Through dissection of 12 fresh finger specimens, the anatomy of the distal part of dorsal aponeurosis and its function was closely observed. A direct reparative procedure of the terminal tendon by using tendon flap graft was deseribed for the treatment of chronic mallet finger deformity. Correction of deformity, restoration of active motion of DIP and avoidance of residual pain were observed in three clinical cases.
Abstract In order to supply allografts for reconstruction of finger, repair of tendon or tendon sheath, the hands from fresh cadavers of healthy young persons who died from accident were amputated at the wristlevel. After disinfected, packed and labelled, the hands were stored into a deep freezer at -30℃ as bank storage. Before grafting, the skin and subcutaneoustissue were stripped from the frozen finger. Then it was immersed in an antibiotic fluid for 1 hour. The results showed that the immunological antigenicity of allograft was decreased by the freezing method. Bony union between the impacted host bone and the allogeneic phalangeal bone was seen on X-ray films. Bone absorption and joint degeneration were found at the area where no impaction between bones. The healing between tendons from host and that from the allografts was b. It was concluded that establishing a cadaveric hand bank in hospital was as important as establishing a bone bank for the supply of bone, joint, tendon, tendon sheath and finger composite tissue, for allogeneic grafts.
Objective?To observe the changes of force bearing area and pressures of the rabbit tibiofemoral contact area and the biomechanical reconstruction level of joint after meniscal allograft.?Methods?A total of 28 Japanese rabbits were involved, weighing 3.0-3.5 kg, male or female. Of 28 rabbits, 7 were selected as meniscus donors, the remaining 21 rabbits were randomized into group A (n=7), group B (n=7), and group C (n=7). Group A underwent single knee opening and suturing, group B underwent medial meniscus excision and suturing, and group C underwent medial meniscus allograft after medial meniscus excision and suturing. The rabbits were sacrified at 12 weeks after operation for biomechanical observation through biomechanical machine and color imaging system. The meniscus tissue specimens were harvested from groups A and C to perform histological and immunohistochemical staining.?Results?After operation, all rabbits in 3 groups survived to the end of experiment. There were significant differences in the force bearing area and pressures at 0-90° flexion between group B and groups A, C (P lt; 0.05) at 12 weeks, showing no significant difference between group A and group C (P gt; 0.05); and there were significant differences in the force bearing area and pressures at 120° flexion among 3 groups (P lt; 0.05). The histological observation showed that the number of cartilage cells and collagen fibers returned to normal in group C, and the immunohistochemical staining showed that transplanted meniscus of group C contained large amounts of collagen fibers consisting of collagen type I and collagen type II. After 12 weeks of operation, the collagen type I contents were 0.612 5 ± 0.059 8 in group A and 0.587 2 ± 0.063 9 in group C, showing no significant difference (t=0.765, P=0.465); the collagen type II contents were 0.772 4 ± 0.081 5 and 0.814 3 ± 0.051 7, respectively, showing no significant difference (t= —0.136, P=0.894).?Conclusion?The allograft of rabbit meniscus can significantly increase the force bearing area of the tibiofemoral contact area and reduce the average pressure. Therefore, biomechanically speaking, the meniscus allograft can protect the articular cartilage and reconstruct the biomechanical balance.
【Abstract】 Objective To evaluate the biocompatibil ity of the sheep BMSCs cultured on the surface of photografting modified copolymers of 3-hydroxybutyrate and 3-hydroxyvalerate(PHBV). Methods BMSCs were isolated from bone marrow of the posterior il iac crest of a 6-month old sheep by whole marrow adherent culture method. The 3rd passage BMSCs were seeded onto modified PHBV and conventional PHBV films, or three-dimension scaffolds. Cell-adhesion rates were calculated by hemocytometer at 1, 2 and 6 hours after seeded. Cell morphology was examined by scanning electron microscope when the BMSCs were cultured for 3 days, 1 week and 3 weeks. Cell cycle was analyzed by flow cytometry at 5 days after seeded. The content of protein in BMSCs was determined by BCA assay and the content of DNA was quantified by Hoechst 33258 assay at 4, 8 and 12 days after seeded. Results At 1 hour after seeded, cell-adhesion rate on modified PHBV films (52.7% ± 6.0%) was significantlyhigher than that of conventional PHBV films (37.5% ± 5.3%) (P lt; 0.05); At 2 and 6 hours after seeded, cell-adhesion rate of modified PHBV films was similar to that of PHBV films (P gt; 0.05). The surface of modified PHBV film was rougher. In the early culture stage, more cells adhered to modified PHBV and the cells displayed much greater spreading morphology. Furthermore, ECM on modified PHBV were richer. There were no significant differences between the trial team and the control on the cell cycle and the content of DNA and protein of BMSCs (P gt; 0.05). Conclusion Photografting modification on PHBV can promote BMSCs’ adhesion and enhance their biocompatibil ity.
Objective To summarize the clinical experience of liver retransplantation. Methods Six liver retransplantations were performed. The indications consisted of primary non-function (PNF, 2 cases), acute or chronic rejection (2 cases), stomas stenosis of biliary tract (1 case) and primary sclerosing cholangitis (1 case). The immunosuppressive protocols included tacrolimus, methylprednisolone (MP) and mycophenolate mofetil (MMF). Results Five patients were cured. One patient died on day 4 after liver retransplantation because of multiple organ failure. Postoperative complications included deep fungal infection and wound infection. Conclusions Liver retransplantation is an effective method for graft failure after liver transplantation. Proper indication and optimum operative time, intensive perioperative supervision and proper treatment are very important to improv effect of liver retransplantation.
