OBJECTIVE To study the function of the composite of bone matrix gelatin(BMG) and plaster in the repairing process of bone defects. METHODS Sixteen New Zealand rabbits which were defected in corpus radii were made as implant zone of bone. Sixteen sides of radii were implanted with the composite of BMG and plaster as experimental group. Others were implanted with BMG(8 sides) and bone stored in alcohol(8 sides) as control groups. The repairing process in bone defects were observed by X-ray and histological examination. RESULTS There was an obvious osteogenesis in experimental group. The defects of radii were almost healed at 12th week after operation. There were osteogenesis in both control groups, but the repairing process was slower than that of the experimental group. CONCLUSION The composite of BMG and plaster is a good material for bone transplantation.
Objective To investigate the osteoblasts effect, compl ications and influencing factors in the appl ication of small freeze-drying allogeneic bone plots mixed autologous bone fragments in spinal surgery, and to compare with autogenous bone graft. Methods From January 2003 to January 2007, 515 cases of spinal injuries were treated. A total of 324 cases weretreated with small freeze-drying allogeneic bone plots mixed with autologous bone grafts (group A), including 211 males and 113 females with an average age of 36 years (18-83 years). There were 182 cases of thoracolumbar vertebra fracture, 68 cases of lumbar spondylol isthesis, 47 cases of lumbar vertebral canal stenosis, 17 cases of cervical disc herniation, 5 cases of cervical spine fracture-dislocation and 5 cases of thoracolumbar vertebra tumor. The weight of bone graft was 10-60 g (mean 30 g). A total of 191 cases were treated with autogenous bone grafting (group B), including 135 males and 56 females with an average age of 32 years (23-78 years). There were 109 cases of thoracolumbar vertebra fracture, 23 cases of lumbar spondylol isthesis, 17 cases of lumbar vertebral canal stenosis, 19 cases of cervical disc herniation, and 23 cases of cervical spine fracture-dislocation. The weight of bone graft was 10-50 g (mean 25 g). Results In group A, effusion of wound increased in 4 cases and the result of bacterial culture was negative; effusion was absorbed after 2 weeks of local irrigation, drainege and cortin management. In group B, no obvious effusion was observed. The follow-up time was 10-36 months (mean 17.4 months) in group A and 8-36 months (mean 16.8 months) in group B. The bone heal ing was achieved in 308 cases within 4-10 months (mean 8.1 months) and in 184 cases within 4-10 months (mean 5.8 months), and the bone fusion rates were 95.06% and 96.34% in groups Aand B, respectively. There was no significant difference in bone fusion rate between groups (P gt; 0.05). According to Mankin and Komender evaluation standard, the response rates were 95.06% and 96.34% in groups A and B, respectively, showing no significant difference (P gt; 0.05). Conclusion Mix-bone grafting has the same effective to autologous bone grafting in bone fusion rate. It could be used as the supplement of the autologous bone inadequacy.
Objective To investigate the effect of microsurgical repair of refractory bone defects and nonunion in distal humers. Methods Twelve cases of bone defects and nonunion indistal humerus wererepaired with free vascularised fibular graft and fixed with the anatomical bone plate. Of the 12 cases, 8 had pseudarthrosis, and 4 had bone defects 3-5 cm. Fibular graft ranged from 5-15 cm, 8.5 cm in average. Results After a follow-up of 3-18 months, 8.5 months in average, all cases of free vascularised fibular graft healed within 38 months. The fibular graft thickenedas time passed. Normal recessive osseous elbow joint, improvement in the inflection and extension of elbow joint, and normal revolving of antebrachium were attained. The short of limbs were corrected. Satisfactory functions of supporting and fine operation were attained. Conclusion With the support of anatomical bone plate, the fibular graft can help the recovery of joint functionand repair bone defects and nonunion as to avoid joint replacement with prosthesis.
ObjectiveTo observe the morphological characteristic by implanting domestic porous tantalum in rabbit patellar tendon and to evaluate biocompatibility features so as to provide experimental basis for porous tantalum used as interface fixation between tendon and bone. MethodsA total of 48 adult New Zealand white rabbits, male or female, weighing 2.5-3.0 kg, were selected. Porous tantalum flake (5 mm×5 mm×2 mm) was implanted in the left patellar tendon (experimental group) and the same size porous titanium flake in the right patellar tendon (control group). The animals were sacrificed at 2, 4, 8, and 12 weeks after implantation, then the specimens were harvested for gross observation, HE staining, scanning electron microscope (SEM) observation, and hard slices observation. ResultsNo animal died after operation. Porous tantalum was bonded closely with host tendon and no inflammatory reaction was found. Loose and thick fibrous capsule was observed at the beginning and became density and thinner in the end by microscope, showing significant difference between different time points in 2 groups (P<0.05), but no significant difference was found between 2 groups at different time points (P>0.05). The SEM observation showed that fibrous tissue attached to the surface and inner walls of porous tantalum at early stage, and extended on the material to reach confluence at late period, but the experimental group was more than the control group. Hard slices observation showed that the collagen fibrils were seen on porous tantalum interface with host tendon, and blood vessels grew into the pores. The control group and the experimental group showed no significant difference. ConclusionThe domestic porous tantalum has good biocompatibility. Connection and integration can be established between tendon and porous tantalum, and therefore it could be used in reconstruction of tendon-bone fixation device.
