ObjectiveTo summarize the research progress of heterotopic ossification of the elbow joint after trauma. MethodsThe recent domestic and foreign literature concerning heterotopic ossification of the elbow joint after trauma was analysed and summarized. ResultsThe mechanism of heterotopic ossification of the elbow joint after trauma is mainly related to bone morphogenetic protein signal transduction disorder. Now there are many treatments of heterotopic ossification, including non-surgical treatment, prevention, and surgical treatment. Non-surgical treatment and prevention mainly aim at patients who have no elbow heterotopic ossification or who have mild limited elbow motion because of elbow heterotopic ossification after trauma, including drug therapy, radiation therapy, Chinese medicine therapy, and rehabilitation treatment. For patients with invalid non-surgical treatment, choosing surgical treatment is a must. Surgical treatment includes surgical resection, arthroscopic resection, and joint replacement, priority should be given first to surgical resection. ConclusionHeterotopic ossification of the elbow joint is common and there is not a recognized standard treatment, comprehensive use of non-surgical treatment and surgical treatment is the future direction.
Objective To investigate the effect of anteromedial coronoid facet fracture and lateral collateral ligament complex (LCLC) injury on the posteromedial rotational stability of the elbow joint. Methods The double elbows were obtained from 4 fresh adult male cadaveric specimens. Complete elbow joint (group A,n=8), simple LCLC injury (group B,n=4), simple anteromedial coronoid facet fracture (group C,n=4), and LCLC injury combined with anteromedial coronoid facet fracture (group D,n=8). The torque value was calculated according to the load-displacement curve. Results There was no complete dislocation of the elbow during the experiment. The torque values of groups A, B, C, and D were (10.286±0.166), (5.775±0.124), (6.566±0.139), and (3.004±0.063) N·m respectively, showing significant differences between groups (P<0.05). Conclusion Simple LCLC injury, simple anteromedial coronoid facet fracture, and combined both injury will affect the posteromedial rotational stability of the elbow.
Objective To evaluate the role of glenoid osseous structure on anterior stabil ity of shoulder so as to provide the biomechanical basis for cl inical treatment. Methods Ten fresh shoulder joint-bone specimens were collected from10 adult males cadavers donated voluntarily, including 4 left sides and 6 right sides. The displacements of the specimens were measured at 0° and 90° abduction of shoulder joint by giving 50 N posterior-anterior load under the conditions as follows: intact shoulder joint, glenoid l ip defect, 10% of osseous defect, 20% of osseous defect, and repairing osseous defect. Results For intact shoulder joint, glenoid l i p defect, 10% of osseous defect, 20% of osseous defect, and repairing osseous defect, the displacements were (10.73 ± 2.93), (11.43 ± 3.98), (13.58 ± 4.86), (18.53 ± 3.07), and (12.77 ± 3.13) mm, respectively at 0° abduction of shoulder joint; the displacements were (8.41 ± 2.10), (8.55 ± 2.28), (9.06 ± 2.67), (12.49 ± 2.32), and (8.55 ± 2.15) mm, respectively at 90° abduction of shoulder joint. There was no significant difference between intact shoulder joint and others (P gt; 0.05) except between intact shoulder joint and 20% of osseous defect (P lt; 0.05). Conclusion When shoulder glenoid l ip defects or the glenoid osseous defect is less than 20%, the shoulder stabil ity does not decrease obviously, indicating articular l igament complex is not damaged or is repaired. When glenoid osseous defect is more than 20% , the shoulder stabil ity decreases obviously even if articular l igament complex is not damaged or is repaired. Simultaneous repair of glenoid osseous defect andarticular l igament complex can recover the anterior stabil ity of the shoulder.
