Background Few data on ankle fractures in China from large multicenter epidemiological and clinical studies are available.The aim of this research was to evaluate the epidemiological features and surgical outcomes of ...Background Few data on ankle fractures in China from large multicenter epidemiological and clinical studies are available.The aim of this research was to evaluate the epidemiological features and surgical outcomes of ankle fractures by reviewing 235 patients who underwent ankle fracture surgery at five hospitals in China.Methods This study included patients who underwent ankle fracture surgery at five Chinese hospitals from January 2000 to July 2009.Age,gender,mechanism of injury,Arbeitsgemeinschaft für Osteosynthesefragen （AO） fracture type,fracture pattern,length of hospital stay and treatment outcome were recorded.Statistical analyses were conducted using SPSS software.The American Orthopedic Foot and Ankle Society （AOFAS） ankle-hindfoot scale,visual analogue scale （VAS）,and arthritis scale were used to evaluate outcome.Results Of 235 patients with ankle fractures,105 were male with an average age of 37.8 years and 130 were female with an average age of 47.3 years.The average follow-up period was 55.7 months.There were significant differences in the ratios of patients in different age groups between males and females,and in mechanisms of injury among different age groups.There were also significant differences in the length of hospital stay among different fracture types and mechanisms of injury.In healed fractures,the average AOFAS ankle-hindfoot score was 95.5,with an excellence rate of 99.6%,the average VAS score was 0.17,and the average arthritis score was 0.18.Movement of the injured ankle was significantly different to that of the uninjured ankle.There were no significant differences between AO fracture types,fracture patterns or follow-up periods and AOFAS score,but there were some significant differences between these parameters and ankle joint movements,pain VAS score and arthritis score.Conclusions Ankle fractures occur most commonly in middle-aged and young males aged 20-39 years and in elderly females aged 50-69 years.The most common mechanisms of injury are twisting injuries and falls from a standing height or less.The results of surgical treatment are satisfactory.展开更多
Background Sacral nerve injury is a common complication of pelvic or sacral fractures. As the sacral nerve courser within the sacrum and has a complex relationship with the surrounding tissues, different parts of the ...Background Sacral nerve injury is a common complication of pelvic or sacral fractures. As the sacral nerve courser within the sacrum and has a complex relationship with the surrounding tissues, different parts of the sacral plexus injury have similar clinical symptoms and signs. Since lack of specific imaging technique in the diagnosis of sacral nerve injury,especially on multi-segment, multi-site, how to determine the preoperative location and extent of the sacral nerve injury accurately becomes a concem of the general orthopaedic and images practitioners. This study was conducted to gain an insight into the overall anatomical features of the sacral nerve （SN） on the same slice in high resolution computed tomography （HRCT） reconstruction and to determine the value of this information for the clinical diagnosis of related diseases.Methods Fifty healthy volunteers and 30 patients （40 sides） with SN lesions confirmed by surgery were scanned using a 16-slice helical CT scanner （Light Speed, GE, USA）. Among the patients, 6 with intervertebral disk hernia （6 sides）, 8with spinal stenosis （12 sides）, 11 with pelvic trauma （14 sides）, 4 with pelvic malignancies （6 sides）, and 1 with sacral vertebral tuberculosis （2 sides）. The SN multiplanar reconstruction was performed using a UNIX-based SCD4.1workstation where the image was set on the same slice. All images were stored in the Digital Imaging and Communications in Medicine format. The display of nerves in different sections was analyzed using a five-graded scale with coordinate curves of each individual score. The overall anatomic features visible on the slice were analyzed and the abnormalities of the lesions were studied.Results The image of the same slice clearly revealed the shape, running direction, thickness, tension and adjacent anatomy of the S1-S4 nerves. The rank of display rates in different sections was： outward-rotated oblique sagittal 〉outward-rotated oblique coronal 〉 oblique coronal plane 〉 coronal 〉 sagittal 〉 transverse section. The S5 nerve was partially displayed from the starting point to the segment around the posterior sacral foramen. The overall anatomy of the triangular sacral plexus was only revealed in the oblique outward-rotated sagittal section, while 100% of its individual rami,as well as two or three of the adjacent rami, were displayed from their starting points to the anterior border of the piriformis. The abnormalities included 39 sides of morphological change （97.5%）, 38 sides of compression （95.0%）, 35sides of adhesion （87.5%）, 32 sides of displacement （80.0%）, 34 sides of shrinkage （85.0%）, 6 sides of thickening （15.0%）, and 2 sides of abruption （5.0%）.Conclusions The 16-slice CT multiplanar reconstruction was able to reveal the overall anatomic features of the SN on the same slice. The section of reconstruction was a crucial factor in determining the display capability of various sacral nerves. This technology was valuable in the diagnosis and management of related diseases.展开更多