Six cases of maxillary tumors after being resccted radically, a primary repair of the maxillary defects were carried out by grafting of the pedicled buccal fat pad as the oral linning combined with bone graft. The cases were followed from 8 to 14 months. The function of the maxillary sinuses was normal and the facial contour was restored symmetrical. The applied anatomy and the method of operation were introduced in details. The advantages of the method were discussed.
OBJECTIVE: To observe the difference of the fracture reparation using autogeneic-iliac bone and allogenic bone. METHODS: Comminuted fracture of humerus in two sides were made in rabbits. Autogeneic-iliac bone was implanted in one side, while allogenic bone of equal capacity was implanted in the other side. General observation, X-ray, and HE histologic section were done when the rabbits were put to death in different stages. RESULTS: One week after implantation, the graft had been enclosed by connective tissue without infiltration of the inflammatory cells. At the 2nd week, the graft had been enclosed in osteoplastic granulation tissue, and the cartilage callus had formed. At the 3rd week, there had been broken sequestrum among the callus; the cartilage had actively formed the bone; and the medulla had been making. At the 4th week, the sequestrum had disappeared, and the mature callus had appeared; the osteoblasts had arranged in a line around the edge of the mature callus. At the 5th week, the callus was b, compact and approached mature bones. At the 6th week, there had been the compact lamellar structures and the complete haversian’s systems. There was no significant difference between callus of two sides by using image quantitative analysis in the 3rd, 4th week (P gt; 0.05). CONCLUSION: The allogenic bone has good histocompatibility and bone conduction effect, and can be used for bone transplantation substitute with autogenous-iliac bone.
The treatmen t of the bone defect of the distal part of the radiu s included repair of the bone defect and resto rat ion of the funct ion of the w rist jo in t. Since 1979, th ree operat ive methods w ere u sed to t reat 13 cases, and they w ere graf t ing of the vascu larized f ibu la by anastom rsis f ibu lar vessels, graf t ing of upper part of f ibu lar w ith lateral inferio rgen icu lar artery and graf t ing vascu larized scapu la f lap. Follow up had been carried ou t from1 to 10 years. The resu lt w as sat isfacto ry. The discu ssion included the repair of the defect of the m iddle o r distal part of the radiu s, the operat ive methods, main at ten t ion s and indications. It was considered that it shou ld be based on the length of bone defect wh ile the operative method was considered.
ObjectiveTo summarize the effectiveness of nitinol memory alloy two foot fixator with autologous cancellous bone grafting in treating old scaphoid fracture and nonunion.MethodsBetween January 2013 and January 2017, 11 patients of old scaphoid fracture and nonunion were treated with nitinol memory alloy two foot fixator and autologous cancellous bone grafting. All patients were male with an average age of 26.1 years (range, 18-42 years). The fractures were caused by sport in 3 cases, falling in 7 cases, and a crashing object in 1 case. The interval between injury and operation was 6-18 months (mean, 8.9 months). Postoperative outcome measures included operation time, fracture healing time, grip strength, range of motion (ROM) of flexion, extension, ulnar deviation, and radial deviation, Mayo score, visual analogue scale (VAS) score, and the Disabilities of the Arm, Shoulder, and Hand (DASH) score.ResultsThe operation time was 35-63 minutes (mean, 48 minutes). All incisions had primary healing with no infection and loosening or breakage of internal fixator. All patients were followed up 12-30 months (mean, 20.7 months). X-ray films showed that fracture healing was achieved in all patients with an average time of 15 weeks (range, 12-25 weeks). All internal fixators were removed after 10-12 months of operation (mean, 11.2 months). At last follow-up, the grip strength, ROMs of flexion, ulnar deviation, and radial deviation were superior to those before operation (P<0.05), no significant difference was found in ROM of extension between pre- and post-operation (t=0.229, P=0.824). There were significant differences in above indexes between affected and normal sides (P<0.05). At last follow-up, the Mayo, VAS, DASH scores were also significantly superior to those before operation (P<0.05).ConclusionFor the old scaphoid fracture and nonunion, Ni-Ti arched shape-memory alloy fixator and autologous cancellous bone grafting can obtain good effectiveness, which is an effective treatment.