Twelve cases (13 hips) of congenital dislocation of hip (CDH)in a group above the age of six were treated by Chiari pelvic osteotomy from Jan. 1991 to Dec. 1992. The results following operative treatment rated as good in 85 percents according to the clinical and radiologic examinations. The indications, and the results with the operation as the functional reconstuction of the hip concerned were discussed.
Osteoinducin is a kind of new biomaterial, which contains bone morphogenic protein (BMP). Its role of inducing osteosis has been confirmed by laboratory study. Since 1992, osteoinducin was applied to treat tumorous defects of bone for 7 cases. After eradication of the lesion of tumor, stickor granulelike osteoinducin was filled in the defects. In 8 weeks, the bone defects had the sign of osteosis on roentgenogram. No rejection reaction and local inflammation were found. The property, operation procedure and indication were introduced. Compared with other artificial bones, the osteoinducin showed faster osteosis, better histoco mpatibility and more convenient usage. It was a good material for bone graft.
Objective To study the release properties of basic fibroblast growth factor (bFGF) chitosan microspheres prepared by cross-linking-emulsion method using chitosan as a carrier material so as to lay a foundation for further study. Methods Using 0.6% sodium tripolyphosphate solution as a crosslinking agent and 1.5% solution of chitosan as a carrier material, bFGF chitosan microspheres were prepared by cross-linking-emulsion method. Laser particle size analyzer and Zeta electric potential analyzer were used to measure the particle diameter distribution, scanning electronic microscope to observe the morphology, and ELISA to determine the drug loading, the encapsulation rate, and the drug release properties. Results The particle size of bFGF chitosan microspheres ranged 20.312-24.152 μm. The microspheres were round with a smooth surface and uniform distribution, and it had no apparent porosity. The drug loading and encapsulation rate of microspheres were (7.57 ± 0.34) mg/g and 95.14% ± 1.58%, respectively. The bFGF chitosan microspheres could continuously release bFGF for 24 days; the bFGF level increased gradually with time and reached (820.45 ± 21.34) ng/mL at 24 days; and the microspheres had a burst effect, and the burst rate was 18.08%, and the accumulative release rate of the microspheres reached 82.05% during 24 days. Conclusion It is easy-to-operate to prepare the bFGF chitosan microspheres with the cross-linking-emulsion method. The bFGF chitosan microspheres have smooth surface, uniform distribution, and no apparent porosity.
ObjectiveTo explore an method and the effectiveness of surgical treatment of thoracic and lumbar tuberculosis complicated with severe kyphotic deformity (Cobb angle≥55°) and paraplegia. MethodsBetween January 2009 and January 2013, 13 cases of thoracic and lumbar tuberculosis complicated with severe kyphotic deformity and paraplegia were treated by one-stage posterior vertebral column resection (PVCR), debridement, bone grafting, and instrumentation fixation. Of 13 patients, 7 were male and 6 were female with an average age of 23.5 years (range, 14-49 years). The disease duration was 13-38 months (mean, 19 months). The Cobb angle of kyphosis was (65.23±7.95)°. The visual analogue scale score (VAS) was 7.38±0.31. In 13 patients with incomplete paraplegia, 1 case was classified as Frankel grade B, 7 cases as grade C, and 5 cases as grade D. The lesion involved 2 vertebrae bodies in 7 cases (T8, 9 in 1 case, T11, 12 in 2 cases, and T12, L1 in 4 cases), 3 vertebrae bodies in 4 cases (T10-12 in 2 cases, T9-11 in 1 case, and T11-L1 in 1 case), and 4 vertebrae bodies in 2 cases (T4-7 in 1 case and T6-9 in 1 case). Imaging examination showed paravertebral abscess in 10 cases. ResultsHealing of incision by first intention was obtained in all patients. The neurological injury and pulmonary infection occurred in 3 cases and 2 cases respectively, which were cured after symptomatic treatment. Thirteen patients were followed up 12-48 months (mean, 17 months). The erythrocyte sedimentation rate restored to normal level in all cases at 3-7 months after operation. All the patients achieved bony fusion at 10-20 months (mean, 14 months) after operation. No fixation loosening, displacement, or fracture occurred during follow-up. Common toxic symptom of tuberculosis disappeared, and there was no recurrence of local tuberculosis. The Cobb angle of kyphosis was corrected to (22.38±1.76)° at 1 week and (22.15±1.83)° at last follow-up, showing significant difference when compared with preoperative one (P < 0.05). There was no significant difference in Cobb angle of kyphosis between at 1 week after operation and at last follow-up (P > 0.05). The Frankel grading was grade B in 1 case, grade C in 10 cases, and grade D in 2 cases at 1 week after operation; and it was grade D in 1 case and grade E in 12 cases at last follow-up; significant differences were found between at pre-and post-operation (P < 0.05), and between at 1 week after operation and at last follow-up (P < 0.05). The VAS score was 4.08±0.76 at 1 week and 0.62±0.14 at last follow-up, showing significant differences between at pre-and post-operation (P < 0.05) and between at 1 week after operation and at last follow-up (P < 0.05). ConclusionOne-stage PVCR, debridement, bone grafting, and instrumentation fixation is proved to be successful in treating thoracic and lumbar tuberculosis complicated with severe kyphotic deformity and paraplegia.