Lever positioning manipulation combined with pulsed electric field on the analgesic effect of patients with lumbar disc herniation and its influence on IL-1β and TNF-α / 中国骨伤

OBJECTIVE@#To observe the analgesic effect of lever positioning manipulation combined with pulsed electric field on patients with lumbar disc herniation and the influence on serum IL-1β and TNF-α.@*METHODS@#From January 2018 to March 2019, 58 patients with lumbar disc herniation were included in the study, which were randomly divided into observation group and control group by digital table method. Observation group of 29 cases, including 16 males and 13 females, aged (38.03±11.29) years old, were treated with lever positioning manipulation combined with pulsed electric field. The 29 cases in control group, including 17 males and 12 females, aged (38.21±9.16) years old, were treated with pulsed electric field. Both groups of patients were treated 3 times a week, once every other day, 3 times as a course of treatment. After 2 courses of treatment, the two groups of patients were scored before and after treatment by the numeric rating scales (NRS);at the same time, the serum levels of IL-1β and TNF-α were measured before and after treatment.@*RESULTS@#The NRS scores of observation group and control group were 4.21±1.76, 4.66±1.61 before treatment, and 1.28±0.84, 2.10±1.35 after treatment, respectively. The NRS scores of the observation group after treatment was significantly lower than that of the control group (@*CONCLUSION@#The lever positioning manipulation combined with pulsed electric field has a good analgesic effect on patients with lumbar disc herniation, and it has a significant impact on the patient's serum IL-1β and TNF-α concentration, which can be used as a clinical guide. However, the synergistic effect of lever positioning technique combined with pulsed electric field and guidelines for clinical treatment need further research.

Closed manipulative reduction and external fixation with cardboard splint for the treatment of Monteggia fracture / 中国骨伤

OBJECTIVE@#To explore clinical efficicacy of closed manipulative reduction and external fixation with cardboard splint in treating Monteggia fracture.@*METHODS@#Fifty-eight children with Monteggia fracture were underwent closed manipulative reduction and external fixation with cardboard splint from January 2010 to Junuary 2018. Among them, including 37 males and 21 females, aged from 3.5 to 12 years old with an average of (8.48±2.29) years old;the courses of disease ranged from 0.5 hours to 9 days with an average of (4.21±1.46) days. Broberg and Morrey scores before treatment, 1, 3 and 6 months after treatment were used to evaluate clinical effects.@*RESULTS@#All children were followed up from 1 to 6 months with an average of (3.35±2.12) months. Broberg and Morrey score (7.24±2.81) before treatment, (32.06 ±8.33) at 1 month after treatment, (73.18±5.56) at 3 months after treatment and (95.87±6.75) at 6 months after treatment; there were statistical differences at each time points after treatment with before treatment (@*CONCLUSION@#Treatment of Monteggia fractures with closed manipulative reduction and external fixation with cardboard splint could reach integration of motion and quietness, also could remove external fixation at early stage, and get obvious short-term and medium-term therapeutic results.

Evaluation of therapeutic effects of the ultramicro needle knife combined with cervical spine fine adjusting on youth cervical curvature abnormality case / 中国骨伤

OBJECTIVE@#To study the therapeutic effects of the ultramicro needle-knife combine with cervical spine fine adjusting on youth cervical curvature abnormality case.@*METHODS@#From November 2016 to October 2018, 88 young patients with abnormal curvature of cervical spine were treated. Due to loss of follow up, 86 cases were actually completely including 37 males and 49 females, ranging in age from 20 to 40 years old, with an average of (30.55±5.21) years old, and the course of disease ranged from 1 to 42 months, with a mean of (14.21±7.38) months. All the patients were divided into two groups:treatment group (44 cases) and control group (42 cases). The patients in the treatment group were treated with ultramicro needle-knife and cervical spine fine adjusting, and the patients in the control group were treated with conventional acupuncture and manipulation. The treatments were done 1 time per week in the treatment group while 3 times per week in control group every week, with a duration of 3 weeks for both groups. Before treatment, 3 weeks after treatment, and at the end of 1 month follow-up, the score of neck pain questionnaire(NPQ), range of the motion(ROM) in the cervical region and the D values of cervical physiological curvature were recorded. The efficacy at the end of treatment and in the follow up was evaluated. During the treatment, the patients were also required to correct the bad posture in daily life, to sleep in a low pillow position, and put a moderately columnar pillow behind the neck for 0.5 hours every morning and evening.@*RESULTS@#Two patients in the control group were dropped out after 3 weeks treatment. No adverse reactions were found in the 2 groups during the treatment period. Compared with those before treatment, all scores at all the observation time points were significantly improved between two groups after treatment(all 0.05). There was statistical difference in ROM scores between different time points, there was time effect (=240.32), =0.000). There was no interaction between time factor and group factor (=0.311, =0.734). The effective rate of the treatment group and control group were 90.91%(40 / 44) and 80.95%(34 / 42) respectively, the treatment group was more effective than the control group (0.05) in the follow-up duration.@*CONCLUSION@#The method of needle knife combined with cervical spine fine adjusting has a better therapeutic efficiency than conventional acupuncturecombined with manipulation in treating youth cervical curvature abnormality patients. Because this novel method can recover the cervical curvature, relieve the neck pain, and improve cervical mobility.

