Diffuse distribution of bone cement in percutaneous vertebroplasty reduces the incidence of refracture of adjacent vertebral bodies北大核心

BACKGROUND: Percutaneous vertebroplasty is one of the effective treatments for osteoporotic vertebral compression fractures. The distribution of bone cement in the vertebral body will influence the clinical efficacy. OBJECTIVE: To investigate the influence of the distribution of bone cement in percutaneous vertebroplasty on the early postoperative outcomes after osteoporotic vertebral compression fractures. METHODS: A total of 132 patients, including 52 males and 80 females, with a mean age of (76.3±8.2) years who diagnosed as osteoporotic vertebral compression fractures in First Hospital of Shanxi Medical University from January 2017 to June 2019 were enrolled. All patients were divided into underdispersion group (n=54) and diffuse distribution group (n=78) according to the pattern of cement distribution on postoperative X-rays. Visual analogue scale scores postoperatively, the height of anterior edge and midline of injured vertebrae, Cobb angle of local kyphosis and the incidence of complications after 1-year follow-up were compared between the two groups. The trial was performed in accordance with the relevant ethical requirements for research in the First Hospital of Shanxi Medical University. RESULTS AND CONCLUSION: (1) The visual analogue scale scores were lower at 2 days, 1 and 6 months after operation than those before operation in the two groups (P < 0.05). The visual analogue scale scores at 1 month after operation in the underdispersion group were higher than those in the diffuse distribution group (P < 0.05), and there was no significant difference between the two groups at 2 days and 6 months after operation (P > 0.05). (2) Cobb angle and vertebral body height improved in both groups postoperatively compared to preoperatively (P < 0.05). The difference in Cobb angle and vertebral body height was not statistically significant between the two groups (P > 0.05). (3) The rate of bone cement infiltration was not significantly different between the two groups (P > 0.05). Incidence of recurrent fractures in adjacent vertebrae was lower in the diffuse distribution group than that in the underdispersion group (P < 0.05). (4) These findings confirm that percutaneous vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures. The distribution of bone cement in the vertebral body will affect the surgical results. The bone cement is diffusely distributed, which may reduce the incidence of recurrent fractures in adjacent vertebrae. © 2022, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

降钙素增强双膦酸盐对绝经后骨质疏松患者慢性腰背痛缓解及生活质量改善的作用

BACKGROUND: Salmon calcitonin or elcatonin has been reported to alleviate acute and severe back pain caused by osteoportic fracture. OBJECTIVE: To evaluate the effects of the combined use of elcatonin and risedronate in the treatment of chronic back pain and the improvement of quality of life in postmenopausal women with osteoporosis. METHODS: Forty-five postmenopausal women with osteoporosis accompanied by chronic back pain persisting for more than 3 months, after excluding women with fresh vertebral fractures within the last 6 months, were randomly assigned to a risedronate group (administration of risedronate alone, n=22) and a combined drug group (combined administration of risedronate and elcatonin, n=23). Pain was evaluated using a visual analogue scale (VAS) and the Roland-Morris questionnaire. Bone mineral density was determined by dual-energy X-ray. Quality of life was assessed using the Medical Outcomes Study 36-Item Short-Form (SF-36) at 6 months after treatment. RESULTS AND CONCLUSION: There were 20 and 19 cases in the risedronate and combined drug groups, respectively included in the final analysis. Significant improvements were found in the combined drug group for VAS and mental health status section scores in the SF-36 at final follow-up compared with baseline and 3-month follow-up, while no change was found in the risedronate group. Bone mineral density was increased significantly in both groups, while no significant difference was found between groups. These findings suggest that the use of elcatonin in addition to risedronate for more than 3 months may reduce chronic back pain in osteoporosis patients. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

