Objective To review the progress of the research on therelationship between the central nervous system injury and the heterotopic ossification. Methods The recent articles on the central nervous system injury and the heterotopic ossification were extensively reviewed, and the related clinical signs, symptoms, pathogenesis diagnosis, risk factors, prophylaxis, and treatment of the neurogenic heterotopic ossification were investigated. Results The possible mechanism for the neurogenic heterotopic ossification might involve the roles of thebone morphogenetic protein and the basic fibroblast growth factor, which were suggested as mediators in differentiation of the progenitor cells. Sonographic, serum creatine phosphokinase, and C-reactive protein were recommended as the useful screening tools for heterotopic ossification. Colchicine and rofecoxib could be used for the prophylaxis or treatment of heterotopic ossification. Conclusion The research on the neurogenic heterotopic ossification has achieved a great development but further studies in this field are still required.
OBJECTIVE: To measure the length and extent of the injured blood vessels in an avulsion amputation model. METHODS: Twenty rabbits were randomly divided into 2 groups. Group A was a sharp amputation group, and group B was an avulsion amputation group. The length and extent of the injured blood vessel was observed with naked eye, operation microscope and electron microscope, and the limbs were replanted. Group A and B were explored at three days and ten days after the replantation respectively. The patency rate and healing process were compared. RESULTS: All the severed ends of vessels in group A were neat with almost the same injured range in the three layers of the vessel wall about 1 mm away from the severed end. The vessels of group B were damaged seriously, the endothelial cells were deleted. The "jumping-like" damage could be observed in the elastic fibers. The injury of 2 to 3 mm away from the normal vessel wall could be observed by operation microscope. CONCLUSION: The damage of avulsion amputation vessels was irregular, 2 to 3 mm or more tissues should be excised under the microscope in the process of operation in order to ensure the healthy intact blood vessel walls.
OBJECTIVE: To summarize the importance of surgical management to repair vascular injury in limbs salvage, and to analyze the influence factors in the management. METHODS: From 1993 to 2000, 42 cases of 58 vascular injuries were reviewed; there were 37 males and 5 females, aging from 12 to 70 years old. Emergency operations were performed in 38 cases and selective operations in 4 cases from 1 hour to 45 days after injury. There were 22 cases of complete rupture in 32 blood vessels, 5 cases of partial rupture in 6 blood vessels, and 15 cases of vascular defect in 20 blood vessels, with 5 cm to 10 cm defect. The operation management included end-to-end anastomosis in 22 cases, side-to-end anastomosis in 1 case, vascular repair in 5 cases and vascular grafting in 14 cases. All of the cases were followed up for 6 months to 7 years. RESULTS: In those received emergency operations, it was successful in 35 cases, with amputation in the other 3 cases; after operation, there were 5 cases of post-operative angio-crisis, 1 case of hematoma and 1 case of pseudoaneurysm. In those received selective operation, all succeeded but 1 case of post-operative angio-crisis. After the follow-up, except for 3 cases of amputation, the other limbs survived; and function of the survived limbs recovered satisfactorily after operation except poor recovery in 7 cases of replantation of the limbs. CONCLUSION: To repair vascular injury immediately, to manage angio-crisis and to remove influence factors is the key to save the injured limbs and to maintain the function of them.
Objective To evaluate the expressive varieties of Nogo-A mRNA in injured optic nerves of rats. Methods Reverse transcription polymerase chain reaction (RT-PCR) method was used to hemi-quantitatively analyze the levels of Nogo-A mRNA in the optic nerves 3, 7, 9, 15, 21, and 25 days respectively after injury.Results The level of the expression of Nogo-A mRNA was low in the normal optic nerves, while it was significantly high in the optic nerves 3 days after in jury, and kept the high level still after 25 days.Conclusion The expression of Nogo-A mRNA in injured optic nerves is increased. (Chin J Ocul Fundus Dis，2003，19：201-268)
OBJECTIVE To investigate the effect of meniscus suture on meniscus healing which included healing time and healing pattern. METHODS Fourty healthy rabbits were adopted in this study. The model of meniscus injury was made by a longitudinal incision at the medial meniscus of the left knee. The rabbits were divided into two groups, the experimental group was treated by meniscus suture and the control group was unsutured. After operation, the meniscus samples were collected periodically and observed by gross, light and electronic microscope to analysis the meniscus healing. RESULTS The injured meniscus was healed gradually and completely at the sixth week in the experimental groups. More fibroblasts and less fibrocartilage cells could be observed in the healed meniscus. Oppositely, there was no meniscus healing in the control group and the edge of injured meniscus was sealed by epithelioid cells. CONCLUSION The meniscus suture can accelerate the healing process of meniscus injury. Besides, early suture make the injured meniscus correctly positioned to ensure the normal healing process.
