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Chinese Journal of Orthopaedic Trauma.2004;0(09):-.

Objective Osteoporosis and tumble are the most common risky factor for geriatric fracture that usually involve spine, hip, and distal radius. The major preventive measures include reasonable exercises, nourishment, and avoidance of substance abuse. To measure bone mineral density is valuable in predicting the risk of hip fracture. Little change will occur in the healing course of geriatric fractures, but the new born formation is slow and the healing time of later stage long. This paper recommends the therapeutic principle, procedure and difficulty in the treatment of geriatric fractures.

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Minimally invasive treatment of osteoporotic vertebral compression fracture

Yan WANG

Chinese Journal of Orthopaedic Trauma.2004;0(09):-.

Osteoporotic vertebral compression fracture is a leading cause of pain and disability for the elderly. It tends to occur more frequently as the senile population continues to increase. The traditional treatment and surgery are often poorly tolerated by the elderly. In recently years, the minimally invasive percutaneous vertebroplasty and percutaneous kyphoplasty have become common procedures to treat painful vertebral compression fractures. Percutaneous injection of bone cement or expansion of an inflatable sacculus to enlarge the compressed vertebra before the vertebral body is strengthened by cement deposition can stabilize the fracture and reduce pain. This article is to review the indications, surgical techniques, clinical results and complications for vertebroplasty and kyphoplasty in recent years.

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How to understand the reasonable treatments of fracture

Yichong WANG

Chinese Journal of Orthopaedic Trauma.2002;0(01):-.

Through the clinical and basic research during the last 30 years, people have realized the one sidedness of the biomechanical viewpoint of AO resuming the anatomical continuity and mechanical integrity early. The specialists put forward improved measurements in many aspects including reduction procedures, fixation methods and modalities of osteosynthesis. The new concept of fracture treatments with a biological viewpoint BO(Biological Osteosynthesis) has been set up progressively. It stresses on the maintenance of the blood supply of surrounding soft tissues as the most important element in the osteosynthesis. The author suggests that it would be more precise if we take the BO for biological logical osteosynthesis. Certainly, non operative osteosynthesis must be taken seriously too.

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Progress in study of road traffic injuries

Zhengguo WANG

Chinese Journal of Orthopaedic Trauma.2002;0(01):-.

Nowadays, more than 1 million people died and about 15 million people injuried as a result of traffic accidents every year in the world. The incidence of traffic injuries on road tends increasingly today. The injuried and died cases most commonly were the young whose damages were characterized as multiple injury. Causes of the accidents were mainly the human factors. The young adults aged less than 24 years and the old aged more than 70 years were in the majority. The traffic accidents have it's own proneness. The viscous injury criterion can be used as a most effective trauma index. The necessary measures for reducing the traffic accident and decreasing mortality should be considered the comprehensive treatments as follows: strengthening the research of the traffic safety, the management and the education, completing the medical service system, strengthening the first-aid of trauma, and shortening the first-aid reactive time.

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Microanatomy and histological study of the fascicular group to deltoid muscle in axillary nerve at the level of quadrilateral zone

Shaoguang LI ; Liqiang GU

Chinese Journal of Orthopaedic Trauma.2002;0(01):-.

Objective To observe and study the distribution and histological feature of the fascicular groups to deltoid muscle in axillary nerve at the level of quadrilateral zone. Methods 12 adult human cadavers (24 upper limbs)embalmed by formalin were used,, and microsurgical longitudinal contradissection of the axillary nerves by tracing their terminal branches were processed. At the level of quadrilateral zone,distrabution of the fscicular groups to deltoid muscle in the never trunk were recorded and their diameters were measured;Another 6 upper extremities (3 right and 3 left) of fresh-frozen human cadavers were obtained.Axillary nerves and their fascicular groups were exposured, and the segments at the level of qusdrilateral zone gotten, then histological cross section was done, acetycholinesterase (ACHE) stained with the method of Karnovsky Roots and myelin stained with the method of Loyezs. Defferent never fibres were distinguished under microscope and the fiber number was counted with IAS . Results At the level of quadrilateral zone,fasciculars were divided into two groups.The fascicular group of anterior branch to deltoid muscle was in the lateral of the nerve trunk . Its cross sectional area was (2.449?1.327)mm2 ,occupied 55.4%?9.3%of the axillary nerve trunk ;Its most fibers were motor fibers;The number of fibers is (2112?631), occupied 45.6 %?1.1%of all fibers of axillary nerve . Conclusions In the treatment of root avulsion of brachial plexus injury, selective suture donor nerve with the lateral fascicular group should be processed to repair the function of shoulder abduction,fibers loss would be reduced and rate of functional restoration improved .

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Comparison of tensile properties of palmar or dorsal placement of stitches in repairing the tendons across the joints

Yu ZHANG ; Jinbo TANG ; Bin WANG

Chinese Journal of Orthopaedic Trauma.2002;0(01):-.