植骨融合内固定修复连续双节段颈椎间盘突出症：钛网与椎间融合器的比较

BACKGROUND: Many studies have shown that different types of anterior cervical surgery in the treatment of two-level contiguous cervical disc herniation can obtain satisfactory results, but which method is the best has not yet reached a consensus. OBJECTIVE: To compare the efficacy and safety of three types of anterior cervical surgery for treating two-level contiguous cervical disc herniation.  METHODS: We retrospectively analyzed clinical data of 62 patients with two-level contiguous cervical disc herniation who underwent anterior decompression and fusion. These patients were assigned to three groups. Bone graft group received anterior cervical discectomy with autogenous iliac bone graft fusion. Titanium mesh group received anterior cervical corpectomy with titanium mesh fusion. Cage group received anterior cervical discectomy with cage fusion. Fusion rate of bone graft and improvement of neurological function (Japanese Orthopaedic Association Scores) were evaluated and compared after treatment in the three groups. Cervical vertebra anteroposterior and lateral images were used to measure height of anterior and posterior margin of vertebral body and Cobb angle changes of fusion segment. RESULTS AND CONCLUSION: All 62 patients were followed up and the follow-up time was ranged from 8 to 30 months. Operation time was significantly longer in the bone graft group than in the titanium mesh and Cage groups (P < 0.05). Intraoperative blood loss was larger in the bone graft group than in the titanium mesh and Cage groups (P < 0.05). Japanese Orthopaedic Association Scores were significantly improved after treatment (P < 0.05). No significant difference was found at different time points (P > 0.05). The fusion rate of bone graft was higher in the bone graft group than in the titanium mesh and Cage groups (P < 0.05) at 3 months after treatment, and bone union was found in the final follow-up. Height of anterior and posterior margin of vertebral body was significantly increased after treatment (P < 0.05). No significant difference in the increase of the height of anterior margin was detected among the three groups (P > 0.05). The increase in the height of posterior margin was higher in the Cage group than in the bone graft group and titanium mesh group (P < 0.05). Vertebral height loss of the anterior margin was higher in the bone graft group than in the titanium mesh and Cage groups, but vertebral height loss of the posterior margin was highest in the bone graft group, followed by titanium mesh group and Cage group at 3 months after treatment (P < 0.05). The increase value of Cobb angle was higher in the titanium mesh group than in the bone graft group and Cage group (P < 0.05). At 3 months after treatment, the altered value of Cobb angle was highest in the bone graft group, followed by titanium mesh group and Cage group (P < 0.05). No significant difference in the height of anterior and posterior margins of the vertebral body and Cobb angle was detectable between final follow-up and 3 months post-treatment (P > 0.05). These findings indicated that the three kinds of fusion method for treating two-level contiguous cervical disc herniation could obviously lessen nervous systems and improve cervical vertebra functions. In the bone graft group, operation time was long. Intraoperative blood loss was more. Postoperative height loss of the posterior margin of the vertebral body was visible. Cervical lordosis could be easily induced. Compared with the bone graft group, titanium mesh and Cage groups could better maintain the height and curvature of the cervical vertebra, but the Cage group had apparent advantages.  中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程      

自体髂骨植骨联合自体骨髓干细胞移植治疗骨折术后骨不连

BACKGROUND: Bone nonunion is a common complication in the orthopedic treatment, and its morbidity reached 5%-10%, which results in the long-term functional disturbance of the limbs, and even disability. Autogenous iliac crest graft has been commonly used to treat bone nonunion, but some limitations still exist. OBJECTIVE: To investigate the treatment outcomes of autogenous iliac crest graft combined with autologous bone marrow stem cell transplantation for bone nonunion after fracture surgery. METHODS: Clinical and follow-up data from 69 patients with bone nonunion were analyzed retrospectively. All patients were allotted to combination (n=37) and iliac (n=32) groups, followed by treated with autologous iliac crest graft combined with autologous bone marrow stem cell transplantation or  autologous crest graft, respectively. Afterwards, the hospitalization time, fracture healing time, bone mineral density and Fereadez-Esteve callus scores were detected and compared between groups. RESULTS AND CONCLUSION: The hospitalization time did not differ significantly between groups (P > 0.05). The fracture healing time in the combination group was significantly shortened compared with the iliac group (P < 0.05). The bone mineral density and Fereadez-Esteve callus scores in the combination group were significantly higher than those in the iliac group at 3 and 6 months after surgery (P < 0.05). The excellent and good rate of the affected limb function in the combination group was significantly higher than that in the iliac group (P < 0.05). These results suggest that autogenous iliac crest graft combined with autologous bone marrow stem cell transplantation for bone nonunion can accelerate fracture healing, promote porosis and improve the functional recovery of affected limbs. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