Abstract To look for a substitute material of microvessel, 30 rabbits were divided into 2 groups. A segment of 5mm of rabbit femoral artery was resected and a segment of 10mm of human placental artery was placed in the defect with both ends anastomosed. Twenty experimental rabbits received freezedried human placental vessel and 10 rabbits received fresh as control. After 24 hours, 2 weeks, 3 months, the arteries were explored. If the artery was found to be obstructed, the segment was removed for histologic examination. The results showed: in the experimental group, 2 weeks after operation, the rateof patency was 85%, and it decreased to 50% 3 months after the operation. Under the light and scanning electronic microscope, the transplanted vessels were decomposed and inside the unobstructed transplanted vessels in both groups a layer of fibrous tissue was formed as the new wall of vessel. It was concluded thatthe immunologic reaction could not be prevented but would only be put off for aperiod of time by cryochem. Further more study should be done in using placental atery as a substitute material in repairing vascular defect.
Objective To explore an effective way fortreating severe complicated distal femoral fractures. Methods Twenty-six patients with complicated distal femoral fracture who all belonged to 33C3.3type according to AO/ASIF lassification, were treated with a lateral condylar buttress plate or self-desinged aliform anatomical plate, and operated on with allogeneic bone grafting. Results All cases were followed up for an average of 14 months (ranging 5-25 months). Twenty-four wounds were primary healing postoperatively, 2 wounds were infected and healed after dressing change. Twenty-four had bone healing after 411 months, 2 needed to operate again because of earlier weight-bearing resulting in fixation failure. According to shelbourne and Brueckmann score, the excellent and good rate was 88.46%. Conclusion The internal fixation forcomplicated distal femoral fracture by self-designed aliform anatomical plate and lateral condylar buttress plate with a great deal of allograft bone is an effective surgical method. As it has long oval holes and the holes are consecutive ,the aliform anatomical plate is more suitable for severe complicated fractures. At the same time, autogenous-ilium transplantation can be substituted by the allograft bone.
Objective
To explore the surgical technique and effectiveness of autologous femoral head bone graft in total hip arthroplasty (THA) for Crowe type Ⅲ developmental dysplasia of the hip (DDH) with acetabular bone defect.
Methods
Between July 2012 and September 2015, 12 cases (12 hips) of Crowe type Ⅲ DDH with acetabular bone defect were included. Of the 12 patients, 2 were male and 10 were female, with an average age of 54.3 years (range, 37-75 years). The Harris score before operation was 41.08±7.90. The preoperative leg length discrepancy was 0.53-4.28 cm, with an average of 2.47 cm. Autologous femoral head bone graft and cancellous screw fixation were used in all cases to reconstruct acetabula in THA. Four cases were performed with subtrochanteric shortening osteotomy at the same time.
Results
All incisions healed by first intention. Twelve cases were followed up 1 year and 10 months to 5 years, with an average of 3.0 years. X-ray films showed that bone healing was observed in all cases at 6 months to 1 year after operation. There was no bone graft osteolysis, absorption, bone graft collapse, and acetabular prosthesis loosening. At last follow-up, the Harris score was 89.50±2.78, showing significant difference when compared with preoperative value (t=–25.743, P=0.003). The length discrepancy was 0-1.81 cm at last follow-up with an average of 0.76 cm.
Conclusion
Autologous femoral head bone graft is effective for Crowe type Ⅲ DDH with acetabular bone defect, which has advantages of restoring pelvic bone stock, obtaining satisfied prosthetic stability and mid-term effectiveness.
The sciatic nerves of adult rats were sectioned bilaterally and the ends of the nerves were placed in silicone tubes. One side of the distal nerve segment was inverted and that of the contralateral side was non-inverted. After 2, 4, 6 weeks, the rats were killed and the specimens were removed for macroscopic, histologic and morphometric analysis. The results showed that either the inverted or non-inverted distal nerve segments had no influence on the number of the myelinated axons in the regenerated nerves, but the number and density of the myelinated axons was markedly diminished in the inverted distal nerve segments.
OBJECTIVE: To study the characteristics of, morphology histology and ultrastructure of anterior cruciate ligament(ACL) autograft and two-step cryopreserved ACL allograft after transplantation. METHODS: Sixty New Zealand rabbits and sixty Japanese rabbits were randomly divided into two groups: ACL autograft group and two-step cryopreserved ACL allograft group. Immunosuppressant were not used after transplantation. The histology and ultrastructure of the ACL of transplantation and normal knee were observed after 4 weeks and 12 weeks, respectively. RESULTS: The rate of remodeling process was faster in ACL autograft than in two-step cryopreserved ACL allograft, but there was similar remodeling process between two groups 12 weeks after transplantation. The proportions of large-diameter fibers(gt; or = 80 nm) of ACL autograft and cryopreserved ACL allograft were 6% and 24% in the 4th week, and were 0 and 2% in the 12th week, respectively. The proportions of small-diameter of fibers(lt; 80 nm) of ACL autogrft and cryopreserved ACL allograft were 94% and 76% in the 4th week, and 100% and 98% in the 12th week, respectively. Histologic incorporation in ACL autograft was similar to that in cryopreserved ACL allograft. CONCLUSION: Two-step cryopreserved bone-ACL-bone allograft were similar to bone-ACL-bone autograft cryopreserved in remodeling process and histology. The rate of remodeling process was faster in ACL autograft than in cryopreserved ACL allograft.
