Clinical Study on Traditional Chinese Medicine Bone-Setting Manipulations Combined with Minimally-Invasive Treatment and Intramedullary Plate Fixation for the Treatment of Moderate Hallux Valgus / 广州中医药大学学报

Objective To evaluate the clinical efficacy of Chevron minimally-invasive osteotomy and internal fixation with ISO intramedullary plate plus traditional Chinese medicine(TCM)bone-setting manipulations for the treatment of moderate hallux valgus.Methods A retrospective study was conducted.A total of 49 patients(62 feet)with moderate hallux valgus were treated with Chevron minimally-invasive osteotomy and internal fixation with ISO intramedullary plate,and were given TCM bone-setting manipulations before the operation,during the operation,and after the operation.The efficacy was evaluated by using the Visual Analogue Scale(VAS)score and the American Orthopedic Foot and Ankle Society(AOFAS)forefoot score after the operation.Before the operation and 12 months after the operation,the hallux valgus angle(HVA),intermetatarsal angle(IMA)between the first and second metatarsal bone,and the distal metatarsal articular angle(DMAA)showed by X-ray imaging in the weight-bearing position of the foot were recorded.Results(1)All of the 49 patients were followed up for 12 to 24 months,with a mean of(20.6±3.1)months.(2)The X-ray imaging assessment showed that 12 months after the operation,the mean HVA,IMA and DMAA values of the 49 patients(62 feet)were significantly lower than those before the operation,and the differences were all statistically significant(P＜0.01).(3)Twelve months after the operation,the pain VAS score of 49 patients was(3.14±1.21)points,which was significantly lower than the preoperative score points(7.26±2.52),and the difference was statistically significant(P＜0.01).(4)The assessment of joint function showed that 12 months after the operation,the scores of various AOFAS items of pain,function and hallux alignment as well as the overall AOFAS scores of 49 patients were significantly higher than those before the operation,and the differences were statistically significant(P＜0.01).(5)For the 62 feet in 49 patients,the excellent efficacy was achieved in 53 feet,good efficacy was achieved in 7 feet,and fair efficacy was achieved in 2 feet,with the fine rate of 96.77%(60/62).Conclusion For the treatment of moderate hallux valgus,the application of Chevron minimally-invasive osteotomy and internal fixation with ISO intramedullary plate plus TCM bone-setting manipulations is effective on promoting the reset of hallux-metatarsophalangeal joint,restoring the balance of the joint,and maintaining the equilibrium state of the joint through postoperative rehabilitation guidance.The combined therapy exerts certain efficacy,reduces the recurrence rate,and eventually achieves the early rehabilitation after the operation.

Stick-point Sinew-soothing and Bone-setting Manipulation for Scapulohumeral Periarthritis： a Randomised Controlled Trial / 中医杂志

ObjectiveTo explore the clinical effectiveness and safety of stick-point sinew-soothing and bone-setting manipulation for scapulohumeral periarthritis. MethodsUsing prospective randomised controlled trial method， 60 cases of patients with scapulohumeral periarthritis were collected and randomly divided into 30 cases each in control group and trial group. Both groups of patients were orally treated with celecoxib， on the basis of which the control group was treated with traditional bonesetting manipulation once every other day for 14 days， while the trial group was treated with stick-point sinew-soothing and bone-setting manipulation once every 3~5 days for 14 days. Both groups were treated for 2 courses. The main observation indexes were pain visual analogue scale （VAS） score and shoulder pain and dysfunction index （SPADI）， which were evaluated once before treatment and after 2 and 4 weeks of treatment. The secondary effectiveness indicators included the university of California at Los Angeles shoulder rating scale （UCLA）， traditional Chinese medicine syndrome score （including symptom scores as joint pain， pain in a fixed place， activity limitation， local stiffness）， and serum interleukin （IL-6） and tumour necrosis factor α （TNF-α） levels before and after the treatment， in order to evaluate the clinical effectiveness， and to record the adverse reactions that occurred in the process of diagnosis and treatment. ResultsCompared with the groups before treatment， the pain VAS score， SPADI and scores of joint pain， pain with a fixed place， activity limitation and local stiffness were lower， UCLA score was higher， and serum IL-6 and TNF-α levels were lower at 4 weeks of treatment in the two groups （P＜0.05）. When comparing the two groups between the groups at 2 and 4 weeks of treatment， the pain VAS score， SPADI and TCM scores of each symptom in the study group were lower than those in the control group， the UCLA score was higher than those in the control group （P＜0.01）， and the serum IL-6 and TNF-α levels were lower than those in the control group at 4 weeks of treatment （P＜0.01）. The clinical effectiveness rate of the study group was 66.67%， which was significantly higher than that of the control group， which was 40.00% （P = 0.038）. No adverse reactions were seen in both groups during the study. ConclusionCompared with the traditional massage manipulation， the treatment of scapulohumeral periarthritis with stick-point sinew-soothing and bone-setting manipulation has more advantages in relieving pain symptoms， reducing inflammatory reaction， and promoting the recovery of shoulder joint function.