Background There are few researches for the healing of metaphyseal fractures; moreover,the animal models to study the metaphyseal fractures are usually made by the oscillating saw osteotomy without reliable fixation,w...Background There are few researches for the healing of metaphyseal fractures; moreover,the animal models to study the metaphyseal fractures are usually made by the oscillating saw osteotomy without reliable fixation,which is not in accordance with our current clinical practice.In this study,we established a new model to observe the healing process of metaphyseal fractures.Methods Eighteen New Zealand rabbits were used in the study.The fracture model was created by splitting the medial tibial plateau in rabbits,then reset,and fixed with compression screws.At 1,2,3,4,6,and 8 weeks postoperatively,the tibial specimens were collected; firstly,a general observation and an X-ray examination of the specimens was done,and then they were embedded in methylmethacrylate and cut into sections with hard tissue slicer.The sections were stained with Giemsa reagent and examined under light microscopy.Results There was no fracture displacement in the tibial specimens of all time points,except for one showing a collapse.No external callus formation could be observed by X-ray and general examination.After 1 week of the operation,the fracture gap was filled by mesenchymal tissue; 2 weeks postoperatively,a large number of woven bones were formed; from the third week onwards,the woven bone began to turn into lamellar bone,and new trabecular structure began to form.In all of the slices,no obvious chondrocytes formed in fracture areas; thus,there was no endochondral ossification.Conclusions This model was an ideal fracture animal model and suitable for the study of metaphyseal fracture healing.The X-ray and histological images demonstrated that metaphyseal fracture healing was a process of direct bone healing through intramembranous bone formation under the conditions of minor trauma,good reduction,and firm fixation.展开更多
With the development of medical science, orthopaedic traumatology, which derives from orthopaedics, becomes an important sub-discipline. Orthopedic traumatology includes： （1） fracture of limbs and spine; （2） inju...With the development of medical science, orthopaedic traumatology, which derives from orthopaedics, becomes an important sub-discipline. Orthopedic traumatology includes： （1） fracture of limbs and spine; （2） injury to blood vessels, nerves, muscles and tendons; （3） traumatic skin defects of the limbs; （4） the limb injury and spinal cord injury, etc. Since the end of the 20th century, the orthopaedic traumatology field has been developing rapidly, and is becoming one of the four major sub-groups of orthopaedics along with musculoskeletal and tumor surgery, spinal surgery, and joint surgery.展开更多
To the editor： It is well known that outgrovah of collateral sprouts is a natural process during regeneration of theperipheral nervous system. However, current knowledge about this phenomenon was that aberrant growth...To the editor： It is well known that outgrovah of collateral sprouts is a natural process during regeneration of theperipheral nervous system. However, current knowledge about this phenomenon was that aberrant growth of axonal sprouts may lead to the fbrmation of persistent neuromas,1.2 From our previous work3-5 verified effectively in clinical environment for nerve repairing and related experiments by small gap sleeve neurorrhaphy, we made a possible inference for peripheral nerve collateral regeneration and functional repairing; the hypothesis of using these collateral sprouts as an auto graft resource to recover the injured nerve.展开更多
文摘Background Few data on ankle fractures in China from large multicenter epidemiological and clinical studies are available.The aim of this research was to evaluate the epidemiological features and surgical outcomes of ankle fractures by reviewing 235 patients who underwent ankle fracture surgery at five hospitals in China.Methods This study included patients who underwent ankle fracture surgery at five Chinese hospitals from January 2000 to July 2009.Age,gender,mechanism of injury,Arbeitsgemeinschaft für Osteosynthesefragen （AO） fracture type,fracture pattern,length of hospital stay and treatment outcome were recorded.Statistical analyses were conducted using SPSS software.The American Orthopedic Foot and Ankle Society （AOFAS） ankle-hindfoot scale,visual analogue scale （VAS）,and arthritis scale were used to evaluate outcome.Results Of 235 patients with ankle fractures,105 were male with an average age of 37.8 years and 130 were female with an average age of 47.3 years.The average follow-up period was 55.7 months.There were significant differences in the ratios of patients in different age groups between males and females,and in mechanisms of injury among different age groups.There were also significant differences in the length of hospital stay among different fracture types and mechanisms of injury.In healed fractures,the average AOFAS ankle-hindfoot score was 95.5,with an excellence rate of 99.6%,the average VAS score was 0.17,and the average arthritis score was 0.18.Movement of the injured ankle was significantly different to that of the uninjured ankle.There were no significant differences between AO fracture types,fracture patterns or follow-up periods and AOFAS score,but there were some significant differences between these parameters and ankle joint movements,pain VAS score and arthritis score.Conclusions Ankle fractures occur most commonly in middle-aged and young males aged 20-39 years and in elderly females aged 50-69 years.The most common mechanisms of injury are twisting injuries and falls from a standing height or less.The results of surgical treatment are satisfactory.
基金This study was supported by the National Natural Science Foundation of China （No. 30973066）.