Back arm flexion and extension combined with manipulation for the treatment of patient with adhesive scapulohumeral periarthritis / 中国骨伤

OBJECTIVE@#To observe clinical efficacy of back arm flexion and extension combined with manipulation in treating adhesive scapulohumeral periarthritis.@*METHODS@#From March 2016 to April 2018, 53 patients with adhesive scapulohumeral periarthritis were treated with back arm flexion and extension combined with manipulation, the main symptoms were shoulder pain and limited activity. There were 22 males and 31 females aged from 45 to 71 years old with an average of (51.63±5.79) years;the courses of disease ranged from 3 to 24 months with an average of (8.62±3.73) months. Manipulation treatment was carried out once a week, and back arm flexion and extension were performed for 3 times a day with15 movements each time, totally 4 weeks for a single course. Visual analogue scale (VAS) and Constant-Murley shoulder function score were observed and compared before treatment and one week, one and three months after treatment.@*RESULTS@#All patients were followed up from 3 to 12 months, with an average of (5.91±3.55) months. VAS score before treatment was 4.02±1.46, and was improved to 3.15±1.54, 1.98±1.37, 1.12±0.86 respectively at one week, one and three months after treatment. Constant-Murley score before treatment was 42.70 ±5.72, and improved to 54.25 ±6.34, 67.45 ±6.84, 82.40 ±6.63 at one week, one and three months after treatment respectively;19 patients got excellent result, 22 good, 9 fair and 3 poor.@*CONCLUSION@#Back arm flexion combined with manipulation for the treatment of adhesive scapulohumeral periarthritis could effectively relieve pain, improve shoulder function, which is a simple effective treatment strategy.

Clinical effect of manipulation therapy for the treatment of degenerative lumbar instability based on myofascial chain theory / 中国骨伤

OBJECTIVE@#To explore clinical effects of manipulation therapy in treating degenerative lumbar instability based on myofascial chain theory.@*METHODS@#Fifty-seven patients with degenerative lumbar spine instability were analyzed retrospectively from January 2018 to December 2019, and treated with massage manipulation therapy. Among them, 29 patients were treated with massage manipulation therapy based on the myofascial chain theory (myofascial chain group), including 14 males and 15 females, aged from 40 to 69 years old with an average of (51.76±5.07) years old, the courses of disease was (3.4±1.6) years. Twenty-eight patients were treated with massage manipulation therapy based on TCM meridian theory (TCM meridian group), including 12 males and 16 females, aged from 42 to 70 years old with an average of(52.48±4.31) years old, the courses of disease was (3.3±1.7) years. Before treatment, after treatment, 1 and 3 months after treatment, visual analogue scale (VAS) was used to evaluate pain degree of lumbar, Japanese Orthopaedic Association (JOA) and modified Oswestry Disability Index (ODI) were used to assess improvement of lumbar function, and changes of lumbar muscle tension were used to evaluate clinical effect.@*RESULTS@#VAS score, JOA score, modified ODI score and lumbar muscle tension after treatment were significantly improved than those of before treatment between two groups (@*CONCLUSION@#Manipulation therapyon in treating degenerative lumbar instability based on myofascial chain theory could effectively relieve low back pain symptom and improve lumbar function. It is worthy of promoting.