Clinical study on the therapy for a herniated lumbar intervertebral disc with Wechsler's bone setting manipulation / 国际中医中药杂志

Objective:To evaluate the efficacy of Wechsler's bone setting manipulation in the treatment of lumbar disc herniation.Methods:A randomized controlled trial was carried out. 50 LDH patients from the Spinal Surgery Department of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine and the Ruikang Hospital Traditional Chinese Medicine Master Hall Affiliated to Guangxi University of Chinese Medicine were selected as observation subjects from January to November 2021. They were divided into two groups using a random number table method, with 25 patients in each group. The control group was treated with traditional bone setting techniques, while the observation group was treated with Wechsler's bone setting correction techniques. Both groups were treated for 3 weeks. VAS scale was used to evaluate the degree of lower back and leg pain, and the Japanese Orthopedic Association was used to evaluate treatment (JOA score) to evaluate lumbar function; the sacral tilt angle (SS), lumbar lordosis angle (LL), and coronal pelvic tilt angle values were measured on the lateral X-ray film of the entire spine; adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate of the observation group was 92.0% (23/25), and the control group was 68.0% (17/25), with statistical significance between the two groups ( χ2=4.50, P=0.034). The VAS score of the observation group after treatment was lower than that of the control group ( t=16.25, P<0.01); the JOA score was higher than that of the control group ( t=-29.39, P<0.01). The SS [(36.00 ± 1.87) ° vs. (34.16 ± 1.57) °, t=-10.64] and LL [(38.08 ± 2.60) ° vs. (34.96 ± 1.90) °, t=-10.04] in the observation group were higher than those in the control group ( P<0.01); the coronal pelvic tilt angle value [(0.47 ± 0.14) ° vs. (0.69 ± 0.14) °, t=42.57] was lower in the control group ( P<0.01). No adverse reactions occurred during the treatment period in both groups. Conclusion:Wechsler's bone setting manipulation can improve the pain symptoms of patients with LDH, and restore the spine pelvis biomechanical balance to a certain extent.

Immediate effect of small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation in improving the treatment of braces for adolescent idiopathic scoliosis / 针灸推拿医学（英文版）

Objective: To observe the immediate effect of small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation in improving the correction of braces for adolescent idiopathic scoliosis. Methods: A total of 50 cases of adolescent idiopathic scoliosis were selected and given brace correction first. The whole spine anteroposterior and lateral radiographs were taken, the Cobb angle was measured, and the visual analog scale (VAS) score of pain caused by brace wearing was recorded. After removal of the brace, small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation was performed once. After treatment, the same brace was put on again to take a whole spine anteroposterior radiograph, the Cobb angle was measured, and the VAS score was recorded. The changes in Cobb angle and VAS score after manipulation were compared, and the immediate efficacy was evaluated. Results: After the manipulation, the Cobb angle was significantly smaller than that before treatment (P<0.01) and the VAS score was significantly lower than that before treatment (P<0.01). Conclusion: Small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation can improve the immediate efficacy of brace in treating adolescent idiopathic scoliosis and relieve the pain caused by brace wearing at the same time.

