Objective To explore the clinical outcomes and complications of the Ilizarov technique for the treatment of femoral infec-tious ununtied fracture and bone defect.Methods A total of 40 patients with femoral infectious ununtied fracture or bone defect were admit-ted into our department from July 2006 to September 2012.After radical debridement,patients were given osteotomy and Ilizarov external fix-ation,and distraction osteogenesis were used in the treatment of bone defects.And the clinical effects and complications of the treatment were evaluated.Results All of the patients were followed up for 12 ~32 months (24.5 months averagely).Totally 39 patients of them acquired bone healing,and the mean healing time was 15.5 months (12 ~26 months).The knee joint range of motion of 32 patients were obviously decreased after operation (P =0.031).There were 10 cases of partial hip joint range of motion decrease,22 cases of leg length discrepancy (more than 1.1 cm),1 case of Iatrogenic vascular injury,and 10 cases required autologous cancellous bone graft.Pin loosening,deep infec-tion,clubfoot deformity,and deep vein thrombosis or bleeding were founded in parts of the patients.Conclusion Ilizarov technique can ac-quire success in the treatment of femoral infectious ununtied fracture and bone defect,but it has many complications.

The construction of featured specialties is the current development strategy of community health service institutions to improve the service scope and to meet the health needs of residents. The rehabilitation medicine has undergone 12 years of development and become a relatively mature featured specialty in Fenglin Community Health Service Center. Based on the Fenglin′s experience, this article discusses the development status and restriction bottlenecks of general practice, and the development status and trend of rehabilitation medicine in the community; and also explores the integrated development model of community-featured specialty with general practice.

Community health institutions have entered a new development stage of featured specialty construction. After 12 years of development, rehabilitation medicine now is the featured specialty of Fenglin Community Health Service Center. This article presents the train of thought and key points of specialty construction in primary care institutions based on the Fenglin′s experience. The positioning of featured specialty should be based on the community. The construction process should include 7 elements, namely, the standard operation procedure(SOP)of service system construction, the detailed publicity and implementation of the collaboration of specialists, prevention and control knowledge promotion for general practitioners, prevention and control knowledge education for community residents, service list, clinical efficacy evaluation, and clinical database. In the later iterations, the head of the department should always focus on the service system construction SOP and clinical database construction, and the rest parts can be assigned to the relevant team members.