Comparison of three methods of bone grafting in the treatment of thoracolumbar burst fracture / 中华创伤骨科杂志

Objective To compare and the advantages and disadvantages of 3 methods of bone grafting in the posterior treatment of thoracolumbar burst fracture.Methods A retrospective analysis was conducted of 258 thoracolumbar burst fractures treated with posterior short-segment fixation from March 2013 to March 2015 at Orthopedic Department One,Foshan Hospital of Traditional Chinese Medicine.Of them,87 were treated with transpedicular bone grafting (group A),87 with laminar and intertransverse process bone grafting (group B) and 84 with small joint turnover plus bone grafting (group C).The 3 groups were compared in terms of cobb angle,loss of correction,bony fusion,internal fixation failure,and Oswestry disability index (ODI).Results The 3 groups were comparable due to insignificant differences in the preoperative general data between them (P ＞ 0.05).The cobb angles in the 3 groups at one week after operation (4.9° ± 1.0°,4.8° ± 0.6° and 4.8° ± 0.6°) and at the final follow-up (6.1 o ± 1.5°,14.5° ± 3.7° and 15.3° ± 4.1 °) were significantly smaller than those before operation (27.5° ± 4.9°,27.6° ± 4.6° and 27.6° ± 4.2°) (P ＜ 0.05).The cobb angles in groups B and C at the final follow-up were significantly larger than those at one week after operation (P ＜0.05).At the final follow-up,both the cob angles and the loss of kyphoplasty correction in groups B and C were significantly larger than in group A (P ＜ 0.05).The fusion rate in group A (100％) was significantly larger than in group B (80.5％) and C (76.2％).There were no significant differences between the 3 groups in the rate of internal fixation failure (0,1.1％ and 2.4％) (x2 =2.108,P=0.348).The ODI for the 3 groups at 6 months after operation (28.5 ± 4.1,28.7 ± 3.9 and 28.8 ± 3.7) and at the final follow-up (10.7 ± 2.6,11.0 ± 2.7 and 11.4 ± 3.1) were all significantly lower than the preoperative values (94.3 ± 0.7,94.4 ± 0.9 and 94.4 ± 0.8) (P ＜ 0.001).In all the patients,the ODI at the final follow-up was significantly lower than that at 6 months after operation(P ＜ 0.001).Conclusions In the treatment of thoracolumbar burst fractures,all the posterior approach plus transpedicular bone grafting,posterolateral bone grafting and reversed bone grafting plus short segmental internal fixation can effectively restore vertebral height and result in a high rate of fusion.Although the latter 2 methods of bone grafting are effective,they may be disadvantageous in leading to long-term loss of vertebral height and kyphosis correction.

Comparison of reliability and reproducibility of three different classifications in pelvic fracture / 重庆医学

Objective To analyze the reliability and reproducibility of three different classification systems of Tile,Young Burgess and AO in pelvic fracture.Methods One hundred cases of pelvic fractures conforming to the inclusion standard and with intact imaging data were selected and classified according to these 3 classification methods by the orthopedic surgeons.The retyping was performed at 8 weeks after disorganizing the order.Then reliability and reproducibility analysis was performed by using the Kappa values and typing consistency.Results The reliability Kappa values during the two periods before and after the Tile classification were 0.743 and 0.745 respectively,and the reproducibility Kappa value was 0.771;the reliability Kappa values during the two periods before and after the Young-Burgess classification were 0.587 and 0.590 respectively,and the reproducibility Kappa value was 0.691;the reliability of Kappa values during the two periods before and after the OA classification were 0.402 and 0.406 respectively,and the reproducibility Kappa value was 0.498.Conclusion the Tile classification has better reliability and reproducibility than the other two classifications in pelvic fracture,which is easy to master and apply.

