BackgroundPatella fractures that require surgery are conventionally treated using Kirschner wires (K-wires) and stainless steel wires. In recent years, the nonabsorbable polyester has been reported to have excellent outcomes clinically. Therefore, the goal of our study was to evaluate the effects of Kirschner wires combined with 5-Ethibond on treating patellar fractures.MethodsFrom July 2018 to January 2022, 22 patella fracture patients were treated with Kirschner wires combined with 5-Ethibond. Radiographs of the knees were used to evaluate fracture healing and hardware complications. The clinical results were evaluated through the functional score, knee joint range of motion (ROM), and Bostman patella fracture functional score.ResultsThe average age of patients was 57.4 ± 11.9 (range 33–74) years. The mean follow-up time was 15.2 ± 7.6 (range 4–36) months. The mean operation time was 56.8 ± 8.7 (range 45–80) min. The entire patients had bony union at an average of 10.5 ± 1.9 (range 8–14) weeks. At the final follow-up, the mean range of postoperative ROM was 123.4° ± 14.6° (range 95°–140°), and the functional score was 28.7 ± 1.2 (range 26–30) points. No patient exhibited internal fixation failure, and no symptomatic implants or skin complications were recorded.ConclusionsThe fixation approach using K-wires combined with 5-Ethibond has a lower complication rate and delivers superior clinical results. This research reveals that such technology is a safe and prospective substitute for conventional metal fixation approaches.

[目的]比较爱惜邦缝线与钢丝张力带固定髌骨骨折的临床效果.[方法]回顾性分析2015年11月—2021年12月本科收治的41例髌骨骨折患者.根据医患沟通结果,23例采用缝线张力带固定(缝线组),18例采用钢丝张力带固定(钢丝组).比较两组围手术期、随访结果及影像资料.[结果]两组手术时间[(58.0±2.0)min vs(57.2±2.3)min,P＞0.05]、切口总长度[(7.8±0.3)cm vs(8.0±0.5)cm,P＞0.05]、术中失血量[(60.4±2.0)ml vs(55.6±2.4)cm,P＞0.05]、切 口愈合[甲/乙/丙,(22/1/0)vs(16/2/0),P＞0.05]以及住院时间[(11.0±0.6)d vs(12.5±0.7)d,P＞0.05]的差异均无统计学意义.两组患者平均随访(17.2±1.0)个月,两组恢复完全负重时间差异无统计学意义(P＞0.05).随时间推移,两组患者VAS评分显著减少(P＜0.05),而Kujala评分、Lysholm评分、Bostman评分和膝伸-屈ROM均显著增加(P＜0.05),相应时间点两组间上述指标的差异均无统计学意义(P＞0.05).影像方面,两组骨折复位质量、Insall-Salvati指数、骨折愈合时间的差异均无统计学意义(P＞0.05).[结论]爱惜邦缝线张力带固定髌骨骨折可以获得与钢丝张力带相当的临床疗效,且具有良好的安全性.爱惜邦缝线张力带有可能替代传统钢丝张力固定.

Background: The present study sought to explore the efficacy of one-third tubular steel plates and screws for the treatment of medial column of pilon fractures. Methods: The present retrospective study comprised 40 subjects with Rüedi-Allgöwer type III pilon fractures that attended Northern Jiangsu People’s Hospital from April 2016 to April 2019. Patients were assigned to 2 groups based on reconstruction and fixation components used on the medial column. The medial column of participants in the control group (n=20) was anchored using screws. The medial column for subjects in the treatment group (n=20) was reconstructed using a one-third tubular steel plate. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at 1, 2, 3, 6, 12 and 24 months after operation, intraoperative blood loss, fracture healing time, preoperative detumescence duration, operation time, postoperative weightbearing duration, and postoperative Burwell-Charnley radiological score of the 2 groups were compared. Results: The findings showed that intraoperative blood loss, preoperative detumescence time, and operation time for the treatment group were not statistically different relative to the control group (P>0.05). The fracture healing time and postoperative weightbearing time in the treatment group were 15.07±0.98 weeks and 6.91±0.61 weeks, respectively, while those in the control group were 15.84±0.59 weeks and 8.60±0.53 weeks, respectively (P<0.05). Patients in the treatment group showed markedly higher AOFAS scores relative to the AOFAS scores of subjects in the control group at month 1, 2, and 3 post-operation (P<0.05). AOFAS scores for the 2 groups were not significantly different at month 6, 12 and 24 post-operation. Subjects in the control group had a significantly lower Burwell-Charnley number radiology score relative to that of subjects in the treatment group (P<0.05). Conclusions: The present findings show that the medial column of subjects with Rüedi-Allgöwer type III pilon fracture can be repaired using a one-third tubular steel plate. Compared with simple screw fixation, the use of a one-third tubular steel plate allows earlier postoperative weightbearing, decreases the rate of postoperative reduction loss, and leads to better clinical effects and prognosis.