Conservative treatment of supination and external rotation for type Ⅲ and Ⅳankle fracture by bone setting / 中国骨伤

OBJECTIVE@#To explore curative effect of conservative treatment of supination-lateral rotation (SER) with type Ⅲ and Ⅳ ankle fracture by bone setting technique.@*METHODS@#From January 2017 to December 2019, 64 patients diagnosed with SER with type Ⅲ and Ⅳ ankle fracture were treated with manipulative reduction and conservative treatment (manipulation group) and surgical treatment with open reduction and internal fixation (operation group), 32 patients in each group. In manipulation group, there were 17 males and 15 females, aged from 15 to 79 years old with an average of (51.42±13.68) years old;according to Lauge-Hansen classification, there were 8 patients with supination external rotation type Ⅲ and 24 patients with type Ⅳ. In operation group, there were 13 males and 19 females, aged from 18 to 76 years old with an average of (47.36±15.02) years old;7 patients with type Ⅲ and 25 patients with type Ⅳ. Displacement of ankle fracture was measured by Digimizer software, and compared before treatment, 3 and 12 months after treatment between two groups. Lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement were measured and compared between two groups. Mazur score was used to evaluate ankle joint function.@*RESULTS@#All patients were followed up from 12 to 36 months with an average of (17.16±9.36) months. There were statistical differences in lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement in manipulation group before and after reduction(P<0.05). Compared with operation group, there were no statistically significant differences in lateral malleolus shift, lateral malleolus shift, lateral malleolus contraction shift(P>0.05), while there were statistically significant differences in lateral malleolus shift, posterior malleolus shift up and down (P<0.05). Mazur scores of ankle joint at 3 months after treatment in manipulation group and operation group were 68.84±13.08 and 82.53±7.31, respectively, and had statistical differences(P<0.05), while there was no difference in evaluation of clnical effect(P>0.05). There were no differences in Mazur score and evaluation of clnical effect between two groups at 12 months after treatment (P>0.05).@*CONCLUSION@#Bone setting technique could effectively correct lateral displacement of medial malleolus, lateral displacement of medial malleolus, lateral displacement of lateral malleolus and lateral contraction displacement of lateral malleolus in supination lateral rotation type Ⅲ and Ⅳ ankle fracture, and has good long-term clinical effect, which could avoid operation for some patients and restore ankle function after fracture.

Clinical observation of sinew-regulating bone-setting manipulations plus exercise therapy for chronic non-specific low back pain / 针灸推拿医学（英文版）

Objective: To evaluate the clinical efficacy of sinew-regulating bone-setting manipulations plus exercise therapy in treating chronic non-specific low back pain (CNLBP). Methods: A total of 65 CNLBP patients were divided into two groups by the random number table method. Thirty-three cases in the treatment group were intervened by sinew-regulating bone-setting manipulations plus exercise therapy; 32 cases in the control group were intervened by medium-frequency electrotherapy plus exercise therapy. Before and after treatment, visual analog scale (VAS), dynamic and static muscle endurance of low back, median frequency (MF) of surface electromyography (sEMG) and Oswestry disability index (ODI) were used to evaluate the low back function. The therapeutic efficacy was estimated after treatment. Results: The two groups each had 2 dropouts during the study. The total effective rate was 90.3％ in the treatment group versus 66.7％ in the control group, and the between-group difference was statistically significant (P<0.05). After treatment, the VAS score, dynamic and static muscle endurance of low back, MF of sEMG and ODI score all changed significantly in both groups (all P<0.05); all the items in the treatment group were significantly different from those in the control group (all P<0.05). Conclusion: Sinew-regulating bone-setting manipulations plus exercise therapy can effectively release pain in CNLBP patients, increase muscle endurance of the low back and improve the quality of life, and its therapeutic efficacy is more significant than that of medium-frequency electrotherapy plus exercise therapy.

