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Abstract Objective This study aimed to investigate the techniques and indications of upper sacroiliac screw fixation for the dysmorphic sacrum. Methods The dysmorphic sacra were selected from 267 three-dimensional pelvic models. The dysmorphic sacra which couldn’t accommodate a 7.3 mm upper trans ilio-sacroiliac screw were classified as the main dysmorphic sacra. Then, the size of the bone corridor, the length of the screw in the corridor, and the orientation of the screw were measured. The insertion point on the sacrum was identified by two bone landmarks. Results totally, 30.3% of sacra were identified as the main dysmorphic sacra. The inclinations of the screw oriented from posterior to anterior were (21.80 ± 3.56)° for males and (19.97 ± 3.02)° for females (p

Objective: To study the effect and mechanism of geraniin on the osteogenesis of tumour necrosis factor-alpha (TNF-α)-induced bone marrow-derived mesenchymal stem cells (BMSCs)., Methods: BALB/c mice aged 4-6 weeks were used to collect BMSC. Methyl thiazol tetrazolium assay and lactate dehydrogenase assay were used to analyse the effect of geraniin on the TNF-α-induced impairments of osteogenesis in BMSCs. BMSCs were stained using Oil red to measure the osteogenesis. Real-time reverse transcription PCR and western blot analysis were used to analyse the expression of RunX2 and Osx miRNA, and expression of NF-κB, IкB-α and p38 MAPK protein in BMSCs., Results: 2.5 µM geraniin significantly inhibited TNF-α-induced BMSCs cytotoxicity. 2.5 µM geraniin significantly reduced the expression of RunX2 and Osx miRNA in TNF-α-induced BMSCs. 2.5 µM geraniin suppressed the expression of NF-κB and p38 MAPK protein and promoted the expression of IкB-α protein in the TNF-α-induced BMSCs., Conclusion: Geraniin inhibits TNF-α-induced impairments of osteogenesis through NF-κB/IкB-α and p38 MAPK signalling pathways in BMSCs., Competing Interests: Competing interests: None declared.

Objective: To explore the biomechanical stability of ideal compression screw (I.CO.S.) for treatment of femoral neck fracture and to provide theoretical basis for choosing I.CO.S. in clinical application., Methods: Thirty cadaveric human femurs were selected and divided randomly into experimental group (n=15) and control group (n=15), 15 in each group were divided equally into three sub-groups (n=5) again. The model of subcapital femoral neck fracture was made, then given anatomical reduction and fixed with I.CO.S. (experimental group) and general cannulated compression screw (control group) separately with three different configurations: two horizontal (parallel screws in superior aspect of femoral neck), two vertical (parallel screws in sagittal plane of femoral neck) and reverse triangle. The different biomechanical performances were evaluated through experimental stress analysis., Results: In biomechanical stability aspect: groups A, B, C was better than groups D, E, F in respect of horizontal displacement and yield load (P < 0.05); groups A, D was better than groups B, E in respect of the straining, horizontal displacement and yield load (P < 0.05); and there were not significant differences in all biomechanical indicators between group C and group F, and between group A and group C (P > 0.05)., Conclusion: I.CO.S. has the good biomechanical stability for treatment of femoral neck fracture, which may provide basis for application.

Objective: To investigate the therapeutic effect of long PHILOS locking compression plate on the proximal humerus and humeral shaft fractures., Methods: From March 2005 to December 2007, 35 cases with the proximal humerus and humeral shaft fractures were treated with long PHILOS locking compression plate, including 16 males and 19 females aged 29-68 years old (average 54.5 years old). There were 34 cases of fresh and close fracture, and the time from injury to operation was 3-9 days. One case had delayed union of fracture 5 months after receiving T-plates and internal fixation with steel plate. For the proximal humerus fracture, 7 cases had 2 parts of fracture, 19 had 3 parts of fracture, and 9 had 4 parts of fracture according to Neer classification; while for the humeral shaft fracture, 3 cases were classified as A1, 5 as A2, 10 as B1, 3 as B2, 6 as B3, 7 as C1 and 1 as C3 according to AO classification. Postoperatively, Neer scoring system was employed to evaluate the function of shoulder joint and HSS scoring system was adopted to evaluate the function of elbow joint., Results: All incisions healed by first intension, and 30 cases were followed up for 12-33 months (average 18.2 months). Postoperatively, 2 cases had symptoms of radial nerve paralysis, which disappeared within 3 weeks; 1 case suffered from humeral head necrosis and received the secondary operation of humeral head replacement; humeral head was reduced evenly in 1 case, and 2 cases felt chronic slight pain in shoulder joints and received no further treatment. X-ray films showed 29 cases had fracture healing 6 months after operation, and all the patients had bone union 12 months after operation except 1 case receiving humeral head replacement. No such complications as screw loosening and internal fixation loosening occurred. By Neer scoring system, 6 cases were graded as excellent, 19 as good, 3 as fair, 2 as poor, and the excellent and good rate was 83.3%. By HSS scoring system, 16 cases were graded as excellent, 14 as good, and the excellent and good rate was 100%., Conclusion: Applying long PHILOS locking compression plate in the treatment of the proximal humerus and humeral shaft fractures provides a solid fixation and high satisfactory rate with minor complications.