Research progress of caput femoris posterior tilt and its impact on prognosis in nondisplaced femoral neck fractures / 中国骨伤

There are still many unresolved problems in the treatment and prognosis of nondisplaced femoral neck fractures, such as nonunion and avascular necrosis of the caput femoris .In order to reduce the risk of various complications after non-displaced femoral neck fractures, the caput femoris posterior tilt of femoral neck fractures and its impact on prognosis have attracted more and more attention. A large number of scholars' studies have found that when the posterior tilt exceeds 20°, the risk of internal fixation failure increases significantly. Based on this concept, we can choose to use primary artificial joint replacement instead of three-screw internal fixation according to the different posterior tilt angles of patients to reduce the incidence of postoperative complications. At the same time, our analysis found that comminution of the posterior segment of the femoral neck would lead to an increase in the posterior inclination angles. The purpose of this review was to investigate the relationship between caput femoris posterior tilt of femoral neck fractures and surgical outcome, and to introduce a new method for measuring caput femoris posterior tilt of the femoral neck.

Comparison of dynamic hip screw plus anti-rotation screw versus three cannulated compression screws in treatment of femoral neck fractures with comminuted posterior wall / 中华创伤骨科杂志

Objective:To compare the efficacy of 2 fixation modes [dynamic hip screw (DHS) plus anti-rotation screw versus 3 cannulated compression screws (CCS)] in the treatment of femoral neck fractures complicated with comminuted posterior wall.Methods:The data were analyzed retrospectively of the 109 patients who had been treated for femoral neck fractures complicated with comminuted posterior wall at Department of Orthopaedics, Shenzhen Hospital, University of Chinese Academy of Sciences from February 2017 to December 2019. They were divided into 2 groups according to 2 fixation modes. There were 42 males and 16 females with an age of 48.5 (40.0, 55.3) years in CCS group of 58 cases subjected to fixation with 3 CCSs; there were 31 males and 20 females with an age of 47.0 (38.0, 53.0) years in DHS group of 51 cases subjected to fixation with DHS plus anti-rotation screw. The length of incision, operation time, intraoperative bleeding, weight-bearing time for the affected limb, visual analog scale (VAS), hip Harris score, and incidence of postoperative complications were compared between the 2 groups.Results:The comparison of preoperative general data between the 2 groups was not statistically significant, showing comparability between groups ( P>0.05). In the CCS group, the incision length [3.0 (2.9, 4.5) cm] and operation time [90.0 (73.8, 125.0) min] were significantly shorter than those in the DHS group [10.0 (9.0, 12.0) cm and 135.0 (110.0, 165.0) min], the intraoperative bleeding [40.0 (10.0, 100.0) mL] was significantly less than that in the DHS group [200.0 (150.0, 300.0) mL], the partial and complete weight-bearing durations of the affected limb [12.0 (12.0, 13.0) weeks and 24.0 (21.0, 25.0) weeks] were significantly longer than those in the DHS group [11.0 (10.0, 12.0) weeks and 19.0 (18.0, 20.0) weeks], and the perioperative VAS pain score [2.0 (2.0, 3.0) points] was significantly lower than that in the DHS group [5.0 (4.0, 6.0) points], but the incidence of follow-up complications [56.9% (33/58)] was significantly higher than that in the DHS group [33.3% (17/51)] (all P<0.05). There was no significant difference between the DHS group and the CCS group in the excellent and good rate of Harris hip score at one year after operation [94.1% (48/51) versus 91.4% (53/58)] ( P>0.05). Conclusions:In the treatment of femoral neck fractures complicated with comminuted posterior wall, DHS plus anti-rotation screw and 3 CCSs can both result in fine therapeutic outcomes but a relatively high incidence of complications at late follow-up. However, the former fixation mode can shorten the weight-bearing time for the affected limb and reduce complications but is more invasive than the latter fixation mode.

