Bridging the Gap between Locking Compressive Plate, Skin Grafting and Rehabilitation for Tibia Fracture: A Case Report

Introduction: Road traffic accidents (RTA) have remained an ongoing endemic problem over the years and a serious economic and medical-social burden for many countries around the world. Among the most complex and frequent fractures inside the joint is tibial plateau fractures. Such fractures are linked to adverse results, because of reasons such as the damage of cartilage but also soft tissue envelopes, complications like compartment syndrome, postoperative infection, knee dysfunction or rigidity, or even post-traumatic osteoarthritis. Case Description: An 18-year-old young girl complaining of pain and inability to perform activities of daily living was referred to physiotherapy after being operated with external fixator (LCP) and skin grafting. Locking compressive plate was placed at lateral side of leg with 2 nails near head of fibula and 2 nails near lateral malleolus. Grafted skin was seen at anterior aspect of knee and anterior to medial aspect to leg. Patient was mostly suffering from pain in right leg and knee with intensity 7/10 at rest and 9/10 slight movement and swelling over right lower limb and patient complained of limited mobility and unable to walk. Discussion: The significance of early mobilisation and range of knee joint motion exercises has been apparent in literature in the past 40 years. From low-intensity activities to progressive strengthening and partial to complete weight with walkers, recovery objectives were devised. Good grafting rates can be achieved with fast ambulation leading low extremity skin grafting operations, which runs counter to conventional lessons in post-operative skin grafting after lower extremity

Design and Experimental Research of Knee Joint Prosthesis Based on Gait Acquisition Technology

Whether the lower limb prosthesis can better meet the needs of amputees, the biomimetic performance of the knee joint is particularly important. In this paper, Nokov(metric) optical 3D motion capture system was used to collect motion data of normal human lower limbs, and the motion instantaneous center of multi-gait knee joint was obtained. Taking the error of knee joint motion instantaneous center line as the objective function, a set of six-bar mechanism prosthetic knee joint was designed based on a genetic algorithm. The experimental results show that the movement trajectory of the instantaneous center of the knee joint is basically similar to that of the human knee joint, so it can help amputees complete a variety of gaits and has good biomimetic performance. Gait acquisition technology can provide important data for prosthetic designers and it will be widely used in prosthetic design and other fields.

The Old Supracondylar Fracture of Femur Treated by Gradual Deformity Correction Using the Ilizarov Technique Followed by the Second-Stage Internal Fixation in an Elderly Patient With Osteoporosis

Background: The supracondylar nonunion of femur in elderly individuals is rare and challenging to manage. Nothing in English literatures or guidelines is available regarding this particular fracture characterized by osteoporosis, soft-tissue contracture, shortening, and joint stiffness. We report a case of an elderly patient with a supracondylar nonunion of the femur, which was successfully treated using staged Ilizarov techniques and dual plating. Case Presentation: An 84-year-old female patient was admitted to our orthopedic department for her pain and soft-tissue swelling around the right knee with claudication and shortening deformity of the affected extremity. She denied any specific history of trauma and had sought traditional Chinese medical attention for 6 months before she presented to our hospital. Diagnosis of the right femoral supracondylar nonunion was made based on the X-ray and computed tomography. Ilizarov external fixator was carried out for successive and slow distraction and gradual correction of the shortening deformity, in consideration of the nonunion was still present. Subsequently, internal fixation with dual plating of the distal femur was performed. Excellent function and patient satisfaction were observed at 6 months of follow-up. Conclusion: The protocol of Ilizarov technique with subsequent internal fixation of dual plating seems to be an efficient solution to the supracondylar nonunion of femur in elderly patients with osteoporosis. The advantage of the protocol is that it allows knee joint motion, avoids neurovascular complications, and gentle correction of soft-tissue contractures.

SOLUTE TRANSPORT IN ARTICULAR CARTILAGE UNDER ROLLING-COMPRESSION LOAD

Solute transport is one of the important aspects involved in maintaining the physiological activity of tissues. The mechanical environment drives nutrition in and waste out in articular cartilage due to its avascularity, which plays a key role in the biological activity of articular cartilage. The human knee joint motion is a complex interaction between different bones including relative rolling and/or sliding movements. Rolling-compression process is a typical physiological load in knee joint motion. To investigate solute transport behavior in articular cartilage under rolling-compression load, fluorescence tracers with molecular weights of 40kDa and 0.43kDa were used respectively to mark the transport in fresh articular cartilage of mature pigs. Solute fluorescence intensity changing with time and depth of cartilage layer was measured under rolling-compression load and static state, respectively, and the distribution of corresponding relative concentration was calculated by the fluorescence microscope imaging method. The experiment results show that the solute relative concentration in articular cartilage under rolling-compression load increases significantly, even up to 62.4%, comparing with that under static state, and the changes of concentration vary in different layers and that small molecular weight solute is easier to transport than relatively large molecular weight solute in articular cartilage. Therefore, rolling-compression load can promote the solute transport in cartilage, and the mechanical loading may have application in functional cartilage tissue engineering.

A Textile Sensor for Long Durations of Human Motion Capture

Human posture and movement analysis is important in the areas of rehabilitation, sports medicine, and virtual training. However, the development of sensors with good accuracy, low cost, light weight, and suitability for long durations of human motion capture is still an ongoing issue. In this paper, a new flexible textile sensor for knee joint movement measurements was developed by using ordinary fabrics and conductive yarns. An electrogoniometer was adopted as a standard reference to calibrate the proposed sensor and validate its accuracy. The knee movements of different daily activities were performed to evaluate the performance of the sensor. The results show that the proposed sensor could be used to monitor knee joint motion in everyday life with acceptable accuracy.