Treatment of displaced midshaft clavicle fracture with convolution method / 中国骨伤

OBJECTIVE@#To explore the clinical effects of convolution method in treating displaced midshaft clavicle fracture.@*METHODS@#From January 2018 to July 2019, 32 patients (21 males and 11 females) with displaced midshaft clavicle fracture were treated, ranging in age from 18 to 65 years old, with a median age of 41.5 years old. Nineteen patients had fractures on the left side and 13 patients had fractures on the right side. The duration from injury to treatment ranged from 30 minutes to 5 days. The patients were treated with convolution method and repeated push and rotation of the affected upper limb, followed by external fixation of clavicle band. The reduction and healing of the fracture and the functional recovery of shoulder joint were observed.@*RESULTS@#After operation, fracture reduction was evaluated by X ray film. Seven patients had an excellent result, 20 good and 5 fair. All the patients were followed up, and the duration ranged from 14 to 18 weeks. The mean Neer score was 89.75±6.88, which included pain score of 32.66±2.54, functional score of 26.44±2.91, range of motion score of 22.38±2.06, and anatomy score of 8.43±0.84;17 patients receive an excellent result, 14 good and 1 fair.@*CONCLUSION@#The rotation method combined with the repeated pushing and rotating of the upper limb of the affected side can well reduce the displaced fracture of the middle clavicle. Bandage and clavicle band can be performed after reduction. Functional exercise runs through the whole course of treatment. Functional recovery of shoulder joint is good and satisfactory therapeutic effect is achieved.

Treatment of acute avulsion of posterior cruciate ligament of left knee with bony fragment by Siddha Varmam therapy and traditional bone setting method

A 42-year-old man with the complaints of left knee swelling, severe pain, difficult to stand was reportedto Siddha Varmam division after a road accident. He was diagnosed as acute avulsion of Posterior cruciateligament (PCL). It was diagnosed based on the history of trauma, knee pain and swelling after trauma,positive posterior drawer test and avulsion fracture shown by radiograph. He was treated with SiddhaVarmam therapy and traditional bone setting. After a month of treatment, the PCL avulsion fracture gothealed without any surgical interventions and patient able to walk normally. This case report summarises the novel Siddha Varmam therapy and traditional bone setting treatments for acute avulsion of PCLwith bony fragment.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Treatment of knee osteoarthritis with six-step manipulation combined with extracorporeal shock wave / 中国骨伤

OBJECTIVE@#To observe the clinical effect of six-step manipulation combined with extracorporeal shock wave in the treatment of knee osteoarthritis.@*METHODS@#Seventy-six patients with KOA from December 2016 to June 2018 were divided into control group and treatment group, 38 in each group. The patients in the control group were treated with oral medicine combined with extracorporeal shock wave therapy, while the patients in the treatment group were treated with six-step manipulation combined with shock wave therapy. The VAS score, WOMAC score and clinical efficacy of the two groups were compared before treatment, 1 day, 1 month and 6 months after treatment.@*RESULTS@#There was no significant difference in VAS score and WOMAC score between the two groups before treatment(>0.05). VAS score and WOMAC score in treatment group were significantly lower than those in control group at 1 day, 1 month and 6 months after treatment, and the difference was statistically significant(<0.05).@*CONCLUSIONS@#Six-step manipulation combined with extracorporeal shock wave therapy can significantly alleviate pain and improve knee function in patients with knee osteoarthritis, and the clinical effect is obvious.

Kinematic parameters and related influencing factors of sitting lumbar spine manipulation with motion capture / 中国骨伤

OBJECTIVE@#To explore the influence of individual characteristics of patients on the kinematics parameters of sitting lumbar spine manipulation.@*METHODS@#From January 2016 to December 2016, 30 patients with degenerative lumbar spondylolisthesis were treatede, including 18 males and 12 females, aged from 45 to 61(52.33±2.34) years old, with a course of 2 to 72(29.13±3.23) months. Motion capture technique was used to measure the kinematics parameters of the same manipulator in sitting lumbar spine manipulation for 30 patients, including rotation time, maximum speed and maximum acceleration. The parameters of the left and right hands of the operator were different. The effects of individual characteristics on the kinematics parameters of sitting lumbar spine manipulation were analyzed.@*RESULTS@#The kinematic and mechanical parameters of manipulation were as follows:spin time, maximum speed, maximum acceleration, the manipulation done by right or left hand showed the similar parameters(>0.05). According to multivariate linear regression, there was a significant correlation between the age of the patient and the rotation time of the operator(<0.01); the height of patient had a significant correlation with the maximum speed and maximum acceleration of the operator(<0.01).@*CONCLUSIONS@#There is no difference between the manipulation of left and right hand in clinical application. Age and height are important influencing factors of sitting lumbar rotation manipulation.