伊班膦酸钠治疗绝经妇女骨质疏松的Meta分析

BACKGROUND: Alendronate has a marked enhancing effect on bone mineral density. Ibandronate is the newest (the third generation) bisphosphonates. Evidence-based medicine data on the therapeutic effects of both two drugs remain lacking because of different administration routes and time. OBJECTIVE: To compare the therapeutic effects of ibandronate and alendronate on postmenopausal osteoporosis. METHODS: A computer-based online search was conducted in CNKI, PubMed, CECDB, BMA, VIP, CQVIP, CBM, EMbase, ASP, The Cochrane Library, and EMCC databases from August 1999 to August 2015 to screen the relevant randomized controlled trials. Meta-analysis was performed using Stata/SE version 12.0 software by extracting data from the relevant articles. RESULTS AND CONCLUSION: A total of 10 randomized controlled trials involving 725 patients (ibandronate and alendronate for 379 and 346 patients, respectively) were included. The meta-analysis results showed that bone mineral density was significantly increased (P=0.174, I2= 29.4%, WMD=0.03, 95%CI (0.01-0.04)) at 6 months after treatment and incidence rate of fracture was significantly decreased (P=5.810, I2=0%, OR=0.32, 95%CI: (0.10-1.00)) during 1-year treatment with ibandronate compared with alendronate treatment. However, no significant differences were found between two drug treatments in lumbar spine bone mineral density at 1 year after treatment and the incidence rate of fracture during 6-month treatment. Six-month treatment of ibandronate can improve bone mineral density and reduce the incidence rate of fracture of patients with postmenopausal osteoporosis. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

甲状旁腺激素1-34、阿仑膦酸钠、辛伐他汀治疗大鼠骨质疏松效果的比较

BACKGROUND:Bone resorption drugs in the treatment of osteoporotic fracture are still controversial. The development of new drugs, especially drugs in the promotion of bone formation, become more important and urgent.  OBJECTIVE: To compare the effects of parathyroid hormone (1-34), alendronate sodium and simvastatin on bone loss in ovariectomized rats. METHODS: Thirty female Sprague-Dawley rats aged 3 months were randomized into five groups of six animals in each group. All rats but those in sham group received dual ovariectomy (OVX) and treated by vehicle (OVX+V), parathyroid hormone (1-34) (5 days per week at a dose of 20 μg/kg, OVX+P), alendronate sodium (70 μg/kg/wk, OVX+A), simvastatin (5 mg/kg/d, OVX+S). Three months later, all rats were sacrificed. Dual energy X-ray method was used to measure bone density of L4 vertebra. Bone histomorphometry was utilized to analyze cancellous bone mass and bone microstructure. Compression test was performed on the L5 vertebra for the maximum loading and elastic modulus.   RESULTS AND CONCLUSION:(1) Bone density: The bone density from high to low levels was OVX+P group, sham group, OVX+A group, OVX+S group, and OVX+V group. No significant difference in bone density was detectable between the OVX+P and sham groups, but significant differences in bone density were determined between any other two groups (P < 0.05). (2) Bone histomorphometry: Relative volume of trabecular bone was significantly lower in the OVX+V group than in other groups. Relative volume of trabecular bone was remarkably higher in the OVX+P group than in the OVX+A group and OVX+S group. (3) Biomechanical properties: Biomechanical properties were noticeably lower in the OVX+V group than in other groups. Biomechanical properties were remarkably higher in the sham group and OVX+P group than in the OVX+S group and OVX+A group. (4) These findings indicated that under the dosage and intervention period used in the present study, parathyroid hormone (1-34), alendronate sodium and simvastatin showed anti-osteoporosis effect on OVX rats in a descending manner. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Establishment of a rat osteoporotic model by ovariectomy combined with glucocorticoid exposure北大核心

