Reconstruction of skin defects around the Achilles tendon with rectangle advancement flap in children / 中华创伤骨科杂志

Objective To explore the clinical efficacy of rectangle advancement flaps used in the reconstruction of skin defects around the Achilles tendon in children.Methods From May 2014 to June 2015,7 children with skin defects around the Achilles tendon were admitted to our trauma center.The areas of skin defect ranged from 3.4 cm × 2.7 cm to 5.5 cm × 4.0 cm.The integrity of Achilles tendon was preserved in 6 cases but the tendon insertion was partly disrupted in one case.The skin defects were reconstructed with self-designed rectangle advancement flaps after debridement.In the one case with the Achilles tendon partly disrupted,the contaminated tendon ends were excised before wound closure.The injured ankles were immobilized in plantar flexion with one 1.5 mm K-wire and plaster splint to decrease the postoperative tension of the flap.Results All the flaps survived completely by primary intention but local infection occurred in 2 wounds which was cured by second intention of dressing change.The follow-up periods ranged from 8 to 12 months (average,11.5 months).The scar around the flap was remarkable in 2 cases,but the flaps in the other cases appeared normal in terms of color and texture.The ankle function was satisfactorily normal in all the cases.Conclusion Our self-designed rectangle advancement flaps provide a simple,safe and reliable way to repair skin defects around the Achilles tendon in children.

Anterior subcutaneous internal fixation of unstable pelvic ring fracture / 中华创伤杂志

Objective To determine the curative effect of stabilizing unstable pelvic ring fracture using the anterior subcutaneous internal fixator (INFIX).Methods From July 2013 to June 2014,15 cases who suffered from anterior pelvic ring fracture were treated with the device.There were 11 males and 4 females,with mean age of 38.5 years (range,23-65 years).Eight cases sustained fracture in traffic accidents,4 in high falls,and 3 in crush injury.According to the Young-Burgess and AO/OTA classification systems,type APC2 or 61-B1 was noted in one case,LC1 or 61-B2.1 in 4 cases,LC2 or 61-B2.2/61-B2.3 in 6 cases,and VS or 61-C1/61-C2 in 4 cases.Basic method in anterior ring fixation was one pedicle screw was respectively inserted into the area between the anterior superior iliac spine and anterior inferior iliac spine of both sides.The precontoured rod was then tunneled subcutaneously from one screw to the other.For the stable posterior injury in pelvic ring fracture,the anterior pelvic ring was stabilized only using the technique.For the unstable posterior injury in pelvic ring fracture,the anterior and posterior ring were both fixed using the technique.During follow-up visits,patients' tolerance to the device,wound infection,myositis ossificans,internal fixation lessening,and lateral femoral cutaneous nerve injury were evaluated.Results Follow-up ranged from 6-12 months (mean,7.5 months).The device was well tolerated by the patients for comfort.None had surgical site infection and internal fixation loosening.Injuries healed without loss of reduction at the 3-month follow-up.Injury of the lateral femoral cutaneous nerve at the both side was reported in 4 cases and at one side in 2 cases,but all restored 3 month after operation.Conclusion The reported technique is minimally invasive with few complications and reliable results,hinting an ideal method to stabilize the anterior pelvic ring fracture.

Low-molecular-weight heparin plus Shuxuetong for deep venous thrombosis following lower extremity fracture / 中华创伤杂志

Objective To compare the therapeutic results between low-molecular-weight heparin therapy and combined therapy of low-molecular-weight heparin and Shuxuetong for deep venous thrombosis (DVT) after lower extremity fracture.Methods Forty-two patients with DVT from 1,037 patients with lower extremity fracture treated from December 2010 through November 2012 were included in the study.There were 31 males and 11 females,aged from 26 to 82 years (mean,63 years).The patients were assigned to administration of 4,250 IU low-molecular-weight heparin subcutaneously,twice daily (Group A,n =19)and 4,250 IU low-molecular-weight heparin subcutaneously,twice daily plus shuxuetong to 6 ml intravenously,once daily (Group B,n =23) according to the random number table.A period of treatment was a week.Color Doppler sonography was performed to detect DVT.Results Longest course of treatment was 3 weeks.In Group A,the results were recanalization in 2 patients with mean time of 2.50 weeks,significantly effective in 3 patients with mean time of 2.67 weeks,effective in 7 patients with mean time of 3 weeks,and invalid or worse in 7 patients with mean time of 3 weeks.Whereas in Group B,the results were recanalization in 7 patients with mean time of 1.86 weeks,significantly effective in 12 patients with mean time of 1.83 weeks,effective in 3 patients with mean time of 3 weeks,and invalid or worse in 1 patient with mean time of 3 weeks (P ＜ 0.05).Conclusion Low-molecular-weight heparin plus Shuxuetong is effective in treatment of DVT after lower extremity fracture and hence can be as an option in clinical application.

Treatment of 320 Cases of Infantile Diarrhea by Needling Technique of Setting Fire on Mountains / 针灸推拿医学（英文版）

In the treatment of 320 cases of infantile diarrhea by the needling technique of setting fire on mountains, with Zusanli (ST 36) and Changqiang (GV 1)as the main acupoints, all cases were cured after 1-3 treatments.