Case-control study on bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle joint / 中国骨伤

<p><b>OBJECTIVE</b>To explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism.</p><p><b>METHODS</b>From 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment.</p><p><b>RESULTS</b>All patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P < 0.05).</p><p><b>CONCLUSION</b>Bone setting manipulation is a good method for treating supination-eversion ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary</p>

Treatment of Barton fractures with external fixation with paper splints / 中国骨伤

<p><b>OBJECTIVE</b>To study the control of instability of paper splints for the treatment of Barton fractures.</p><p><b>METHODS</b>From 1998 to 2007, 30 patients with Barton fractures were treated with manual reduction and external fixation with paper splints. Among the patients, 20 patients were male and 10 patients were female, ranging in age from 20 to 68 years, averaged 45.3 years. The course of the disease ranged from 1 to 15 hours, with a mean of 4.2 h. All the patients had a history of trauma. The X-rays showed palm-side distal radius fractures, fractured fragments displacing toward proximal palm and the radius bone sudislocating toward the palm. Anderson assessment method was adopted.</p><p><b>RESULTS</b>All the patients were followed up ranging from 0.5 to 2 years (12.3 months on average). When clinical healing, the X-ray showed good position in 26 cases, and the fractured fragments on the palm side displaced 1 to 2.5 mm toward palm in 4 cases. Final results : the motion range and function of wrist and forearm recovered completely in 24 patients; the motion range and function of wrist and forearm were limited slightly without hindering daily life in 6 patients. According to Anderson assessment method, 24 patients got an excellent result and 6 good.</p><p><b>CONCLUSION</b>This fixation method possesed such advantages as improving hematoma absorption, reinforcing fixation on the basis of original fixation at any time without pressure sore and necrosis, safe and effective.</p>

Manual reduction of 90 degree bending elbow and external fixation with paper splint for treatment of type I capitellum fractures / 中国骨伤

<p><b>OBJECTIVE</b>To study the operation points of manual reduction for treatment of capitellum fractures of type I and analyze the characteristics of fixation with paper splint.</p><p><b>METHODS</b>From April 2000 to February 2008, 27 cases with capitellum fractures of type I were treated by manual reduction of 90 degrees bending elbow and external fixation with paper splint, included 23 males and 4 females aged from 5 to 14 years old (means 8.9 years) with the course from 1 to 23 hours (averaged 5.4 hours). Before treatment all the wounded elbows were swollen and malfunctioned, the X-ray film showed that the fracture fragments of capitellum were separated and upside down displaced in varying degrees. During reduction, the correct restoration point was found and the reduction was correct, continuous and steady, and coordinated the passive movement of forearm and elbow joint, and the 90 degrees bending elbow was fixed by paper splint. All the patients were assessed according to JOA elbow joint function assessment method.</p><p><b>RESULTS</b>All 27 patients were followed-up for from 6 months to 2 years (averaged 17 months). All the elbow joints were painless, the movement and functions were normal, the elbow joints were stable. After reduction, no complication was found. There were 25 cases with the fracture site reaches or nearly reaches healing of anatomical counterparts, only 2 cases with slight cubitus valgus deformity. According to JOA score 25 cases gained 100 scores and 2 cases gained 97 scores.</p><p><b>CONCLUSION</b>This method has advantage of strong stability, high success rate, firm and easy fixation, without pressure sore and necrosis.</p>

Effect of zhenggu powder (Chinese characters: see text) on the inflammatory cell factor of soft tissue in experimental acute injury / 中国骨伤

<p><b>OBJECTIVE</b>To probe the recovery mechanism of Zhenggu powder (ZGP) on acute soft tissue injury in cell levels.</p><p><b>METHODS</b>Forty rabbits which established animal model of acute soft tissue injury with hammer hitting,were divided randomly into normal group (A), model group (B), vaseline group (C)and ZGP group (D). Injured part was applied external drug daily after model was made. All animals were killed after using drug for 4 days. The local tissue of injured part was taken pathologic study, and was measured the content of IL-1beta, IL-6, TNFalpha by ELISA method and TXB2, 6-keto-PGF1alpha by RIA method.</p><p><b>RESULTS</b>Muscular tissue of group A was normal. But that of group B and C was aberrant,such as swelling and broken of muscular fiber or infiltration of inflammatory cell. Such histological change of group D was lightly and hyperplasia of blood vessel was found. The contents of IL-1beta, TNFalpha, TXB2 and TXB2/6-keto-PGF1alpha in group D were lower than that of group B and group C. On the contrary, the contents of 6-keto-PGF1alpha in the group D were higher than that of group B and group C. The difference of content of IL-6 between groups was not obvious.</p><p><b>CONCLUSION</b>ZGP could promote not only the dilution and the transportation of inflammatory cell factors,but also the repair and the regeneration of the injured tissue structures. The therapeutic effect of ZGP was not relative to IL-6.</p>

Comparison of the therapeutical effectiveness between paper splint adduction fixation and plaster abduction fixation in Bennett fracture / 中国骨伤

<p><b>OBJECTIVE</b>To study and compare the difference on the therapeutical effectiveness between paper splint adduction fixation and plaster abduction fixation in Bennett fracture.</p><p><b>METHODS</b>In the study, seventy outpatient were selected from October 2005 to April 2007, and devided into two groups randomly involving experiment group (35 cases with paper splint adduction fixation) and control group (35 cases with plaster abduction fixation). After the fracture clinical healed and removed fixation, the patients had been followed up 6 months. At the 6th, 8th, 12th, 16th, 20th, 24th week after fracture, the fracture hand had been scored and compared according to Gabriele's score system.</p><p><b>RESULTS</b>At the 8th, 12th, 16th and 20th week, the excellent rate of experiment group was higher than control group, there was significant difference (P<0.05) At 6th week and 24th week there was no significant difference (P>0.05). At 8th, 12th, 16th, 20th and 24th week, the functional score of experiment group was higher than control group, there was significant difference (P<0.05); At 6th week there was no significant difference (P>0.05).</p><p><b>CONCLUSION</b>The paper splint adduction fixation could promote recovery of the hand function in Bennett fracture. In addition, the paper splint adduction fixation is comfortable to recipient. It could be spreaded in clinic as a effective fixation method.</p>