Finite element analysis of bending and standing manipulation in the treatment of lumbosacral joint disorder / 中国骨伤

OBJECTIVE@#To analyze the displacement, stress and mechanism of lumbosacral joint disorder patients after bending and standing manipulation in the finite element model.@*METHODS@#A three-dimensional finite element model of a patient with lumbosacral joint disorder was established. The finite element analysis method was used to observe and analyze the three loading conditions of the model:axial, 34 degree inclined upward and vertical upward.@*RESULTS@#In the lumbosacral joint disorder model, the L₅ vertebral body was concentrated in the middle of the lower endplate, the intervertebral disc was concentrated in the center of the intervertebral disc, and the stress of S₁ and related structures were concentrated in the anterior and posterior edges of the vertebral body. After simulated manipulation, stress mainly concentrated in the anterior, posterior and central circular areas of L₅ vertebral upper endplate. The posterior structures of vertebral body concentrated in the ventral part of pedicle, isthmus and dorsal part of lamina. The stress of intervertebral disc dispersed in the posterior edge of vertebral body. Displacement results:In the lumbosacral joint disorder model, the left transverse process, the upper and lower articular process and the left part of spinous process were significantly displaced to the left, and the intervertebral disc was protruded forward. After simulated manipulation, the lower notch of L₅ vertebral body moved forward and upward; the area of intervertebral foramen increased; the inferior articular process of L₅ vertebral body moved forward; the superior articular process of sacrum moved forward and downward; the distance of articular process joints increased; and the displacement of sacrum concentrated on the posterior edge of vertebral body and the median sacral crest.@*CONCLUSIONS@#Successful lumbosacral joint modeling can be carried out by finite element analysis, and the mechanism of bending and erecting manipulation is clear, which is effective and safe for the treatment of lumbosacral joint disorders.

Comparison of the effect of operation and manipulation reduction on ankle fracture / 中国基层医药

Objective@#To compare the clinical effect of operation and manual reduction in the treatment of ankle fracture and provide guidance for clinical practice.@*Methods@#From March 2015 to March 2018, 88 cases of ankle fracture who admitted and treated in the People's Hospital of Xianju County were selected as the observation objects.Forty-eight patients in the operation group were treated with surgery.Forty cases in the manipulation group were treated by manipulation reduction.The two groups were followed up for half a year, and the rate of excellent and good reduction, hospitalization time, hospitalization cost, fracture healing time, excellent and good recovery rate of ankle joint function, ankle joint function score and incidence of complications were compared between the two groups.@*Results@#The positive and negative rate of reduction in the operation group was 93.75%(45/48), which was higher than 75.00%(30/40) in the manipulation group(χ2=6.092, P<0.05). The length and cost of hospitalization in the operation group were (17.56±3.12)d, (14 265.56±1 543.78)CNY, respectively, which in the manipulation group were (6.42±2.25)d, (2 565.56±487.69)CNY, respectively.There were statistically significant differences between the two groups(t=18.856, 46.019, all P<0.05). The healing time of fracture in the operation group was (9.12±1.25)weeks, which was shorter than that in the manipulation group[(11.56±2.36)weeks](t=6.200, P<0.05). There was no statistically significant difference in ankle function score between the two groups(P>0.05). The excellent and good rate of ankle function recovery in the operation group was 95.83%(46/48), which in the manipulation group was 92.50%(37/40), there was no statistically significant difference(P>0.05). The incidence rate of complications in the operation group was 14.58%(7/48), which was higher than that in the manipulation group [2.50%(1/40)](χ2=3.855, P<0.05).@*Conclusion@#The treatment of ankle fracture by operation and manual reduction has good results, both of which have advantages and disadvantages.The treatment cost of manual reduction is less than surgery, and the length of hospitalization is shorter than surgery.However, the fracture healing time is long, and a reasonable treatment plan can be developed in combination with the patients' condition and family economy.

Comparison of the effect of operation and manipulation reduction on ankle fracture / 中国基层医药

