Objective To evaluate the method of the allogenous boneplate reconstructing the spinal channel and grafting in treatment of thoracolumbar burst fracture with paraplegia. Methods Thirty-six patients with thoracolumbar burst fracture with paraplegia were included in this study. Their ages ranged from 18 to 56 (average, 38). The vertebral injury involvedT11 in 3 patients，T12 in 10 patients，L1 in 14 patients，L2 in 7 patients，and L3 in 2 patients. Neurological deficits were classified by the Frankel grading. There were 9 patients in grade A, 11 patients in grade B, 13 patients in grade C, and 3 patients in grade D. All the patients were treatedwith the anterior approach, decompression of the spinal channel, interbody graft, and internal fixation. The grafting materials consisted of the allogenous femoral bone plate that was degreased in advance and implanted in the intervertebral posterior region, with cut ribs and bone mills during the decompression. Results Postoperative CT scanning showed clearance of the spinal cord compression and expansion of the spine channel. During the follow-up period averaged 2 years, almost all the patients showed an improvement in the neurological function. Spinal fusion occurred in 32 patients. There was no screw loosened or broken. Only 1 patient failed to achieve the fusion. Conclusion The anterior approach, allograft bone plate reconstructing the spine channel is a safe and effective method in treatment of the thoracolumbar burst fracture with paraplegia, which may be a replacement of the autogenous illiac bone graft.
Objective To investigate the development of dynamic hipscrew (DHS) internal fixation in the treatment of intertrochanteric femur fractures. Methods The latest relevant articles were reviewed extensively, including biomechanics and clinical application research. Results DHS is the effective selection for the treatment of intertrochanteric femur fractures, especially by the innovation of DHS structure, operative manipulation.Conclusion Treatment of intertrochanteric femur fractures with DHS is still a gold level, but strict selection of patients, proficiency operation and invasive manipulation are the most essential principles.
Objective To investigate the effect of magnesium phosphate cement (MPC) to fix fractures.Methods In vitro: fifty four pairs of fresh pig femoral heads were made 1 cm2 fracture and divided into 6 groups(n=9 pairs ). MPC was used to agglutinate fracture of femoral headsat 100% humidity and at 25℃, 37℃ respectively. At 30 minutes, 2 and 24hours after agglutination, the biomechanical strength was measured. In vivo:the tibia plateau fracture models on both sides of 24 rabbits were made, one side was fixed with “L” shaped plate, and the other side was fixed with MPC. Then the effect of treatment was investigated by macrography, micrography, radiography and the changes of serum electrolyte levels at 3 days, 3，6 and 9 weeks after operation. Results In vitro: the adhesive ability of MPCwas b. At 24 hours after MPC agglutination, the average tensile strength was 117.16±23.29 N/cm2. In vivo:after 6 weeks of fixation, the X-ray results showed that all rabbits’ tibia plateau fractures were healed without displacement, and MPC was absorbed gradually. The changes ofserum electrolyte levels were very minimal. The macrography observation showed that reduction of fracture were good at 3 days after operation, partial MPC remained in fracture end at 3 weeks, fracture line disappeared at 6 weeks and good remodeling was achieved at 9 weeks after operation in the experimental group. Themicrography observation showed that the interface between bone and MPC was distinct at 3 days, MPC was degraded gradually and trabeculae began to grow into MPCat 3 weeks, and almost all MPC was degraded at 6 and 9 weeks of operation. Conclusion MPC is a promising biomaterial, and might potentially be used for fracture treatment.
目的:对前路病灶清除取髂骨植骨融合K型钢板内固定治疗胸腰段脊柱结核的临床疗效进行分析。方法:2003年1月至2007年1月,对我科22例患者进行随访。结果:20例患者腰痛完全消失,植骨块完全融合,内固定材料稳定牢固,无松动及断裂,脊柱后突有效纠正,仅2例患者结核复发。结论:前路病灶清除植骨融合K型钢板内固定术能有效治疗胸腰段脊柱结核,有效纠正脊柱后突畸形,恢复椎体的高度,建立脊柱的稳定性。