A 2-year follow-up survey of 523 cases with peripheral nerve injuries caused by the earthquake in Wenchuan, China.

We performed a 2-year follow-up survey of 523 patients with peripheral nerve injuries caused by the earthquake in Wenchuan, Sichuan Province, China. Nerve injuries were classified into three types: type I injuries were nerve transection injuries, type II injuries were nerve compression injuries, and type III injuries displayed no direct neurological dysfunction due to trauma. In this study, 31 patients had type I injuries involving 41 nerves, 419 had type II injuries involving 823 nerves, and 73 had type III injuries involving 150 nerves. Twenty-two patients had open transection nerve injury. The restoration of peripheral nerve function after different treatments was evaluated. Surgical decompression favorably affected nerve recovery. Physiotherapy was effective for type I and type II nerve injuries, but not substantially for type III nerve injury. Pharmacotherapy had little effect on type II or type III nerve injuries. Targeted decompression surgery and physiotherapy contributed to the effective treatment of nerve transection and compression injuries. The Louisiana State University Health Sciences Center score for nerve injury severity declined with increasing duration of being trapped. In the first year after treatment, the Louisiana State University Health Sciences Center score for grades 3 to 5 nerve injury increased by 28.2% to 81.8%. If scores were still poor (0 or 1) after a 1-year period of treatment, further treatment was not effective.

Custom-made locked plating for acetabular fracture: a pilot study in 24 consecutive cases.

Clinical implementation of site-specific locking plates for acetabular fracture remains untested. Custom-made locking plates were manufactured using computer-aided design and computer-aided manufacture techniques for acetabular fractures to test this procedure. The 3-dimensional images constructed from computed tomography data of pelvises in patients with acetabular fractures were used for preoperative planning and to design the plates. Data for each plate were input into software for programming, and the generated code was transferred into a computerized numerical control digital milling machine for manufacturing. These plates were clinically implemented, and the implementation parameters, reduction quality, and Postel Merle d'Aubigné score were evaluated. Forty-nine custom-made locking plates were manufactured for 24 unilateral acetabular fractures. The manufacturing process for the plates averaged 6.9±2.2 days. Processing the plates delayed operations by 2.6±1.3 days in one-third of the cases. Plate contouring was avoided in 48 plates. The plates had anatomical shapes, excellently matching reduced bone surface. The screws locked with the obtained plates avoided intra-articular penetration and provided secure fixation that allowed early out-of-bed rehabilitation. No indications of implant failures or observations of screw back-outs were observed during follow-up. The clinical application of such plates is associated with the avoidance of plate contouring, low risk of intra-articular penetration, early out-of-bed rehabilitation, and a low rate of implant failure. Implementing such plates in clinical practice is worthy of further investigation, with a focus on selecting patient population and minimizing the time required for and cost of plate manufacturing.

Development of site-specific locking plates for acetabular fractures.

Site-specific locking plates have gained popularity for the treatment of fractures. However, the clinical use of a site-specific locking plate for acetabular fractures remains untested due to production limits. To design a universal site-specific locking plate for acetabular fractures, the 3-dimensional (3D) photographic records of 171 pelvises were retrospectively studied to generate a universal posterior innominate bone surface. Using 3D photographical processing software, the 3D coordinate system was reset according to bony landmarks and was scaled based on the acetabular diameter to allow a direct comparison between surfaces. The measured surface was separated into measurement units. At each measurement unit, the authors calculated the average z-axis values in all samples and obtained the 3D coordinate values of the point cloud that could be reconstructed into the universal surface. A plate was subsequently designed in 3D photographical processing software, and the orientation and distribution of locking screws was included. To manufacture a plate, the data were entered into Unigraphics NX version 6.0 software (Siemens PLM Software, Co, Ltd, Plano, Texas) and a CNC digital milling machine (FANUC Co, Ltd, Yamanashi, Japan). The resulting locking plate fit excellently with the reduced bone surface intraoperatively. Plate contouring was avoided intraoperatively. Universal 3.5-mm locking screws locked successfully into the plate, and their orientations were consistent with the design. No screw yielded to acetabular penetration. This method of designing a site-specific acetabular locking plate is practical, and the plates are suitable for clinical use. These site-specific locking plates may be an option for the treatment of acetabular fractures, particularly in elderly patients.

[Comparison of therapeutic effects of acupuncture-cupping plus acupoint catgut embedding and electroacupuncture on simple obesity of stomach and intestine excess-heat type].

OBJECTIVE: To search for a therapy of increasing clinical therapeutic effect on simple obesity with stomach and intestine excess-heat. METHODS: Eighty-two cases of simple obesity with stomach and intestine excess-heat were randomly divided into group A (n=40) and group B (n=42). They were treated with electroacupuncture (EA), movable cupping plus acupoint catgut embedding, and simple EA, respectively. EA at Zhongwan (CV 12), Xiawan (CV 10) and Qihai (CV 6) were given in the two groups. And in the group A, acupoint catgut embedding and movable cupping at the Channels CV, GV, SP, ST and UB were added. The therapeutic effect, main symptoms, body mass index (BMI), waist circumference (WC), hip circumference (HC), and WHR were investigated. RESULTS: The total effective rate was 90.0% in the group A, significantly better than 78.6% in the group B (P< 0. 01), with significant differences in decrease of body weight, BMI, WC, HC and main symptoms between the two groups (P<0.05, P<0.01). CONCLUSION: Acupuncture, cupping plus acupoint catgut embedding therapy can increase therapeutic effect on simple obesity of stomach and intestine excess-heat type, and it is a better method for treatment of this disease.