文摘Background Sacral nerve injury is a common complication of pelvic or sacral fractures. As the sacral nerve courser within the sacrum and has a complex relationship with the surrounding tissues, different parts of the sacral plexus injury have similar clinical symptoms and signs. Since lack of specific imaging technique in the diagnosis of sacral nerve injury,especially on multi-segment, multi-site, how to determine the preoperative location and extent of the sacral nerve injury accurately becomes a concem of the general orthopaedic and images practitioners. This study was conducted to gain an insight into the overall anatomical features of the sacral nerve （SN） on the same slice in high resolution computed tomography （HRCT） reconstruction and to determine the value of this information for the clinical diagnosis of related diseases.Methods Fifty healthy volunteers and 30 patients （40 sides） with SN lesions confirmed by surgery were scanned using a 16-slice helical CT scanner （Light Speed, GE, USA）. Among the patients, 6 with intervertebral disk hernia （6 sides）, 8with spinal stenosis （12 sides）, 11 with pelvic trauma （14 sides）, 4 with pelvic malignancies （6 sides）, and 1 with sacral vertebral tuberculosis （2 sides）. The SN multiplanar reconstruction was performed using a UNIX-based SCD4.1workstation where the image was set on the same slice. All images were stored in the Digital Imaging and Communications in Medicine format. The display of nerves in different sections was analyzed using a five-graded scale with coordinate curves of each individual score. The overall anatomic features visible on the slice were analyzed and the abnormalities of the lesions were studied.Results The image of the same slice clearly revealed the shape, running direction, thickness, tension and adjacent anatomy of the S1-S4 nerves. The rank of display rates in different sections was： outward-rotated oblique sagittal 〉outward-rotated oblique coronal 〉 oblique coronal plane 〉 coronal 〉 sagittal 〉 transverse section. The S5 nerve was partially displayed from the starting point to the segment around the posterior sacral foramen. The overall anatomy of the triangular sacral plexus was only revealed in the oblique outward-rotated sagittal section, while 100% of its individual rami,as well as two or three of the adjacent rami, were displayed from their starting points to the anterior border of the piriformis. The abnormalities included 39 sides of morphological change （97.5%）, 38 sides of compression （95.0%）, 35sides of adhesion （87.5%）, 32 sides of displacement （80.0%）, 34 sides of shrinkage （85.0%）, 6 sides of thickening （15.0%）, and 2 sides of abruption （5.0%）.Conclusions The 16-slice CT multiplanar reconstruction was able to reveal the overall anatomic features of the SN on the same slice. The section of reconstruction was a crucial factor in determining the display capability of various sacral nerves. This technology was valuable in the diagnosis and management of related diseases.
基金This research was funded by grants from the Chinese National Natural Science Fund for Outstanding Youth （No.30625036）,Chinese ＂973 Project Planning＂ （No.2005CB522604）,National Natural Science Foundation of China （Nos.81171146,30971526,31040043）,Beijing Natural Science Foundation （No.7113170）,and Doctoral Fund of Ministry of Education of China （No.20090001120096）.
文摘Background There are few researches for the healing of metaphyseal fractures; moreover,the animal models to study the metaphyseal fractures are usually made by the oscillating saw osteotomy without reliable fixation,which is not in accordance with our current clinical practice.In this study,we established a new model to observe the healing process of metaphyseal fractures.Methods Eighteen New Zealand rabbits were used in the study.The fracture model was created by splitting the medial tibial plateau in rabbits,then reset,and fixed with compression screws.At 1,2,3,4,6,and 8 weeks postoperatively,the tibial specimens were collected; firstly,a general observation and an X-ray examination of the specimens was done,and then they were embedded in methylmethacrylate and cut into sections with hard tissue slicer.The sections were stained with Giemsa reagent and examined under light microscopy.Results There was no fracture displacement in the tibial specimens of all time points,except for one showing a collapse.No external callus formation could be observed by X-ray and general examination.After 1 week of the operation,the fracture gap was filled by mesenchymal tissue; 2 weeks postoperatively,a large number of woven bones were formed; from the third week onwards,the woven bone began to turn into lamellar bone,and new trabecular structure began to form.In all of the slices,no obvious chondrocytes formed in fracture areas; thus,there was no endochondral ossification.Conclusions This model was an ideal fracture animal model and suitable for the study of metaphyseal fracture healing.The X-ray and histological images demonstrated that metaphyseal fracture healing was a process of direct bone healing through intramembranous bone formation under the conditions of minor trauma,good reduction,and firm fixation.
文摘With the development of medical science, orthopaedic traumatology, which derives from orthopaedics, becomes an important sub-discipline. Orthopedic traumatology includes： （1） fracture of limbs and spine; （2） injury to blood vessels, nerves, muscles and tendons; （3） traumatic skin defects of the limbs; （4） the limb injury and spinal cord injury, etc. Since the end of the 20th century, the orthopaedic traumatology field has been developing rapidly, and is becoming one of the four major sub-groups of orthopaedics along with musculoskeletal and tumor surgery, spinal surgery, and joint surgery.
文摘To the editor： It is well known that outgrovah of collateral sprouts is a natural process during regeneration of theperipheral nervous system. However, current knowledge about this phenomenon was that aberrant growth of axonal sprouts may lead to the fbrmation of persistent neuromas,1.2 From our previous work3-5 verified effectively in clinical environment for nerve repairing and related experiments by small gap sleeve neurorrhaphy, we made a possible inference for peripheral nerve collateral regeneration and functional repairing; the hypothesis of using these collateral sprouts as an auto graft resource to recover the injured nerve.