To compare the clinical effect of operation and manual reduction in the treatment of ankle fracture and provide guidance for clinical practice.Methods From March 2015 to March 2018,88 cases of ankle fracture who admitted and treated in the People＇s Hospital of Xianju County were selected as the observation objects.Forty-eight patients in the operation group were treated with surgery.Forty cases in the manipulation group were treated by manipulation reduction.The two groups were followed up for half a year ,and the rate of excellent and good reduction,hospitalization time, hospitalization cost , fracture healing time, excellent and good recovery rate of ankle joint function,ankle joint function score and incidence of complications were compared between the two groups . Results The positive and negative rate of reduction in the operation group was 93.75%(45／48),which was higher than 75.00%(30／40) in the manipulation group(χ2 ＝6.092,P＜0.05).The length and cost of hospitalization in the operation group were (17.56 ±3.12)d,(14 265.56 ±1 543.78)CNY,respectively,which in the manipulation group were (6.42 ±2.25) d, ( 2 565.56 ±487.69) CNY, respectively.There were statistically significant differences between the two groups(t＝18.856,46.019,all P＜0.05).The healing time of fracture in the operation group was (9.12 ±1.25)weeks,which was shorter than that in the manipulation group [(11.56 ±2.36)weeks](t＝6.200,P＜0.05).There was no statistically significant difference in ankle function score between the two groups (P＞0.05).The excellent and good rate of ankle function recovery in the operation group was 95.83%(46／48),which in the manipu-lation group was 92.50%(37／40),there was no statistically significant difference (P＞0.05).The incidence rate of complications in the operation group was 14.58%(7／48), which was higher than that in the manipulation group [2.50%(1／40)] (χ2 ＝3.855,P＜0.05).Conclusion The treatment of ankle fracture by operation and manual reduction has good results,both of which have advantages and disadvantages.The treatment cost of manual reduction is less than surgery,and the length of hospitalization is shorter than surgery.However,the fracture healing time is long, and a reasonable treatment plan can be developed in combination with the patients ＇condition and family economy.

Treatment of anterior glenohumeral dislocations with manual reduction of WU medical school / 中国骨伤

OBJECTIVE@#To investigate the technique, mechanism and clinical efficacy of manual reduction of WU medical school in the treatment of anterior glenohumeral dislocations.@*METHODS@#From January 2016 to December 2017, 181 patients with anterior glenohumeral dislocations were treated with our manual reduction, including 71 males and 110 females, ranging in age from 19 to 94 years old, with a mean age of(61.1±16.3) years old; 68 cases of subglenoid type, 93 cases of subcoracoid type and 20 cases of subclavian type. Constant score was used to evaluate limb function while the external fixation was removed.@*RESULTS@#One hundred and fifty-seven patients achieved reduction at the first attempt and 23 patients achieved at the second time. There was no vascular damage, nerve damage or iatrogenic fracture accmpanied. The Constant score ranged from 75 to 100, with a mean score of 92.1±4.3. One hundred and sixty-eight patients were followed up, and the duration ranged from 12 to 24 months, with an average of (16.1±3.2) months, no recurrent dislocation occurred during the follow up period.@*CONCLUSIONS@#The manual reduction of WU medical school in the treatment of anterior glenohumeral dislocations has high success rate and low complication rate, which is scientific, safe, standardized, easy to learn and worth promoting.

Case-control study on the treatment of heel spur syndrome with modified stretching manipulation combined with needle Dao loosing / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical effects of modified plantar fascia stretching manipulation combined with needle Dao loosing in the treatment of heel spur syndrome.</p><p><b>METHODS</b>From September 2010 to September 2015, 115 patients diagnosed as heel spur syndrome were divided into two groups: treatment group and control group. There were 58 patients in the treatment group, including 21 males and 37 females, ranging in age from 26 to 73 years old, with the course of disease from 6 to 51 months. The patients in the treatment group were treated with modified plantar fascia stretching manipulation combined with needle Dao loosing. There were 57 patients in the control group, including 22 males and 35 females, ranging in age from 31 to 75 years old, with the course of disease from 7 to 58 months. The patients in the control group were treated with traditonal stretching manipulation combined with needle Dao loosing. The NRS scores of heel pain were evaluated at the 1st week, 1 and 3 months after treatment; and the clinical effects of the two groups were evaluated with the Foot and Ankle Ability Measure(FAAM) scale evaluation system.</p><p><b>RESULTS</b>The numerical rating scale(NRS) scores were 3.89±0.96 and 2.46±0.95 in the treatment group 1 month and 3 months after treatment, which were superior to 4.52±1.21 and 4.73±1.11 in the control group; and the FAAM rates in the treatment group were (3.89±0.96)% and(2.46±0.95)% separately 1 month and 3 months after treatment, which were better than (4.52±1.21)% and (4.73±1.11)% in the control group. The total curative effects of the treatment group were better than that of the control group.</p><p><b>CONCLUSIONS</b>The modified plantar fascia stretching manipulation combined with needle Dao loosing can locate the traction point, which has a significant effect on the patients with heel spur syndrome. Compared with traditonal stretching manipulation combined with needle Dao loosing, this modified mainpulation combined with needle knife loosing has better medium to-long term effects.</p>