Effects of cortical comminution following femoral neck fracture on fixation with femoral neck system in young adults / 中华创伤骨科杂志

Objective:To investigate the effects of cortical comminution on therapeutic outcomes and postoperative complications in young patients with femoral neck fracture after fixation with femoral neck system (FNS).Methods:A retrospective study was conducted of the 86 patients with femoral neck fracture who had been treated by FNS fixation from January 2020 to December 2020 at Department of Hip Orthopaedic Trauma, Tianjin Hospital. Of them, 41 had cortical comminution at the fracture ends of the femoral neck. They were 16 males and 25 females with a mean age of 53.0 (40.5, 57.0) years. The other 45 patients had intact cortical bone at the fracture ends of the femoral neck. They were 21 males and 24 females with a mean age of 55.0 (44.5, 62.5) years. The 2 groups were compared in terms of incidence of postoperative complications, Harris hip score, Barthel index and visual analogue scale (VAS) pain score after 6-month follow-up.Results:There were no statistically significant differences between the 2 groups in baseline data or reduction mode except for fracture classification, showing comparability between groups ( P>0.05). In the cortical comminution group, the incidences of nonunion [17.1%(7/41)] and femoral neck shortening [29.3%(12/41)] were significantly higher than those in the cortical intact group [0% (0/45) and 11.1% (5/45)], the Harris hip score and Barthel index [82.0 (72.5, 91.5) points and 100.0 (90.0, 100.0)] at 6 months postoperatively were significantly lower than those in the cortical intact group [94.0 (88.0, 98.0) points and 100.0 (100.0, 100.0)], the VAS pain score [1.5 (0, 4.5) points] was significantly higher than that in the cortical intact group [0 (0, 1.0) points] (all P<0.05). However, there was no significant difference between the 2 groups in osteonecrosis of the femoral head or internal fixation failure ( P> 0.05). Conclusions:Cortical comminution following femoral neck fracture is a major risk factor for post-operative complications after FNS fixation, because it may seriously affect the recovery of hip function and quality of life in young patients.

Minimally Invasive Plate Osteosynthesis (MIPO) for Proximal and Distal Fractures of the Tibia

Introduction: The treatment of fractures of proximal and distaltibia is challenging, because of the possibility of soft tissuecomplications. The treatment of choice remains controversialand it depends on the fracture morphology, displacement andpresence of comminution. Options for the management ofthese fractures vary from closed reduction and cast applicationto open reduction and fixation with plate. Open reduction andplate osteosynthesis is associated with extensive dissectionand soft tissue complications in post-operative period. Weconducted a case series on management of these fractures byusing Minimally Invasive Plate Osteosynthesis (MIPO)technique, which has the advantage of preservation of osseousand soft tissue vascularity.Methods: We conducted a prospective study on closedreduction and percutaneous plating by MIPO technique in 30cases (mean age 42.5 years; 23 males and 7 females) ofclosed fractures of tibia. 22 cases had proximal tibial fracturesand eight had distal tibial fractures. The mean time from injuryto surgery was 7.6 days.Results: Mean time for radiological union was 18 weeks(range: 14-24 weeks). Two patients had superficial operativesite infections, which were managed with oral antibiotics andregular dressings. One patient with proximal tibia fracturedeveloped a non-union, which was treated with bone grafting.Conclusions: In closed peri-articular fractures of the tibia,favourable results can be achieved by MIPO technique.Principles of MIPO technique like minimal soft tissuedissection, closed and indirect reduction, biological fixation andearly mobilization have to be followed for a favourablefunctional outcome.

