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Relationship among bone mineral density,collagen composition,and biomechanical properties of callus in the healing of osteoporotic fracture

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Chinese Journal of Traumatology 2007年第6期10卷 360-365页

作者：沈彬牟健雄裴福兴 Department of Orthopaedics West China Hospital Sichuan University

Objective： To study the change and relationship among bone mineral density （BMD）, collagen composition and biomechanical properties of the callus in the healing process of osteoporotic fracture. Methods： The osteoporotic rat model and fracture model were established through bilateral ovariectomy （OV＇X） and osteotomy of the middle shaft of the right hind tibiae, respectively. Ninety female SD rats were randomly divided into OVX group and sham group. With the samples of blood and callus, roentgenoraphic and histological observation were performed for the assessment of the healing progress of the fracture, and the serum concentration of TRAP-5b, proportion of type I collagen, BMD and biomechanical properties of the callus were measured. Results： The OVX group experienced a significant delay of fracture healing. The mean serum concentration of TRAP-5b of rats in the OVX group was much higher than that in the sham group after the operation （P 〈 0.05）, but the difference at the same time point after fracture was smaller than that before fracture （P 〈 0.05）. The BMD of the callus in both groups reached the peak value at the 6 th week after fracture while the proportion of the type I collagen and the biomechanical strength reached the peak at the 8th week. Conclusions. The deficiency of estrogen after the ovariectomy could induce the up-regulation of the osteoclasts activities, whereas the potency of further activation after fracture was depressed. Although the synthesis of collagen together with its mineralization determines the biomechanical properties of new bone, the accumulation of collagen could be assessed as an index in the prediction of biomechanical strength of bones independent of the bone mineral deposition.

关键词： Osteoporosis fracture, bone Collagen: Biomechanics

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fracture of the radial sesamoid bone of the thumb： an unusual fracture

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Chinese Journal of Traumatology 2011年第5期14卷 309-311页

作者： Luca Deabate Guido Garavaglia Stefano Lucchina Cesare Fusetti Department of Orthopaedic & Trauma Surgery EOCORBV Via ospedale 1 CH-6500 Bellinzona Switzerland

The hand consists of five sesamoids. Two of them are present at the metacarpophalangeal （MCP）joint of the thumb. fracture of the sesamoid bones of the thumb is a rare injury and the literature on the radial side is seldom reported. We reported a case of a patient with a fracture of the radial sesamoid at the MCP joint of the thumb in order to increase attention regarding this type of injuries. A 44-year-old male, high level gymnastic trainer, was helping one of his athletes during an exercise while he reported a hyperextension trauma to the MCP joint of the right *** week after trauma, he presented to the hand surgeon complaining of a painful thumb at the MCP joint level on its palmar aspect. Standard A-P and lateral X-rays revealed a fracture of the radial sesamoid and the fracture was treated with a splint for 3 weeks. He was able to resumed his entire work 6 weeks after the injury. The sesamoid fractures is an indicator of the magnitude of the hyperextension injury and sometimes associated with tears of the volar plate ligament of the MCP joint. And a failure to recognize the ligament injury may lead to a long-term hyperextension instability on pinching.

关键词： fracture, bone Sesamoid bones Thumb

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Early total hip arthroplasty for severe displaced acetabular fractures

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Chinese Journal of Traumatology 2006年第6期9卷 329-333页

作者：杨述华张宇坤许伟华李进刘国辉杨操刘勇田洪涛 Department of Orthopaedies Union HospitalTongji Medical College of Huazhong University of Science and TechnologyWuhan 430022China

Objective ： To investigate the effect of early total hip arthroplasty for severe displaced acetabular fractures. Methods： Total hip arthroplasty was performed on 17 cases of severe fracture of the acetabulum from 1997 to 2003. The mean follow-up was 2.1 years（ 1-6 years） and the average period from fracture to operation was 8 days （5-21 day）. The average age of the patients was 53 years （ 26-69 years）. Restdts： At the final follow-up the Harris hip score averaged 82（69-100） points and 15 cases have got a good outcome. There was one case of heterotopic bone formation. There were no radiographic evidences of lateloosening of the prosthesis. One patient had severe central displacement of the cup. Conclusions： In patients with severe displaced acetabular fractures, particularly in elderly patients, early total hip arthroplasty is probably an alternative efficient way to achieve a painless and stable hip.

关键词： Acetabulum fracture, bone Arthroplasty, replacement, bid

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Definition, classification and treatment of destructive fractures

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Chinese Journal of Traumatology 2011年第5期14卷 301-303页

作者： FANG Guo-jun QU Zhi-guo LIU Zhuo CHEN Yuan Department of Orthopedic Surgery Siping Central Hospital Siping 136000 Jilin Province China

Destructive injury is defined as a very serious damage both to the bone and the soft tissues. But in clinical practice we found that in some fracture cases, the damage to soft tissues is not as severe as ＂destructive injury＂ indicates, whereas comminuted fractures still cannot show the severity of bone damage. Therefore we proposed a new term ＂destructive fractures＂ after combining the definition of destructive injury with typical clinic cases. Destructive fractures refer to the fractures whose osseous tissues are damaged too seriously to be repaired, but soft tissues, nerves and veins are less severely injured and can be repaired. From the year 2001 to 2010, 75 cases of destructive fractures were admitted in our department. According to whether the fractures interlinked with the external environment, together with the fracture sites, they were divided into 6 types： al type, closed diaphysis destructive fracture; a2 type, open diaphysis destructive fracture; b1 type, closed joint-involved destructive fracture; b2 type,open joint-involved destructive fracture; cl type, closed mixed destructive fracture; c2 type, open mixed destructive fracture. Corresponding clinical treatments were conducted for each *** new classification criterion of destructivefracture is simple and practical and thus can be used as an important guide to make reasonable treatment plans for destructive fractures.

关键词： fracture, bone Classification Therapeutics

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Double segmental tibial fractures-- an unusual fracture pattern

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Chinese Journal of Traumatology 2011年第4期14卷 247-249页

作者： Kamal Baili Vishal Kumar Sandeep Patel Sameer Aggarwal Department of Orthopaedics Postgraduate Institute ofMedical Education and Research Sector 12 Chandigarh160012 India

A case of a 50-year-old pedestrian who was hit by a bike and suffered fractures of both bones of his right leg was presented. Complete clinical and radiographic assessment showed double segmental fractures of the tibia and multisegmental fractures of the fibula. Review of the literature revealed that this fracture pattern was unique and only a single case was reported so far. Moreover, we discussed the possible mechanisms which can lead to such an injury. We also discussed the management of segmental tibial fracture and the difficulties encountered with them. This case was managed by modern osteosynthesis technique with a pleasing outcome.

关键词： fracture, bone Tibia Fibula Nails

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