Treatment of proximal humerus fractures combined with shoulder dislocation using bone setting manipulation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the treatment skill and clinical effect of bone setting manipulation in treating proximal humeral fracture with shoulder dislocation.</p><p><b>METHODS</b>From January 2015 to December 2015, 118 cases of proximal humeral fractures with shoulder joint dislocation were treated by bone setting reduction and fixation with adhesive tape or Kirschner wire after reduction, including 56 males and 62 females with an average age of 61 years old ranging from 48 to 88 years old. The time from injury to treatment was 1 to 31 days with an average of 3 days. All fractures were closed, according to Neer standard classification, there were 27 cases of type II, 55 cases of type III and 36 cases of type IV. There were 85 cases of shoulder subglenoid dislocation, 33 cases of subcoracoid dislocation. All the patients were accompanied by obvious shoulder joint deformity, dysfunction and other symptoms. All cases were diagnosed by X-ray examination, and the bone setting manipulation was performed under the brachial plexus anesthesia. According to the type of fracture and fixation method, the patients were encouraged to exercise the limb rehabilitation, and the curative effect was determined by Constant-Murley shoulder score system.</p><p><b>RESULTS</b>All cases were followed up for 6 to 12 months with an average of 9 months. There were 1 case of humeral head necrosis, 2 cases of traumatic frozen shoulder. The score of shoulder joint function Constant-Murley was 84.5±4.5; among them, 78 cases were excellent, 28 cases were good, 9 cases were fair, 3 cases were poor, the excellent and the good rate was 89.8%. X-ray showed bony union of all cases.</p><p><b>CONCLUSIONS</b>The treatment of proximal humeral fracture with dislocation of shoulder joint by bone setting manipulation is a skillful method, with simple operation, small trauma and satisfactory curative effect.</p>

Analysis of curative effect of traditional Chinese bone setting manipulation for the treatment of femoral neck fracture / 中国骨伤

<p><b>OBJECTIVE</b>To analysis the outcome of modified closure bone setting manipulation for the treatment of femoral neck fracture.</p><p><b>METHODS</b>From January 2012 to December 2012, 47 cases of femoral neck fracture were treated and included 25 males and 22 females with an average age of (44.58±10.32) years old ranging from 23 to 61 years old. All patients had a history of trauma, hip pain and movement limited, limb shortening extorsion deformity, X-ray showed fracture between femoral head and femoral neck basic. Among them, 32 cases were Garden type III and 15 cases were type IV. Patients were performed surgical treatment at 2 to 5 days after admission with 45 degrees abduction and extension position, internal rotation reduction, and 3 guide pins were inverted in a equilateral triangular structure of upside down arrangement. The postoperative recovery quality, fracture healing, femoral head necrosis and hip function were observed.</p><p><b>RESULTS</b>Operation time was 40 to 70 min, intraoperative bleeding was 20 to 50 ml. All patients received good reposition, and the intraoperative perspective was 12 to 25 times. Forty-five patients were followed up for 24 to 36 months, and 2 cases were lost. Fracture of 45 cases were got bony healing, 3 cases with partial necrosis of femoral head, both in the ARCO stage II. Twenty-four months after operation, Harris hip function score was 43.24±2.74 in pain, 42.82±1.95 in function, 3.72±0.45 in deformity, 2.77±0.52 in activity, 92.56±4.42 in total;the outcome was excellent in 39 cases, good in 4 cases, fair in 2 cases, without unbroken nails, infection, deep venous thrombosis, fracture and other complications.</p><p><b>CONCLUSIONS</b>Treatment of femoral neck fracture with the modified bone setting manipulation has an advantages of good effect, postoperative hip function recovery, curative effect.</p>