Sensorial ability, mastication and nutrition of single-implant overdentures wearers

Abstract The use of two-implant overdentures improves mastication of edentulous elderly patients. However, little is known about the effects of single-implant overdentures (SIO) on oral perception and masticatory function in such elders. This study compared the effects of conventional complete dentures (CD) and SIO on the oral sensorimotor ability (OSA), masticatory function, and nutritional intake of elderly people with residual alveolar mandibular height classified as Class III or IV according to the American College of Prosthodontics. Twelve elders first received new conventional CD, which were later converted to SIO. All variables were evaluated after use of each prosthesis for 2 months. To evaluate OSA, elders closed their eyes and orally identified test pieces prepared from raw carrots. A kinesiographic device was used to measure chewing movements during mastication of a test material (Optocal). Masticatory performance (MP) was determined with the sieving method, and a 3-day food diary verified nutrient intake based on a standard Brazilian Food Composition Table. Data were analyzed using the Wilcoxon signed rank test and Student's paired t test (P < 0.05). OSA results did not differ according to prosthesis type. However, opening and closing velocities during chewing and MP increased after SIO insertion (P < 0.05). Although no difference was observed in the intake of most nutrients, sodium ingestion decreased after SIO insertion (P < 0.05). SIO use had no effect on OSA, but significantly improved mastication and sodium intake of elders with decreased residual ridges height (Brazilian Registry of Clinical Trials #RBR-3kgttj).

Resumo A utilização de overdentures suportadas por dois implantes melhora a mastigação de pacientes idosos edêntulos que apresentam rebordos residuais reabsorvidos. No entanto, pouco se sabe sobre os efeitos de overdentures suportadas por único implante central mandibular (SIO) em relação à percepção oral e função mastigatória em tais idosos. O atual estudo comparou os efeitos de próteses totais convencionais (CD) e SIO na capacidade de sensorimotora oral (OSA), função mastigatória e ingestão nutricional de idosos com altura de rebordos mandibulares tipo III e IV de acordo com a Colégio Americano de Prótese. Doze idosos receberam primeiramente novas CD convencionais, as quais, posteriormente, foram transformadas em SIO. Variáveis foram avaliadas após o uso de cada prótese durante 2 meses. Para avaliar OSA, os idosos fecharam os olhos e testaram oralmente a identificação de formatos geométricos confeccionados de cenouras cruas. Um dispositivo cinesiográfico foi utilizado para medir os movimentos durante a mastigação de material de teste (Optocal). A performance mastigatória (MP) foi determinada com o método de fracionamento de peneiras e um diário de alimentação aplicado por 3 dias consecutivos verificou a ingestão de nutrientes com base em uma Tabela Brasileira Padrão de Composição de Alimentos. Os dados foram analisados utilizando os testes Wilcoxon signed rank test e Student's paired t test (p<0,05). OSA resultados não diferiram de acordo com o tipo de prótese. No entanto, as velocidades de abertura e fechamento durante a mastigação e MP aumentaram após a inserção de SIO (p<0,05). Embora não tenha sido observada diferença na ingestão da maioria dos nutrientes, a ingestão de sódio diminuiu após a inserção de SIO (p<0,05). O uso de SIO não teve efeito sobre OSA, mas melhorou significativamente a mastigação e a ingestão de sódio de idosos com altura de rebordos residuais reduzidas (Registro Brasileiro de Ensaios Clínicos # RBR-3kgttj).

Fracturas Mandibulares Conminutadas por Impacto de Proyectil Balístico: Propuesta de Tratamiento Inicial Mediante Método de Fijación Alternativo / Mandibular Fractures Comminuted by Ballistic Projectile Impact: Initial Treatment Proposal Using Alternative Fixation Method

RESUMEN: El trauma maxilofacial por arma de fuego representa un desafío terapéutico principalmente debido a la gran conminución de tejidos que genera. Específicamente, en casos de fracturas mandibulares conminutadas, las modalidades de tratamientos incluye la reducción cerrada, fijación con tutor externo, fijación interna con alambres y reducción abierta y fijación interna utilizando placas y tornillos. El objetivo del presente trabajo es describir un tratamiento inicial con un método de fijación para fracturas mandibulares conminutadas como dispositivo alternativo al tutor externo clásicamente utilizado. Se desarrolla una revisión de la literatura actual acerca del tratamiento inicial o de urgencia de fracturas mandibulares conminutadas por impacto de proyectil balístico, haciendo énfasis en las indicaciones de cada modalidad de tratamiento y sus respectivas ventajas y desventajas. Luego se describe detalladamente el proceso de confección de un método de fijación alternativo junto con la exposición de casos clínicos donde fue utilizado como alternativa de tratamiento. La reducción y fijación obtenida por el dispositivo presentado logra resultados satisfactorios, sin encontrarse diferencias significativas a los elementos de fijación clásicos. Tanto el uso de placas de reconstrucción como el de tutor externo constituyen alternativas válidas para el tratamiento de fracturas mandibulares conminutadas. El dispositivo descrito y utilizado en los pacientes es una alternativa eficiente, de fácil confección y bajo costo económico demostrando buenos resultados en relación a la consolidación de fracturas conminutadas. Se debe conocer las indicaciones para la aplicación de cada modalidad de tratamiento.

