N klA Case Report on a IV-degree Thermal Crush Injury of Right Upper Arm: The Application of Functional Prosthesis Implantation Technology.

Severe IV-degree thermal crush injury of limbs involved the subcutaneous fascia, muscle and bone, which may lead to amputation and has a great impact on the patient's quality of life. We can repair wounds with pedicle flaps or even free flaps, However, there are still huge challenges in bone defect of extremities and functional reconstruction. In recent years, with the development of functional prostheses, we have reconstructed limb functions in many patients helping them to complete their daily lives.

Poly (Glycerol Sebacate)-Based Bio-Artificial Multiporous Matrix for Bone Regeneration.

In recent years, bone repair biomaterials that combine cells and bioactive factors are superior to autologous and allogeneic bone implants. However, neither natural nor synthetic biomaterials can possess all desired qualities such as strength, porosity, and biological activity. In this study, we used poly (glycerol sebacate) (PGS), a synthetic material with great osteogenic potential that has attracted more attention in the field of tissue (such as bone tissue) regeneration owing to its good biocompatibility and high elasticity.

Docosahexaenoic Acid Improves Diabetic Wound Healing in a Rat Model by Restoring Impaired Plasticity of Macrophage Progenitor Cells.

Background: Chronic inflammation associated with delayed diabetic wound healing is induced by disturbed polarization of macrophages derived mainly from predisposed progenitor cells in bone marrow. Docosahexaenoic acid plays a critical role in regulating the function of macrophage progenitor cells. The authors evaluated whether docosahexaenoic acid accelerates diabetic wound healing in rats.

Dimethyloxaloylglycine-stimulated human bone marrow mesenchymal stem cell-derived exosomes enhance bone regeneration through angiogenesis by targeting the AKT/mTOR pathway.

Background: Mesenchymal stem cell (MSC)-derived exosomes have been recognized as new candidate agents for treating critical-sized bone defects; they promote angiogenesis and may be an alternative to cell therapy. In this study, we evaluated whether exosomes derived from bone marrow-derived MSCs (BMSCs) preconditioned with a low dose of dimethyloxaloylglycine (DMOG), DMOG-MSC-Exos, exert superior proangiogenic activity in bone regeneration and the underlying mechanisms involved.

Methods: To investigate the effects of these exosomes, scratch wound healing, cell proliferation, and tube formation assays were performed in human umbilical vein endothelial cells (HUVECs).

Chinese expert consensus on diagnosis and treatment of infection after fracture fixation.

Currently, accurate diagnosis and successful treatment of infection after fracture fixation (IAFF) still impose great challenges. According to the onset of infection symptoms after implantation, IAFF is classified as early infection (<2 weeks), delayed infection (2∼10 weeks) and late infection (>10 weeks). Confirmation of IAFF should be supported by histopathological tests of intraoperative specimens which confirm infection, cultures from at least two suspected infection sites which reveal the same pathogen, a definite sinus or fistula which connects directly the bone or the implant, and purulent drainage from the wound or presence of pus during surgery.

L-shaped corticotomy with bone flap sliding in the management of chronic tibial osteomyelitis: surgical technique and clinical results.

Background: We described the use of the technique of L-shaped corticotomy with bone flap sliding to treat chronic osteomyelitis of the tibia in eight patients and presented the preliminary results.

Methods: L-shaped corticotomy with bone flap sliding was performed in eight patients between 2007 and 2014. All patients had chronic tibial osteomyelitis involving the anterior tibial cortex with intact and healthy posterior cortex.

Glucocorticoid receptorβ isoform exhibits a disproportionate increase over the α isoform in the lungs of a polytrauma rat model.

Glucocorticoids (GCs) are potent anti-inflammatory agents that act by binding to the glucocorticoid receptor (GR). GR has two main isoforms, GRα and GRβ, and the balance between GRα and GRβ servesan important role in glucocorticoid sensitivity. In the present study, GRα and GRβ mRNA expression was investigated in the lungs ofa polytrauma rat model.

