Clinical Effectiveness of the Plate Screw Internal Fixation Technique in the Treatment of Patients with Traumatic Fractures of Long Bones in the Lower Extremities

Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 2022 to December 2023, 70 patients with traumatic fractures of long bones in the lower extremities were admitted to the hospital and randomly divided into two groups: the control group and the observation group, each consisting of 35 cases. The control group underwent traditional closed interlocking intramedullary nailing, while the observation group received internal fixation with steel plates and screws. Relevant surgical indicators, treatment effectiveness, and postoperative complication rates were compared between the two groups. Results: The observation group exhibited significantly short surgical duration (80.65 ± 5.01 vs. 88.36 ± 5.26 minutes), fracture healing time (13.27 ± 0.32 vs. 15.52 ± 0.48 weeks), and hospitalization days (10.49 ± 1.13 vs. 16.57 ± 1.15 days) compared to the control group (P = 0.000). The effective treatment rate was significantly higher in the observation group (29/82.86%) than in the control group (21/60.00%), with a significant difference observed (χ2 = 4.480, P = 0.034). Additionally, the complication rate in the observation group (2/5.71%) was significantly lower than that in the control group (8/22.86%), with a correlated difference (χ2 = 4.200, P = 0.040). Conclusion: The plate screw internal fixation technique demonstrates significant clinical efficacy in treating traumatic fractures of long bones in the lower extremities. It improves the healing rate, reduces complications, and represents a safe and effective treatment strategy worthy of widespread use and application.

Transcapsular scleral fixation of the standard capsular tension ring and in-the-bag intraocular lens implantation for severely subluxated lenses

AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices.

Lateral femoral tunnel preparation and graft fixation for anterior cruciate ligament reconstruction–A discussion

This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.

Triple Arthrodesis with Internal and External Fixation: Technique Paper

Background: The triple arthrodesis was described early by Myerson in 1923 and has been the gold standard surgical procedure for various conditions with the goal to reduce pain, improve deformity and facilitate function. Methods: The procedure consists of fusion of the subtalar joint, talonavicular joint and calcaneocuboid joint [1]. The procedure is traditionally done with internal fixation, however, Marinet al. has shown it to be performed with external fixation [2]. Dr. Marin and the associates have developed an alternative technique to perform a triple arthrodesis using internal and external fixation. This paper describes a step-by-step technique to perform a triple arthrodesis with both internal and external fixation. It will demonstrate the use of the prefabricated arches on the footplate for more precise and accurate placement of transosseous wires using arch-wire technique [3]. Results/Conclusion: We believe this technique will not only help increase the ability to achieve fusion with a less chance of non-union, but may also decrease healing time, which may allow patients to be mobile from the first week post-operatively and may diminish the risks associated with being non-weightbearing.

MIPPO technique and LCP internal fixation for open tibial shaft fractures

Objective To explore the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) technique and locking compression plate (LCP) for open tibial shaft fractures.Methods From March 2005 to May 2009,16 cases with open tibial

Value of helical CT volume rendering technique in post-operative evaluation of screw in screw fixation of axis fractures

To explore the value of helical CT volume rendering technique (VRT) in post-operative evaluation of screw fixation of axis fractures.Methods There were 21 cases of screw fixation of axis fractures between February 2002 and May 2004 in the study including six cases with fractures on axis body,five on odontoid process and 10 on axis body and odontoid process.All cases received X-ray plain film,helical CT scanning,multi-planar reformatting(MPR) and VRT.Results Screw fixation through axis body and massa lateralis atlantis was performed in 10 cases and that through axis body and odontoid process in 11.VRT could clearly display full aperture of screw orbit,location of screw and angle of fixation and hence was superior to X-ray plain film and MPR.Multi-angle VRT displayed asymmetrical space of odontoid process and massa lateralis atlantis in four cases and medial deviation of 2～5 mm of half screw in screw fixation through axis body and massa lateralis atlantis in six.Conclusion VRT can eliminate false shadow of fixation screw,clearly display full aperture of screw orbit and hence supply improtant imaging evidence for post-operative evaluation of screw fixation of axis fractures.7 refs,1 fig,1 tab.