ABSTRACT: Ballistic maxillofacial trauma represents a challenge for surgeons because of the important comminution process it presents. Specifically, in cases of mandibular comminuted fractures, the different treatment modalities include closed reduction, external fixation and internal fixation. The purpose of this case series is to describe an initial treatment modality, with a fixation method for comminuted mandibular fractures as an alternative for the classic external fixator. We conducted a literature review about the initial treatment for ballistic comminuted mandibular fractures, emphasizing indications of each treatment modality and their respective advantages and disadvantages. Next, we described the preparation process of an alternative fixation method along with a case series, where it was used as a therapeutical alternative. The reduction as well the fixation achieved by the external fixator, showed satisfactory results without significant differences noted with traditional fixation methods. Both, reconstruction plates and external fixators, are valid alternatives for treating comminuted mandibular fractures. The method described and used in these patients is and efficient alternative, easy to make and at a low cost, with good results in relation to fracture consolidation. We propose that every treatment modality and its indications should be evaluated in order to treat each case adequately.

Effect of micro-fracture and comminution of fat pad on meniscal tear healing under arthroscopy / 中国内镜杂志

Objective To analyze the curative effect of fossa intercondyloidea of micro-fracture and comminution of subcutaneous fat pad on meniscal tear healing under arthroscopy. Methods During the clinical operation, the samples of the micro-fracture and fat pad comminution were attracted to the outside of the joint. The source and properties of cells were identified based on preclinical medicine experiment in vitro. In clinical research, 75 cases of the simple meniscus injury were selected from January 2014 to January 2016 and divided into three groups refer to treatment: Group A, B and C. Different treatments were used in the three groups. Group A - micro-fracture group; Group B - fat pad group; Group C - blank group. All patients' conditions were assessed with Lysholm, VAS score and adverse event (Swelling, anterior knee pain). Results In the preclinical medicine experiment, cells released by micro fracture were fibroblast-like cells which tend to grow more rapidly in vortex shape. Cells released by comminution of fat pad contained a small amount of impurities and necrotic cells and are mostly similar to fibroblast in long spindle shape. Besides, the Human MSC Analysis Kit was used to authenticate two cells which were considered to be as BMSCs and IPFPSCs. In clinical research, all patients received an average of 10 (8 ～ 11) months follow-up visit. No severe complication, such as blood-vessel and nerve injury, infection occurred after operations in the patients followed. Before receiving the treatment, difference in Lysholm, VAS score and general condition of joint of Group A and B, C showed no statistical difference (P > 0.05). Compared with those before operation and after operation in both of four groups, the Lysholm and VAS score were improved (P < 0.05). Besides, there had significantly difference between group A and C, B and C after post treatment in Lysholm and VAS score (P < 0.05), however, group A and B did not. Compared group A and C, the early prevalence of adverse event of group B was higher, but last follow-up show no difference between three groups. Conclusion Combined with basic experimental and clinical studies, our research suggest that micro-fracture and comminution of fat pad have good effect on the repair of meniscus injuries. Nevertheless, it should be concerned that early prevalence of increased swelling amd anterior knee pain of comminution of fat pad.