A biomechanical evaluation of different fixation strategies for posterolateral fragments in tibial plateau fractures and introduction of the 'magic screw'.

Background: Posterior plate fixation is biomechanically the strongest fixation method for posterolateral column fracture (PLCF) of the tibial plateau; however, there are inherent deficiencies and risks of a posterior approach. Thus, the 'magic screw' was proposed to enhance fixation stability of the lateral rafting plate used for PLCF. The purpose of this study was to re-examine and compare the stability of different fixation methods for PLCF.

Resection arthrodesis using distraction osteogenesis then plating as a hybrid surgical technique for the management of bone sarcomas of the distal tibia.

Purpose: We report the oncological and functional results of limb salvage for bone sarcomas involving the distal tibia using hybrid surgical technique of resection arthrodesis by bone transport then plating.

Methods: Five patients (mean age 18.6 years) with primary distal tibial sarcomas (two Ewing's sarcomas and three osteosarcomas) were treated by this method.

Reinforcement strategy for lateral rafting plate fixation in posterolateral column fractures of the tibial plateau: The magic screw technique.

Background: A posterolateral column fracture of the tibial plateau (PLCF) is not uncommon, especially lateral and bicondylar tibial plateau fractures. Currently, there is no consensus on the methods of surgical treatment for PLCF, including the surgical approach or the fixation strategy. Though various posterior approaches have been explored and can allow posterior buttress plate fixation, the necessity of a posterior approach with fixation for PLCFs is increasingly questioned.

The Combined Use of a Neurocutaneous Flap and the Ilizarov Technique for Reconstruction of Large Soft Tissue Defects and Bone Loss in the Tibia.

Background: Management of posttraumatic large soft tissue defects and bone loss remains a therapeutic and surgical challenge for orthopedic surgeons. We assessed the use of a neurocutaneous flap and the Ilizarov technique in the reconstruction of severe composite defects in the tibia.

Methods: We retrospectively reviewed 18 consecutive patients with trauma-related soft tissue defects and bone loss.

Plate fixation for Letenneur type I Hoffa fracture: a biomechanical study.

Background: A coronal fracture of the posterior femoral condyle, also known as a Hoffa fracture, is an unusual injury, and there are only a handful of case reports or series exploring it. The optimal fixation method of these intraarticular fractures remains controversial; improper or unstable fixation usually lead to an unsatisfactory prognosis. The use of posterior-anterior or reversed lag screw fixation is still a popular method.

The Effect of Atorvastatin on the Viability of Ischemic Skin Flaps in Diabetic Rats.

Background: Endothelial progenitor cells play a critical role in neovascularization. However, the mobilization, recruitment, and functional capacity of endothelial progenitor cells are significantly impaired in diabetes. Statins have been shown to augment the number and improve the function of endothelial progenitor cells.

Comparison of percutaneous vertebroplasty with and without interventional tumor removal for spinal metastatic tumor without epidural involvement.

Aim: To evaluate the efficacy of percutaneous vertebroplasty (PVP) combined with interventional tumor removal (ITR) in providing pain relief, reducing disability, and improving functional performance in patients with malignant vertebral compression fractures without epidural involvement.

Methods: Patients with malignant vertebral compression fractures (n=58) were treated with either PVP+ITR (n=31, group A) or PVP alone (n=27, group B). A 14 G needle was inserted into the vertebral body, and the tract was sequentially dilated with working cannulae.

Fingertip Replantation With Palmar Venous Anastomoses in Children.

Background: Fingertip amputation in children is difficult to manage using microsurgical replantation techniques and many salvage procedures have failed owing to the nonavailability of suitable veins for anastomosis in the fingertip. This study reviewed our experience of pediatric fingertip replantation involving palmar venous anastomoses and evaluated the clinical outcomes.

