Manipulative reduction and percutaneous pin fixation for the treatment of severely displaced distal tibial fractures in children / 中国骨伤

<p><b>OBJECTIVE</b>To study the therapeutic efficacy of manipulative reduction and percutaneous pin fixation for the treatment of severely displaced distal tibial fractures in children.</p><p><b>METHODS</b>From May 2009 to December 2012,56 children with severely displaced distal tibial fractures were analyzed, who had been treated with manipulative reduction and percutaneous pin fixation. Preoperative fractures were confirmed as severely displaced fractures by X-ray apparatus. There were 33 boys and 23 girls,ranging in age from 3 to 14 years, with an average of 10.1 years. All the fractures were closed without vascular or nerve injuries. According to the bone fracture type, under C-arm fluoroscopy, functional reduction was achieved by manipulative reduction. The fractures were fixed with percutaneous pins. Postoperative X-ray confirmed the functional reduction. Follow-up indexes were recorded: intra-operative and postoperative complications,postoperative radiographic examination, lower extremity length and range of ankle motion. Ankle score system of Teeny was used to evaluate ankle function.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 3 to 46 months, with an average duration of 19.4 months. According to the Teeny score standard, 35 patients got an excellent result, 7 good and 3 fair. Pin track reaction was found in 4 cases. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. All the patients could participate in the normal physical activities, having a normal range of motion and excellent strength of the ankle joint.</p><p><b>CONCLUSION</b>The method of manipulative reduction and percutaneous pin fixation is a safe and convenient treatment for severely displaced distal tibial fractures in children. It has several advantages as follow: micro-trauma, tiny tissue damage, firm fixation, and the patients can exercise the function of ankle early, suggesting that it is an effective treatment method.</p>

Treatment type C fracture of the distal radius with locking compression plate and external fixators / 中国骨伤

<p><b>OBJECTIVE</b>To compare efficacy of unilateral external fixators and locking compression plates in treating type C fractures of the distal radius.</p><p><b>METHODS</b>From January 2009 to June 2010, 76 patients with distal radius fracture were treated with LCP and external fixators, 54 patients were followed up. Among them, 29 cases were male and 25 cases were female with an average age of 45.31 (ranged, 24 to 68) years old. There were 29 patients in LCP group. According to AO classification, 8 cases were type C1, 7 cases were type C2 and 14 cases were type C3. There were 25 cases in external fixators group. According to AO classification, 6 cases were type C1, 8 cases were type C2 and 11 cases were type C3. Radial height, volar tilt and radial inclination were compared, advanced Gartland-Werley scoring were used to assessed wrist joint function after 6 and 12 months' following up.</p><p><b>RESULTS</b>Two cases were suffered from nail infection in external fixators group. Fifty-four patients were followed up from 12 to 24 months with an average of 21.3 months. Radial height was (9.60 +/- 0.72) mm, volar tilt was (9.55 +/- 0.80) degrees and radial inclination was (21.40 +/- 0.78) degrees in LCP group,while those were (9.40 +/- 0.70) mm, (9.47 +/- 0.71) degrees and (21.20 +/- 0.73) degrees in external fixtors group, and with no statistical significance (P>0.05). Advanced Gartland-Werley score after 6 months' following up was 3.31 +/- 1.17 in LCP group, 5.56 +/- 1.58 in external fixtors group, and with significant difference (t=-5.99,P<0.05); after 12 months' following up, advanced Gartland-Werley score was respectively 2.66 +/- 1.01 and 3.08 +/- 1.00, but with no statistical meaning (t=-1.55, P>0.05).</p><p><b>CONCLUSION</b>LCP and external fixtors can receive good curative effects in treating type C distal radius fracture, and LCP can obtain obviously short-term efficacy, while there is no significant difference between two groups in long-term results. For serious distal radius comminuted fracture which unable to plate internal fixation, external fixators is a better choice.</p>

Risk assessment of renal dysfunction caused by occupational lead exposure / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To assess the risk of renal dysfunction caused by occupational lead exposure through epidemiological investigation.</p><p><b>METHODS</b>The workers in a battery factory were selected as the subjects for the exposure and effect assessment. The occupational environmental monitoring data was collected and used to calculate the total external dose of lead. The relationship between external dose and internal dose of lead was analyzed. The external dose, blood lead (BPb) and urinary lead (UPb) were used as exposure biomarkers while the urinary N-acetyl-D-glucosaminidase (UNAG), and urinary albumin (UALB) were used as the effect biomarkers for the renal dysfunction caused by lead. Software of BMDS (BMDS 11311) was used to calculate BMD.</p><p><b>RESULTS</b>The external and internal does of lead was positively correlated (BPb: r = 0.466, P < 0.01; UPb: r = 0.383, P < 0.01). The levels of BPb, UPb in exposure group (654.03 microg/L, 143.45 microg/g Cr) were significantly higher than those in the control group (57.12 microg/L, 7.20 microg/g Cr), so were UALB, UNAG; in addition, all of them presented significant dose-response relationship. The BPb BMD of UALB, UNAG were 607.76, 362.56 microg/L respectively and the UPb BMD of UALB, UNAG were 117.79, 78.79 microg/gCr respectively.</p><p><b>CONCLUSION</b>Occupational lead exposure can cause renal dysfunction, which presents dose-response relationship; the risk assessment of renal dysfunction caused by occupational lead exposure is performed by BMD calculation of BPb and UPb.</p>

Genetic effects of workers occupationally exposed to mercury using three genetic end-points / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigating genetic effects of workers occupationally exposed to mercury (Hg).</p><p><b>METHODS</b>The peripheral lymphocytes from 20 workers exposed to mercury and 20 controls were measured with micronucleus test, comet assay, hrpt gene mutation test and TCR gene mutation test.</p><p><b>RESULTS</b>The mean micronuclei rate(MNR) and mean micronucleated cells rate(MCR) in 20 workers were (5.90 +/- 0.91) per thousand and (5.30 +/- 0.81) per thousand, respectively while MNR and MCR in controls were (1.50 +/- 0.47) per thousand and (1.30 +/- 0.31) per thousand respectively, The difference of MNR and MCR between workers and controls was very significant (P < 0.01). The mean tail length (MTL) of workers and controls were (3.16 +/- 0.31) and (0.99 +/- 0.07) microm, respectively. The mean tail moment (MTM) of workers and controls were 1.63 +/- 0.22 and 0.39 +/- 0.03, respectively, There was a significant difference in MTL and MTM between workers and controls(P < 0.01). When the average mutation frequencies (Mfs-hprt) of hprt and (Mfs-TCR) of TCR of workers were compared with those of controls, there were not significant difference (P > 0.05).</p><p><b>CONCLUSION</b>The results of the investigation indicated that the adverse genetic effects in workers occupationally exposed to mercury could be detected.</p>