Case-control study on therapeutic effects of elastic stable intramedullary nails in the treatment of stable and unstable fractures of femoral shaft in children / 中国骨伤

<p><b>OBJECTIVE</b>To investigate curative effects of elastic stable intramedullary nails in the treatment of stable and unstable fractures of femoral shaft in children and to guide its clinical application.</p><p><b>METHODS</b>From January 2008 to October 2010,44 children with femoral shaft fractures were treated,including 24 boys and 20 girls,ranging in age from 5 to 12 years, with an average of 7.4 years. Based on the fractures stable or not, the patients were divided into stable fractures group(group S) and unstable fractures group (group U). All the children received the same operation to fix broken femoral with elastic stable intramedullary nails and some children received traction or small splint protection after operation when reduction and fixation were considered unsatisfied or his/her weight beyond 30 kg. During the followed-up, the healing time, irritation of the soft tissue (ache, cyst, t al), malunion (angulation above 5 degree in X-ray), limb shortening or lengthening and excellent and good rate were observed.</p><p><b>RESULTS</b>All the patients were followed up,and the duration ranged from 5 to 19 months, with an average of 13 months. All the fractures were healed at the latest follow-up. The average healing time was 10.2 weeks (ranges, 8 to 14 weeks). The incidence rate of malunion was 23.8% in group U and the average angulation was 9 degree (6 to 12 degree), which was higher than those of patients in the group S (0%). The average healing time, limb shortening or lengthening, irritation of the soft tissue and the excellent and good rate between two groups had no significance differences, which were (10.6 +/- 1.3) vs. (9.9 +/- 1.2) weeks, 0 vs. 3 cases, 3 vs. 1 case and 2 vs. 4 cases respectively. In the group U, among 5 patients had malunion, 4 patients were not treated with traction or small splint protection,and the incidence was higher than those who were given traction or small splint protection.</p><p><b>CONCLUSION</b>Both the stable and unstable femoral shaft fractures in children treated with elastic stable intramedullary nails can receive well short-term curative effects. If given certain postoperative protection like as traction or small splint, the malunion incidence can be reduced.</p>

Successful short-segment fixation for thoracolumbar burst fractures using CYL-pedicle screw / 中华外科杂志

<p><b>OBJECTIVE</b>To access the efficacy of posterior short-segment fixation for single level thoracolumbar burst fractures without spinal injury using CYL-pedicle screw.</p><p><b>METHODS</b>From September 2007 to December 2009, 74 cases who underwent posterior short-segment fixation for single level thoracolumbar burst fractures (Denis burst fracture type A, B, C) without spinal injury were analyzed retrospectively. There were 53 male and 21 female, mean age was (39 ± 15) years. Neither of them treated with direct decompression, grafting or fusion. Changes in the anterior vertebral height ratio, vertebral wedge angle, Cobb angle, regional angle were measured preoperatively, postoperatively, before implant removal, and at final follow-up to find the statistic difference. Pain status and work status were evaluated using Denis criterion. The incidence of incision infection, screw breakage, iatrogenic spinal injury were recorded as well.</p><p><b>RESULTS</b>The time of follow-up was (20 ± 11) months, no significant change was noted in anterior vertebral height ratio and vertebral wedge angle (P > 0.05). A significant loss was noted in Cobb angle and regional angle, which were 9.8° ± 5.1° and 9.1° ± 4.8° respectively (t = 2.48 and 3.41, P < 0.05). Comparing with the patients with Cobb angle > 20°, the patients with Cobb angle ≤ 20° had better pain scale rate (χ(2) = 4.16, P = 0.04) and work scale rate (χ(2) = 24.34, P < 0.01). There were incision infection in 1 case, screw breakage in 1, screw loose in 1, and no iatrogenic spinal injury.</p><p><b>CONCLUSIONS</b>CYL-pedicle screw could be successfully used in posterior short-segment fixation for single level thoracolumbar burst fractures without spinal injury based on radiographic and clinic outcomes.</p>

Quintessence of academician SHI Xue-min's acupoint needling method / 中国针灸

Under guidance of the traditional theories of acupuncture and modern knowledge of anatomy and in combination with his long-term clinical practice and clinical researches, academician SHI Xue-min formulates scien tific and strict acupuncture methods and corresponding quantitative requirement for the acupoints for treatment of stroke and relative diseases and symptoms, including patient's posture, doctor's posture, angle of needle insertion, manipulation, amount of arrival of qi, etc. Correct grasping these needling methods of acupoints is a key to learn and understand SHI Xue-min's Acupuncture Science and "Xingnao Kaiqiao" needling method and quantitative acu puncture manipulation theory. In this paper, SHI Xue-min's partial experiences on needling acupoints are introduced.