Osteoporosis,which is characterized by bone loss,increases the risk of fractures and s and seriously affected the amputee’s health.Muscle mass is an important factor affecting bone mineral density(BMD).Muscular atrop...Osteoporosis,which is characterized by bone loss,increases the risk of fractures and s and seriously affected the amputee’s health.Muscle mass is an important factor affecting bone mineral density(BMD).Muscular atrophy and decreased muscle mass can cause BMD to fall.The bone quantity and quality are used to assess by Microcomputer tomography(micro-CT)with non-destructive.To investigate the performance of micro-CT in evaluating amputation-induced osteopenia in rats,the micro-CT was used to evaluate the change of the microstructure in trabecular bone and cortical bone of amputation.Muscle morphology was analyzed by micro-CT and transmission electron microscopy.Female Sprague–Dawley rats(8 week old)were divided into two groups:control(CON)groups and left hind limb amputation(LHLA).At 35 days,microstructure and volumetric bone mineral density(vBMD)of the tibia and femur were detected through micro-CT.The results showed:(1)the trabecular and cortical vBMD of the proximal tibia and distal femur in the LHLA group were significantly lower than those in the CON group.(2)Compared with the CON group,the trabecular number,bone volume fraction and trabecular thickness of proximal tibia and distal femur in LHLA group decreased significantly,whereas the trabecular separation,structure model index and bone surface/bone volume increased significantly in LHLA group.(3)The whole cross-sectional area(CSA)of whole calf muscles of left limb in LHLA group decreased significantly compared with CON group.In general,hind limb amputation could cause bone loss,changes in the microstructure of trabecular bone and muscle atrophy.Micro-CT is sensitive in evaluating bone microstructure destruction caused by amputation,and can be used for early diagnosis or monitor the development of bone loss in amputation in vivo.展开更多
Multiple segmental fractures of the lower limbs, common in developing countries, are the prerogative of Road Traffic Accidents (RTA) involving two-wheeled vehicles. Their management is difficult, associated with compl...Multiple segmental fractures of the lower limbs, common in developing countries, are the prerogative of Road Traffic Accidents (RTA) involving two-wheeled vehicles. Their management is difficult, associated with complications, and is most often based on a two-stage strategy: Damage Control Orthopaedics, followed by delayed internal osteosynthesis. The aim is to allow early functional rehabilitation and rapid recovery of patients. We report the case of a 39-year-old man, bike rider, after his RTA, presented with segmental homolateral fractures of the femur and two bones of the left leg. Short-term evolution was marked by the appearance of significant lymphedema and bone infarctions of the lower left limb necessitating a transfemoral amputation. Through this observation, the authors highlight the problems related to the complexity of the management of multiple segmental fractures of the lower limb by emphasizing two post-traumatic complications rarely described but to be feared: chronic lymphedema and bone infarction.展开更多
基金This study was funded by National Key R&D Program of China(No.2018YFB1107000)the National Natural Science Foundation of China(No.11902089)Supported by Sichuan Science and Technology Program(No.2018SZ0036).
文摘Osteoporosis,which is characterized by bone loss,increases the risk of fractures and s and seriously affected the amputee’s health.Muscle mass is an important factor affecting bone mineral density(BMD).Muscular atrophy and decreased muscle mass can cause BMD to fall.The bone quantity and quality are used to assess by Microcomputer tomography(micro-CT)with non-destructive.To investigate the performance of micro-CT in evaluating amputation-induced osteopenia in rats,the micro-CT was used to evaluate the change of the microstructure in trabecular bone and cortical bone of amputation.Muscle morphology was analyzed by micro-CT and transmission electron microscopy.Female Sprague–Dawley rats(8 week old)were divided into two groups:control(CON)groups and left hind limb amputation(LHLA).At 35 days,microstructure and volumetric bone mineral density(vBMD)of the tibia and femur were detected through micro-CT.The results showed:(1)the trabecular and cortical vBMD of the proximal tibia and distal femur in the LHLA group were significantly lower than those in the CON group.(2)Compared with the CON group,the trabecular number,bone volume fraction and trabecular thickness of proximal tibia and distal femur in LHLA group decreased significantly,whereas the trabecular separation,structure model index and bone surface/bone volume increased significantly in LHLA group.(3)The whole cross-sectional area(CSA)of whole calf muscles of left limb in LHLA group decreased significantly compared with CON group.In general,hind limb amputation could cause bone loss,changes in the microstructure of trabecular bone and muscle atrophy.Micro-CT is sensitive in evaluating bone microstructure destruction caused by amputation,and can be used for early diagnosis or monitor the development of bone loss in amputation in vivo.
文摘Multiple segmental fractures of the lower limbs, common in developing countries, are the prerogative of Road Traffic Accidents (RTA) involving two-wheeled vehicles. Their management is difficult, associated with complications, and is most often based on a two-stage strategy: Damage Control Orthopaedics, followed by delayed internal osteosynthesis. The aim is to allow early functional rehabilitation and rapid recovery of patients. We report the case of a 39-year-old man, bike rider, after his RTA, presented with segmental homolateral fractures of the femur and two bones of the left leg. Short-term evolution was marked by the appearance of significant lymphedema and bone infarctions of the lower left limb necessitating a transfemoral amputation. Through this observation, the authors highlight the problems related to the complexity of the management of multiple segmental fractures of the lower limb by emphasizing two post-traumatic complications rarely described but to be feared: chronic lymphedema and bone infarction.