Surgical Fixation of a Comminuted Inter-Trochanteric Fracture in a Patient with Bilateral Below Knee Amputation

@#Surgical fixation of hip fractures in patients with below kneeamputation is challenging due to the difficulty in obtainingoptimal traction for reduction of the fracture. Surgeons mayface difficulty in positioning such patients on the tractiontable due to the absence of the foot and distal lower limb.There are several techniques described to overcome thistechnical difficulty. In this case report, we present a case ofa 64-year old gentleman with bilateral below kneeamputation presenting with a comminuted rightintertrochanteric fracture. We highlight a simple andeffective method of applying skin traction to obtain adequatereduction for hip fracture fixation.

Anatomical Reduction with Brick-Work Technique in Comminuted Intraarticular Distal Radius Fractures

PURPOSE: This study examined the clinical outcomes of comminuted intraarticular distal radius fractures treated by an anatomical reduction using a brick-work technique. MATERIALS AND METHODS: Seventeen patients with AO/OTA type 23-C3 distal radius fractures were enrolled in this study. An anatomical reduction of the articular surface was achieved using a brick-work technique through the dorsal approach and dorsal plates were used for fixation. The postoperative functional results were assessed with the range of motion of the wrist and the modified Mayo wrist score (MMWS). In addition, the radial length, radial inclination, volar tilt, and Lidstrom score were evaluated from the radiology results. The mean postoperative follow-up period was 13.6 months. RESULTS: All patients showed bony union and the mean range of motion of the injured wrists was 94% (92% to 95%) of the uninjured side. The mean MMWS was 85.3, and the functional results were excellent in 12 patients, good in 4, and fair in one at the final follow-up. Based on the final radiographic measurements, the radial length, volar tilt, and radial inclination were 11.4 mm (10.0 to 13.5 mm), 6.6° (−1.8° to 9.2°), and 21.3° (20.1° to 25.7°), respectively. The radiologic results according to the Lidstrom score were excellent in 14 patients and good in three. CONCLUSION: An anatomical reduction with the brick-work technique is relatively easy, results in a reproducible clinical outcome, and could be a safe and effective treatment option for severe comminuted intraarticular distal radius fractures that are not amenable to volar plate fixation.

Radiological Outcome of Short Segment Posterior Instrumentation and Fusion for Thoracolumbar Burst Fractures

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the radiological outcome of the surgical treatment of thoracolumbar burst fractures by using short segment posterior instrumentation (SSPI) and fusion. OVERVIEW OF LITERATURE: The optimal surgical treatment of thoracolumbar burst fractures remains a matter of debate. SSPI is one of a number of possible choices, yet some studies have revealed high rates of poor radiological outcome for this SSPI. METHODS: Patients treated using the short segment instrumentation and fusion technique at the Spinal Injuries Center (Iizuka, Fukuoka, Japan) from January 1, 2006 to July 31, 2012 were selected for this study. Radiographic parameters such as local sagittal angle, regional sagittal angle, disc angle, anterior or posterior height of the vertebral body at admission, postoperation and final observation were collected for radiological outcome evaluation. RESULTS: There were 31 patients who met the inclusion criteria with a mean follow-up duration of 22.7 months (range, 12-48 months). The mean age of this group was 47.9 years (range, 15-77 years). The mean local sagittal angles at the time of admission, post-operation and final observation were 13.1degrees, 7.8degrees and 14.8degrees, respectively. There were 71% good cases and 29% poor cases based on our criteria for the radiological outcome evaluation. The correction loss has a strong correlation with the load sharing classification score (Spearman rho=0.64, p<0.001). CONCLUSIONS: The loss of kyphotic correction following the surgical treatment of thoracolumbar burst fracture by short segment instrumentation is common and has a close correlation with the degree of comminution of the vertebral body. Patients with high load sharing scores are more susceptible to correction loss and postoperative kyphotic deformity than those with low scores.

Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation?

