[Objective ] To investigate the improvement of the surgical treatment effect on cerebral palsy with spastic diplegia by performing modified surgeries since 2004. [Method ] Twenty-three cases of severe cerebral palsy with spastic diplegia were operated, 14 male, 9 female; age 3 ～ 12 years; the average age of 5.7 years; their main symptoms were unable to stand and walk independently, with severe hypermyotonia of both lower extremities, and a scissoring type of gait when standing, hip and knee flexing contracture, ankle and foot equinovarus. Physical examination: there was hypermyotonia of the iliopsoas, adductor musculus, hamstrings, triceps surae, anterior and posterior tibial muscle, flexor pollicis longus and flexor digitorum longus. The muscle tone was 3 ～4 grade according to Ashworth criterion. Treatment: The intramuscular tenotomy, fascial division or sliding elongation were performed, to lengthen the tendon of the joint flexion contracture, the lateral half of anterior tibial muscle tendon was transferred laterally to balance the muscle force at the foot. Finally, both lower extremities were fixed by a new designed external frame, to straigthen the articular genu, keep both ankles and feet in neutral position, both lower extremities abducting 30°, and to correct all joint deformities. Family rehabilitation programs started after the external frame was removed 6 weeks later. [Result] All cases were followed up in 1 ～3 years with the average 2. 2 years. The results were evaluated as excellent, good and ineffective, according to correction of the joint deformities, the ability to stand and walk, and parent's satisfaction to the treatment. Of them 21 cases were excellent, 2 cases good, and no ineffective case. [ Conclusion ] For the severe cerebral palsy with spastic diplegia in children, reasonable release of the tight tendons of the multi-joint flexion contracture, balance of muscle force at the foot, correction of all deformities and fixation of the lower extremities with the new external frame, and long term of family rehabilitation after the surgery, are more effective treatment.

[Objective] Aneurysmal bone cyst of the ealeaneus is an uncommon entity. The purpose of the report is to describe aneurysmal bone cyst of the ealcaneus seen in a child.[ Methods] The clinical, radiological and histopathologic findings of a boy with aneurysmal bone cyst of the calcaneus were retrospectively analyzed with reference to literature. [ Results ]The tumor mainly involved the right calcaneus. He was treated successfully after the curettage and bone grafting. Histopathological examination revealed an aneurysmal bone cyst of the right calcaneus. He is now disease-free for 2 years, and no sign of recurrence was found. [ Conclusion] Aneurysmal bone cyst of the calcaneus is an uncommon entiy. To simple aneurysmal bone cyst,curettage and bone grafting are effective therapic method.

[ Objective] To analyze the clinical results of scoliosis patients treated by anterior correction surgery using the KASS (Kaneda Anterior Scoliosis System: the dual rod system). [ Method] Total 123 idiopathic scoliosis patients were treated. The patients' curve patterns by King classification were as follows:Thoracic scoliosis [ type Ⅱ (n = 13), Ⅲ (n = 18 ) , and Ⅳ (n = 16) ,total (n =47) and thoracolumbar or lumbar (TL/L) curve (n = 76)]. In all patients, anterior correction surgery within the range of the major curve was performed. The average follow-up period was 7 years 7 months (2 ～ 13 years 6 months).[ Result] Fusion was attained in all patients. Correction rates of the major curve scoliosis were 68% in thoracic scoliosis and 81%in TL/L scoliosis. In sagittal alignment, all patients restored nearly physiologic thoracic kyphosis and lumbar lordosis. Correction rates of horizontal tilt of the lowermost end vertebra were 78% in thoracic scoliosis and 83% in TL/L scoliosis. Correction rates of the apical vertebral rotation were 59% in thoracic scoliosis and 70% in TL/L scoliosis. No neurovascular and implant related complications were observed. [ Conclusion ] KASS allows excellent 3-D correction of the scoliosis and rigid enough stability to maintain the correction with a shorter fusion.

Intelligentized muti-functional limb treatment and rehabilitation based on micro-computer is introduced in this paper. It is mainly used for rehabilitation in the disablement of limb. The range speed and training time can be automatically controlled. Training parameter and result can be monitored on computer. The apparatus has the advantages of high reliability, easy operation and compact design. It is a new kind of intelligent limb rehabilitation.

