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OBJECTIVE@#To compare clinical efficacy and safety of plate internal fixation (ORIF) and external fixator (EF) in treating distal radius fractures by Meta-analysis.@*METHODS@#From establishment of database to August, 2019, randomized controlled trial (RCT) about open reduction and internal fixation (ORIF) and external fixation (EF) in treating distal radius fractures was conducted by using computer-based databases, including CNKI, VIP, Wanfang Data, Medline, Cochrane library databases. Data extraction and quality evaluation of included study according to inclusion and exclusion criteria, RevMan 5.3 software was used to perform Meta-analysis. Palm angle, ulnar deflection angle, radius height, grip strength, ulnar variation, disabilities of arm, shoulder and hand (DASH) score, total complication rate, infection rate and tendon rupture between two groups were compared.@*RESULTS@#Totally 19 RCT were included with 1 730 patients, 873 patients in ORIF group and 857 patients in EF group. Meta analysis result showed that after operation at 12 months, there were no significant difference in radial height [@*CONCLUSION@#Compared with EF in treating distal radius fracture, ORIF has better clinical effects in postoperative complications, palm angle, ulnar deviation angle, ulnar variation rate and infection rate. While there were no significant difference between in DASH score, radial height, tendon rupture and carpal tunnel syndrome better EF and ORIF. For the patient pursue rapid recovery of function, ORIF is better choice.
Subject(s)
Humans , Bone Plates , External Fixators , Fracture Fixation , Fracture Fixation, Internal , Radius Fractures/surgery , Range of Motion, Articular , Treatment OutcomeABSTRACT
OBJECTIVE@#To study the sedative and hypnotic effects and underlying mechanisms of Polygala tenuifolia (PT) on treating aged insomnia rats.@*METHODS@#Sixty Sprague-Dawley male rats were divided into 6 groups by a random number table, including control group, model group, diazepam group (0.92 mg/kg), as well as PT low-, medium- and high-dose groups (0.0875, 0.175, 0.35 g/kg, respectively), 10 rats in each group. Aged insomnia rat model was established with subcutaneous injection of D-galactose for 42 days and then intraperitoneal injection of para-chlorophenylalanine for 3 days. PT and diazepam were respectively given to aged insomnia rats by intragastric administration for 7 days after model establishment. Then the rats were investigated by body weight, Morris water maze test, pentobarbital test, enzyme-linked immunosorbent assay, and transcriptome sequencing.@*RESULTS@#Compared with the model group, PT increased the body weight, improved memory ability, and prolonged pentobarbital-induced sleep time of aged insomnia rats (P<0.01 or P<0.05). The medium dose of PT also increased the neurotransmitter levels of 5-hydroxytryptamine (5-HT) and gamma-aminobutyric acid (GABA), and decreased the level of Glu in the hippocampus of aged insomnia rats (P<0.05 or P<0.01). Twenty-four differentially expressed genes (DEGs) were overlapped among model group, medium-dose PT group, and diazepam group in transcriptome analysis. Fuom and Pcp2 were down-regulated by the treatment of medium-dose PT (P<0.01 or P<0.05). The metabolic pathways of PT were relatively less than diazepam (91 vs. 104).@*CONCLUSIONS@#The sedative and hypnotic effects of PT in aged insomnia rats might be related to neuro, metabolism pathways, especially through GABAergic signaling pathway. It provided more effective herb choice for the treatment of senile insomnia.
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<p><b>OBJECTIVE</b>The factors influencing the grade of knee osteoarthritis were screened by ordered Logistic regression analysis. The classification model of knee osteoarthritis was established, which provided tool for the evaluation of clinical classification of knee osteoarthritis.</p><p><b>METHODS</b>A total of 753 cases of knee osteoarthritis from Wangjing Hospital, China Academy of Chinese Medical Sciences were treated with single factor and multivariate Logistic regression analysis from September 18, 2014 to April 26, 2016. The model formula was constructed and evaluated.</p><p><b>RESULTS</b>In this study, it was found that 13 factors associated with knee osteoarthritis grading. Old age, obesity, long course of disease, recurrence, lower limb deformity, quadriceps muscle atrophy, WOMAC index, TCM syndrome score, VAS score and grading degree were positively correlated. One knee pain, limited pain range, knee activity and grading degree were negatively correlated. The knee osteoarthritis grading model was constructed and the evaluation test was effective(Training set AUC=0.860, test set AUC=0.879).</p><p><b>CONCLUSIONS</b>In this study, a classification model of knee osteoarthritis was established which has a good ability to predict the classification of knee osteoarthritis under preliminary evaluation.</p>
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<p><b>OBJECTIVE</b>To evaluate efficacy and safety of Baimai ointment (see symbol in text) in the treatment of wrist-dysfunction after distal radius fracture.</p><p><b>METHODS</b>From April, 2011 to June, 2012, 43 patients with distal radius fracture were treated with plaster fixation. All the patients were divided into two group: test group and control group. Twenty-one patients in test group and 22 in control group, and the baseline was balance (P > 0.05). The 21 patients in test group were treated with Baimai ointment (see symbol in text), fomentation, functional exercises. The 22 patients in control group were treated with placebo, fomentation, functional exercises. Foment affected side wrist with wet towel in 20 min before medication, with the temperature between 50 degrees C and 60 degrees C. Smear drugs uniformly in range of 3 cm in the vicinity of palm stripes after drying (about 3 g) and take functional exercises for the activities of wrist and hand. Continuous follow the program per 8 hours once and follow-up for 8 weeks. The Wrist's pain was assessed with VAS. The wrist's activities were measured with the protractor of orthopedic. Measure The grip strength was measured with dynamometer. The wrist's function were assessed with the table of Cooney.