OBJECTIVE: The acetabular buttress-plate has been widely used in treating difficult cases with satisfying clinical results. However, the biomechanical properties of a postoperative acetabular fracture fixed by the buttress-plate are not clear. The purpose of this study was to evaluate the biomechanical properties of stability after the anterior tube buttress-plate fixation of complex acetabular fractures in the quadrilateral area. METHODS: A construct was proposed based on anterior construct plate - 1/3 tube buttress plate fixation for acetabular both-column fractures. Two groups of six formalin-preserved cadaveric pelvises were analyzed: (1) group A, the normal pelvis and (2) group B, anterior construct plate-1/3 tube buttress plate with quadrilateral area fixation. The displacements were measured, and cyclical loads were applied in both standing and sitting simulations. RESULTS: As the load was added, the displacements were A<B, increasing in line. In the 600 N physiological loading, the differences were significant (standing position: p = 0.013; sitting position: p = 0.009) between groups A and B. CONCLUSION: The anterior construct plate - 1/3 tube buttress plate fixation provided a better stable construct for early sitting. The standing mode yielded more significant differences between the groups. Placing a 1/3 tube buttress-plate via an anterior approach is a novel method of providing quadrilateral area support in this setting. .

Correlation of comminution degree and astragalus polysaccharides yield in Mt. Hengshan Astragalus membranaceus / 中草药

Objective: To study the correlation between the comminution degree and astragalus polysaccharides yield in Mt. Hengshan Astragalus membranaceus (MHAM). Methods: MHAM was processed with the ultrafine treatment by mini plant mill, and grouped according to the different sizes. The yields of astragalus polysaccharides in each group were obtained under the different temperatures and ratios of material to liquid by water and CaO extraction methods. Results: When the powder size ≥ 600-mesh, the yield of astragalus polysaccharides with CaO extraction is higher than that with water extraction; When the powder size ≤ 800-mesh, the yields are almost the same by the two extraction methods. With the methods of both water and CaO extraction, the highest yields of astragalus polysaccharides (8.36% and 8.49%) were obtained at the following conditions: 800-mesh crushing granularity, 80°C extraction temperature, and 1:8 solid-liquid ratio. Conclusion: The yield of astragalus polysaccharides and the comminution degree of MHAM are related.

Closed Reduction and Cast Immobilization for the Treatment of Distal Radius Fracture: Does Dorsal Metaphyseal Comminution Predict Radiographic and Functional Outcomes?

PURPOSE: The purpose of this study was to determine the relationship between dorsal metaphyseal comminution and the radiographic and functional outcomes of patients with distal radius fractures treated by closed reduction and cast immobilization. METHODS: Twenty-six patients with acute distal radius fractures were retrospectively reviewed. The mean age of this patient group was 62.8 years (range, 45-87 years). Eighteeen cases were AO type-A3 and 8 were AO type-A2. Radiographic and functional parameters were analyzed and compared between the patients who presented with or without dorsal metaphyseal comminution on their initial radiographs in order to assess the clinical outcomes. The radiographic parameters included radial inclination, radial length, volar/dorsal tilt, and ulnar variance. In order to measure the functional outcomes, each patient's range of motion, grip strength, Quick disabilities of the arm, shoulder, and hand (DSAH), visual analog scale (VAS), and Mayo score were determined. RESULTS: Seventeen patients (65%) presented with dorsal metaphyseal comminution on the initial radiographs. Radial inclination, radial length, and volar/dorsal tilt were decreased and ulnar variance was increased on the final radiographs in comparison with the postreduction. However, there were no statistically significant differences between the two groups that presented with or without dorsal metaphyseal comminution (p>0.05). None of the functional parameters (i.e., range of motion, grip strength, DASH, Mayo, and VAS score) were significantly different between the two groups (p>0.05). CONCLUSION: Dorsal metaphyseal comminution seems to have no significant impact on radiographic and functional outcomes when closed reduction and cast immobilization was planned for the treatment of distal radius fracture.