Ketamine sedation for orthopedic procedures in a high complexity emergency service: a descriptive study / Sedación con ketamina para procedimientos ortopédicos en un servicio de urgencias de alta complejidad. Un estudio descriptivo

Abstract Introduction: Rapid recovery and low cost are among the benefits of ketamine for emergency sedation. It has been excluded as the first choice because of the associated adverse events. Objective: To describe the adverse events associated with the use of ketamine in a high-complexity emergency service. Materials and methods: Review of clinical records of patients who received sedation with ketamine for orthopedic procedures in the emergency room between January 2012 and June 2015, with identification of adverse events. Results: Overall, 354 patients were identified (74% males, 32% children), with a median age of 21 years, interquartile range (IQR) of 20 years. Of them, 66% had upper limb injuries, 79% were treated on an outpatient basis, with a median length of stay in the emergency service of 3.6hours (IQR 2,5). In 98%, sedation was given by a different practitioner from the orthopedic surgeon. Ketamine and midazolam were administered together in the same proportion, and 3 or more medications were used in 13% of cases. Overall, 14 adverse events (3.9%) were described, 9 related to desaturation between 80% and 90% which was solved with oxygen through nasal cannula, 3 were cases of vomiting following sedation with no aspiration, and 2 were cases of desaturation <80% which were managed with oxygen administration through a cannula and maneuvers to maintain airway patency. One patient had visual hallucinations. No patient required advanced airway maneuvers. Conclusion: The use of ketamine for sedation in the emergency service is associated with a low prevalence of major adverse events. Sedation with ketamine and midazolam appears to be a safe strategy for these procedures.

Resumen Introducción: La ketamina para sedación en urgencias tiene beneficios tales como recuperación rápida y bajo costo. Se ha excluido como primera opción por sus eventos adversos. Objetivo: Describir los eventos adversos relacionados con el uso de ketamina en un servicio de urgencias de alta complejidad. Materiales y métodos: Se revisaron historias clínicas de pacientes que recibieron ketamina en urgencias para sedación en procedimientos ortopédicos entre enero de 2012 y junio de 2015, identificando eventos adversos. Resultados: Se identificaron 354 pacientes, (74% hombres, 32% niños), con una mediana de edad de 21 años, rango intercuartílico (RIQ) de 20 años. 66% con lesiones del miembro superior, 79% tratados ambulatoriamente con una mediana de estancia en urgencias de 3,6 horas (RIQ 2,5). En el 98% la sedación fue realizada por un médico diferente al ortopedista. En la misma proporción se administró ketamina y midazolam conjuntamente, en 13% se utilizaron tres o más medicamentos. Se describieron 14 eventos adversos (3,9%), nueve correspondían a desaturación entre 80 y 90% resuelta con oxígeno por cánula nasal, tres casos de vómito después de la sedación sin broncoaspiración, y dos casos de desaturación <80% resuelta con oxígeno por cánula y maniobras para permeabilización de la vía aérea. Hubo alucinaciones visuales en un paciente. Ning un paciente requirió maniobras avanzadas para la vía aérea. Conclusiones: El uso de ketamina para sedación en urgencias tiene una baja prevalencia de eventos adversos mayores. La sedación con ketamina y midazolam, parece ser una estrategia segura en estos procedimientos.

Clinical study onDuhuo-Jisheng decoction combined with traditional manipulation for lumbar intervertebral disc herniation / 国际中医中药杂志

Objective To evaluate the efficacy of Duhuo-Jisheng decoction combined with traditional manipulation for the patients with lumbar intervertebral disc herniation.Methods A total of 126 patients with orthopedic inpatients were enrolled and divided into two group by random number table method: the treatment group (63 patients) and the control group (63 patients).The control group was treated with loxoprofen sodium dispersible tablets, while the treatment group was treated with Duhuo-Jisheng decoction and traditional manipulation. Both groups were treated for 2 courses. After treatment, the patients were evaluated by VAS. The clinical effect was evaluated by Oswestry ODI.Results After treatment, the VAS scores (2.8 ± 0.3 vs. 3.5 ± 0.7, t=7.296) and ODI (10.5% ± 3 .2% vs. 15.5% ± 6.2%,t=5.688) in the treatment group were significantly lower than those in the control group. The time of symptoms relief (2.3 ± 0.5 dvs. 5.3 ± 0.7 d,t=27.681) and the time of symptoms disappearance (28.6 ± 5.7 dvs. 54.4 ± 8.2 d,t=20.506) in the treatment group were significantly less than those in the control group (both Ps<0.01). The total effective rate (95.2% vs. 87.3%) of the treatment group was significantly better than the control group (χ2=3.938,P=0.047). Team of the incidence of adverse reactions (14.2% vs. 41.2%) in the treatment group was significantly lower than that in the control group (χ2=10.128,P=0.002). Conclusions TheDuhuo-Jisheng decoction combined with traditional manipulation can alleviate the symptoms, shorten the treatment time, reduce adverse reactions for the patients with lumbar intervertebral disc herniation.