目的 通过有限元分析比较3种内固定方式治疗髋臼后壁骨折的生物力学性能,评估不同内固定方式的稳定性.方法 建立包括骨盆主要韧带及股骨上1/3的骨盆三维有限元模型,模拟骨折面积＞50％的髋臼后壁骨折,髋臼后壁骨折采用后柱钢板+空心钉(空心钉组)、后柱钢板+弹簧板(弹簧板组)、后柱钢板+弹簧板+空心钉(弹簧板+空心钉组)内固定,统一用后柱钢板压住骨折块.加载不同负荷模拟站立、前屈、侧弯三种运动状态,比较分析3组骨盆各部件与内固定物的应力分布及垂直位移.结果 骨盆模型生物力学传递途径与既往研究高度一致,表明模型的可靠性与内固定治疗的有效性.相同载荷下空心钉组骨盆和内固定物的应力最大.空心钉组骨折区域的最大应力、垂直位移、内固定物与骨折区域应力差值均大于弹簧板组与弹簧板+空心钉组,而弹簧板+空心钉组最小.结论 上述3种内固定方式治疗髋臼后壁骨折均能取得良好的生物力学稳定性,但后柱钢板+弹簧板+空心钉内固定能改善整体的应力分布,降低再骨折和内固定断裂的风险,同时能促进骨折愈合,表现出更好的生物力学相容性.

目的 分析合并同侧股骨干骨折的Hoffa骨折的临床特点.方法 2014年1月～2019年12月收治的合并同侧股骨干骨折的Hoffa骨折病人14例,均采用髌旁入路逆行髓内钉治疗股骨干骨折,螺钉结合钢板治疗Hoffa骨折.所有病人术后均接受积极的康复治疗.随访12个月,记录膝关节协会评分(KSS),膝关节活动范围(ROM)以及固定稳定性进行影像学和功能结果分析.结果 所有病人均达到骨性愈合标准,股骨髁关节面解剖复位,平均愈合时间为(6.18±0.87)个月,内固定物牢靠,未发生内固定物松动、关节炎、感染等并发症;膝关节功能恢复满意,末次随访时ROM平均0°～122.86°,平均KSS评分88.6±4.9,术后3个月患侧KSS评分低于健侧,但术后6、12个月病人双侧KSS评分比较,差异无统计学意义(P>0.05).结论 采取髌旁入路逆行髓内钉治疗股骨干骨折,螺钉结合钢板治疗Hoffa骨折创伤小、安全,固定可靠,在配合康复的情况下可获得满意的功能恢复效果.

An editorial decision has been made to retract this manuscript due to breach of publishing guidelines, following the identification of non-original and manipulated figures. Reference: Yuelai Zhou, Jinlong Hu: Evodiamine Induces Apoptosis, G2/M Cell Cycle Arrest, and Inhibition of Cell Migration and Invasion in Human Osteosarcoma Cells via Raf/MEK/ERK Signalling Pathway.  Med Sci Monit 2018; 24: 5874-5880. 10.12659/MSM.909682.

目的:分析髓芯减压并同种异体植骨治疗早期股骨头缺血性坏死的临床应用.方法:选取收治的1例早期股骨头缺血坏死男性患者,入院后术前对患侧股骨头行多层螺旋CT扫描,然后将CT扫描的图片资料导入专业的有限元分析软件,建立股骨头缺血坏死的有限元模型,在有限元模型上模拟进行髓芯钻孔减压术,隧道植入骨块到软骨下骨约0～6 mm处,自体松质骨夯实.双足站立位为股骨头的模拟受力体位,髋关节的负荷条件为:外展肌合力M、髂胫束力T以及髋关节接触力J分别为1060、1721、1621 N,选取90°、120°以及150°的坏死角度,分别计算未处理过的股骨头坏死模型的塌陷值、行单纯髓芯减压以及行髓芯减压加植骨时的塌陷值.结果:股骨头的正常骨质杨氏模量高于坏死骨的杨氏模量,正常骨质的横向变形系数低于坏死骨.行股骨头髓芯钻孔减压术后,股骨头的塌陷值显著增加,而减压隧道植入同种异体骨后,其塌陷值显著减低,但高于正常的股骨头.同时,由于股骨头坏死角度的增加,其塌陷值也明显增加.结论:髓芯钻孔减压并同种异体植骨术能有效增进坏死区的骨质修复,加强减压通道所致股骨头支撑结构的改变,防止股骨头关节面的塌陷.