Lapidus operation combined with bone setting manipulation in treatment of hallux valgus in elderly patients / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of Lapidus operation combined with bone setting manipulation of traditional Chinese medicine in treating hallux valgus in elderly patients.@*METHODS@#From March 2013 to October 2017, 53 elderly patients (87 feet) with hallux valgus were treated with Lapidus operation combined with bone-setting manipulation of traditional Chinese medicine, including 12 males (18 feet) and 41 females (69 feet), ranging in age from 65 to 92 years old, with an average of (76.3±4.8) years old. Visual analogue scale(VAS) was used to evaluate the degree of relief of foot pain before and 26 months after operation. American Orthopaedic Foot and Ankle Society(AOFAS) was used to evaluate the function of foot pain. The changes of hallux valgus angle(HVA angle), interphalangeal angle (IMA angle) and metatarsal wedge angle(MCA angle) were compared on X-ray films.@*RESULTS@#All the patients were followed up, and the duration ranged from 12 to 42 months, with an average of(26.0±2.7) months. In all patients, the first metatarsal joint reached bone fusion within 6 to 8 months, with an average of 4.7 months. The preoperative VAS score was 8.06±1.44, which was significantly different from 2.14±1.98 at 26 months(<0.05). The preoperative AOFAS score was 53.90±7.89, which was significantly different from 92.80±2.78 at 26 months(<0.05). The HVA, IMA and MCA were significantly improved from preoperative(38.60±2.72)°, (21.90±1.91)° and(20.90±2.20)° to the latest follow-up(17.80±1.94)°, (9.70±2.56)° and(11.70±0.48)°(<0.05). According AOFAS score, 74 feet got an excellent result, 11 good and 2 fair.@*CONCLUSIONS@#Lapidus operation combined with bone-setting manipulation of traditional Chinese medicine on the treatment of hallux valgus foot in elderly patients has satisfactory clinical effects, shortens the time of osteotomy and fixation, protects the soft tissue around the osteotomy end and promotes the bone fusion on the most satisfactory position.

Treatment of 60 patients with temporomandibular joint dysfunction by manipulative reduction of cervical vertebrae combined with Pi needle release / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of manipulative reduction of cervical vertebrae combined with Pi needle release for the treatment of temporomandibular joint dysfunction.</p><p><b>METHODS</b>From March 2012 to May 2017, 60 patients with temporomandibular joint dysfunction were treated by manipulative reduction of cervical vertebrae with Pi needle release, including 26 males and 34 females, ranging in age from 18 to 60 years old, with an average of 32.5 years old. The courses of the disease ranged from 1 week to 5 years, with a mean duration of 3 months. The patients were followed up before and after treatment by maximum active opening of temporomandibular joint, joint clicking and comparison of visual analogue scale (VAS) pain scores.</p><p><b>RESULTS</b>All 60 patients were followed up, and the duration ranged from 6 to 24 months, with an average of 12 months. The maximum active opening of temporomandibular joint increased from(1.99±0.47) cm before treatment to(3.17±0.19) cm. The joint clicking decreased from 100% before treatment to(27.33±13.51)% after treatment. The VAS score decreased from 4.73±0.67 before treatment to 1.80±0.53 after treatment.</p><p><b>CONCLUSIONS</b>Treatment of temporomandibular joint dysfunction by manipulative reduction of cervical vertebrae combined with Pi needle release has such advantages as easy operation, obvious curative effect, short course of treatment, which is an effective method for the treatment of temporomandibular joint dysfunction.</p>

Treatment of distal radius fracture with manual reduction and external fixation with small splint steel support external fixation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the short-term result for the treatment of distal radius fracture with manual resetting and fixing with small splint.</p><p><b>METHODS</b>From January 2015 to December 2016, 60 cases of distal radial fractures were treated by manual resetting and small splint fixation including 39 males and 21 females with an average age of (43.50±10.56) years old ranging from 18 to 65 years old. According to AO classification, 38 cases were type A, 19 cases were type B, 3 cases were type C. The anteroposterior and lateral X-ray of the wrist joint was performed before reduction, 1, 2, 4 weeks after reduction, and the removal of the small splint, the palm inclination angle, ulnar deviation angle and radius height were measured. At 8, 24 and 48 weeks after reduction, the wrist extensor, palmar flexion, pronation, supination, ulnar deviation and radial deviation were measured. Wrist strength was measured at 4, 8, 24 and 48 weeks after fracture reduction. After the distal radius fracture healed, the splint support was removed. After dismantling small splint steel support, Mayo score of wrist joint was performed.</p><p><b>RESULTS</b>All cases of distal radius fractures were followed up, the healing time of fracture was 6 to 8 (7.1±0.9) weeks. The difference of palmar obliquity, ulnar deviation angle and radius shortening between before reduction and 2 weeks after reduction was statistically significant. There was no significant difference in palmar inclination, ulnar deviation and radius shortening between 2 and 4 weeks after reduction. After 24 weeks and 8 weeks, 48 weeks and 24 weeks after reduction, there was significant difference in wrist extensor, palmar flexion, pronation, supination, ulnar deviation and radial deviation. The grip strength was statistically significant between after reduction and 4 weeks after reduction, 8 weeks and 4 weeks after reduction, 16 weeks and 8 weeks after reduction, 24 and 16 weeks after reduction. There was no significant difference in grip strength between 48 weeks and 24 weeks after reduction. The Mayo wrist function scoring system was used to evaluate the curative effect, the results were excellent in 50 cases, good in 8 cases, fair in 1 case and poor in 1 case.</p><p><b>CONCLUSIONS</b>The treatment of distal radius fracture with the method of manual resetting and fixing with plywood is simple and the clinical efficacy is accurate.</p>