A study on the knee joint function recovery and the quality of life by the massage and manipulation combined external application of Chinese medicine for the patients after knee arthroscope surgery of osteoarthritis / 国际中医中药杂志

Objectives In order to evaluate the difference of the clinical effect of the knee joint function recovery and the quality of life by the massage and manipulation combined external application of Chinese medicine for the patients after knee arthroscope surgery of osteoarthritis. Methods A total of 160 hospitalized patients after knee joint arthroscope surgery of osteoarthritis from Tongchuan People's Hospital, Shanxi Tongchuan, were randomly divided into manipulation treatment group and control group. The manipulation treatment group revieved the manipulation combined with external application of Chinese medicineafter arthroscope surgery, and the control group received the regular massage combined with external application of Chinese medicine. Both groups were treated for two weeks. The WOMAC scale, ISOA scale and KPS rating scale were evaluated before and after treatment.The joint fluid IL-1β, TNF-α, the content of NO were detected before and after treatment of 3 months.Results After treatment,the WOMAC(21.26 ±13.16 vs.31.19 ± 12.67, t=8.967), ISOA (3.28 ± 1.52 vs. 6.45 ± 2.31, t=5.261) of the manipulation group were significantly lower than those of the control group(P<0.05);the KPS(88.26 ±7.42 vs.76.39 ±8.59,t=6.164)of the manipulation group was significantly higher than the control group (P<0.05); the TNF-α (21.31 ± 10.43 ng/ml vs. 28.29 ± 11.74 ng/ml, t=6.219), IL-1β (11.36 ± 4.22 pg/ml vs. 16.57 ± 6.44 pg/ml, t=5.645) of the manipulation group were significantly lower than the control group (P<0.05); the NO (33.15 ± 10.28 μmol/ml vs.34.22 ± 11.05 μmol/ml, t=1.364) of the manipulation group was higher than the control group without significance(P>0.05). Conclusions Manipulation combined with external application of Chinese medicine can reduce the content of joint fluid IL-1β, TNF-α, and the NO after knee joint arthroscope surgery of osteoarthritis, and can improve the function of knee joint, reduce pain, improve the quality of life.

Manipulative reduction and percutaneous Kirschner wire internal fixation for grade IV supination-external rotation ankle fractures / 中国骨伤

<p><b>OBJECTIVE</b>To investigate surgical skills and clinical effects of manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures.</p><p><b>METHODS</b>From May 2013 to October 2016, 35 patients with grade IV supination-external rotation ankle fractures were treated with percutaneous Kirschner wire internal fixation, involving 22 males and 13 females with an average age of 38.2 years ranged from 18 to 65 years old. The time from injury to operation ranged from 2 h to 10 d with an average of 5 d. Reduction quality was assessed by Burwell-Charnley radiological criteria. Baird-Jackson ankle scoring system was used to assess clinical effects.</p><p><b>RESULTS</b>Thirty-three patients were followed up from 10 to 28 months with an average of 14 months. Fracture healing time ranged from 10 to 18 weeks with an average of 12 weeks. According to Burwell-Charnley radiological criteria, 30 cases were obtained anatomic reduction, 3 cases moderate. According to Baird-Jackson ankle scoring system, total score was 93.8±5.4, 17 cases got excellent result, 12 good, 2 fair and 2 poor.</p><p><b>CONCLUSIONS</b>Manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures has advantages of reliable efficacy, less complications. But higher require techniques were required for closed reduction. It is not suitable for severe crushed fracture and compressive articular surface fracture.</p>