Modern posterior screw techniques in the pediatric cervical spine

Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw–rod systems, have been shown to be many including: improved arthrodesis rates, diminished times in halo-vest immobilization, and improved reduction of deformities. The anatomy of children and the corresponding pathology seen frequently is at the upper cervical spine and craniocervical junction given the relatively large head size of children and the horizontal facets at these regions predisposing them to instability or deformity. Posterior screw fixation, while challenging, allows for a rigid base to allow for fusion in these upper cervical areas which are predisposed to pseudarthrosis with non-rigid fixation. A thorough understanding of the anatomy of the cervical spine, the morphology of the cervical spine, and the available screw options is paramount for placing posterior cervical screws in children. The purpose of this review is to discuss both the anatomical and clinical descriptions re-lated to posterior screw placement in the cervical spine in children.

All-epiphyseal versus trans-epiphyseal screw fixation for tillaux fractures:Does it matter?

BACKGROUND Tillaux fractures occur primarily in adolescents due to the pattern of physeal closure and are classified as Salter-Harris type III physeal fractures.Operative management with screw fixation is recommended for more than 2 mm of displacement or more than 1 mm of translation.However,the efficacy and complications of trans-physeal vs all-physeal screw fixation have not been investigated extensively.AIM To compare the clinical and functional outcomes of trans-physeal(oblique)and all-epiphyseal(parallel)screw fixation in management of Tillaux fractures among pediatric patients.METHODS This was an ethics board approved retrospective review of pediatric patients who presented to our tertiary children’s care facility with Tillaux fractures.We included patients who had surgical fixation of a Tillaux fracture over a 10 year period.Data analysis included demographics,mode of injury,management protocols,and functional outcomes.The patients were divided into group 1(oblique fixation)and group 2(parallel fixation).Baseline patient characteristics and functional outcomes were compared between groups.Statistical tests to evaluate differences included Fisher’s Exact or Chi-squared and independent samples t or Mann Whitney tests for categorical and continuous variables,respectively.RESULTS A total of 42 patients(28 females and 14 males)were included.There were no significant differences in body mass index,sex,age,or time to surgery between the groups[IK2].Sports injuries accounted for 61.9%of the cases,particularly non-contact(57.1%)and skating(28.6%)injuries.Computed Tomography(CT)scan was ordered for 28 patients(66.7%),leading to diagnosis confirmation in 17 patients and change in management plan in 11 patients.[GRC3]Groups 1 and 2 consisted of 17 and 25 patients,respectively.For mid to long-term functional outcomes,there were 14 and 10 patients in groups 1 and 2,respectively.Statistical analysis revealed no significant differences in the functional outcomes,pain scores,or satisfaction between groups.No infections,non-unions,physeal arrest,or post-operative ankle deformities were reported.Two(4.8%)patients had difficulty returning to sports post-surgery due to pain.One was a dancer,and the other patient had pain while running,which led to hardware removal.Both patients had parallel fixation.Hardware removal for groups 1 and 2 were 4(23.5%)and 5(20.0%)patients,respectively.The reasons for removal was pain in 2 patients,and parental preference in the remaining.CONCLUSION This is the largest reported series of pediatric patients with Tillaux fractures comparing functional outcomes of different methods of screw fixation orientation to the physis,which showed no difference regarding functional outcomes.

A knotless, one-haptic fixation of posterior chamber intraocular lenses: one-year results

AIM: To assess the results of a modified technique for scleral fixation of a posterior chamber intraocular lens(IOL) in eyes which had deficient of posterior capsular support.METHODS: This retrospective study was comprised of ten patients with deficient posterior capsular support who underwent one-haptic fixation of posterior chamber IOLs, between February 2010 and October 2011. IOL as implanted with one haptic supported on the capsular remnant and the other haptic drawn into the sulcus by anchoring suture without a knot. All patients were evaluated for pre- and postoperative visual acuity, lens centration, intra-and postoperative complications.RESULTS: A knotless, one-haptic fixation of posterior chamber IOLs has successfully been performed on ten eyes. All cases had inadequate capsular support(i.e. a capsular tear ranged from 5 to 7 clock hours). The average age was 74.25 ±8.87y(SD). The average postoperative uncorrected visual acuity was 0.51 log MAR.Complications included hyphema in one eye, a mild inflammatory reaction in the anterior chamber in two eyes, and a transient rise in IOP in one eye. Neither IOL tilt nor dislocation was observed and there were no later complications.CONCLUSION: In the presence of insufficient capsular support, a knotless, one-haptic fixation of posterior chamber IOLs is a safe and viable option which reduces the operation time, and minimizes postoperative suture-related complications.