OBJECTIVE To investigate the effects of basic fibroblast growth factor(bFGF) on repairing transected sciatic nerves in rats. METHODS The animal models of the transected sciatic nerve of 40 SD rats were established, which divided into 4 groups: normal saline (NS) group, nerve growth factor (NGF) group, bFGF group and normal control group. The epineurium of the transected sciatic nerve was sutured under microscope, then bFGF or NGF was dropped into local sites and injected intramuscularly once a day for 30 days after operation. Functional repair for the transected sciatic nerves was studied by nerve conductive velocity (NCV) and sciatic nerve function index (SFI). RESULTS As a criterion, the level of the normal control group was regarded as zero, SFI of NS group, NGF group and bFGF group were -114.30 +/- 10.34, -70.50 +/- 11.01, -50.45 +/- 7.82 respectively at 1 month after operation, and they were -54.96 +/- 16.46, -35.21 +/- 10.80, -27.53 +/- 11.23 respectively in 3 months after operation. NCV of bFGF group was significantly faster than NS group and NGF group. CONCLUSION bFGF can significantly promote the functional repair of injured peripheral nerve, and its effects are better than NGF.
Objective To explore the traumatic situation and transfer methods of the in-patients injured in Lushan Earthquake, and to provide evidence for treating injured mass in future. Methods The information of the patients injured in Lushan Earthquake who were admitted in Chengdu Military General Hospital were collected by “No. 1 Military Medical Project” hospital information system and a self-edited “Questionnaire for Hospitalized Patients Injured in 4.20 Lushan Earthquake”. Results A total of 65 patients were admitted in this hospital: 63 (96.92%) patients were injured in the main shock; 28 (43.08%) patients were injured by building collapse; 23 (35.38%) patients got injured due to falls or got bruised when escaping; and 14 (21.54%) patients were accidentally injured. Rescue methods: 32 (49.23%) patients were saved by themselves; 23 (35.38%) patients were mutually helped; 10 (15.38%) patients were rescued by local non-military rescue team; 34 (52.31%) patients were rescued by military rescue teams; and 26 (44.83%) patients were transferred by air transport. Conclusion In order to cope with emergencies and major disasters (e.g. earthquake) and to treat injured mass scientifically in the future, we should set up emergency wards scientifically and reasonably, carry out education on earthquake prevention and disaster mitigation widely, reinforce self-care and mutual aid in the stricken area, quickly send rescue and medical teams, and organize training for air transportation of patients.
Objective〓〖WTBZ〗To assess treating results of functional reconstruction of irrecoverable partial injury of brachial plexus and to improve the function ofinjured upper extremity. Methods Seventiy-nine cases with irrecoverable partial injury of brachial plexus were treated in transfer of muscle (tendon) or by fuctional anthrodesis (fixation of tendon) from January 1984 to June 2003. According to the evaluation criterion by American Shoulder and Elbow, Hand Association,all patients were followed up in motion of reconstructive joint and daily activities after operation for 1 year to 19 years. The effect of the operation was comprehensively scored and evaluated. Results Final results in 54 caseswere as follows: 30 patients with good results, 19 patients with fair results, and 5 with poor results. The results demonstrated some points as follow: ①if the shoulder was instable, athroedesis of shoulder would be a better choice;②the flexion of the elbow joint should be only reconstructed with the dynamic reconstructive methods. The reconstruction of flexion of elbow by transfer of pectoral major muscle was more effective than that by transfer of flexor carpi ulnaris muscle; ③the dynamic reconstruction of extension of digital and carpi was better than that of flexion of digital and opposition function of the thumb; ④the supination of the forearm was effectively reconstructed by transfer of flexorcarpi ulnaris muscle. Pronation teres muscle should be studied more in reconstruction of supination function of the forearm.
Objective To study the diagnosis and treatment of the acute medial collateral ligament ruptures of the knee.Methods From August 1998 to August 2003, 87 cases of acute medial collateral ligament ruptures were examined with physical method and MR imaging. Out of them, 35 cases of Ⅰdegree and Ⅱ degree ruptures were treated with non-surgery and 52 cases of Ⅲ degree ruptures were treated surgically. The torn medial collateral ligaments were mended, 21 of which were strengthened with the anterior partial gracilis muscle tendon after the arthroscopy. Results In 35 cases of Ⅰ and Ⅱ degree ruptures, 32 were followed up 13 months on average. According to Lysholm scoring system, the clinical results were classified as excellent or good in 93.7% of the cases. In 52 cases of Ⅲ degree ruptures, 50 were followed up 16 months on average. The excellent or good result was 90%.Conclusion For Ⅰ and Ⅱ degree ruptures, MR imagimg is an important way to definitely- diagnose medial collateral ligament ruptures. Abduction stress test of knee extension shows that the medial direct instability is a main way to definitely diagnose Ⅲ degree ruptures. The results of conservative treatment of Ⅰ degree and Ⅱ degree ruptures are excellent. Surgical therapy are fitfor the cases of Ⅲ degree ruptures.
Objective To evaluate the effect of tendon transfer on reconstructing the extension of wrist, thumb and digit after irreversible radial nerve injury. Methods From January 1987 to February 2005, 25 cases of irreversible radial nerve injury were treated with Riordan tendon transfer. Among them there were 19 cases of central radial nerve injury with wrist ,thumb and digit extension dysfunction and 6 cases of deep branch of radial nerve injury with digit and thumbextension dysfunction. The muscle strength of wrist and digit extension ranged from grade 0 to grade Ⅰ. Tendon transfer was done 4 months to 8 years after their injuries. Results Twenty-three cases were followed up for3 to 60 months. According to the standard established by Chen Desong, 19 cases (82.6%) showed excellent and good results. Fair result was showed in 2 cases and poor result was showed in 2 cases. Conclusion Riordan tendon transfer should be the first choice of treating irreversible radial nerve injury.