The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters fol...The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters following treatment of intra-articular fractures of the distal radius （IFDR） in patients older than 65 years. We hypothesized that using volar or dorsal plating would improve functional outcomes, but that it would be associated with more complications and equivalent functional outcomes when compared with the external fixation group. A total of 123 consecutive patients suffering from IFDR were recruited into the study. The patients were measured for clinical, radiological, and psychosocial functioning outcomes and were followed up after I week and 3, 6 and 12 months. After 3 months, the plating group had better pronation （P = 0.001）, supination, （P = 0.047） and extension （P = 0.043） scores. These differences were somewhat attenuated by 6 months and disappeared at I year. The plating group had a greater occurrence of wound infection （P = 0.043）, tendonitis, （P = 0.024） and additional surgery compared with the external fixation group. The only TNO-AZL Adult Quality of Life scores in the plating group that were lower than those in the external fixation group were in the ＂gross motor＂ category （walking upstairs, bending over, walking 500 yards; P = 0.023）. Internal fixation was more advantageous than external fixation in the early rehabilitation period; after I year the outcomes were similar. The plating group showed significantly higher levels of wound infection and tendonitis and had a greater need for additional surgeries.展开更多
Objective： To explore the therapeutic ef- fect of osteogenically induced adipose-derived stem cells （ADSCs） on vascular deprivation-induced osteonecrosis of the femoral head （ONFH） in rabbit model. Methods： Vas...Objective： To explore the therapeutic ef- fect of osteogenically induced adipose-derived stem cells （ADSCs） on vascular deprivation-induced osteonecrosis of the femoral head （ONFH） in rabbit model. Methods： Vascular deprivation-induced ONFH was established by intramuscular injection of methylpre- dnisolone, and vascular occlusion of the capital femoral epiphysis by electrocoagulation in adult New Zealand white rabbits. Eight weeks afLer the establishment of vascular dep- rivation-induced ONFH, animals were randomly divided into three equal groups. In Group A （control）, no therapy was given. In Group B, core decompression was performed by drilling a hole （1.2 mm in diameter） from the outer cortex 2.5 cm distal to the proximal end of the greater trochanter. In Group C, 1 x 107 osteogenically induced ADSCs were resus- pended in 0.5 ml PBS, and then injected directly into the femoral head. Femoral head specimens were obtained at postoperative 8 weeks. The bone formation and three-di- mensional microstructure of the femoral head was evaluated by micro-computed tomography scans （u-CT）. Immunohistochemical analysis was performed to detect the expression ofosteocalcin. Angiogenesis and repair of the femoral head were observed histologically. Results： In trabecular bone at the proximal femur region, the trabecular volume was higher in Group C （130.70 mm3± 4.33 mm3） than that in Groups A （101.07 mm3±7.76 mm3） and B （107.89 mm3±8.6g mm3, P〈0.01）. Bone volume was significantly increased in Group C （40.09 mm3±6.35 mm3） than in Groups A （29.65 mm3±4.61 mm3） and B （31.80 mm3± 4.01 mm3, P〈0.01）. The trabecular number was higher in Groups C （1.58±0.25） than other two groups （1.15±0.18, 1.16± 0.21, P〈0.01）. Bone mineral density showed statistically significant difference between Groups C and A or B （375.38± 23.06） mg HA/ccm, vs （313.73 ± 19.30） mg HA/ccm and （316.09± 16.45） mg HA/ccm, P〈0.01）. Histological examination indicated that there was more new bone formation in Group C than in other groups. Conclusion： Treatment with autologous osteogenically induced ADSCs transplantation results in an enhanced osteogenesis and microstructure of the vascular deprivation-induced osteonecrosis in rabbits.展开更多
基金supported by National Natural Science Foundation of China Grant 81560350
文摘The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters following treatment of intra-articular fractures of the distal radius （IFDR） in patients older than 65 years. We hypothesized that using volar or dorsal plating would improve functional outcomes, but that it would be associated with more complications and equivalent functional outcomes when compared with the external fixation group. A total of 123 consecutive patients suffering from IFDR were recruited into the study. The patients were measured for clinical, radiological, and psychosocial functioning outcomes and were followed up after I week and 3, 6 and 12 months. After 3 months, the plating group had better pronation （P = 0.001）, supination, （P = 0.047） and extension （P = 0.043） scores. These differences were somewhat attenuated by 6 months and disappeared at I year. The plating group had a greater occurrence of wound infection （P = 0.043）, tendonitis, （P = 0.024） and additional surgery compared with the external fixation group. The only TNO-AZL Adult Quality of Life scores in the plating group that were lower than those in the external fixation group were in the ＂gross motor＂ category （walking upstairs, bending over, walking 500 yards; P = 0.023）. Internal fixation was more advantageous than external fixation in the early rehabilitation period; after I year the outcomes were similar. The plating group showed significantly higher levels of wound infection and tendonitis and had a greater need for additional surgeries.
基金This work is supported by a grant from the National Natural Science Foundation of China （30960390） and Doctoral Innovation Fund of Xinjiang Medical University （DC2010-12）.
文摘Objective： To explore the therapeutic ef- fect of osteogenically induced adipose-derived stem cells （ADSCs） on vascular deprivation-induced osteonecrosis of the femoral head （ONFH） in rabbit model. Methods： Vascular deprivation-induced ONFH was established by intramuscular injection of methylpre- dnisolone, and vascular occlusion of the capital femoral epiphysis by electrocoagulation in adult New Zealand white rabbits. Eight weeks afLer the establishment of vascular dep- rivation-induced ONFH, animals were randomly divided into three equal groups. In Group A （control）, no therapy was given. In Group B, core decompression was performed by drilling a hole （1.2 mm in diameter） from the outer cortex 2.5 cm distal to the proximal end of the greater trochanter. In Group C, 1 x 107 osteogenically induced ADSCs were resus- pended in 0.5 ml PBS, and then injected directly into the femoral head. Femoral head specimens were obtained at postoperative 8 weeks. The bone formation and three-di- mensional microstructure of the femoral head was evaluated by micro-computed tomography scans （u-CT）. Immunohistochemical analysis was performed to detect the expression ofosteocalcin. Angiogenesis and repair of the femoral head were observed histologically. Results： In trabecular bone at the proximal femur region, the trabecular volume was higher in Group C （130.70 mm3± 4.33 mm3） than that in Groups A （101.07 mm3±7.76 mm3） and B （107.89 mm3±8.6g mm3, P〈0.01）. Bone volume was significantly increased in Group C （40.09 mm3±6.35 mm3） than in Groups A （29.65 mm3±4.61 mm3） and B （31.80 mm3± 4.01 mm3, P〈0.01）. The trabecular number was higher in Groups C （1.58±0.25） than other two groups （1.15±0.18, 1.16± 0.21, P〈0.01）. Bone mineral density showed statistically significant difference between Groups C and A or B （375.38± 23.06） mg HA/ccm, vs （313.73 ± 19.30） mg HA/ccm and （316.09± 16.45） mg HA/ccm, P〈0.01）. Histological examination indicated that there was more new bone formation in Group C than in other groups. Conclusion： Treatment with autologous osteogenically induced ADSCs transplantation results in an enhanced osteogenesis and microstructure of the vascular deprivation-induced osteonecrosis in rabbits.