改良Masquelet技术联合Ilizarov Mini-Fixator治疗掌指骨大段骨缺损的临床疗效

目的探讨改良Masquelet技术联合Ilizarov Mini-Fixator外固定治疗掌指骨大段骨缺损的可行性、临床应用及疗效分析。方法回顾性分析2019年11月-2021年10月符合手术适应证的掌指骨大段骨缺损17例患者的病历资料,均行改良Masquelet技术联合Ilizarov Mini-Fixator外固定治疗。⑴创伤性骨缺损:一期急诊行“地毯式”清创及相应修复手术,抗生素聚甲基丙烯酸甲酯(Polymethylmethacyrlate,PMMA)填充骨缺损,皮肤软组织缺损者同时给予骨水泥覆盖;二期:行带蒂皮瓣或植皮修复皮肤缺损创面,伤口愈合6~8周后去除骨水泥行自体骨移植联合Ilizarov Mini-Fixator外固定治疗;⑵感染性骨缺损:一期彻底清创、PMMA填充骨缺损,皮肤软组织缺损或皮肤软组织条件较差者给予彻底清创修复创面;二期方案同创伤性骨缺损。术后均给予预防或控制感染、观察患指(肢)及皮瓣血运等对症处理,均早期(2周)进行功能康复训练。结果17例术后随访5~29个月,移植骨均愈合,平均愈合时间11.9周(10.5~14.0周),术后均未出现伤口感染及皮瓣坏死等并发症。16例伤口均甲级愈合,1例延期愈合,移植骨愈合优良率为82.35%。根据随访结果,骨折愈合康复结束后手部功能评估:优5例,良8例,可4例,优良率为70.47%。均实现保指(肢)的目的,部分患者获得较好的手功能。结论应用改良Masquelet技术联合Ilizarov Mini-Fixator治疗掌指骨创伤性及感染性大段骨缺损的方法疗效可靠,具有操作简单、经济实用、损伤小,且移植骨愈合率高、愈合快、并发症及风险小等优点。可早期进行功能训练,有助于恢复手的外观及功能。

Development of L-Type Fixation Equipment for Transporting Unit Modules

The unit modular technique is one in which unit modules are prefabricated in a factory and then constructed at a construction site. That is why an important process, transport of unit module, is added in this technique. However, it is not easy to transport a unit module that is high prefabrication ratio （prefab. ratio） （70-90%）, since the walls and interior and exterior materials installed in it can become broken when the unit module is fixed using general fixation tools, including ropes and fixing belts. When the external wall, windows, etc. are damaged during the transportation, the efficiency of unit modular method is deteriorated. Taking this into account, the purpose of this study is to develop an improved fixation device that is convenient for fixing a unit module with a high prefab, ratio to a vehicle and securing the safety while running. The L-type adapter block proposed in this study was evaluated the structural safety through simulation method. The result of the simulation is that it seems desirable to set the working load of the L-type adapter block as 15 kN for Case 1 and 30 kN for Case 2. Therefore, when the L-type adapter block is utilized under the conditions in which the same load is applied as in Case 2, it is expected that safety will be improved.

牵引钉颌间牵引联合可吸收微型聚合物内固定治疗颌骨骨折的效果

目的探讨在牵引钉颌间牵引基础上应用可吸收微型聚合物内固定治疗颌骨骨折的临床效果。方法选取2021年5月至2022年8月郑州大学第一附属医院收治的280例颌骨骨折患者,以随机数字表法将其分为联合组和对照组,每组140例。对照组接受牵引钉颌间牵引联合钛板内固定术治疗,联合组接受牵引钉颌间牵引联合可吸收微型聚合物内固定治疗。评估两组术后3个月时疗效,比较两组术前及术后6个月时口腔功能、牙周指数,统计两组术后6个月内并发症发生情况。结果术后3个月时,联合组优良率高于对照组(P<0.05);两组术后6个月颞下颌关节功能、张口度以及咬合关系评分较术前低,且联合组低于对照组(P<0.05);两组菌斑指数(PI)、软垢指数(DI)及牙龈指数(GI)水平均高于术前,而联合组低于对照组(P<0.05);联合组并发症总发生率低于对照组(P<0.05)。结论牵引钉颌间牵引联合可吸收微型聚合物内固定更有利于加强牵引钉颌间牵引治疗颌骨骨折的临床效果,可提高患者颞下颌关节功能的改善效果,降低对牙周组织的影响,治疗安全性较好。