Research on the stability of teaching robots of rotation-traction manipulation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the stability of teaching robot of rotation-traction manipulation.</p><p><b>METHODS</b>Operators were required to get the hang of rotation-traction manipulation and had clinical experience for over 5 years. The examination and data processing of the ten operators in our research were collected by the teaching robot of rotation-traction manipulation. Traction, pulling force, maximum force, pulling time, rotational amplitude and pitch range were recorded and compared for five times(G1, G2, G3, G4 and G5). The qualification rates were analyzed to evaluate the stability of teaching robot of rotation-traction manipulation.</p><p><b>RESULTS</b>Nonconforming items were found in G1 and G2, for instance, pulling force(=0.074), maximum force(=0.264) and rotational amplitude (=0.531). There was no statistically difference. None nonconforming item was found in G3, G4 and G5. All data were processed by SPSS and One-way ANOVA was used to analysis. Pulling force was found statistically different in G1, compared with G4 and G5(=0.015,=0.006). Maximum force was found statistically different in G1, compared with G4 and G5 (=0.021,=0.012). None differences were found in other comparisons (>0.05).</p><p><b>CONCLUSIONS</b>The teaching robot of rotation-traction manipulation used in our research could provide objective and quantitative indices and was considered to be an effective tool of assessing the rotation-traction manipulation.</p>

Traditional manipulative reduction and percutaneous elastic intramedullary nail fixation for the treatment of proximal humeral fractures in children / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects and safety of traditional manipulative reduction and percutaneous elastic intramedullary nail fixation for the treatment of proximal humeral fractures in children.</p><p><b>METHODS</b>From October 2012 to May 2016, 65 patients with proximal humeral fractures were treated with traditional manipulative reduction and percutaneous elastic intramedullary nail fixation. There were 52 boys and 13 girls, ranging in age from 7 to 14 years old, with an average age of 11.2 years old. Twenty-three patients had injuries on the left side, and 42 patients had injuries on the right side. There were 13 cases of oblique fracture, 49 cases of transverse fracture, and 3 cases of comminuted fracture. All the patients had closed, obviously displaced fractures, without vascular and nerve injuries. The duration from injury to treatment ranged from 20 minutes to 5 days, with a mean of 3 days. The fracture healing and complications were observed after operation, and the curative effect was evaluated by Neer shoulder function score.</p><p><b>RESULTS</b>The operation time ranged from 30 to 40 minutes, with a mean of 35 minutes; intraoperative blood loss ranged from 5 to 10 ml, with a mean of 6.5 ml. All the patients were followed up, and the duration ranged from 12 to 28 months, with an average of 18 months. All the fractures healed. According to the Neer evaluation system, 59 patients got an excellent result, 5 good and 1 fair. Four patients had a small amount of secretions on the tail of the needle; 2 patients had skin irritation; 1 patient had partial withdrawal of the nail, and the skin in all the patients healed after taking out the nail. No patients had nonunion fractures due to the broken nails and loosen screws, and no vascular or nerve injuries occurred.</p><p><b>CONCLUSIONS</b>Traditional manipulative reduction and percutaneous elastic intramedullary nail fixation for the treatment of proximal humeral fractures in children has the advantages of less trauma, quicker recovery, less complications and simple operation.</p>

Application of mechanical measurement in assessment of neck pain and manual therapy / 中国骨伤

Manual therapy is one of the effective methods in treating neck pain. It has certain advantages in the short term to ease the symptoms of neck pain. In recent years, using different mechanical sensors and imaging equipment with computer software, the researchers found the difference of cervical activity between health adult and patients with neck pain. They also analyzed the kinematics, magnitude of force, stress and strain of the related structure and other mechanical parameters during cervical manipulation. These biomechanical researches revealed the functional anomaly caused by neck pain, reflect the safety of cervical manipulation, explain the abnormal stress of neck pain and the adjusting role of manipulation. Relatively speaking, these studies are too basic, and their analysis also are limited for the stress and strain about internal tissue. Study to aim directly at above problems will have important significance in understanding neck pain and standardizing manipulation therapy.