Influence of early involvement of rehabilitation treadmill on function recovery after total hip arthoroplasty / 医疗卫生装备

Objective To observe the influence of early involvement of rehabilitation treadmill on hip function and daily life after total hip arthroplasty (THA).Methods Totally 80 patients receiving THA in Foshan Hospital of Traditional Chinese Medicine from January 2013 to January 2016 were randomized into a trial group (40 cases) and a control group (40 cases).The control group underwent conventional rehabilitation treatment such as training of muscle strength,joint motion and daily life,and the trial group applied rehabilitation treadmill for early training besides above measures.The two groups were compared on Harris score,Barthel scaore and re-visiting rate at the time points of 1,3 and 6 months after THA.Results Follow-up was carried out for the two groups.Harris scores and Barthel scores of the two groups were significantly enhanced 3 and 6 months after THA (P＜0.05).Harris scores in the trial group were (83.08±2.38) and (88.05±2.54) respectively 3 and 6 months after THA,which were statistically higher than (69.03±2.39) and (74.85±3.39) of the control group.Barthel scores in the trial group were (79.25±3.31) and (90.25+2.25) respectively 3 and 6 months after THA,which were obviously higher than (75.13±3.10) and (84.88±3.84) in the control group.The trial group had the re-visiting rate (17.5％) significantly higher than that (37.5％) in the control group 6 months after THA (P＜0.05).Conclusion Early involvement of rehabilitation treadmill combined with conventional training promotes the recovery of hip function,lower limb muscle strength,walking ability and daily life,while decreases the re-visiting rate of the patient.

Effects of Shangke Huangshui Gauze on postoperative knee joint function in patients following total knee arthroplasty / 中成药

AIM To observe the effects of Shangke Huangshui Gauze (Scutellariae Radix,Coptidis Rhizoma,Phellodendri chinensis Cortex,etc.) on postoperative knee joint pain,swelling degree and functional recovery in patients following total knee arthroplasty (TKA).METHODS Eighty patients receiving TKA and routine care in Foshan Hospital of Traditional Chinese Medicine (FHTCM) from 2015.1 to 2016.1 were randomly and equally divided into observation group and control group.The patients in the observation group were given external use of Shangke Huangshui Gauze.The swelling degree,the score of VAS,and the score of HSS in the two groups were compared.RESULTS On the 7th,14th and 30th days after the surgery,the swelling degree in the observation group was lower than that in the control group.On the 7th,14th days,VAS scores in the observation group were significantly lower than those in the control group.In the 1st,3rd and 6th months after the surgery,patients in the two groups got higher HSS scores,but HSS scores in the observation group were significantly higher than those in the control group.All the differences had statistical significances (P ＜ 0.05).CONCLUSION The long-term external use of Shangke Huangshui Gauze can effectively relieve postoperative pain and swelling,and improve knee joint function in patients following TKA.

Research progress of Chinese medicine treatment for chest contusion / 国际中医中药杂志

Chest contusion is the soft-tissue injury disorders that the external violence directly destroys the chest wall and the soft tissues, causing chest pain, fullness, and symptoms aggravate when the chest moves. Chinese medicine showed many treatments with clinical efficacy. Therefore, Chinese medicine has been widely used in clinics. This paper was to review the research progress of Chinese medicine treatment for chest contusion.

Observations on the Efficacy of Multi-functional Fire Needling plus Auricular Plaster Therapy for Moderate to Severe Acne Vulgaris / 上海针灸杂志

Objective To investigate the clinical efficacy of multi-functional fire needling plus auricular plaster therapy for moderate to severe acne vulgaris.Methods One hundred and fifty patients with moderate to severe acne vulgaris were randomly allocated to treatment and control groups, 75 cases each. Both groups were first given bloodletting at Ear apex and Helix 4. Then the treatment group received multi-functional fire needling plus auricular plaster therapy and the control group, auricular plaster therapy alone. The symptom and sign score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the symptom and sign score in the two groups (P<0.01). There was a statistically significant post-treatment difference in the symptom and sign score between the two groups (P<0.05). The total efficacy rate and the cure and marked efficacy rate were 98.6% and 88.7%, respectively, in the treatment group and 93.2% and 60.8%, respectively, in the control group. There was a statistically significant difference in the cure and marked efficacy rate between the two groups (P<0.05).Conclusion Multi-functional fire needling plus auricular plaster therapy is an effective way to treat moderate to severe acne vulgaris.