The aim of the study was to evaluate the efficacy custom 3D-printed osteosynthesis plates in the treatment of intercondylar humeral fractures.Thirteen patients with distal intercondylar humeral fractures were randomized to undergo surgery using either conventional plates (n = 7) or 3D-printed plates (n = 6) at our institution from March to October 2014. Both groups were compared in terms of operative time and elbow function at 6 month follow-up.All patients were followed-up for a mean of 10.6 months (range: 6–13 months). The 3D-printing group had a significantly shorter mean operative time (70.6 ± 12.1 min) than the conventional plates group (92.3 ± 17.4 min). At the last follow-up period, there was no significant difference between groups in the rate of patients with good or excellent elbow function, although the 3D-printing group saw a slightly higher rate of good or excellent evaluations (83.1%) compared to the conventional group (71.4%).Custom 3D printed osteosynthesis plates are safe and effective for the treatment of intercondylar humeral fractures and significantly reduce operative time.
Background: Surgical treatment for terrible triad injuries remains a challenging clinical problem, and controversy exists of whether it is better to repair or replace the radial head. The objective of this systematic review was to evaluate the clinical outcomes of repair and arthroplasty replacement of the radial head in patients with terrible triad injury. Methods: Medline, Cochrane Library, EMBASE, and Google Scholar were searched up to July 30, 2018 to identify the relevant studies, which included patients who had received treatments of the terrible triad of the elbow and also had reported with the quantitative outcomes. Outcomes of interest were functional outcomes. Results: Four studies with a total of 115 patients were included in the systematic review. Most patients were type II or III radial head fractures based on the Mason classification systems. Fifty-one patients received radial head repair surgery and 64 underwent replacement. Two studies had indicated that patients in the replacement group were significantly associated with better treatment outcome assessed by DASH (Disabilities of the Arm, Shoulder and Hand) and MEPS (Mayo Elbow Performance Score) scores. The meta-analysis indicated that patients with the arthroplasty replacement were associated with significantly better ROM outcomes in flexion, extension, pronation than those with radial head repaired. In addition, patients in the replacement group showed fewer post-surgery complications than those in the repair group. Conclusions: Our review had indicated that patients with terrible triad injuries undergo arthroplasty replacement have better clinical outcomes and fewer post-surgery complications than those received the repair surgery. Radial head replacement might be a more effective treatment approach with good clinical outcomes for patients with a terrible triad of the elbow.
BackgroundOpen fractures of the tibial diaphysis are usually caused by high-energy trauma and associated with severe bone and soft tissue injury. Reamed and unreamed intramedullary nailing are often used for treatment of tibial injury. The purpose of this study was to investigate the clinical efficacy of reamed versus unreamed intramedullary nailing for open tibial fractures (OTF).MethodsA meta-analysis was conducted according to the guidelines of the Cochrane Collaboration using databases containing the Cochrane Library, PubMed, EMbase, Chinese Biomedical Database, Chinese VIP information, and WanFang Database. Randomized and semi-randomized controlled clinical trials of both reamed and unreamed intramedullary nailing for OTF treatment were analyzed using Reviewer Manager (RevMan5.0) software.ResultsA total of 695 references were initially identified from the selected databases. However, only four studies were assessed, matching all the eligibility criteria conducted by two independent reviewers. The result showed that there was no statistical difference in healing rate, secondary surgery rate, implant failure rate, osteofascial compartment syndrome, and infection during the postoperative period between reamed and unreamed nails in OTF.ConclusionsFindings of this study suggest that there was no statistical difference between reamed and unreamed intramedullary nailing in clinical treatment of OTF. However, the result of this meta-analysis should be cautiously accepted due to some limitations, and further studies are still needed.
Destrin, also known as actin depolymerizing factor (ADF), is a member of the ADF/Cofilin/destrin superfamily that has the ability to rapidly depolymerize F-actin in a stoichiometric manner. Remodeling of the actin cytoskeleton through actin dynamics (assembly and disassembly of filamentous actin) is known to be essential for numerous basic biological processes including bone formation. The aim of current study was to elucidate whether destrin was involved in the progression of bone loss induced by modeled microgravity. We used the hindlimb suspension (HLS) mice model to simulate microgravity in vivo. Exposure to HLS in mice enhanced femur destrin expression. Destrin deletion in Dstn (-/-) mutant mice enhanced HLS-induced reduction of BMD, ultimate load, stiffness, trabecular thickness, trabecular number, and bone volume fraction in femur, but did not affect them under control static condition. The Rotary wall vessel bioreactor was used to model microgravity in vitro. Exposure to modeled microgravity in cultured 2T3 murine osteoblast precursor cells upregulated destrin expression. RNAi-mediated destrin knockdown enhanced the microgravity-induced reduction of osteoblastic proliferation and differentiation significantly. In conclusion, for the first time we demonstrated that destrin deletion enhances the bone loss in hindlimb suspended mice. Destrin may be a potential target for the prevention or management of microgravity-induced bone loss.
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