BACKGROUND: There are many postmenopausal women taking hormone, which leads to much loss of bone mass, further inducing fragility fractures. The studies on the hormone exposure combined with ovariectomy-induced osteoporotic model are still immature, and the related molecular mechanism remains unclear. OBJECTIVE: To establish the rat osteoporotic model induced by ovariectomy combined with glucocorticoid exposure and to explore the underlying molecular mechanism. METHODS: Thirty 3-month-old female Sprague-Dawley rats were randomly divided into blank control, sham and model groups (n=10 per group). The rats in the blank control group received no intervention; rats in the sham group were clipped off a little of coeliac adipose tissue; the model rats received bilateral ovariectomy and 4-week administration of glucocorticoid. RESULTS AND CONCLUSION: At 4 weeks after modeling, compared with blank control and sham groups, the model group showed significantly lower bone mineral density of the femur, number of bone trabeculae and bone volume/total volume, and significantly wider bone trabecular spacing. Additionally, the model group revealed the damaged bone trabecular structure and thiner cortical bone. The expression level of Runx2 was downregulated whereas both collagen type 1 α1 and peroxisome proliferators activated receptor γ mRNA were upregulated in the model group. These findings suggest that ovariectomized rats exposed to glucocorticoid rapidly develop femur osteoporosis, maybe by downregulating the expression of Runx2, as well as upregualting collagen type 1 α1 and peroxisome proliferators activated receptor γ mRNA. © 2017, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.     

同种异体骨移植强化高危人群肱骨近端骨折内固定的疗效观察

BACKGROUND: Numerous studies have focused on the clinical efficacy of allogeneic bone graft and humeral head replacement for the treatment of proximal humeral fractures, but their comparative studies are rarely reported. OBJECTIVE: To investigate the effect of allogeneic bone grafting in the treatment of proximal humeral fractures in the high risk group. METHODS: Clinical data of 120 cases of proximal humeral fractures aged ≥ 60 years were retrospectively analyzed. Sixty of the 120 cases underwent allogeneic bone grafting combined with locking plate fixation as experimental group, and the other 60 cases were subjected to semi-shoulder joint replacement as control group. All patients were followed up for 8-24 months. Fracture healing, collodiaphyseal angle, humeral head height and shoulder joint function were observed and measured. RESULTS AND CONCLUSION: During the postoperative 8-24 months, all the fractures were healed by first intention, and there were no rejection reactions, large/small nodules, humeral head displacement, necrosis, and screw loosening. Loss of the humeral head height at the last follow-up and the active flexion angle of the shoulder at postoperative 12 weeks were significantly higher in the experimental group than the control group (P < 0.05). Scores on forearm, shoulder and hand dysfunction were significantly lower in the experimental group than the control group (P < 0.05). However, no significant difference was observed in the collodiaphyseal angle and SF-36 scores between the two groups. These finding indicate that allogeneic bone grafting can strength the internal fixation of proximal humeral fractures in the high-risk group, and improve patient’s upper limb function.   中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

牙槽骨骨密度与甲状腺激素的影响

BACKGROUND: Overproduction of thyroid hormones is shown to increase the activities of osteoblasts and osteoclasts, stimulating bone resorption and transformation. Inadequate compensation of increased bone resorption by bone transformation results in an increased loss of bone mass. OBJECTIVE:To investigate the effects of hyperthyroidism on the density of the alveolar bone. METHODS:Twenty-four New Zealand rabbits were equally randomized into hyperthyroidism group and control group. Rabbits in the hyperthyroidism group or control group were daily injected intraperitoneally with 50 μg/kg levothyrocine diluted in physiological saline solution or equal volume of physiological saline. At 8 weeks after treatment, serum levels of thyroid hormones (FT3 and FT4), alkaline phosphatase, magnesium and calcium, phosphorus were determined; meanwhile, the bone densities of the lumbar vertebra, mandible, bilateral distal femur were determined by dual energy X-ray absorptiometry and the correlation analysis was performed. RESULTS AND CONCLUSION: At 8 weeks after treatment, serum levels of FT3, FT4, alkaline phosphatase calcium, phosphorus, and magnesium in the hyperthyroidism group were significantly increased (P < 0.01), while the bone densities of the lumbar vertebra, mandible, bilateral distal femur were significantly decreased (P < 0.05), compared with the control group. Bone density of the mandible was positively correlated with the bone density the lumbar vertebra and bilateral distal femur. These findings suggest that the changes in FT3 and FT4 are sufficient for the diagnosis of hyperthyroidism. Hyperthyroidism results in the decreased density of the alveolar bone, indicating the occurrence of osteoporosis. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Biomechanical Properties of Bilateral Puncture PVP and Unilateral Curved PVP

