Abstract Background: This study investigates treatments for ulnar shortening caused by osteochondromatosis. Methods: A retrospective analysis was conducted on patients diagnosed with osteochondromatosis and admitted to Xiamen University Affiliated First Hospital and Fudan Zhongshan Xiamen Hospital from February 2017 to February 2022. Patients were divided into two groups based on the dislocation status of the radial head: the dislocation group and the non-dislocation group. The effectiveness of treatments was evaluated by comparing wrist movement, forearm rotation function, elbow movement, length discrepancy between the radius and ulna, presence of radial head dislocation, and carrying angle. Results: A statistically significant difference was observed in the annual length discrepancy between the radius and ulna before and after surgery, in both the dislocation and non-dislocation groups (P < 0.05). A similar statistically significant difference was also observed in the carrying angle between the groups (P < 0.05). However, no statistically significant difference in elbow and wrist function was observed before and after surgery in either of the groups (P > 0.05). Conclusion: Resection of osteochondroma can reduce further aggravation of ulnar deformity. Ulnar shortening contributes to secondary radial head dislocation, and ulnar lengthening can effectively treat this condition.

目的 探讨撬拨杠杆辅助复位在难复性儿童肱骨髁上骨折应用的效果.方法 回顾性分析 2019 年 7 月～2021 年12 月30 例难复性儿童肱骨髁上骨折资料,其中2020 年7 月前15 例继续尝试闭合复位为对照组,2020 年7 月后撬拨杠杆辅助复位15 例为观察组.2 组年龄、性别、侧别、骨折分型、术前等待时间差异无显著性(P＞0.05).比较2 组手术指标及术后6 个月随访结果.结果 观察组手术时间短于对照组[35(25～50)min vs.42(35～80)min,Z =-3.045,P = 0.002],术中透视次数少于对照组[39(26～55)次vs.52(39～92)次,Z =-3.535,P =0.000],2 组闭合复位成功率、术后6 周Baumann角、术后6 个月肘关节功能差异无统计学意义(P＞0.05).按 Flynn标准,术后 6 个月肘关节功能优良率 100%(30/30).均无并发症发生.结论 合理地使用撬拨杠杆技术辅助闭合复位难复性儿童肱骨髁上骨折能缩短手术时间,减少术中透视次数,不增加临床并发症,值得临床推广应用.

ObjectiveThis study aims to explore whether growth arrest lines can predict epiphyseal fracture healing.MethodThe data of 234 children with distal tibial epiphysis fractures treated in our hospital from February 2014 to February 2022 were retrospectively analyzed. Imaging data were examined to record epiphyseal grade, fracture type, and the time to appearance of growth arrest lines. Follow-up data were retrieved to record treatment results (i.e., malunion, premature closure, or bone bridge formation).ResultsThere was a significant difference in the time to appearance of growth arrest lines between patients with epiphyseal grade 0–1 and grade 2–3 (P < 0.05) and between patients with normal healing and patients with a bone bridge (P < 0.05). Among patients with normal healing, there were no significant differences in the time to appearance of growth arrest lines between men and women and between patients with and without surgery (P > 0.05). There was a significant difference in the time to appearance of growth arrest lines between patients with different Salter–Harris fracture types (P < 0.05).ConclusionFor patients with epiphyseal grade 0–1, the time to appearance of growth arrest lines could be useful for predicting the treatment result of a distal tibial epiphyseal fracture.