Randomized controlled trials of needle knife therapy combined with rotation traction manipulation for the treatment of cervical spondylotic radiculopathy / 中国骨伤

<p><b>OBJECTIVE</b>To compare the therapeutic effects between needle knife therapy combined with rotation traction manipulation and rotation traction manipulation for the treatment of cervical spondylotic radiculopathy.</p><p><b>METHODS</b>From November 2013 to June 2015, 80 patients with cervical spondylotic radiculopathy meeting the inclusion criteria were divided into two groups randomly:the control group in which 39 patients were treated with rotation traction manipulation, and the treatment group in which 41 patients were treated with needle knife combined with rotation traction manipulation. The patients in the control group were treated once dayly for 2 weeks, which was 1 course. The patients in the treatment group were treated with needle knife firstly once a week for 2 weeks, which was 1 course;then were treated with the same methods as the patients in the control group. The symptoms, signs score and the therapeutic effects of the two groups before and after treatment were observed.</p><p><b>RESULTS</b>After treatment, symptoms and signs scores declined in both groups(<0.05). The results of the treatment group were better than effects in the control group(<0.05). In the treatment group, 19 patients got an excellent result, 16 good, 5 fair and 1 bad;while in the control group, 10 patients got an excellent result, 10 good, 16 fair and 3 bad;the results of the treatment group were better than the results of the control group(<0.01).</p><p><b>CONCLUSIONS</b>Needle knife combined with rotation traction manipulation is an effective method for the treatment of cervical spondylotic radiculopathy, which is better than using manipulation method simply. Needle knife therapy has follow advantages:improving local blood circulation, reducing local content of pain substance, increasing production of substances resisting pain, opening channels and collaterals, and make body reaching new static and dynamic balance on the new foundation.</p>

Case control study on clinical effects of sacrococcygeal manipulation in the treatment of coccyx pain / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical efficacy of sacral manual therapy in the treatment of coccygodynia.</p><p><b>METHODS</b>From November 2013 to July 2015, 184 patients with sacrococcygeal pain were divided into treatment group and control group. There were 26 males and 65 females in the treatment group, with an average age of (39.63±11.62) years old. In the control group, there were 31 males and 62 females, with an average age of (41.47±11.56) years old. The patients in the treatment group were treated with sacrococcygeal massage therapy, 3 times a week for 2 weeks. The patients in the control group were treated with Diclofenac Diethylamine Emulgel, 2 times a day for 2 weeks. The VAS pain score, score in rating scale of sacrococcygeal pain and degree of tenderness were obtained on the first day of treatment, 2, 7, 14 days and 3 months after treatment to evaluate clinical results.</p><p><b>RESULTS</b>When comparing the VAS pain score of sacrococcygeal pain within the two groups, the differences began to reach statistical significance on the second day(<0.001). The chagne of VAS pain scores, the change of scores in rating scale of sacrococcygeal pain and the degree of tenderness in the treatment group were all significontly larger that those in the contral group from the second day.</p><p><b>CONCLUSIONS</b>The curative effect of sacral manipulation group is better than that of Diclofenac Diethylamine Emulgel group in the treatment of sacrococcygeal pain.</p>

Clinical study on Huayu-Zhentong capsule combined with traditional manipulation for after operation of lumbar intervertebral disc herniation / 国际中医中药杂志

Objective To evaluate the efficacy of Huayu-Zhentong capsule combined with traditional manipulation in patients with inflammatory cytokines after operation of lumbar intervertebral disc herniation.Methods A total of 80 patients with orthopedic inpatients were enrolled and divided into two group by random number table method:a treatment group (40 patients) and a control group (40 patients).On this basis,the control group was added to loxoprofen sodium dispersible tablets,the treatment group was added to Huayu-Zhentong capsule.2 groups were continuous treated for 2 courses.Flow cytometry was used to detect the level of IL-8 and IL-6 before and after treatment,and the patients were evaluated by VAS.The clinical efficacy was evaluated by Oswestry ODI.Results After treatment,the VAS score (2.22 ± 0.31 vs.3.54 ± 0.67,t=11.309) and ODI (10.51 ± 3.22 vs.15.54 ± 6.21,t=4.548) of the treatment group were decreased than the control group (both P＜0.01).Lymphocyte IL-6(0.58％ ± 0.20％ vs.0.84％ ± 0.32％,t=4.358),IL-8(0.41％ ± 0.11％ vs.0.61％ ± 0.20％,t=5.542),mononuclear cells IL-6(25.31％ ± 4.26％ vs.29.19％ ± 5.32％,t=3.604),IL-8(17.80％ ± 2.81％ vs.3.31％ ± 3.77％,t=7.411) of the treatment group were lower than the control group (all P＜0.01).The total effective rate (100％ vs.75.0％) of the treatment group was better than the control group (x2=9.257,P=0.002).Conclusions Huayu-Zhentong capsule combinated with traditional manipulation can reduce inflammatory cytokines IL-6 and IL-8 levels in patients with LIDH.Its curative effect is better than traditional manipulation with loxoprofen sodium dispersible tablets.