Case-control study on clinical effects of squeezing and clapping manipulation for treating the postpartum pubic symphysis separation / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical effect of squeezing and clapping bone setting manipulation in treating the postpartum pubis symphysis separation.</p><p><b>METHODS</b>From June 2015 to March 2017, 80 patients with postpartum pubic symphysis separation were randomly divided into treatment group and control group, 40 patients in each group. In treatment group, the patients' reproductive age ranged from 26 to 40 years old with an average of (30.61±5.94) years old and the neonatal weight ranged from 3.2 to 4.52 kg with an average of (3.59±0.13) kg. In control group, patients' reproductive age ranged from 22 to 37 years old with an average age of (27.51±4.57) years old and the neonatal weight ranged from 3 to 5.8 kg with an average of (3.81±0.63) kg. The patients in the treatment group were treated with the squeezing and clapping manipulation, once a week for 3 weeks. The patients in the control group were treated with pelvic bandage immobilization, and the immobilization of the pelvis was not less than 8 hours per day, 3 weeks for 1 course. The VAS pain score, Oswestry dysfunction index (ODI) and separation distance of pubis were clinical observed and evaluated on the first day of treatment, 1, 2, 3 weeks and 1 months after treatment.</p><p><b>RESULTS</b>The pubic symphysis VAS score was compared with that before treatment, in the treatment group, the difference was statistically significant at 1 week(0.013); the difference was statistically significant in the control group for 1 month (0.042). The two groups were less than those of the control group after treatment (<0.05). The ODI score was compared with that before the treatment, in the treatment group, the difference was statistically significant at 1 week (0.009), the difference was statistically significant in the control group for 1 month(0.013), the two groups were less than those before treatment(<0.05). The pubic symphysis distance was compared with that before treatment, the treatment group decreased significantly after treatment (<0.05), there was no significant difference in the control group after treatment (>0.05), the two groups were compared, the difference was statistically significant at first weeks(0.042) and third weeks (0.005).</p><p><b>CONCLUSIONS</b>The "squeezing and clapping" manipulation can quickly restore the distance between pubic symphysis separation, relieve local pain and improve lumbosacral function, and is better than pelvic bandage fixation treatment.</p>

Manual reduction and traction fixation for the treatment of metacarpal neck fractures under ultrasound-guided / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical efficacy of manual reduction and traction fixation for the treatment of metacarpal neck fracture under ultrasound-guided.</p><p><b>METHODS</b>From April 2013 to August 2016, 30 patients with metacarpal neck fractures were treated with manual reduction and traction fixation under ultrasound-guided, including 26 males and 4 females aged from 14 to 56 years old with an average of (25.6±1.6) years old, the courses of diseases ranged from 7 h to 5 d with an average of (2.7±0.6) d. Twenty patients were the fifth metacarpal neck fracture, 7 patients were the 4th and 5th metacarpal neck fractures, 3 patients were the second metacarpal neck fracture. Fracture healing, angle of bilateral head shaft angle and active range of metacarpophalangeal joints was measured, and DASH score was applied to evaluate function.</p><p><b>RESULTS</b>Twenty-seven patients were followed up from 6 to 11 months with an average of(7.2±0.8) months. Fracture were healed from 5 to 8 weeks with an average of (5.6±0.4) weeks. The affected shaft angle was (15.1±1.8)°, and health head shaft angle was (13.5±2.8)°, while there was no significant difference (=1.54, >0.05). The affected range motion of metacarpophalangealjoint was(86.3±2.6)°, health active range motion of metacarpophalangeal joint was(91.8±1.6)°, and no significant difference between both side (=1.16, >0.05). DASH score was 4.3±1.5 at 7 months after operation.</p><p><b>CONCLUSIONS</b>Manual reduction and traction fixation for the treatment of metacarpal neck fracture under ultrasound-guided could dynamic observe fracture position in time, high patients' acceptability and is a feasible method for the treatment of metacarpal neck fracture.</p>