Objective: To compare the biomechanical properties of bilateral puncture PVP and unilateral curved PVP. Methods: Twenty old sheep spine models were taken as research specimens in this experiment, which were randomly divided into control group and experimental group, with 10 in each group. The specimens were made into a compressive spinal fracture model and treated with bone cement for vertebroplasty. In the control group, 1.5 ml of bone cement was injected into one side through bilateral punctur...     

椎体骨折线内骨水泥弥散情况在经皮椎体成形中的作用

背景：骨水泥在椎体骨折线内的弥散情况可能是影响经皮椎体成形治疗效果的主要因素之一,但目前对此的研究甚少。 目的：分析椎体骨折线内骨水泥弥散情况对经皮椎体成形治疗效果的影响。 方法：纳入T1-L2骨质疏松性椎体压缩骨折患者77例,其中男28例,女49例,年龄55-86岁,均进行经皮椎体成形治疗,依据治疗后CR、MRI资料将患者分为2组,试验组(n=53)显示骨水泥在椎体骨折线内弥散良好,对照组(n=24)显示骨水泥在椎体骨折线内弥散不均。比较两组治疗前后目测类比评分、Oswestry功能障碍指数及骨折椎体局部后凸Cobb角变化。 结果与结论：两组治疗前的目测类比评分、Oswestry功能障碍指数及骨折椎体局部后凸Cobb角比较差异均无显著性意义,两组组内治疗后2 d、6个月的目测类比评分、Oswestry功能障碍指数及骨折椎体局部后凸Cobb角均较治疗前明显改善(P < 0.05)。试验组治疗后第2天的目测类比评分、Oswestry功能障碍指数评分低于对照组(P < 0.05),两组治疗后6个月的目测类比评分、Oswestry功能障碍指数评分比较差异无显著性意义;试验组治疗后6个月的骨折椎体局部后凸Cobb角小于对照组(P < 0.05)。试验组治疗6个月的椎体塌陷率低于对照组(P < 0.05),两组间再骨折率比较差异无显著性意义。表明骨水泥在骨折线内弥散不佳会影响近期疼痛及功能障碍的缓解,增大远期发生继发性椎体塌陷的可能性。     

碳质涂膜人工股骨头置换修复老年股骨不稳定合并骨质疏松性骨折

背景：老年人较易发生不稳定性合并骨质疏松性股骨骨折,临床对其进行修复治疗的过程中,可以采取不同的方案,以往大多实施内固定治疗。但目前关于老年股骨不稳定合并骨质疏松性骨折修复方法的具体选择,尚存在一定的争议。 目的：观察碳质涂膜人工股骨头置换修复老年股骨不稳定合并骨质疏松性骨折的随访结果。 方法：回顾性分析西安交通大学医学院附属红会医院2013年2月至2014年2月收治的83例老年股骨不稳定合并骨质疏松性骨折患者的临床资料,按照修复方法分为对照组(42例)和观察组(41例),分别实施常规内固定治疗和人工股骨头置换治疗。观察两组患者的手术所用时间、术中出血量、术后卧床时间及住院天数;随访12个月,观察两组患者的髋关节功能恢复情况以及并发症发生情况,并进行比较。 结果与结论：观察组手术所用时间和术中出血情况与对照组比较差异无显著性意义(P > 0.05),但观察组的术后卧床时间和住院天数均显著短于对照组(P < 0.05)。观察组的治疗后髋关节功能优良率显著高于对照组,并发症发生率则显著低于对照组(P < 0.05)。表明对老年股骨不稳定合并骨质疏松性骨折患者实施碳质涂膜人工股骨头置换可以获得较好的修复效果,对患者造成的损伤小,并发症少,且可以更好的改善患者的髋关节功能。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