目的 比较弹性髓内钉内固定闭合或切开复位治疗学龄儿童股骨粗隆下骨折的疗效.方法 选取我院2013年1月至2017年12月采用弹性髓内钉治疗股骨粗隆下骨折的学龄儿童19例.受伤至手术时间2～8天,平均4天.按照手术方法分为闭合复位内固定组(A组):共10例,其中男7例,女3例;年龄6～10岁,平均7.2岁.致伤原因分为交通事故伤6例,高处坠落伤3例,其它伤1例.骨折按Seinsheimer分型分为 ⅡA型3例,ⅡB型2例,ⅡC型2例,ⅢB型2例,IV型1例.切开复位内固定组(B组):共9例,其中男6例,女3例;年龄7～12岁,平均7.8岁.交通事故伤5例,高处坠落伤3例,其它伤1例.骨折按Seinsheimer分型分为 ⅡA型3例,ⅡB型2例,ⅡC型1例,ⅢB型2例,IV型1例.B组中归入4例先行闭合复位不满意后再切开复位患儿.本组术后均辅以髋人字石膏固定.所有患儿均获满意随访,平均随访时间14.9(12～36)个月.比较两组患儿的一般资料、手术时间、术中出血量、骨折愈合时间和并发症的发生情况.结果 两组患儿的性别、年龄、体重、受伤至手术时间相比,差异均无统计学意义(P>0.05),不具有可比性.A组术中出血量(12.6±4.2)ml少于B组(55.4±10.5)ml,A组手术时间(98±12)min长于B组(75±10)min,两组相比差异均有统计学意义(P<0.05).骨折愈合时间两组相比差异无统计学意义(P>0.05).两组均无切口感染以及其它严重并发症发生.依据Flynn等提出的评分标准评定髋关节功能,A组优8例,良2例,B组优8例,良1例,所有患儿髋膝关节活动良好,两组比较差异无统计学意义(P>0.05).结论 弹性髓内钉治疗学龄儿童股骨粗隆下骨折是一种安全有效的方法,术中闭合复位或切开复位均可获得满意疗效.

Background Tendon adhesion is one of the most common clinical problems, which poses a considerable challenge to orthopedics doctors. Quercetin (QUE) as a popular drug at present, it has various biological functions, including anti-inflammatory, anti-ischemic, anti-peroxidation, and antioxidant. The purpose of this study was to investigate the effect of quercetin on tendon adhesion and whether quercetin can inhibit oxidative stress. Method Thirty-six rats were randomly divided into three groups, including control group, low QUE (50 mg/kg/day) group, and high QUE (100 mg/kg/day) group. After 1 week, the levels of SOD, MDA and GPx were measured. The degree of tendon adhesion was assessed by macroscopic evaluation and histological evaluation. After 4 weeks. Besides, the pharmacological toxicity of quercetin to main organs were evaluated by histological analysis. Results The extent of superoxide dismutase (SOD) and glutathione peroxidase (GPx) of tendon tissue in high QUE group was significantly higher than those of low QUE group and control group. And the extent of malondialdehyde (MDA) of tendon tissue in high QUE group was significantly lower than that of low QUE group and control group. By macroscopic evaluation and histological analysis, the extent of tendon adhesion in high QUE group was lower than low QUE group and control group. However, there were no significant changes of the major organs through histological analysis. Conclusions Quercetin may be a good and safe strategy in preventing tendon adhesion. But further clinical research is needed before its recommendation in the prevention and treatment of tendon adhesion.