Expert consensus on the comprehensive individualized protocol of Tuina therapy for knee osteoarthritis / 国际中医中药杂志

In order to form the expert consensus which researched on the comprehensive individualized protocol of Tuina therapy for Knee osteoarthritis, the preliminary protocol was summarized and formed by analyzing the interviews and published paper. And then the expert consensus method was applied for the protocols of Tuina therapy for KOA. After discussions, the consensus of three protocols according to the classification of KOA main symptomes was researched. In the protocols, 75％～80％ of the entries were considered as strong recommendation, and the others were weak recommended. Thus, it is believed that the comprehensive protocols for the treatment of KOA with different Tuina manipulations is feasible and reproducible after standardization.

Therapeutic Observation of Acupuncture, Chiropractic plus Functional Exercise for Postpartum Sacroiliac Malposition / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles in treating postpartum sacroiliac malposition.Method Forty patients with postpartum sacroiliac malposition were randomized into group A, group B, group C and group D, 10 cases in each group. Group A was intervened by acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles, group B by acupuncture plus chiropractic, group C by acupuncture plus functional exercise of lumbar and gluteal muscles, and group D by chiropractic plus functional exercise of lumbar and gluteal muscles. The four groups were intervened once every other day. The modified Oswestry Disability Index (ODI) score was observed before and after 5 treatment sessions, and the clinical efficacies in the four groups were compared.Result The total effective rates were 100.0% in the four groups, and the inter-group differences were statistically insignificant (P>0.05). The ODI scores in the four groups were significantly changed after treatment and in the 3-month follow-up study compared with those before the treatment (P<0.05). After the treatment, the ODI score in group B was significantly different from that in the other groups (P<0.05). The ODI scores in group A and B in the 3-month follow-up study were significantly different from those after the treatment in the same group (P<0.05). The ODI score in group A was significantly different from that in the other groups in the 3-month follow-up study (P<0.05). The ODI score in group B in the 3-month follow-up study was significantly different from that in group C and D (P<0.05).Conclusion Acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles is definitely effective in treating postpartum sacroiliac malposition, acupuncture plus chiropractic can produce a significant short-term efficacy and alleviate the symptoms, and functional exercise of lumbar and gluteal muscle can produce an obvious long-term efficacy.

Application of convolute manipulation for the treatment of femoral fractures in children / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the application of convoluted manipulation in pediatric femoral fractures.</p><p><b>METHODS</b>From March 2015 to October 2016, 12 children with femoral fractures were treated by Chinese traditional manipulation including 8 males and 4 females with an average age of 6 years old ranging from 1 to 12 years old. The causes of injury were falls in 10 cases and traffic accidents in 2 cases. Of which 1 case was transverse fractures, 4 cases were oblique fractures and 4 cases were spiral fractures, 2 cases were comminuted fracture, 1 case was greenstick fracture. All patients underwent manual reduction within 1 to 2 days, plus small splint with cedar bark, and parallel lower limb traction.</p><p><b>RESULTS</b>All the 12 patients were followed up for 1-3 months, with an average of 2 months. All the 12 patients achieved clinical union, and the average healing time was 6 weeks. There was no obvious shortening and rotational angulation. At the last follow-up, Schatzker-Lambert distal femoral fracture evaluation results were excellent in 11 cases, good in 1 case.</p><p><b>CONCLUSIONS</b>Convoluted manipulation is very important for reduction of femoral fractures in children, with the splint of cedar bark, satisfactory therapeutic effect can be achieved.</p>