Objective This study was designed to evaluate the biomechanical properties in tendons across the joints when Palmar or dorsal stitches were used. Methods Twenty porcine tendons were transected and then repaired in zone Ⅱand divided into two groups,using modified Kessler by placing the stitches in volar or dorsal part of tendons.The repaired tendons were placed on a joint model with flexion of 60?. An instron tensile testing machine was used to investigate 2 mm gap formation force and ultimate tensile strength. Results 2 mm gap formation force and ultimate tensile strength were both higher when dorsal placement of stitches was used. Conclusions Dorsal placement of stitches was recommended for repairing the tendons across the joints because it can offer greater tensile strength.

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An experimental study of guided bone regeneration using collagen membrane

Honggang GUO ; Baixun ZHANG ; Shibi LU

Chinese Journal of Orthopaedic Trauma.2002;0(01):-.

Objective The purpose of this study is to observe the property of guided bone regeneration by collagen membrane and investigate the mechanism of guided bone regeneration. Methods 10mm defect of radius was created bilaterally in adult New Zealand rabbits. The experimental group was transplanted by collagen membrane with surface decalcified bone allograft,and the control group was transplanted by surfaced decalcified bone allograft alone.Radiological and histological and immunohistochemical examinations were taken postoperatively. Results In the transplantation area of experimental group,distinctive periosteal reaction and new bone growth occurred remarkably,bone remodeling progressed successfully,and defects healed completely.But in the transplantation area of the control group,new bone growth and mature bone replacement were delay due to occupation of fibrous connective tissue. Conclusions Collagen membrance has an ability to block and guide.In addition,membrane tube can keep endogenic BMP with exogenic BMP greatly concentrating and effectively distributing. The distributive characteristic of BMP exerts an influence on cellular resources and pattern of bone healing.

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Repair of serious medial collateral ligaments reuptures of the knee

Bin CHEN ; Yinwang ZHENG ; Weijiang ZHOU

Chinese Journal of Orthopaedic Trauma.2002;0(01):-.

Objective To study surgical therapy of the serious medial collateral ligament ruptures of the knee. Methods 12 patients with acute medial collateral ligament ruptures were treated operatively.Their degrees of injury were all Ⅲdegree that superficial and deep collateral ligaments were completely ruptured.Some of them were accompanied with the injury of medial joint capsule ligament or anterior cruciate ligament or posterior cruciate ligament.The torn medial collateral ligaments were anatomically corrected by their ends with direct suture or staple internal fixation.They were followed 6 to 18 months. Results 12 patients were graded with the Lysholm score .The postoperative score (mean, 76; range, 59 to 90) was higher compared with the preoperative score (mean, 35; range, 20 to 54), P

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Clinical report of fracture complicated with brain-type fat embolism syndrome

Tingyou FU ; Zhaohui LAN

Chinese Journal of Orthopaedic Trauma.2002;0(01):-.

Objective To study on diagnosis and treatment of brain type fat embolism syndrome complicated with fracture. Method The diagnosis and treatment of 7 cases of brain type fat embolism syndrome complicated with fracture were reviewed. All of 7 cases did not have any brain injury, 3 cases were complicated with femural fracture, 3 cases with fractures of tibia and fibula, and 1 cases with limbs multi fracture. They presented somnolence or coma complicated with rise in temperature (37.7℃～39℃) ,increase in breath and heart rate,anemia,small bleeding spots at chest. It was discussed how to distinguish brain type fat embolism syndrome from brain injury. Synthetical measure was adopted mainly using dexamethasone (20～80mg/d). Results 7 cases of brain type fat embolism syndrome complicated with fracture were cured in 1～7 days. Conclusions Sudden somnolence or coma that does not result from brain injure after limb fracturees in early stage can be diagnosed as brain type fat embolism syndrome. A synthetical measure should be adopted by mainly using dexamethasone (40～80mg/d) .

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Postmedial approach to the knee for repair and reconstruction of the posterior cruciate ligament(24 cases report)

Hongfu SHI ; Xianhua CAI ; Xiding WANG

Chinese Journal of Orthopaedic Trauma.2002;0(01):-.

Objective To describe postmedial approach to the knee and discuss the main technique using it to repair and reconstruct posterior cruciate ligament (PCL). Methods 24 patients with PCL injury were operated on with the postmedial approach. 13 cases were repaired directly using the technique of pulling out steel wire and 11 cases were reconstructed by semitendinosus. Prone position was adopted in 16 cases and supine position in 8 cases (21 cases had been followed up over six months). Applied anatomy, main techniques and clinical results were evaluated. Results The postmedial approach saved 30～60 minutes compared with the posteior approach, and was not restricted by body posture. Neurovascular structure did not need to be dissected, PCL repair and reconstruction could be finished in one incision.By a six month follow up evaluation, no symptoms of instability occured and they were completely stable on physical examination. Conclusion The postmedial approach is simple, safe, and yields excellent exposure. It's an ideal approach for repair and reconstruction of the PCL.The technique of pulling and steel wire and semitendinosas drawn out "U" shaped pins fixation are essential methods to repair and reconstruct the PCL.

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