</p><p><b>RESULTS</b>The test group had a significantly better results than those of control group in the extent of wrist's pain throughout the treatment (P < 0.001), and grip strength on the 28th day and the 56th day (P < 0.05), and Cooney functional assessment on the 56th day (P < 0.05). Wrist's activities had no significane difference throughout the 8 weeks (P > 0.05). There were no drug adverse reactions occurred.</p><p><b>CONCLUSION</b>Tibetan Baimai ointment (see symbol in text) has the treatment of wrist-dysfunction after distal radius fracture for external use, which can reduce the extent of wrist's pain, promote grip strength recovery in the middle and late of process, promote wrist's function recovery latterly, and safety for external use.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Case-Control Studies , Double-Blind Method , Medicine, Tibetan Traditional , Ointments , Radius Fractures , Drug Therapy , Recovery of Function , Wrist JointABSTRACT
Objective To investigate the regular pattern of traction forces during the treatment of distal radius fracture by reduction fixator with pins. Methods A self-designed pin-lock style force transducer instead of two original pin locks in the distal of reduction fixator was adopted to conduct continuous testing on six cases of unstable distal radius fracture of forearms treated by reduction fixator in vivo. The value of static traction force and the added value of traction force in fist clenching at the postoperative 1st, 5th, 14th, 21st, 28th, 35th, 42nd, 49th day, was recorded respectively. Results The maximum and minimum static traction force was 9.93 kg and 2.26 kg, respectively, with mean value of (4.93±1.79) kg. The maximum and minimum traction force increment in fist clenching was 10.40 kg and 0.13 kg, respectively, with mean value of (3.17±2.42) kg. Conclusions Larger axial forces can be generated in muscles of the forearm, by both static tension and dynamic contraction, which might be a serious negative factor in healing unstable distal radius fractures.
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<p><b>OBJECTIVE</b>To explore the clinical effects of diaplastic external fixator on the treatment of unstable fractures of distal radius.</p><p><b>METHODS</b>A clinical data of 60 patients with unstable fractures of distal radius admitted to Wangjing Hospital from August 2005 to September 2009 were retrospectively analyzed with the paired design. According to the paired design, 60 patients were equally divided into two groups (internal fixation group and external fixation group), which were respectively treated with open reduction and steel plate internal fixation (internal fixation group) or closed reduction and external fixation (external fixation group), including 8 males and 52 females, with an average age of 60.27 years ranging from 34 to 85 years. Left side was in 33 cases and right side was in 27 cases. All fractures were closed and caused by hand supporting when falling down. According to AO classification, type A3 was in 22 cases, type B2 was in 4 cases, type B3 was in 2 cases, type C1 was in 20 cases, type C2 was in 8 cases, type C3 was in 4 cases. Palmar flexion, dorsiflexion, radial deviation, ulnar deviation, pronation, supination, grip strength, radial angle, radial length, volar tilt were observed before and after operation.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 18 months with an average of 15.4 months. The radial length was (4.85 +/- 2.75) mm,volar tilt (14.66 +/- 10.77) degrees, radial angle (7.90 +/- 4.70) degrees in the external fixation group,while those were (4.29 +/- 1.53) mm, (14.39 +/- 5.01) degrees, (6.19 +/- 3.15) degrees in the internal fixation group, but with no statistical significance (P>0.05). Function comparison of internal and external fixation group, P-value of every function is more than 0.05 or equal to 0.05, with no statistical significance except for supination and radial deviation. The functions of wrist joints were evaluated according to Batra scoring system at 1 year after operation. The average radiological scores of external fixation group was 86.27,in which 15 cases were excellent, 11 good, 1 fair,3 poor,while the average functional scores was 94.93, and all the cases were excellent. The average radiological scores of internal fixation group was 91.27, 16 cases were excellent, 12 good, 2 fair, while the average functional scores was 94.23, in which all the cases were excellent.</p><p><b>CONCLUSION</b>Compared with the open reduction and steel plate fixation, the unstable fractures of distal radius treating by diaplastic external fixator can be achieved a similar result, with no statistical significance.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Case-Control Studies , External Fixators , Fracture Fixation, Internal , Methods , Radius Fractures , General Surgery , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To explore the mechanism of continuous traction in treating unstable distal radius fracture.</p><p><b>METHODS</b>Thirty patients with unstable distal radius fractures were treated by diaplastic external fixator including 4 males and 26 females with an average age of 61 years ranging from 18 to 85 years. According to AO classification, 12 cases were type A3, 3 were type B2, 8 were type C1, 4 were type C2, 3 were type C3. The distance of the processus radial malleolus and ulnar articularis were measured through X-ray examination.</p><p><b>RESULTS</b>Thirty patients were followed-up for 6 to 15 months with an average of 11.2 months. The results of distance before treatment measuring in X-ray was (0.55+/-0.22) cm, and the distance after treatment was (1.07+/-0.23) cm. The distance after treatment was higher than the distance before treatment, there were significant difference between them (P<0.01).</p><p><b>CONCLUSION</b>Continuous traction by diaplastic external fixator can explain by the theory of tendon reinforced bone and ligament restoration, or distraction osteogenesis.</p>