Objective To evaluate the clinical applied effects of tibial shaft fracture with intramedullary interlocking nail and small incision. Methods From November 2004 to October 2005,47 cases of tibial shaft fracture were treated with intramedullary interlocking nail, all the cases were adopted with small incision and intramedullary interlocking nail, and analysed the curative effects Results 47 cases were followed-up ranged 8 ～ 27 months. All cases resumed normal knee function 6 to 12 weeks after operation,without nonunion and malunion. Conclusion Treatment of tibial shaft fracture with intramedullary interlocking nail and small incision had the advantages of little trauma,good stability, high rate of fracture union and rapid functions recovery. It is worthy deserveed to be put into application and populatization in clinics.

Objective To evaluate operative methods and the clinical effect for comminuted calcaneal fractures.Methods 21 cases(24 feet)of comminuted calcaneal fractures were treated by one stage bone grafting plus open reduction and internal fixation with plastic calcaneus titanium plate.The fractures were classified according to the Sanders system into Sanders Ⅱ,Ⅲ and Ⅳ subgroups.Results All cases were followed up for 9～20 months(14months in average).All cases recovered with good healing of fracture.According to Maryland score,the results were excellent in 14 feet,good in 7 feet,fair in 2 feet,and poor in 1 foot.The excellent and good rate was 87.5％.Conclusions By using the method of internal fixation with plastic calcaneus titanium plate,fracture site can be well exposed,which is helpful to recover calcaneus to its normal length,width,height,Gissane angle and Bohler angle.A reliable internal fixation is helpful for early stage functional excise after surgery,which can maximize the recovery of the ankle function.

Objective To explore the clinical effects of three nail and plate systems in treating femoral intertrochanteric fracture.Methods The clinical data of 75 patients with femoral interochanteric fiactures treated by internal fixation were analyzed.According to different treatment methods,75 patients were divided into three groups:DHS group(treated with dynamic hip screw) 26 cases,PFN group(treated with proximal femoral nail) 15 cases,LCP group (treated with anatomical proximal femoral locking plate) 34 cases.Fracture union time,complications and hip function scores according to Harris's scoring were recorded.Results All patients were followed up for 18 to 36 months.Four patients appeared coax vara in DHS group and one case appeared coax vara in PFN group,three case appeared coax vara in anatomical proximal femoral locking plate (LCP.) There was no significant difference in fracture union time and the excellent and good rate of hip function scores among the three groups (F =2.25,χ2 =0.032,all P ＞ 0.05).Conclusion The effects of three nail and plate systems in treating femoral intertrochanteric fracture is similar,but they have their own characteristics and indications.And the reasonable treatment should be selected according to different fracture types.

Objective To explore the surgical method and effect of arthroscopy assisted minimally invasive therapy in the treatment of tibial plateau fractures .Methods Under arthroscopy surveillance ,32 patients with tibial plateau fracture ( Schatzker Ⅰ-Ⅳ) were taken reduction and fixation .Results All cases were followed up for 4-39 months .All fractures were unitied 3-6 months after operation ,and no joint infection compartment syndrome or ankylo-sis occurred.The results were excellent in 25 patients,good in 7 cases according to the HSS evaluating system 9 months after operation .Conclusion For tibial plateau fractures under arthroscopy assisted reduction and minimally invasive plate osteosynthesis has little injury ,exact reset fixation ,early recovery of the knee joint function ,the curative effect is satisfied .

Objective To study the anatomic data of the first metatarsal dorsal artery and to provide anatomical basis for clinical tissue transplantation based on the first metatarsal dorsal artery.Methods The 16 adult cadaver specimens with 32 feet were dissected and meas-ured by vernier caliper.Then the anatomic data of the first metatarsal dorsal artery were analyzed.Results Through the examinations of 32 feet sample,the first metatarsal dorsal artery were classified into 5 types.Type Ⅰ:the first metatarsal dorsal artery runs at the surface of the first dorsal interosseous muscle (13 sides,40.6%).Type Ⅱ:the first metatarsal dorsal artery runs in the interior of the first dorsal interosse-ous muscle (11sides,34.4%).Type Ⅲ:the first metatarsal dorsal artery runs underneath the first dorsal interosseous muscle (6 sides, 18.8%).Type Ⅳ:the first metatarsal dorsal artery is slender (1 side,3.1%).TypeⅤ:the first metatarsal dorsal artery is absent (1 side, 3.1%).Distance relationship was measured between the first metatarsal bone and the first metatarsal dorsal artery:the vertical distance be-tween the origin of the posterior branch of the first metatarsal dorsal artery and base of the first metatarsal bone was (2.4 ±0.3)mm,the ver-tical distance between the origin of the posterior branch of the first metatarsal dorsal artery and head of the first metatarsal bone was (10.1 ±1.0)mm;the vertical distance between the origin of the anterior branch of the first metatarsal dorsal artery and the first metatarso-phalangeal joint was (7.6 ±2.7)mm.Conclusion The first metatarsal dorsal artery has clinical reference significance for the hands and feet’s trauma and skin flap transplantation such as thumb reconstruction.