Long noncoding RNAs (lncRNAs) are key regulators that participate in multiple biological processes, including cancer formation and progression. The biological function and molecular mechanism of LINC00612 in the progression of osteosarcoma has not been elucidated before. In this study, we evaluated the expression of LINC00612 in osteosarcoma by qRT-PCR. ShRNA-induced LINC00612 downregulation and plasmid-transduced LINC00612 overexpression were conducted in U2OS and HOS cells. The in vitro functional effects of LINC00612 downregulation and overexpression on osteosarcoma cells were evaluated by CCK-8 assay, colony formation assay, scratch assay, transwell invasion assay and flow cytometry; in vivo tumor xenografts were conducted in nude mice. The effects of LINC00612 downregulation and overexpression on epithelial-mesenchymal transition (EMT) were assessed by scratch assay, transwell assay and qRT-PCR. The possibility of LINC00612 acting as a competing endogenous RNA (ceRNA) to target microRNA miR-214-5p was examined by dual-luciferase reporter assay. Then, miR-214-5p was downregulated or overexpressed to examine its effect on invasion and SOX4 expression in osteosarcoma cells. LINC00612 was found to be significantly upregulated in osteosarcoma cells and metastatic osteosarcoma. LINC00612 overexpression promoted the proliferation, invasion and in vivo explant growth of osteosarcoma. In addition, LINC00612 overexpression regulated EMT by elevating the expression of ZEB1, Snail, and Fibronectin 1 and inhibiting E-cadherin. MiR-214-5p was confirmed to be a ceRNA of LINC00612. LINC00612 overexpression upregulated SOX4 by inhibiting miR-214-5p. Our study shows that LINC00612 plays an important role in regulating the proliferation and invasion of osteosarcoma by endogenously competing with miR-214-5p and mediating EMT.

患者,女,63岁,左前臂肿痛2h入院.患者2 h前不慎被树枝戳伤前臂,约0.5cm伤口,少些血性渗出,无明显活动性出血.伤后开始稍疼痛,后左前臂逐渐肿胀加重,张力较高,伴剧烈疼痛,急诊送至当地医院就诊,当地医院简单处理后转入我院(见封二图1).病程中,患者无其他不适.既往无特殊,否认其他重大手术及外伤史.

目的 探讨带线锚钉在手术治疗肘关节“恐怖三联征”中的临床效果.方法 回顾性分析2010年1月至2017年6月期间本院手术治疗22例肘关节“恐怖三联征”患者的临床资料,根据桡骨头骨折Mason分型,Ⅰ型2例,Ⅱ型8例,Ⅲ型12例;根据尺骨冠状突骨折Regan-Morrey分型,Ⅰ型5例,Ⅱ型12例,Ⅲ型5例;22例患者均伴有内外侧副韧带损伤,并采用肘部外侧、前内侧联合入路进行手术治疗.15例患者手术后以长臂石膏托外固定1～2周,之后逐步进行肘关节被动、主动康复锻炼.7例使用可活动铰链式外固定架辅助固定的患者早期行肘关节康复锻炼.结果 所有患者手术后随访6～18个月,平均12个月.末次随访时肘关节屈曲(110±10)°,伸直受限(10±4)°,前臂旋前(70±6)°,旋后(80±6)°,并对患者进行Mayo肘关节功能评分:优(≥90分)3例,良(75～89分)12例,可(60～74分)7例,优良率为68.2％.手术后2例出现异位骨化,1例出现一过性的正中神经症状,无感染、肘关节不稳定、骨折不愈合、脱位及肘关节僵硬等并发症.结论 带线锚钉通过对肘关节内外侧副韧带、关节囊等软组织修复,既增加了肘关节的稳定性,同时也减少了相关并发症的发生,值得临床推广应用.

目的 探索应用3D打印导板结合数字技术辅助手术治疗复杂距骨骨折的方法.方法 选取2013年1月至2017年6月收治的复杂距骨骨折病例15例,男性13例,女性2例;年龄16～57岁,平均年龄36.8岁.将患者的薄层CT扫描数据导入Mimics软件,构建距骨骨折的三维模型.在Solidworks软件中建立螺钉的三维数字模型导入Mimics,模拟手术入路、复位、固定骨折块,设计、打印导板.术中根据数字技术模拟的方案选择入路、复位骨折,根据螺钉导板选择合适的螺钉和角度固定骨折.术后将骨折复位内固定结果与术前方案比较,随访患者远期踝关节功能,评价3D打印结合数字技术治疗复杂距骨骨折的效果.结果 15例患者解剖复位10例,良好3例,可2例.螺钉安放与术前设计基本一致,无螺钉误入关节、长度合适.美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)踝-后足评分:优9例,良4例,可2例.结论 3D打印结合数字技术为复杂距骨骨折的术前设计、术中植入螺钉提供了直观、有效的手段,能提高手术内固定的精确性.

