Comparative study on effect and safty of treating on calcaneus fractures with manipulative reduction with percutaneous K-wire fixation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects and safty of manipulative reduction with percutaneous poking K-wire fixation for the treatment of the calcaneus fractures and analyze the indication of the minimal invasion.</p><p><b>METHODS</b>From December 2008 to December 2011,135 closed calcaneal fractures cases were divided randomly into poking group and plate group, treated respectively by percutaneous poking reduction and operative reduction. In poking group, there were 69 cases (82 feet) including 60 males and 9 females, with an average age of (43.29+/-10.46) years ranging from 18 to 64 years; 30 cases of left, 26 cases of right and 13 cases of double; 54 feet of Essex-Lopresti classification tongue form, 28 feet of joint compression; 33 feet of Sanders type II ,49 of type III. In plate group, there were 66 cases (75 feet) including 58 males and 8 females,with an average age of (46.00+/-2.42) years ranging from 21 to 63 years; 31 cases of left, 26 cases of right and 9 cases of double; 48 feet of Essex-Lopresti classification tongue form, 27 feet of joint compression; 28 feet of Sanders type II, 47 of type III. According to Kerr scoring standard,clinical effects and complications were evaluated combining with Sanders and Essex-Lopresti classification.</p><p><b>RESULTS</b>All 135 cases were followed up after 24 weeks. Fractures were recoveried in 8 to 12 weeks (means 10.2 weeks). In poking group, there were 2 cases of infection, 5 cases of wire movement; in plate group,18 cases of wound local skin necrosis, 5 cases of calf intestines nerve injured; there were statistical significant (P<0.05). Postoperative evaluation of Sanders type II after 24 weeks, the proportion of excellent results was above 70%,and there were no significant differences on effects of tongue form and compressing form of calcaneus fractures with percutaneous poking and operative redution (P>0.05). In the caes of Sanders type III, there were no significant differences on effects of tongue form fractures with percutaneous poking and operative reduction (P>0.05). There were significant differences on effects and complications of compressing form fractures (P<0.01), operative reduction better than percutaneous poking. Pain, walking,Kerr scoring of tongue form fractures of Sanders II , III with poking reduction were better than compression fractures. In compression fractures of Sanders Ill, plate internal fixation was better than poking redution in working and walking function, there were significant difference (P<0.05).</p><p><b>CONCLUSION</b>For tongue form or compressing form of Sanders type II and tongue form of Sanders type III, manipulative reduction with percutaneous poking K-wire fixation has advantages of minimal invasion, minimized complications. Compressing form of Sanders type III fracture should be treated with operative redution.</p>

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>

Research progress in the treatment of calcaneal fractures / 中国骨伤

Calcaneal fracture is a kind of common injury of foot. Calcaneal fracture could be treated with conservative therapy, open reduction and internal fixation (ORIF), minimal invasive poking reduction and Kirschner wire fixation, arthrodesis or external fixation and other treatment methods. Open reduction and internal fixation as the main treatment method of calcaneus fracture, especially for intra-articular calcaneal fractures, as Sanders type II and III fractures, could gain satisfactory effect. But whether bone grafting should be taken is controversial in Sanders type IV fractures, because soft tissue complications are disadvantages of ORIF. The treatment of minimally invasive percutaneous poking reduction and internal fixation for calcaneal fractures has been paid more and more attention. Because of the differ of the classification of calcaneal fractures, indications of poking reduction and fixation methods, efficacy evaluation standard of choose, the clinical efficacy is different. Because of the complex treatment process, various treatment methods have their own advantages and disadvantages. Through consulting relevant literatures of domestic and abroad in recent years, comprehensive analysis is made and new progress of the calcaneal fractures treatment is summarized.

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>