A patient with 20-segments multi-planar amputation of the 2nd-5th fingers of the right hand was treated in December 2020 in the Department of Hand and Microsurgery, Affiliated Taihe Hospital of Hubei Universtiy of Medicine. The groupings was performed with microscopic anastomosis and splicing, and the replantation was finally completed. Followed-up at 1 year after surgery, the 17 segments of 20 severed finger segments finally survived. According to the Chinese Medical Association's Hand Surgery Branch's Functional Evaluation Criteria for Replantation of Amputated Fingers, the patient's finger function rating was 57 points and the function was poor at 1-year follow-up. The range of motion of the metacarpophalangeal joint was significantly improved compared with half a year after the operation. The simple grasping, pinching and fingering can be completed. The finger sensation was improved compared with half a year after the operation, but the finger body of right hand atrophied progressively, the interphalangeal joint was stiff, wirheut flexion nor extension range of motion. The function of the replanted finger was limited.

Objective To investigate the clinical values of sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients.Methods From June 2012 to September 2015 in Taihe Hospital Affiliated to Hubei Medical College,136 patellofemoral arthritis knee pain patients were selected and randomly divided into treatment group (68 cases) and control group (68 cases).All patients were given arthroscopic joint clean-up surgery,the control group were given the postoperative glucosamine sulfate capsules treatment,and the treatment group were given the postoperative intra-articular injection of sodium hyaluronate choose treatment,the treatment period was 5 weeks.Results Five weeks after treatment,the response rates in the treatment group and control group were 98.5％ (67/68) and 89.7％ (61/68),and the effect of the treatment group was better(x2 =4.202,P＜0.05).The pain scores in the treatment and control group were (1.34±0.45) points and (2.89±0.62) points,significandy lower than that of before operation ((7.30 ± 0.76) points and (7.31 ± 0.56) points;t =34.855,25.142;P ＜ 0.05).The Lysholm score in the treatment and control group were (88.87 ± 6.33) points and (76.13 ± 5.98) point,significantly higher than before operation ((44.23 ± 4.29) points and (44.67 ± 5.13) point;t =14.875,8.113;P＜0.05).The incidence of adverse events during the treatment in the treatment group and the control group were 8.8％(6/68) and 13.2％(9/68) respectively,there was no significant differemce between the two groups (x2 =0.391,P＞0.05).All adverse reactions after symptomatic treatment were improved.Conclusion Sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients can effectively play the role of promoting the knee pain and function,and has good efficacy and safety,and is worth popularizing and applying.

Objective To investigate the effect of arthroscopic reconstruction of anterior cruciate ligament on the expression of serum osteopontin (OPN) and CD44.Methods Ninety-six cases patients with joint cross ligament injury who were teated in Taihe Hospital Affiliated to Hubei University of Medicine from February 2013 to June 2015 were selected and randomly equally divided into treatment group and control group.Two groups were adopted arthroscopic surgical treatment,and the control group were given the singletunnel reconstruction,the treatment group were given the double-tunnel reconstruction.Results The IKDC scores of 3 months after operation in the treatment group and control group were (92.44±5.13)points and (85.25±4.67) points,both significantly lower than before operation ((57.24 ± 4.19) points,(57.10 ± 4.87)points;P ＜ 0.05)),while there was statistically significant difference between groups (P ＜ 0.05).The total complication rate after 3 months operation in the treatment group was 6.3％,significantly less than that of the control group (35.4％;x2 =5.838,P＜0.05).The OPN expression levels of before and 3 months after operation in the treatment group were (31.98±4.21) μg/L,(7.13±2.89) μg/L,and CD44 were (419.45±20.45) μg/L,(167.24± 18.46) μg/L,the differences were significant (t =34.214,21.774;P＜ 0.05).The OPN expression levels of before and 3 months after operation in the control group were (32.09 ± 3.98) μg/L,(15.98 ± 3.67) μg/L,and CD44 were (421.87 ± 19.45) μg/L,(245.98 ± 20.56) μg/L,the differences were significant (t=21.833,14.099;P＜0.05).There were significant differences on OPN and CD44 of after operation between the two groups (t =12.847,7.498;P＜ 0.05).Conclusion Compare to single-tunnel reconstruction,double-tunnel reconstruction for the anterior cruciate ligament endoscopic surgery can increase restore knee function and reduce postoperative complications,and its mechanism may effectively reduce the levels of OPN and CD44 expression.