Axial Malalignment after Minimally Invasive Plate Osteosynthesis in Distal Femur Fractures with Metaphyseal Comminution / 대한정형외과학회잡지

PURPOSE: We wanted to report on the functional results and the presence of axial malalignment after performing minimally invasive plate osteosynthesis in distal femur fractures with metaphyseal comminution. MATERIALS AND METHODS: Between March 2007 and June 2009, fifteen patients with distal femur fractures and metaphyseal comminution were treated with minimally invasive plate osteosynthesis, and they were followed for a mean of 17.0 months (range: 12-40 months). The fractures according to the AO/OTA classification were two cases of 33A and thirteen cases of 33C, and seven cases were open fracture. We analyzed the axial malalignment and functional results according to bone union and Sanders' score. RESULTS: All the fractures were united without a bone graft after a mean of 20.4 weeks (range: 16-26 weeks) after the definitive plate fixation. One case had superficial infection and a stiff knee. The average ROM of the knee was 123.6degrees. The average Sanders' score was 33.0, and the results were five cases of excellent results, eight cases of good results and two cases of fair results. There was axial malalignment such as varus malunion in 3 cases and valgus malunion in 2 cases and the average shortening of the limb length was 7.9 mm (range: 0.3-21.9 mm). CONCLUSION: Minimally invasive plate osteosynthesis in a distal femur fracture with metaphyseal comminution provides satisfactory outcomes. However, this should be approached with caution because of the possibility of axial malalignment.

Biothermo-kinetic comparative study on Taohua anti-diarrhea decoction prepared by two different ways / 第二军医大学学报

Objective: To compare the bioactivities of Taohua anti-diarrhea granula prepared by two different methods based on biothermo-kinetics study. Methods: The coarse and fine powder preparations of Taohua decoction were prepared. Microcalorimetry was used to obtain the metabolic curves and biothermo-kinetic parameters of Escherichia coli (E. coli) growth after treated by the two preparations to evaluate their bioactivities. Results: The values of growth rate constant k and maximum heat-out power Pm declined with the concentration increase of the 2 preparations; meanwhile, the values of peak time of the highest peak tm and growth inhibitory ratio I increased with the concentration increase of the two preparations. The results showed that the growth of E. coli was inhibited and the inhibitory effect was strengthened with the concentration increase of the two preparations. The IC50 was 35.9 mg/ ml for the coarse powder preparation and 31.4 mg/ml for the fine powder preparation. Aggregate analysis of the metabolic curves and biothermo-kinetic parameters of E. coli indicated that the fine powder preparation of Toohua decoction had stronger inhibitory action against E. coli growth than the traditional coarse powder preparation. Conclusion: Microcalorimetry can be used to examine the bioactivity differences of the fine and coarse preparations of Taohua decoction. Superfine comminution may increase the inhibitory action of Taohua decoction.

Factors Influencing the Result of Transverse Acetabular Fractures / 대한정형외과학회잡지

PURPOSE: To review the results and factors affecting the surgical treatment of transverse acetabular fractures. MATERIALS AND METHODS: Among 15 cases of transverse fractures with an average follow-up period of 43 months (mean age, 46.6 years), there were 8 cases with and 7 cases without posterior wall fractures. Seven cases included those with a comminution of the weight-bearing dome. The post-operative radiographic results were evaluated using Matta's criteria. The final clinical results were evaluated using a modified Merle d'Aubigne scoring system. RESULTS: All the fractures united. The average time for fracture healing was 17.5 weeks. The post-operative radiology results revealed 6 cases with an anatomic reduction, 5 cases with an imperfect reduction, and 4 cases with a poor reduction. The clinical results showed nine cases with satisfactory results but 6 cases with unsatisfactory results. Regarding complications, there were 4 cases with traumatic osteoarthritis and 3 cases with heterotropic ossification. The cases of an anatomic reduction showed a higher rate of satisfactory results. The comminution of the transverse fracture appeared to have an adverse influence on the radiological results after surgery, and also appeared to correlate with the development of traumatic arthritis. CONCLUSION: Transverse acetabular fractures, if not reduced anatomically, may have a tendency toward traumatic osteoarthritis and a poor clinical outcome. Comminution of the dome may produce a poor outcome.