目的 探讨围术期使用低分子量肝素钙(LMWH Ca)对股骨近端防旋髓内钉(PFNA)内固定治疗股骨粗隆间骨折隐性失血和术后下肢深静脉血栓情况的影响.方法 回顾性分析使用PFNA内固定治疗股骨粗隆间骨折的92例患者资料.根据围术期是否使用LMWH Ca分为2组.LMWH Ca组(n=42)术前和术后使用低分子量肝素钙;对照组(n=50)围术期不使用低分子量肝素钙.记录并且比较2组患者的术中出血量、术中输入红细胞量、术后引流量、术后2d内输血率,并计算2组显性失血量、隐性失血量、围术期总失血量.观察术后下肢深静脉血栓和术后并发症发生情况.结果 2组的术中出血量、术中输入红细胞量、术后引流量、术后2d内输血率、显性失血量、隐性失血量、围术期总失血量相比差异无统计学意义(P＞0.05).LMWH Ca组术后下肢深静脉血栓发生率为2.3％,显著低于对照组的14.0％,差异有统计学意义(P＜0.05).结论 PFNA内固定治疗股骨粗隆间骨折围术期使用低分子量肝素钙,可以显著降低术后下肢深静脉血栓的发生,且对患者术中出血量、术后引流量、显性失血量、隐性失血量、围术期总失血量无显著影响.

目的 探讨采用弹性髓内钉和钢板螺钉治疗腓骨骨折的临床疗效.方法 将2012年12月至2018年9月收治的62例胫腓骨骨折手术的患者,按照腓骨内固定手术方式不同分为弹性髓内钉组和钢板螺钉组,弹性髓内钉组31例,男21例,女10例;年龄22～75岁,平均(49.5±15.6)岁.钢板螺钉组31例,男18例,女13例;年龄24～73岁,平均(45.8±13.2)岁.对比两组患者的手术时间、术中出血量、美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)的踝与后足评分、腓骨骨折临床愈合时间、愈合率和手术后并发症发生率的情况等.结果 所有患者均获随访,随访时间4～24个月,平均(15.0±3.8)个月.弹性髓内钉组:手术时间(24.5±4.6) min,术中出血量(18.2±4.5)mL,骨折临床愈合时间(2.9±0.7)个月,术后无感染发生;钢板螺钉组:手术时间(32.2±10.6)min,术中出血量(30.6±9.9)mL,骨折临床愈合时间(2.5±0.6)个月,术后3例切口局部感染;两组比较差异均有统计学意义(P＜0.05).两组末次随访时踝关节功能按AOFAS的踝与后足评分标准评价,弹性髓内钉组优17例,良11例,可3例,平均(89.8±5.2)分;钢板螺钉组获优16例,良10例,可5例,平均(89.1±5.6)分;差异无统计学意义(P=0.582).弹性髓内钉组骨折愈合率为93.5％,钢板螺钉组骨折愈合率为90.3％,两组比较差异无统计学意义(P=0.859).结论 在治疗腓骨骨折方面,弹性髓内钉比钢板螺钉具有手术时间短、手术出血量少、骨折愈合时间短和并发症少等优势,具有良好的临床应用前景.

目的 探讨Kessler缝合法结合带线锚钉手术治疗急性闭合性跟腱断裂的临床疗效.方法 回顾性分析2014年2月至2017年10月在东南大学附属中大医院采用Kessler缝合法结合带线锚钉手术治疗的21例急性闭合性跟腱断裂患者临床资料,对术后疼痛、行走能力、步态、小腿关节活动度、踝关节稳定性、关节对线等进行系统随访.结果 本组病例均获得完整随访,随访时间12～18个月,平均15.4个月.末次随访时,美国足踝外科学会踝-后足评分系统(AOFAS)评分由术前(45.5±4.5)分上升至(93.5±6.2)分;末次随访踝关节活动范围:背伸为9.5°～14.5°,跖屈为40.5°～49.3°;末次随访患者满意度为(4.8±0.1)分.所有病例无切口感染及切口周围皮肤坏死、无腓肠神经损伤、无跟腱再次断裂等相关并发症.结论 Kessler缝合法结合带线锚钉手术治疗急性闭合性跟腱断裂短期疗效满意.

