Medical textiles in orthopedics: An overview

The use of textile in the medical field is not new; this has given rise to a new branch known as medical textiles. These are being used to repair or replace various other musculoskeletal tissues. The most common uses of biomaterials are to create aseptic conditions for protection, general health care, and hygiene including bedding and clothing, surgical gowns, face masks, head and shoe covers, sterilization wraps, suture anchors, fiber cast and braces/orthotics. These are also used as materials for preparation of wipes, swabs, wound dressings, bandages, gauzes, plasters, pressure garments, orthopedic belts and for new applications, such as heart valves, vascular grafts, artificial veins, artificial ligaments, artificial joints, artificial skin, and artificial cartilage. The truth is that nowadays the use of biomedical textiles is more rampant than anyone realizes. Commonly used materials for preparation of biomedical textiles includes Cotton, Nylon, Silk, Ultra-high molecular weight polyethylene, Polyester, Polypropylene, Poly tetra-fluoro ethylene, Polyether ether ketone, and Polyether ketone. These are prepared from various monomers in varying proportions as per the requirement of the material to be used. Various methods are used in their preparation like Braiding, Knitting, and Weaving, which helps in the development of certain kinds of materials with different specificity and character. Other important measures in the preparation of the medical textile include Denier (the filament counts in multifilament fibers), Tenacity (the strength per denier) and Heat shrink (the amount of shrinkage at a particular time and temperature).     

Does operative fixation of isolated fractures of ulna shaft results in different outcomes than non-operative management by long arm cast?

Objective

The optimal treatment for isolated fractures of ulnar shaft is debatable. The purpose of this study was to compare functional outcomes and radiological union in patients treated for isolated fractures of the ulnar shaft by open reduction and internal fixation and a long arm cast.

The efficacy of removable devices to offload and heal neuropathic plantar forefoot ulcers in people with diabetes: a single‐blinded multicentre randomised controlled trial

Non‐removable offloading is the ‘gold standard’ treatment for neuropathic diabetic plantar forefoot ulcers. However, removable offloading is the common ‘standard of care’. We compared three removable offloading devices for ulcer healing efficacy. In this multicentre, randomised controlled trial, 60 persons with neuropathic diabetic plantar forefoot ulcers were randomly assigned to wear a custom‐made knee‐high cast [BTCC (bivalved TCC)], custom‐made ankle‐high cast shoe or a prefabricated ankle‐high forefoot‐offloading shoe (FOS). Primary outcome was healing at 12 weeks. Dynamic plantar pressures, daily stride count and treatment adherence were assessed on a randomly selected subset (n = 35). According to intention‐to‐treat analysis, 58% of patients healed with BTCC [OR 0·77 (95% CI 0·41–1·45) versus FOS], 60% with cast shoe [OR 0·81 (95% CI 0·44–1·49) versus FOS] and 70% with FOS (P = 0·70). Mean ± SD peak pressure in kPa at the ulcer site was 81 ± 55 for BTCC, 176 ± 80 for cast shoe and 107 ± 52 for FOS (P = 0·005); stride count was 4150 ± 1626, 3514 ± 1380 and 4447 ± 3190, respectively (P = 0·71); percentage of 2‐week intervals that patients wore the device <50% of time was 17·3%, 5·2% and 4·9%, respectively. Non‐significant differences in healing efficacy between the three devices suggest that, when non‐removable offloading is contraindicated or not available, each can be used for plantar forefoot ulcer offloading. Efficacy is lower than previously found for non‐removable offloading maybe because suboptimal adherence and high stride count expose the patient to high repetitive stresses. These factors should be carefully considered in decision making regarding ulcer treatment.     

