groups(<0.05). The Harris score at last follow-up was significantly increased compared with preoperative score in two groups(<0.05), but there was no significant difference between two groups(>0.05). The postoperative discrepancy of bilateral lower limbs had significant difference(<0.05). CONCLUSIONS THA with no femoral shortening osteotomy can achieve good clinical results in patients with unilateral Crowe IV developmental dysplasia of hip. Comparing with subtrochanteric osteotomy, the procedure of no femoral shortening osteotomy is easier technically. For unilateral high dislocation DDH patients with limb lengthening <=4 cm and good tissue conditions, THA without femoral osteotomy may be considered.
Adult ; Arthroplasty, Replacement, Hip ; Femur ; Hip Dislocation, Congenital ; surgery ; Humans ; Osteotomy ; Retrospective Studies