关节面塌陷的尺骨鹰嘴横形骨折应对策略

目的探讨关节面塌陷的尺骨鹰嘴横形骨折的固定方法,评估张力带钢丝技术的可靠性。方法回顾性分析2015年6月至2021年6月本院32例选用张力带钢丝技术治疗的关节面塌陷的尺骨鹰嘴横形骨折患者的临床资料。记录患者的手术时间、随访时间、骨折愈合时间、并发症发生情况、肘关节屈伸活动度及肘关节活动功能。结果手术时间为40~60 min,平均(45.0±8.6)min。所有患者均获得随访,随访时间12~18个月,平均(14.2±1.8)个月,骨折均获得临床愈合,愈合时间9~12周,平均(10.2±1.2)周。随访期间未发生感染、内固定失效、骨折移位及关节面再塌陷情况,有1例患者在术后6个月出现了退针并引起皮肤激惹,但此时骨折已愈合,予以取出内固定。所有患者在随访期间内均取出内固定。末次随访时,关节活动范围为100°~135°,平均(115.0°±8.6°);Mayo肘关节功能评分(MEPS)为(92.15±5.12)分,其中优30例,良2例。结论张力带钢丝技术治疗关节面塌陷的尺骨鹰嘴横形骨折可以获得满意的临床效果,克氏针可对塌陷的关节面进行有效支撑。

钢板螺钉内固定技术治疗四肢骨折患者的效果及术后反应分析

目的探究钢板螺钉内固定技术治疗四肢骨折患者的临床效果及对术后并发症的影响。方法选取2019年5月—2023年8月江苏省连云港市赣榆区人民医院骨科接受手术治疗的80例四肢骨折患者为研究对象,采用信封法分为对照组和观察组,每组40例。对照组实施闭合复位交锁髓内钉固定治疗,观察组实施钢板螺钉内固定技术治疗。比较两组治疗有效性、临床指标、术后并发症发生情况。结果观察组治疗总有效率为95.00%,明显高于对照组的77.50%,差异有统计学意义(χ^(2)=5.165,P=0.023)。观察组手术、住院和骨折愈合时间均短于对照组,差异有统计学意义(P均<0.05);观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论钢板螺钉内固定技术应用在四肢骨折患者治疗中安全有效,对患者尽早康复出院有利。

不同入路法联合小针刀术在胸腰椎创伤性骨折微创椎弓根钉内固定术中的临床疗效研究

目的:分析不同入路法联合小针刀术在胸腰椎创伤性骨折微创椎弓根钉内固定术中的临床疗效,以及对血清骨特异性碱性磷酸酶(BALP)、Ⅰ型胶原羧基肽β特殊序列(β-CTX)水平的影响。方法:选取我院2020年1月-2022年6月收治的120例行微创椎弓根钉内固定术联合小针刀术干预治疗的胸腰椎创伤性骨折患者,随机分为三组。A组(40例)选择经皮入路,B组(40例)选择经Wiltse入路,C组(40例)选择经后正中入路。记录并比较三组伤椎有效性指标:Oswestry功能障碍指数(ODI)、后凸Cobb角和前缘高度比;视觉模拟疼痛(VAS)评分、血清BALP、β-CTX水平和围手术期指标(手术时间、术中出血量和术后引流量)。结果:三组患者术后7 d、30 d的伤椎ODI、后凸Cobb角和前缘高度比均优于术前,差异有统计学意义(P <0.05),但三组间伤椎ODI、后凸Cobb角和前缘高度比差异无统计意义(P>0.05);三组患者术后VAS评分均显著下降,差异有统计学意义(P <0.05),且三组术后1 d、7 d的VAS评分比较差异有统计意义(P <0.05);三组患者术后血清BALP水平均明显上升,血清β-CTX水平均明显下降,差异均有统计学意义(P <0.05),且三组术后7 d的血清BALP及β-CTX水平比较差异有统计意义(P <0.05);三组手术时间、术中出血量和术后引流量关系为A组<B组<C组,差异有统计学意义(P <0.05)。结论:经皮入路和经Wiltse入路微创椎弓根钉内固定术联合小针刀术干预治疗能有效改善胸腰椎创伤性骨折患者伤椎有效性及骨代谢水平,而传统后正中入路的有效性及对骨代谢水平的改善作用相对较差,临床可结合患者情况在经皮入路和经Wiltse入路二者之间酌情选择入路方式,并结合小针刀术进行干预治疗。