Methods: From October 2008 to May 2013, 21 pediatric fingertips that had been completely amputated at or distal to the distal interphalangeal joint of the finger, or at or distal to the interphalangeal joint of the thumb were managed using complete replantation.

Stimulation of Nitric Oxide Production Contributes to the Antithrombotic Effect of Stromal Cell-Derived Factor-1α in Preventing Microsurgical Anastomotic Thrombosis.

Background Intimal injury plays a critical role in initiating the pathogenesis of thrombosis formation after microsurgical anastomosis. Application of stromal cell-derived factor-1α (SDF-1α) is reported to promote early regeneration of injured intima through migration of endothelial cells and mobilization of endothelial progenitor cells. We therefore hypothesized that local transfer of SDF-1α gene would inhibit microsurgical anastomotic thrombosis.

Combined Anterolateral Thigh and Anteromedial Thigh Flap for Extensive Extremity Reconstruction: Vascular Anatomy and Clinical Application.

Background: The combined anterolateral thigh (ALT) and anteromedial thigh (AMT) flap has been previously reported for use in complicated head and neck reconstruction. However, it has not gained popularity due to the vascular variation. Here, we explore the vascular basis of this combined flap, and report its application in extremity reconstruction.

Management of hypertrophic nonunion with failure of internal fixation by distraction osteogenesis.

Introduction And Aim: Distraction osteogenesis is employed in the management of hypertrophic nonunion associated with angular deformity and shortening. This study was aimed at evaluating the outcomes of Ilizarov apparatus without bone graft or open osteotomy in cases of hypertrophic nonunion not responding to treatment with internal fixation.

Methods: We retrospectively reviewed the data of 12 patients (mean age, 46.

Superficial peroneal neurocutaneous flap based on an anterior tibial artery perforator for forefoot reconstruction.

The distally based superficial peroneal neurocutaneous (SPNC) island flap has been widely used for foot reconstruction. It is based on the descending branch of the peroneal artery perforator. However, damage to the perimalleolar vascularization or anatomic variations of the descending branch often causes flap necrosis.

Expandable Proximal Femoral Nails (EPFNs) in Elderly Patients.

Purpose: The purpose was to study the performance of expandable proximal femoral nails (EPFNs) for the treatment of unstable intertrochanteric fractures in elderly patients.

Patients And Methods: Eighty-four patients were treated with a newly designed EPFN and followed up for one year.

Results: The mean operating time was 50.

Systemic administration of sclerostin monoclonal antibody accelerates fracture healing in the femoral osteotomy model of young rats.

Genetic studies have demonstrated that sclerostin was a key negative regulator of bone formation. Sclerostin monoclonal antibody (Scl-Ab) treatment enhanced bone healing in experimental fracture healing. The purpose was to investigate the effects of systemic Scl-Ab administration on open fracture healing in young rats.

Pedicled fibular flap for reconstruction of composite defects in foot.

Introduction: Reconstruction of complex injuries involving bone and soft-tissue in foot remains a tough challenge for surgeons. The free fibular flap is a popular flap for treating these composite defects. However, complications caused by microvascular anastomoses are not uncommon.

Lentivirus-mediated Wnt10b overexpression enhances fracture healing in a rat atrophic non-union model.

Lentivirus vectors encoding Wnt10b gene (LV-Wnt10b) or luciferase gene (LV-luc) were constructed to determine whether Wnt10b overexpression improved fracture healing in a rat atrophic non-union model. After fracture, rats were injected with LV-Wnt10b or LV-luc. Luciferase signals were clearly detected.

A "hybrid" sural flap for treatment of chronic calcaneal osteomyelitis.

Background: The treatment of chronic calcaneal osteomyelitis remains a challenge for orthopedic and plastic surgeons. The basis of surgical therapy includes thorough debridement of infected tissue and reconstruction with well-vascularized flaps.

Methods: A "hybrid" sural flap composed of an adiponeurofascial flap proximally and a neurofasciocutaneous flap distally is described here.