目的 探讨开放性踝关节骨折伴脱位的损伤特点及急诊内固定手术治疗效果.方法 回顾性分析自2010-01-2016-12诊治的25例开放性踝关节骨折脱位,均急诊行踝部创面彻底清创,将关节腔内的软骨、骨碎片予以清除,踝关节骨折脱位复位后行内固定.合并的后踝骨折采用空心钉固定,合并的内踝骨折采用空心钉或克氏针固定,下胫腓联合分离者复位后用1或2枚直径3.5 mm皮质骨螺钉经三皮质固定.结果 1例外踝处伤口感染,进行局部换药、全身使用抗生素治疗,1个月后伤口愈合;其余患者伤口顺利愈合.25例均获得随访,随访时间平均15(12～18)个月.骨折均顺利愈合,愈合时间平均4.5(3～6)个月.末次随访时疗效:优15例,良8例,可2例,优良率92.0％.结论 开放性踝关节骨折脱位,急诊彻底清创是预防感染的关键,行坚强内固定为骨折愈合提供稳定环境,取得良好疗效.

BACKGROUND Osteosarcoma is a prevalent type of bone tumor mainly reported in children and adolescents. The treatments for osteosarcoma are limited and are associated with serious adverse effects. In this study we evaluated the anticancer activity of Evodiamine, a plant-derived natural product, against a panel of osteosarcoma cells and explored the underlying mechanisms. MATERIAL AND METHODS The viability of osteosarcoma cell lines was investigated by MTT assay. Apoptosis was detected by DAPI and annexin V/PI staining and cell cycle analysis was performed by flow cytometry. The expression of the proteins was examined by Western blotting. RESULTS The results of the present study indicated that Evodiamine inhibited the proliferation of U2OS osteosarcoma cells with an IC50 of 6 µM. Further investigations indicated the antiproliferative effects of Evodiamine are due to induction of apoptosis and G2/M cell cycle arrest. The results of Western blotting revealed that the expression of several apoptosis (Cytochrome c, Bax, Bid, Caspase 3, 9, 8, and PARP) and cell cycle-related proteins (cyclin B1, Cdc25c, and Cdc2) was significantly altered. Evodiamine also suppressed the migration and invasion of U2OS osteosarcoma cells. Moreover, Evodiamine downregulated the expression of important regulatory proteins such as p-MEK and p-ERK, leading to the inhibition of Raf/MEK/ERK signalling pathways. CONCLUSIONS We found that Evodiamine exerts anticancer effects on osteosarcoma cells and has potential in the treatment of osteosarcoma.

目的:探讨采用经皮微创锁定钢板内固定术、髓内钉内固定术和锁定钢板外置术治疗闭合性胫骨干骨折的疗效.方法2012年1月—2014年6月,收治闭合性胫骨干骨折患者96例.男52例,女44例;年龄21~70岁,平均33.42岁.均为新鲜闭合性骨折.采用前内侧做手术切口,直视下骨折复位后,采用三种手术方式进行治疗.结果术后出现2例钉道感染,3例骨折不愈合,7例骨折延迟愈合.96例患者均获随访,随访时间12~20个月,平均14.82个月.术后6周及3、6、12月复查X线片,比较3组患者术中出血量、手术时间、术后12个月内并发症情况、骨折临床愈合时间.手术时间三组差异有统计学意义(P<0.05),术中出血量三组差异有统计学意义(P<0.05),3组患者骨折临床愈合时间比较,差异无统计学意义(F=1.742,P=0.256);按Johner-Wruhs疗效标准评估术后12个月临床疗效,3组优良率比较差异无统计学意义(χ2=0.325,P=0.830).结论经皮微创内固定术和锁定钢板外置术与髓内钉内固定术相比,在治疗闭合性胫骨干骨折方面具有创伤小、不良并发症少的优点.

Objective To investigate clinical outcome of topical tranexamic acid (TXA) soaked absorbable hemostatic sponge for postoperative stop bleeding in patients with surgical treatment of lumbar vertebrae.Methods The consecutive 84 patients undergoing two-segment lumbar posterior decompression and intervertebral fusion were randomly enrolled in two groups.Each group had 42 cases.TXA soaked absorbable hemostatic sponge was applied in the lumbar wound in experiment group before suture,while the patients in control group were not given.The total volume of postoperative drainage,extubation time,total blood loss,postoperative hospital stay,prothrombin time(PT),D-dimer,lower limbs deep vein thrombocis (DVT) were compared between the two groups.Results Postoperative total volume of drainage,extubation time,total blood loss and postoperative hospital stay in the experimental group were significantly less than those in the control group(P<0.05).There were no significant differences in terms of postoperative PT,D-dimer,lower limbs DVT between groups (P>0.05).Conclusions TXA soaked absorbable hemostatic sponge can significantly reduce drainage and extubation time after two-segment lumbar posterior decompression and intervertebral fusion and no increase in the risk of DVT.