髓内复位与撬拨复位结合锁定钢板治疗复杂老年肱骨近端骨折的疗效比较

目的比较髓内复位技术与撬拨复位技术结合锁定钢板治疗复杂老年肱骨近端骨折的疗效。方法选取2020年9月至2022年9月在我院就诊的肱骨近端骨折病人,采用随机数表法分为A组(撬拨复位组)与B组(髓内复位组),每组各24例。记录并比较2组手术时间、透视时间,术后3 d、12个月时的影像学指标、Constant-Murley肩关节功能评分与VAS评分,术后12个月复位丢失发生情况。结果B组的手术时间、透视时间均短于A组(P<0.05或P<0.01)。2组术后3 d、12个月时的颈干角及肱骨头高度差异均无统计学意义(P>0.05),但A组颈干角丢失量及肱骨头高度丢失量大于B组,差异均有统计学意义(P<0.05)。术后12个月,2组VAS、Constant-Murley肩关节功能评分均较术后3 d显著改善,且B组的Constant-Murley肩关节功能评分高于A组,VAS评分低于A组,差异均有统计学意义(P<0.05)。B组复位丢失率显著低于A组(4.2%比33.3%,P<0.05)。结论髓内复位技术治疗老年骨质疏松肱骨近端骨折可以缩短手术时间,减少病人及医护人员在射线下的暴露时间,同时,可以提高肱骨距的复位质量,降低术后发生复位丢失的风险,改善术后肩关节功能。

皮质骨通道螺钉技术在腰椎退变性疾病中的应用效果

目的:探讨皮质骨通道螺钉技术在老年腰椎退行性疾病患者中的应用效果。方法:选取2021年7月—2023年7月中国人民解放军联勤保障部队第926医院收治的腰椎退变性疾病患者64例作为研究对象,采用随机数字表法分为对照组以及观察组,各32例。对照组实施椎弓根螺钉内固定术治疗,观察组实施皮质骨通道螺钉技术治疗。比较两组手术相关指标、疼痛情况、腰椎功能。结果:观察组手术时间短于对照组,切口长度小于对照组,术中出血量、术后引流量少于对照组,差异有统计学意义(P<0.001)。治疗前,两组视觉模拟评分法(VAS)、日本骨科协会评估治疗分数(JOA)评分比较,差异无统计学意义(P>0.05)。治疗后6个月,两组VAS评分降低,观察组低于对照组,差异有统计学意义(P<0.05);两组JOA评分升高,差异有统计学意义(P<0.05);两组JOA评分比较,差异无统计学意义(P>0.05)。结论:皮质骨通道螺钉技术在老年腰椎退行性疾病患者中的应用效果显著,可缩短手术时间,减小手术切口,减少术中出血量与术后引流量,减轻疼痛,且不会影响腰椎功能。