BACKGROUND:Circular RNA (circRNA) has been shown to affect the pathological process of osteoarthritis (OA) and is expected to become a potential marker for disease diagnosis. This study aimed to investigate the association between circRNA derived from the gene of runt-related transcription factor 2 (RUNX2) and OA risk.METHODS:The expression profile of RUNX2-derived circRNAs in serum of OA patients was detected. Then, the cytological localization of screened differential circRNAs was studied. Luciferase (LUC) reporter assay was used to identify the microRNA (miRNA) sponge capacity of the circRNAs. Bioinformatics analysis was used to construct the functional pathway of this circRNA-miRNAs network. And then, the diagnostic value of RUNX2-derived circRNAs in OA was evaluated.RESULTS:RUNX2-derived hsa_circ_0005526 (circ_RUNX2) is significantly highly expressed in OA serum and mainly located in the cytoplasm within the cartilage cell by sponging multiple miRNAs (miR-498, miR-924, miR-361-3p, and miR-665). Bioinformatics analysis showed ECM-receptor interaction pathway ranked the most significant pathway of circ_RUNX2-miRNAs regulatory network in KEGG database. The ROC curve showed that there may be good diagnostic value of serum circ_RUNX2 in OA.CONCLUSION:RUNX2-derived circ_RUNX2 may be involved in OA development via ECM-receptor interaction pathways and may be used as potential clinical indicator of OA.

目的:观察A型肉毒毒素联合物理治疗对难治性先天性肌性斜颈(CMT)的近期疗效及其安全性.方法:选取2018年9月至2019年8月厦门大学附属第一医院收治的23例难治性CMT患儿,随机分为对照组(n=12)和联合治疗组(n=11).对照组应用单纯物理治疗,联合治疗组应用局部注射A型肉毒毒素联合物理治疗,记录治疗前后头颈倾斜度和颈部旋转范围等相关参数.结果:治疗后,联合治疗组患儿头部倾斜度显著小于对照组,颈部旋转范围明显大于对照组,差异具有统计学意义(P＜ 0.05).联合治疗组头部倾斜的改善程度和颈部旋转改善程度均显著高于对照组,差异具有统计学意义(P＜0.05).两组患儿不良反应发生率比较,差异无统计学意义(P＞0.05).结论:A型肉毒毒素联合物理治疗对难治性CMT有效,并发症较少,安全性较好.

目的:儿童急性起病的单关节炎症,多数为细菌感染导致的化脓性关节炎.但部分风湿性关节炎急性起病的临床表现与化脓性关节炎难以鉴别.通过分析血清学炎性标志物的差异,以帮助在急诊中增强对两类疾病的诊断与认识.方法:选取2014年3月-2018年3月笔者所在医院骨科急诊首诊以急性化脓性关节炎收治的患儿42例,其中确诊为风湿性关节炎10例,化脓性关节炎32例.按最终诊断将患儿分为化脓组与风湿组.对比两组患儿基本资料及血清学炎性标志物检查结果.结果:两组患儿性别比例、入院体温、WBC、CRP及ESR比较差异无统计学意义(P>0.05).化脓组患儿年龄及ASO低于风湿组,化脓组的PCT及IL-6高于风湿组,差异均有统计学意义(P<0.05).结论:结合血清学炎性标志物检查,可提高早期对急性化脓性关节炎与风湿性关节炎的鉴别诊断.

目的:对比分析小儿股骨干骨折采取闭合复位弹性髓内钉固定术和切开复位接骨板内固定术治疗的临床效果.方法:选取2015年6月-2017年6月于笔者所在医院择期行手术治疗的股骨干骨折患儿134例,运用随机数字表法分为观察组和对照组,每组67例.其中观察组行闭合复位弹性髓内钉固定术,对照组行切开复位接骨板内固定术.比较两组手术时间、术中出血量、住院时间、骨折愈合时间、下地负重时间及术后并发症发生情况.结果:观察组手术时间[(68.92±7.19)min]、术中出血量[(61.28±6.27)ml]、住院时间[(6.77±0.44)d]、骨折愈合时间[(62.73±6.35)d]和下地负重时间[(82.17±8.26)d]均显著少于对照组,差异有统计学意义(P<0.01).观察组术后并发症总发生率为2.99％(2/67),显著低于对照组[23.88％(16/67)],差异有统计学意义(P<0.01).结论:与切开复位接骨板内固定术相比,小儿股骨干骨折应用闭合复位弹性髓内钉固定术治疗患儿创伤小,术后恢复快,安全性高.