基于曲线拟合法与算术平均法计算双探头SPECT旋转中心漂移值的比较

目的 研究基于曲线拟合法与算术平均法计算单光子发射计算机断层成像（SPECT）设备探头旋转中心漂移值的差异性。方法 选取3个厂家的9台SPECT设备,每台设备都分别用曲线拟合法与算术平均法计算探头旋转中心漂移值,比较两种计算方法计算结果的差异性。同时将探头按照厂家分组,根据各厂家规定的合格值,将两种计算方法的结果与厂家自带软件计算的结果进行比较。结果 一共13个探头的13组数据中,两种计算方法计算结果之间数据差异无统计学意义（P>0.05）,两种计算方法计算结果分别与厂家计算结果之间比较,数据差异均无统计学意义（P>0.05）。两种计算方法计算结果分别与厂家计算结果相比,通过性均一致。结论 两种方法均能为旋转中心漂移的检测提供参考。     

Analysis of the factors causing tight cast syndrome after closed reduction and casting of pediatric distal radius fractures

Objective

The aim of this study was to evaluate the most important factors which can cause “tight cast syndrome’’ (TCS) in pediatric patients with distal radius fractures.

寻找HLA匹配无关供者概率曲线的计算及其应用

目的　建立在骨髓库中寻找到HLA匹配供者概率曲线P的回归方程式 ,并用于评估骨髓库的最适大小。方法　在哈迪 -温伯格群体中的HLA单体型频率可以从供者表型资料求得。寻找到一个HLA匹配供者的概率可以表示成供者数和HLA单体型频率的函数。使用对数曲线拟合方法推导出该概率曲线的回归方程。结果　笔者推导出在中国人骨髓库中寻找到至少一例HLA -A ,B ,DR抗原全配合供者概率的回归方程式为P =- 0 .6 7+0 .2 5lgN(N为骨髓库中的供者数 ,介于 5万到 1 0 0万 )。在骨髓库供者数达到 75万人时 ,大约 80 %的患者可以找到HLA配合供者。结论　找到HLA配合供者概率取决于骨髓库供者人数的多寡以及HLA单体型频率。HLA群体遗传学资料有助于决定骨髓库的最适大小及其供者成员的组成。     

定量磁化率成像的基本原理及方法概述

定量磁化率成像(quantitative susceptibility mapping,QSM)是磁共振成像(magnetic resonance imaging,MRI)中一项新兴的用于定量测量组织磁化特性的技术。利用定量磁化率成像,可以对组织的铁含量、钙化、血氧饱和度等进行有效的定量分析,对脑出血、多发性硬化症及帕金森综合症等脑神经疾病的研究和诊断也具有重要意义。定量磁化率图像的重建是一个复杂的过程,包括几个不同的步骤,因此其准确性受到很多因素的影响。本文主要概述定量磁化率成像的基本原理和重建流程,并对重建过程中每个步骤的主要方法进行介绍。同时,也将对当前定量磁化率成像的几种主要临床应用进行介绍。     

128颗普通金属烤瓷前牙的临床效果评价

目的观察普通金属烤瓷前牙修复3-5年后的临床效果。方法对我科2004年1-12月期间采用普通金属烤瓷前牙进行修复的128颗普通金属烤瓷冠进行临床效果评价。结果修复体戴用3-5年后随访观察,疗效成功69例,109颗修复体,占85.15%,失败9例,19颗,占14.85%。结论合理的选择修复材料及正确的操作是前牙良好修复效果的必要保证。     

CAD／CAM锆瓷冠在后牙种植修复中的临床应用

目的探讨CAD／CAM锆瓷冠在后牙种植体修复中的临床应用。方法选取种植术后患者30例,采用CAD／CAM全瓷冠修复,随访2年,检查患者锆瓷冠完整情况及修复体情况。结果30例患者共修复缺失牙43颗,经2年随访观察发现,1颗磨牙面瓷破损,其余修复体均正常,失败率为2．3％,修复体形态、表面质地,边缘适合性能、修复体颜色等级等修复效果满意。结论采用CAD／CAM锆瓷冠进行后牙种植修复,种植体周围无不良刺激,咀嚼效果良好,稳定不脱落,舒适美观,患者可取得良好的修复效果。