双层软组织缝合封闭技术在下颌骨中早期药物相关性颌骨骨坏死患者手术治疗中的应用

目的:探究双层软组织缝合封闭技术在单纯应用抗骨吸收药物引起的发生在下颌骨的中早期药物相关性颌骨骨坏死(medication-related osteonecrosis of the jaw,MRONJ)患者手术治疗中的临床应用效果。方法:选择2021年10月至2022年9月于北京大学口腔医院四病区经手术治疗的中早期下颌骨MRONJ患者的病历资料进行回顾性分析,收集患者术前基线临床资料,包括原发疾病、伴发疾病、用药方案(药物种类、用药时长)、MRONJ分期、临床症状、影像学表现等,所有患者在手术中行下颌骨边缘切除术去除坏死骨,运用双层软组织缝合封闭技术关闭伤口,术后定期复查随访,评价双层软组织缝合封闭技术的治疗效果及并发症,并对患者进行疼痛评分和功能状态评价。结果:研究共纳入13例患者(女12例,男1例),年龄(66.69±13.14)岁。原发疾病包括骨质疏松7例,肺癌2例,乳腺癌3例,前列腺癌1例;2例伴发糖尿病,2例伴发心血管疾病,1例伴发干燥综合征。9例患者静脉注射唑来膦酸,平均用药时间(37.7±20.0)个月,7例患者同时服用了来曲唑片等其他药物;3例患者应用地舒单抗注射液,平均用药时间(10.3±11.9)个月;5例患者服用阿仑膦酸钠片,平均用药时间(55.20±27.20)个月,2例患者不同程度地服用醋酸泼尼松片或阿卡波糖片。MRONJ 1期4例,2期9例。13例患者均采用双层软组织缝合封闭技术关闭伤口,术后平均随访11.9个月(9~17个月),13例患者皆治愈,无溢脓等并发症发生。患者术前Karnofsky功能状态评分量表(Karnofsky performance status,KPS)评分为(68.46±14.05)分,术后评分为(82.31±15.36)分,差异有统计学意义(P<0.05)。患者术前疼痛评估视觉模拟评分量表(visual analogue scale,VAS)评分为(5.77±0.73)分,术后评分为(0.38±0.51)分,差异有统计学意义(P<0.001)。结论:双层软组织缝合封闭技术在中早期单纯使用抗骨吸收类药物的下颌骨MRONJ患者中可以取得良好的临床治疗效果,可为用药情况更加复杂的MRONJ患者提供临床治疗思路。

磁场成骨效应在口腔领域的应用及机制研究进展

磁场是一种安全、无创的物理治疗方法。大量研究证实磁场具有良好的成骨效应,在加速正畸牙移动、促进种植体骨整合、促进骨折愈合和提高牵张成骨效果等方面有一定的临床应用价值,有望成为治疗口腔疾病的一种有效辅助手段。为更好地将磁场应用于临床,本文就磁场在口腔领域的应用、对骨组织细胞的生物学效应和磁场调控骨代谢的分子机制三方面进行综述。磁场对骨组织细胞的生物学效应主要体现为促进成骨细胞和间充质干细胞的成骨,降低骨细胞的凋亡率,对破骨细胞的影响则尚无定论。在分子层面,骨组织细胞感应并响应磁刺激,磁信号经位移电流、洛伦磁力和自由基对效应等机制转变为生物可识别的电信号,进而激活下游P2嘌呤能受体、腺苷受体信号通路、转化生长因子-β受体信号通路、哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,m TOR)和Notch通路等信号网络。此外,本文还探讨了影响磁场成骨效应的因素——磁场参数,以期为临床医生提供参考。然而,磁场成骨效应的作用机制目前尚未明确,继续深入研究磁场的作用机制可为骨组织再生和牙周组织再生提供有效策略。另外,聚焦磁场的作用靶点,将磁场与其他药物联合应用,可为口腔疾病的治疗提供新思路。

钢板滑移技术治疗陈旧性胫腓骨骨折的临床疗效

目的观察钢板滑移技术治疗陈旧性胫腓骨骨折的临床效果。方法纳入我院骨科2020年10月—2022年4月收治的8例3周以上陈旧性胫腓骨骨折患者,术前X线检查显示骨折端存在不同程度短缩或分离移位。术中采用钢板滑移技术结合软组织松解恢复肢体长度,随后常规进行内固定操作,术中无需其他辅助装置。观察所有患者临床治疗后的临床效果。结果8例患者骨折均获得良好的复位,X线显示下肢长度基本恢复,力线正常。术后随访伤口愈合良好,没有发现血管神经损伤。结论钢板滑移技术是一种术中纠正陈旧性胫腓骨骨折短缩或分离移位的良好方法,可以结合或替代外固定支架或撑开器的使用。