Objective: To study characteristics of diagnosis and treatment of arachnoid cysts in the sacral canal. Method: After laminectomy of the sacral canal, arachnoid cysts were treated in three ways: 13 cases underwent excision of the most of the cyst wall and suture of redundant wall around the intracystic nerve; 8 cases underwent the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle; 2 cases underwent excision of most of the cyst wall and leaving them unsutured. Clinical results were evaluated after 30. 2 months' follow-up. Changes in the imaging materials (X-ray, CT, CTM and MRI) were also evaluated. The clinical behaviors, pathologies and complications post-operatively were analyzed. Result: Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between first two methods of treatments. The complications post-operatively included erosion of wound skin and intracranial infection. Conclusion: MRI allows us to better illustrate the arachnoid cyst in sacral canal, and the cyst seems to arise as a result of congenital defect of thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to to a reasonable method to treat the carachnoid cysts in the sacral canal. Do not put the drain tube and forbidding patients to lie supinely are better for reducing the complications.

Objective: To treat limb length discrepancy or deformity using external fixation,and Correct potential complications. The authors present their figures for reapplication of external fixator frames in the same bone segment following complications during or after the treatment phase. Methods: Two hundred and sixty-one patients (297 limbs) underwent this type of treatment in our unit between Feb. 1991 and July 1999 with either Orthofix or Ilizarov fixators.228 in children and 69 limb segments in adults. Results: Reapplication of 22 fixators in children (9.65%), and 4 fixators in adults (5.8%) was performed. This gives an overall reapplication rate of 8.75%. The reason for reapplication was fracture and / or deformity of the regenerate (15 segments). Four patients eventually came to amputation. Conclusion: The authors recommended the continue use of this technique for the treatment of severe deformity particularly in congenital disorders.

Objective: To estimate the biological characteristics of HA gradient coating in vivo.Method:We inserted coated and uncoated implants in bilateral femur of loading area in dogs.Result:Histological findings demonstrated that HA coated implants bind the host bone tightly and the amount and velocity of the new bone formation are more than the uncoated implants.The mean interface shear strength between HA gradient coated implants were greater than those of uncoated implants (p<0.01).Conclusion:The results of this study confirms that HA gradient coatings can has its practical value in orthopeadics fields.

Objective: To discuss the clinical effect of the treatment of metaphyseal cancellous bone fracture with fragment fixation system implants(FFS).Methods:Thirty patients treated with FFS were reviewed.Results:The patients were followed up for 7～　24 months (8.7 months in average).The fractures in all cases were healed in 6 months and the function recovered or nearly reeovered. Conclusion:By traction with FFS to treat this kind of fracture,the fractures and joint function recovered.The operation is simple and trauma is little.

Objective: To report a newly designed method for treating supracondylar fracture of the humerus,and to inquire into the problems of cubitus varus deformity and joint stiff.Methods:Based on a review of anatomy,a new method which called tension band with sphenoid-shaped osteotomy through posterior approach was designed and applied for 46 cases of patients in clinic.The clinical effect was compared with effect of crossing Kirchner's wire.Results:The tension band with sphenoid-shaped osteotomy was a better method and can abide by anatomical and biomechanical principles.After follow-up for 12-36 months,curative effect was estimated as follow:30 cases were excellent,14 cases good and 2 cases poor according to Home's evaluation.Conclusions:It is a better methods in treating supracondylar fracture of the humerus following advantages including simple,reliable fixation and early mobilization etc.

Objective: To study the effects of soluble multi-peptide agent,marked “Gu Kang Tai Ling”,derived from bone tissue on rat bone fracture healing.Methods 80 right tibia defects of rats were sawed.The “Gu Kang Tai Ling”were intramuscularly injected to the rats.The quality of the defect healing was investigated continuously and respectively by the defect bone histomorphometry,biomechanics,X-ray film,and bone mineral density(BMD).Results: Under the treatment of the agent,at early stage trabecular bone volume (TBV)ratio increased 24.7%,and osteoblast surface(OBS)26.7%,at late stage mean trabecular healing surface rate(MTHSR)was increased 38.8%,tibia anti-fracture strength 0.4527～1.4350N，and BMD 7.65% compared with the control group.Conclusion: “Gu Kang Tai Ling”can accelerate rat fracture healing and improve the quality of healing.