低弹性模量骨水泥对骨质疏松压缩性骨折椎体及邻近椎体应力的影响：三维有限元分析

BACKGROUND: Vertebroplasty and kyphoplasty can effectively repair osteoporotic vertebral compression fractures, but bone cement injection can cause the change of stress in the fractured vertebrae and adjacent vertebrae after surgery, leading to new fractures. OBJECTIVE:To analyze the stress changes of the fractured vertebrae and adjacent vertebrae after vertebroplasty with different elastic modulus bone cement by a three-dimensional finite element method. METHODS:One healthy adult male volunteer was selected for lumbar spine CT scan. The acquired images were imported for three-dimensional reconstruction using Mimics. The three-dimensional model was smoothed, polished and denoised by Geomagic software, and then the solid mode was built under Workbench Ansys. An osteoporotic vertebral compression fracture model in L_2-4 segments was established after assignment. Bone cement (4 mL) with different elastic moduli (8 000, 4 000, 2 000 and 1 000 MPa) injected into the L₃ segment distributed in the middle of the vertebrae as spherical shape. 500 N pre-load was applied on the L₂ surface with an additional bending moment of 50 N•m. The lower surface free degree of L₄ was restrained. The L_2-4 forward flexion, posterior extension, right flexion and axial rotation on the right side were stimulated. The stress changes of the fractured vertebrae and the upper and lower adjacent vertebrae before and after bone cement injection with different elastic moduli were compared.  RESULTS AND CONCLUSION: The stress of the fractured vertebrae and adjacent vertebrae were significantly increased compared with that before operation. With the increase of elastic modulus, the stress of the fractured vertebrae increased, but there were no changes in the stress of adjacent vertebrae. These findings indicate that the elastic modulus of bone cement may be a method to reduce new fractures of the fractured and adjacent vertebrae after bone cement injection. 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

胫骨平台骨折重建过程中64层CT的定位导航方法

BACKGROUND: 64-slice CT reconstruction technique for tibial plateau fractures has obtained satisfactory results. This technology can reconstruct three-dimensional fracture relations, provide more scientific positioning and navigation standards for physicians, and improve the clinical cure rate. However, in the clinic, navigation method of 64-slice CT reconstruction techniques for tibial plateau fractures lacks a unified standard.     

胫腓骨中下1/3段骨折时机分析

目的探讨胫腓骨中下1/3段骨折的治疗时机。方法选择2006年~2012年间220例胫腓骨中下1/3段骨折治疗时机进行分析,其中急诊手术为164例,择期手术56例。结果220例患者均获随访,时间为8个月~2年,平均随访1年6个月,2例钢板过敏早期取出内固定,2例骨不连改用外固定支架固定+植骨后愈合。结论术前对治疗时机及方法的选择是极其的重要,在胫腓骨中下1/3段骨折治疗中,急诊手术为首选,同时以Ⅰ期闭合伤口、减张方法缝合。     

30例髋臼骨折的治疗体会

目的 探讨髋臼骨折的有效治疗方法。方法 回顾分析资料完整30例髋臼骨折病例，非手术治疗7例，采用持续骨牵引。手术治疗23例，主要采用切开复位钢板、螺钉、钢针固定。结果 随访10个月－3年（平均26月），根据Matta髋臼骨折复位标准，非手术治疗组5例满意复位，2例复位不满意；手术治疗组解剖复位10例，较满意复位10例，不满意复位3例。患髋功能：非手术组优良率为71．4％；手术组优良率为87％。结论 髋臼骨折有手术指征应早期手术治疗，根据骨折类型选择手术入路与固定材料。     