Biothermo-kinetic comparative study on Taohua anti-diarrhea decoction prepared by two different ways / 第二军医大学学报

Objective:To compare the bioactivities of Taohua anti-diarrhea granula prepared by two different methods based on biothermo-kinetics study.Methods:The coarse and fine powder preparations of Taohua decoction were prepared.Microcalorimetry was used to obtain the metabolic curves and biothermo-kinetic parameters of Escherichia coli(E.coli)growth after treated by the two preparations to evaluate their bioactivities.Results:The values of growth rate constant k and maximum heat-out power Pm declined with the concentration increase of the 2 preparations;meanwhile,the values of peak time of the highest peak tm and growth inhibitory ratio I increased with the concentration increase of the two preparations.The results showed that the growth of E.coli was inhibited and the inhibitory effect was strengthened with the concentration increase of the two preparations.The IC50 was 35.9 mg/ml for the coarse powder preparation and 31.4 mg/ml for the fine powder preparation.Aggregate analysis of the metabolic curves and biothermo-kinetic parameters of E.coli indicated that the fine powder preparation of Taohua decoction had stronger inhibitory action against E.coli growth than the traditional coarse powder preparation.Conclusion:Microcalorimetry can be used to examine the bioactivity differences of the fine and coarse preparations of Taohua decoction.Superfine comminution may increase the inhibitory action of Taohua decoction.

Application of superfine comminution technique in Renzhujianwei Granule / 中成药

AIM: To study the application of superfine comminution in Renzhujianwei Granule. METHODS: After being pretreated, Rhizoma Altractylodis macroleplea and coix seed were crushed into ultra-fine powder by TC20 medical superfine crusher. Then the ultra-fine powder was made into the granule. RESULTS: Detected by scanning electron microscope and EDS X-ray detector, the mean diameter of the particle was ≤5 ?m; The detection of the normal distribution was 87.93%≤20 ?m and 95.08%≤20 ?m. CONCLUSION: The application of ultra-fine powder in Renzhujianwei Granule develops a new method of producing granule, that can save the pharmaceatic adjuvants and keep the effective components, and is propitious to the molding of the preparation, and also can improve the stability.

Clinical Study of Posterior Comminution of the Femoral Neck Fractures / 대한정형외과학회잡지

The management of the femoral neck fractures remains a major challenge to the orthopaedic surgeons because there are many critical complications such as non-union and avasular necrosis in spite of the advanced technics of treatment. The posterior comminution of this fracture is known to be an important comtributing factor of these complications as the most important cause of the instalility of reduction after internal fixation as well as difficulty of stable reduction, Authors reviewed 61 cases of the femoral neck fractures which were able to identify the presence or absence of posterior comminution on x-ray or operative findings and were managed at Daegu Fatima Hospital during the 10 years from 1975 to 1984 and the following results were obtained. 1. The incidence of posterior comminution in 61 femoral neck fractures was 56% in x-rays of lateral view and operative findings. 2. Open reductions were performed in 31% of 39 cases in which reductions were necessary for internal fixation and 43% of the fractures with posterior comminution were unstable to reduce by closed method while 88% of the fractures without postrior comminution were reduced by closed method. 3. The positions of reductio were in valgus in 46% and anatomic in the rest of cases and valgus reductions were more common in the cases of posterior comminution. 4. Loss of the reduction after internal fixation noted in 48% of the fractures with posterior comminution and 9% without posterior comminution. 5. 77% of the fractures united including 14% of mal-union and the late complication of non-union noted in 14% and avascular necroris in 9% in 35 cases which were followed for over 1 year. 6. The normal unions were more common in the fractures without posterior comminution, the cases of open reduction and the reduction in valgus position. 7. Most of the mal-unions and non-unions noted in the fractures with posterior comminution, the cases of closed reduction and the reduction in anatomic position. 8. These results suggest that the posterior comminution of the femoral neck fracture causes considerable instability and the better results could be expected in the femoral neck fractures with posterior comminution by the reduction in valgus and by the open reduction if necessary.