OBJECTIVEThe purpose of this study was to observe the roentgenographic characters of distraction osteogenesis (DO) correction of cleft palate (CP), to study the expression of BMP proportional to fixation period time intervals, and to explore the new bone formation mechanism in Cleft Palate bone shelf.

METHODS12 cats were used to establish the CP animal model surgically, and then were assigned randomly to (1) Experimental group (12 cats): CP defects were DO repaired at the rate and rhythm of 0.4 mm x 2/day. Specimen retrieval at 2, 4, 6, 8, 12 weeks after completion of distraction, roentgenography and Anti-BMP immunohistochemistry studies were performed; (2) Experimental control group (2 cats): CP defects without any treatment procedures, and (3) Empty control group of 2 cats.

RESULTSAnti-BMP immunohistochemistry study showed positive DAB dye in early 2 weeks and most extensively positive expression of BMP in 4 to 6 weeks. The expression of BMP wore off gradually through 8 to 12 weeks. The roentgenography showed that the newly mineralized bone was developed from the cut bone edges bilaterally to the central transparent zone, and the newly formed bone bridged the defect area completely at the end of the study. The CP bone defect was reconstructed and the distraction gap was filled with de nove osteogenesis. No new bone formation was observed in experimental control group.

CONCLUSIONThe process of new bone formation in the distraction area is dynamic. Being stimulated primarily, the process was kept highly active till quiescence phase finally. The X-ray examination shows that there is distinctively low roentgenopeque. Nevertheless, roentgenography is so far a very effective and convenient method to evaluate and monitor the DO correction efficiency.

Animals ; Bone Morphogenetic Proteins ; biosynthesis ; metabolism ; Bone Regeneration ; Cats ; Cleft Palate ; diagnostic imaging ; metabolism ; surgery ; Osteogenesis ; Osteogenesis, Distraction ; Palate, Hard ; diagnostic imaging ; metabolism ; surgery ; Radiography ; X-Ray Film

OBJECTIVEThe aim of this study was to explore ultrastructural characters of the newly formed bone in the correction of cleft palate (CP) bone defect by distraction osteogenesis (DO).

METHODSThe CP experimental animal models (12 cats) were established surgically, and were divided randomly into the experimental group (10 cats), in which the hard palate bone defects were corrected with DO procedure at the rate of 0.4 mm x 2/day. The specimen retrieval with euthanasia was carried out at 2, 4, 6, 8, 12 weeks after completion of distraction. Ultrastructural study was then performed; the experimental control group (2 cats) was kept for 6 weeks before euthanasia without any correction, the other extra 2 cats were used as the negative control.

RESULTSNew bone formation appeared in early 2 weeks. Exclusively intramembranous bone formation was observed in all specimens. The remodeling activities were keep observed throughout the period of study, and the bone structure matured gradually till 12 weeks after the completion of DO. No repair was observed in experimental control group.

CONCLUSIONThe reconstruction of CP bone defect by means of DO could get active intramembranous bone formation and remodeling, which adapted to normal functional activities.

Animals ; Bone Regeneration ; Cats ; Cleft Palate ; pathology ; surgery ; Osteogenesis ; Osteogenesis, Distraction ; methods ; Palate, Hard ; ultrastructure

Objective: To observe the mechanism and characteristics of new bone formation and remodeling process during distraction osteogenesis (DO) in the reconstruction of bone defect in cleft palate (CP). Methods: Sagittal palatal osteoectomy were performed in 12 cats to establish the CP model. The CP defects were reconstructed by intraoral distractors at the rate and rhythm of 0.4 mm?2/day till the transport disc (TD) reached the opposite edge across the defect region. Tetrachloride fluorescent labeling was administered 6 days before euthanasia specimen retrieval at 2, 4, 6, 8, 12 weeks through fixation period. Histological and fluoroscopical study were performed; control groups (2 animals in each group) were set for comparison. Results: The bone defect of CP was successfully reconstructed by DO. Exclusively intramembranous de novo osteogenesis were observed. Soft tissues attaching to TD were elongated simultaneously. No spontaneous repair was observed in control animals. Conclusion: With effective distraction and steady fixation, CP bone and soft tissue defect can be reconstructed by active intramembranous bone formation and remodeling following the applicaion of DO.