髁突颈横行截骨和骨折对大鼠下颌骨生长发育的影响

目的 建立年轻SD大鼠单侧髁突颈部截骨、骨折的动物模型,探讨应力改变对大鼠下颌骨及髁突生长发育的影响.方法 4周龄72只雄性SD大鼠按随机数字表法分3组,每组24只,分为截骨组、骨折组、对照组.建立大鼠单侧髁突颈部横行截骨,骨折的动物模型,观察术后1、3、5、9周髁突影像学、组织学及下颌骨解剖学的变化.检测与髁突生长发育关系密切的结缔组织生长因子（CTGF）及X型胶原（Col X）在髁突软骨中表达的变化.结果 截骨组手术侧术后1、3周髁突区膨大,髁突颈呈分离影像.骨折组手术侧术后1周髁突呈圆柱状,见骨折线.截骨组手术侧术后4个时间点下颌骨生长发育受到限制,髁突软骨的总厚度术后1周代偿性增厚为（1468.28±53.73） μm,大于骨折组手术侧;术后3、5周总厚度明显降低;术后9周与骨折组手术侧比较差异无统计学意义（P＞0.05）,但都小于对照组（P＜0.05）.截骨组手术侧CTGF在髁突软骨中的表达在术后1、3、5周分别为60.18±1.23、72.43±2.82、86.00±2.90均高于骨折组手术侧和对照组Col X表达在术后1周时为64.46±3.76,高于骨折组手术侧和对照组（均为P＜0.05）.结论 单侧髁突颈截骨,致应力改变明显,影响下颌骨及髁突生长发育,可导致手术侧、非手术侧下颌骨的不对称,并影响CTGF及Col X在髁突软骨的表达.     

股骨近端髓内钉与人工髋关节置换修复股骨转子间骨折的对比

背景：股骨转子间骨折多发于骨质疏松的老年患者,常用的治疗方法有髓内、外固定治疗和关节置换等。 目的：对比股骨近端髓内钉与人工髋关节置换两种方法治疗股骨转子间骨折的临床疗效。 方法：将菏泽市立医院在2009年8月至2013年8月收治的股骨转子间骨折患者198例,分为股骨近端髓内钉固定组和人工髋关节置换组,各99例。股骨近端髓内钉固定组和人工髋关节置换组患者分别采用股骨近端髓内针固定和人工髋关节置换治疗。 结果与结论：股骨近端髓内钉固定组患者手术时间、术中出血量和住院时间均显著少于人工髋关节置换组,但骨折愈合时间显著长于人工髋关节置换组;但2组患者治疗后1年时的Harris评分、髋关节功能优良率和总并发症发生率差异无显著性意义。提示采用股骨近端髓内钉固定和人工髋关节置换治疗老年股骨近端骨折均有良好的生物相容性,均可取得良好的临床效果,2种方法虽各有优缺点,临床上均可根据患者病情需要制定合适的治疗方案。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

不同置钉方式修复中青年移位型股骨颈骨折：复位质量及股骨头坏死率对比

背景：股骨颈骨折闭合复位与切开复位的关键区别就在于是否切开关节囊,对于这个问题国内外学者抱有不同的意见,目前尚无统一结论。 目的：比较切开复位与闭合复位置钉内固定修复中青年移位型股骨颈骨折的复位质量及股骨头坏死率。 方法：分析2008年6月至2014年6月在贵州省骨科医院创伤科就诊且获得完整随访的102例中青年股骨颈骨折患者的临床资料,根据复位方式分为两组,切开复位组39例,闭合复位组63例。对比两组患者的一般资料、治疗后骨折愈合情况、股骨头坏死率及复位质量。 结果与结论：两组患者的一般资料、治疗前后血红蛋白差值、骨折愈合时间及骨折不愈合率相比,差异均无显著性意义(P > 0.05)。切开复位组的股骨头坏死率低于闭合复位组,复位质量高于闭合复位组,差异有显著性意义(P < 0.05)。提示切开复位置钉内固定修复中青年移位型股骨颈骨折的股骨头坏死率较低,复位质量好。尽管表明切开复位有一定优势,但病例数量以及病例研究仍有一定限制,应根据患者病情选择合适的复位修复方式。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程