Objective To determine the change in humeral head anterosuperior migration after releasing the coracoacromial l igament in shoulders from cadavers with simulated intact or irreparable teared rotator cuff, to provide biomechanical basis for preserving the coracoacromial l igament or not during hemiarthroplasty. Methods Twelve freshfrozen cadaveric glenohumeral joints of adult preserving the scapula, upper 2/3 of the humerus, articular capsule and the coracoacromial l igament, were divided into 2 groups. The suprascapularis was preserved in group A (6 shoulders) and excised in group B (6 shoulders). Positioning the joint in a combination of 30° extension, 0° abduction and 30° external rotation, and imposing a 50 N axial compressive load to the humeral shaft, the anterosuperior displacement of the humeral head weremeasured before and after excising the coracoacromial l igament. Results In group A, the displacement of the humeral head was (5.96 ± 0.77）mm with intact coracoacromial l igament and (6.83 ± 0.84）mm after transecting the l igament. In group B, the displacement of the humeral head was (8.07 ± 2.46）mm with intact coracoacromial l igament and (9.92 ± 3.29）mm after transecting the coracoacromial l igament. So the mean increase of anterosuperior migration of the humeral head was (0.88 ± 0.34) mm (P lt; 0.01) in group A, and (1.85 ± 0.99) mm (P lt; 0.01) in group B, which was greater than the former (P lt; 0.05). Conclusion The coracoacromial l igament restrained anterosuperior translation of the humeral head, especially for patients with rotator cuff deficiency, so it should be preserved as far as possible during hemiarthroplasty.
Objective To review the research progress in transplantation of the skeletal muscle myoblast. Methods The recentlypublished articles concernedwith the myoblast transplantation were reviewed, including myoblast culture, modified transplant methods, preparation of the recipient, scaffold choice, and aninfluence of the recipient’s immunity on the transplantation. How to improve the efficiency of the myoblast transplantation was also discussed. Results The techniques of the myoblast transplantation were improved and transplantation efficiency was increased. 〖WTHZ〗Conclusion The transplantation of the skeletal muscle myoblast has a great potential value in clinical practice and a promising future in its clinical application.
Objective To investigate the initiation of fracture repair and regulation on molecular level.Methods Literature concernedfracture repair and effects of correlative factors in the process in recent years was reviewed. The initiation in the process of fracture repair and the effects of the correlative factor were summarized to probe into effective methods to intervene. Results During fracture repair, the initiation had particular character and the correlative factors were concerned with the process. Conclusion The correlative factors regulate the initiation of fracture repair on molecular level.
ObjectiveTo review the research progress of the biomechanics of proximal row carpal instability (IPRC). MethodsThe related literature concerning IPRC was extensively reviewed. The biomechanical mechanism of the surrounding soft tissue in maintaining the stability of the proximal row carpal (PRC) was analyzed, and the methods to repair or reconstruct the stability and function of the PRC were summarized from two aspects including basic biomechanics and clinical biomechanics. ResultsThe muscles and ligaments of the PRC are critical to its stability. Most scholars have reached a consensus about biomechanical mechanism of the PRC, but there are still controversial conclusions on the biomechanics mechanism of the surrounding soft tissue to stability of distal radioulnar joint when the triangular fibrocartilage complex are damaged and the biomechanics mechanism of the scapholunate ligament. At present, there is no unified standard about the methods to repair or reconstruct the stability and function of the PRC. So, it is difficult for clinical practice. ConclusionSome strides have been made in the basic biomechanical study on muscle and ligament and clinical biomechanical study on the methods to repair or reconstruct the stability and function of PRC, but it will be needed to further study the morphology of carpal articular surface and the adjacent articular surface, the pressure of distal carpals to proximal carpal and so on.
【Abstract】 Objective To review the progress in pathoanatomy, diagnosis, and treatment of posterolateral rotatory instability (PLRI) of the elbow. Methods Related literature concerning PLRI of the elbow was extensively reviewed, comprehensive analysis was done. Results The lateral collateral ligament complex (LCLC), radial head, capitellum, and coronoid process are important constraints to PLRI. Muscle groups that cross the lateral elbow are secondary constraints to PLRI. Clinical examination includes lateral pivot-shift test, lateral pivot-shift apprehension test, chair sign, active floor push-up sign, tabletop relocation test, and posterolateral rotatory drawer test. Radiology, arthroscopy, and ultrasound can help diagnosis of PLRI. Reconstruction of bony fixation or soft tissue fixation can be used for treatment of injured LCLC. Conclusion The primary constraints to PLRI is LCLC. Ultrasound imaging is accurate for identification and measurement of normal LCLC. Therefore, ultrasound may prove valuable in assessment of abnormal lateral ulnar collateral ligaments. Reconstruction of soft tissue fixation, which can avoid iatrogenic fracture, is a selective treatment method.