ObjectiveTo review and evaluate the research progress of traumatic heterotopic ossification (HO). Methods The domestic and foreign related research literature on traumatic HO was widely consulted, and its etiology, pathogenesis, pathological progress, diagnosis, prevention, and treatment were summarized. Results Traumatic HO is often caused by severe trauma such as joint operation, explosion injury, nerve injury, and burn. At present, it is widely believed that the occurrence of traumatic HO is closely related to inflammation and hypoxia. Oral non-steroidal anti-inflammatory drugs and surgery are the main methods to prevent and treat traumatic HO. Conclusion Nowadays, the pathogenesis of traumatic HO is still unclear, the efficiency of relevant prevention and treatment measures is low, and there is a lack of specific treatment method. In the future, it is necessary to further study the pathogenesis of traumatic HO and find specific prevention and treatment targets.
Flexion tendons in fibrous sheath of 36 New Zealand white rabbits was repaired, after excision of fibrous sheath and vinculum, with microsurgical technique. Histological examination was made. The results showed that as the prolongation of the postoperative time, the adhesion around the tendon became more and more dense. 7 days after operation, tendon was connected by hemocyte and fibroid materials. Following 7 days after operation, fibroblaste origined from extrinsic memberance of tendon obviously produced,and strentched to tendon stump. The synthesis of collage fibers began at 21 days after operation .28 days,connective tissure between tendon stumps was tendency of reconstruction. The experiment demonstrated that pattern of tendon healing belinged to extrinsic repair . That was related to destroy of tendon nutrition systems in fibrous sheath.
ObjectiveTo evaluate the risk factors for postoperative indwelling catheter following enhanced recovery after primary unilateral total knee arthroplasty (TKA) under general anesthesia.MethodsPatients who underwent primary unilateral TKA under general anesthesia between January 2017 and August 2018 were enrolled in the study. Among them, 205 patients who met the selection criteria were included in the study, and the clinical data were collected, including gender, age, body mass index, preoperative range of motion, Hospital for Special Surgery (HSS) score, American Society of Anesthesiologists (ASA) score, disease type, comorbidity, hemoglobin, hematocrit, blood volume, length of operation and operation time, whether to keep drainage after surgery, intraoperative blood loss, total blood loss, and preoperative, intraoperative, postoperative fluid infusions, and total fluid infusion on the day of surgery, urine volume on the day of surgery. Univariate analysis and logistic regression analysis were used to screen the risk factors for postoperative indwelling catheter. Length of stay and incidences of complications (intermuscular vein thrombosis, deep vein thrombosis, pulmonary embolism, incision swelling and exudation, electrolyte disorder, nausea and vomiting, and urinary tract infection) were compared between the patients with or without indwelling catheter.ResultsIndwelling catheter occurred in 41 (20%) of 205 patients. Single factor analysis showed that the influence factors were age, gender, keeping drainage after surgery, total fluid infusion and urine volume on the day of surgery (P<0.05). The multiple factors analysis showed that the males and more urine volume on the day of surgery were the significant risk factors for indwelling catheter after primary TKA (P<0.05). In addition, postoperative length of stay was shorter and the incidence of urinary tract infection was lower in non-indwelling catheter group than in indwelling catheter group, showing significant differences (P<0.05).ConclusionThe male patients with more urine on the day of surgery have higher risk for indwelling catheter after primary unilateral TKA under general anesthesia with an enhanced recovery program.
OBJECTIVE: To study the expression of interleukin-1 receptor in normal mice sciatic nerves and in transected sciatic nerves treated with or without extrinsic interleukin-1 locally at different periods. METHODS: Seventy-two KM mice were equally divided into two groups. All the left sciatic nerves were transected. The stumps in experimental group were soaked in liquid with interleukin-1, whereas those in control group without interleukin-1. Then all the stumps were repaired end to end. At the 3rd hour, 1st day, 3rd day, 7th day, 14th day, and 28th day after operation respectively, every proximal stump was dissected and the expression of interleukin-1 receptor was carried out by immunohistochemistry method (LSAB method). The expression level of interleukin-1 of ten normal sciatic nerves of mice was studied, too. RESULTS: Normal nerves showed interleukin-1 receptor expression on the membrane of Schwann cells. After nerve injury, the interleukin-1 receptor expression increased biphasically in both groups, but the intensity of increase was lower in the experimental group than in the control group. CONCLUSION: Schwann cell is the target cell of interleukin-1.
wenty-one cases with injurys of upper trunk of brachial plexus in 18 and poliomyelitis in 3were treated by transfer of flexor carpi ulnaris muscle to restore flexion of elbow from may, 1981through November, 1992. There were 16 males and 5 females with an average age of 28 years old(ranged 17-60 years). All of the patients was combined with incompetence of abduction function ofshoulder, 6 cases with incompotence of extenxor function of elbow and 11 cases with incompotence ofsupifiation fu...
The influence on the wrist stability following ulnar head resection (Darrach s procedure)was studied. A series of X-ray films and arthrography of the wrist joint were taken before and after ulnar head re- section. The results showed that after ulnar head resection the radial deviation increased 3 degree(Plt;0.01). and the ulnar deviation 11.92 degree (Plt;0.001). The position of the lunate remained unchanged. Arthrography of the wrist joint demonstrated that 11 specimens had injury of the triangular fibrocartilage.The stability of the wrist joint would no doubt be certainly affected following the ulnar head resction.
目的:总结髋臼骨折的手术入路和复位固定经验。方法:2006年1月至2008年2月经Kocher Langenbeck、髂腹股沟、前后联合入路手术治疗髋臼骨折52例。结果:随访6～36个月,优良率90.4％。术后发生创伤性关节炎10例,股骨头坏死2例,异位骨化10例,所有患者均骨愈合。结论:手术治疗髋臼骨折能较好地恢复骨盆形态及下肢活动功能,防止骨折畸形愈合。正确的选择手术入路和术中良好的复位固定是提高髋臼骨折疗效的基础。
ObjectiveTo summarize the research progress on the application of tranexamic acid (TXA) in traumatic orthopedic surgery in recent years.MethodsThe domestic and foreign literature in recent years was reviewed, and the efficacy and safety of TXA in traumatic orthopedic surgeries with different regimen, dose and route of administration were comprehensively summarized and compared.ResultsThe application of TXA in traumatic orthopedic surgeries increased gradually in recent years. Intravenous or topical administration of TXA efficaciously reduced blood loss and transfusion requirements during hip fracture surgery without significantly increasing the risk of thromboembolic events. However, the efficacy was not clear in other traumatic orthopedic surgeries such as pelvic and acetabular fractures.ConclusionMore studies are needed to confirm the efficacy and safety of TXA in traumatic orthopedic surgeries.
The injuries of the femoral arteries were mistreated in 5 cases. The causes of the mistakes were resulted from: the initial cause of the injury was not carefully analyzed; the arterial injury was overlooked by the concomitant injuries, and the improper method of management was selected, as a result, 2 patients died from acute renal failure and the other 3 patients developed the complications of secondary thrombosis of the artery or rupture of the artery at the anastomotic site following repair. Of the 3 patients, 2 patients had recovered following reoperation and the other 1 patient had lost his limb from amputation. It should be emphasized that all of the following key points might avoid the mistakes occurred in the management of the injury of the femoral artery: (1) early diagnosis; (2) debredment of arteral end; (3) in infections wounds, insted of vein transplantation bypass technique should be done.