24 h)with VAS ranging from 5-9 points.There was no occurrence of severe complications such as infection or shoulder malfunction.[Conclusion]The technique of glenohumeral joint injection without any guidance through modified Nevaiser approach is highly accurate.No complication was noted.This thechnique be widely used in glenohumeral joint injection.

Objective To evaluate the foot function after Lisfranc injury with local soft tissue in-jury. Methods From November 2000 to April 2006, 43 patients (at mean age of 32 years) with fresh Lisfranc injuries (45 sides) were managed with open reduction and internal fixation with screws, Kir-schner wires and AO plates. All patients had no joint surface damage and received no fusion surgery. Ac-cording to the Quenu-Kuss classification of Lisfranc injury, there were 14 patients with type-A injury, 21 with type-B and 10 with type-C. According to AO classification, there were 29 feet without severe soft tis-sue injury and 16 feet with severe soft tissue injury, of which 10 patients were combined with severe local soft tissue injury (one patient with Foot compartment syndrome). The period from injury to surgery was seven days. All patients received cast immobilization for 8-12 weeks and the foot function was evaluated by anteroposterior and lateral X-rays and American Orthopedic Foot and Ankle Society (AOFAS) score. Results All patients were followed up for 12-69 months (average 37 months), which showed that all pa-tients obtained anatomic reduction and 32 patients were satisfied with operative outcome. The average postoperative AOFAS score was 97 points for patients without severe soft tissue injury and 82 points for pa-tients with severe soft tissue injury (P<0.05). Conclusion After Lisfranc injury, the foot function is related to severity of both joint injury and local soft tissue injury.

Objective To evaluate the clinical results of flexor hallucis longus (FHL) tendon transfer in treatment of patients with Achilles tendon defects of more than 6 cm. Methods Between January 2005 to February 2009, 19 patients with Achilles tendon defects, 13 males and 6 females, were treated with FHL tendon transfer. Their ages ranged from 20 to 61 years, with an average of (42. 6 ± 8.2)years. Fifteen defects were found during tendonitis debridement, and 4 were old ruptures. Time from rupture to surgery ranged from 0 to 6 months (average, 2.6 months). Defects were 6 cm to 10 cm long. Procedures were performed in a two-incision manner. The postoperative ROM of ankle joint, American Orthopaedic Foot and Ankle Society(AOFAS) and visual analogue scale(VAS) scores were recorded at 3 months, 12 months,and the last follow-up. The results were statistically analyzed to evaluate the functional recovery. Results Follow-ups lasted from 12 to 48 months (average, 22. 2 months). At the last follow-up, the average ROM of ankle joint was 17.8°± 1.9° at dorsal flexion and 39.1°±2.3° at plantar flexion, and the last average AOFAS score was up to (91.8 ± 1.7), significantly different from those at 3 months after surgery (P＜0.05), but not significantly different from those at 12 months (P＞0.05). The difference were significant between the results of 3 months and 12 months (P＜0.05). The last average VAS score was (1.0±0.7),significantly different from those at 3 months and 12 months(P＜0.05) . There was also significant differences between the VAS scores of 3 months and 12 months (P＜0.05). Patient's satisfaction was 100%.Conclusion FHL tendon transfer is an efficient procedure for long Achilles tendon ruptures associated with tendonitis in relieving pain and maintaining the function of ankle joint.

This paper introduces the effectiveness's concept and classification of military equipment. The generation, development and content of effectiveness study are also presented. The typic methods of evaluating equipment's effectiveness are emphasized. The characteristics of effectiveness evaluations for several kinds of equipments are analyzed based on examples.

Objective To explore the clinical feature and treatment method of the dopa responsive dystonia (DRD).Methods To observe the clinical manifestation,auxiliary test and the response on the treatment of levodopa in 6 patients from 4 families.Results 1 patient for childhood onset and 2 patients for adolescent onset with DRD, first symptom showed leg dystonia and toe walking with difficulty, whereas 3 patients of adult onset showed tremor and rigidity. Babinski sign was presented in 3 cases. Diurnal fluctuation in symptom severity occurred in all cases. All patients had obvious response to small dose levodopa in 1～6 days. In 2 cases, the effect was maintained for 7 years, without increasing the intake of levodopa.Conclusion The clinical feature of DRD was more remarkable,the therapeutic effectiveness of levodopa was rapid,sustained and obvious.

Objective To approach the clinical features of batched severe burn accompanied by blast injury in lungs, and to sum up both experiences and lessons drawn from the treatment on those cases. Methods 16 cases of severe burn accompanied by blast injury in lungs were inductively analyzed on their clinical features and the experiences and lessons drawn from the treatment were summed up. Results 14 cases got full recovery, and the 2 remainders died of multiple organ failure. Conclusion An overall treatment plan, evacuation in time and individual therapy are necessary for the batched treatment of severe burn accompanied by blast injury in lungs, and an integrated therapy may get a satisfied result.

Objective To explore effective methods of organization and early treatment of mass casualties of burn-blast combined injury. Methods Early clinical data of a batch of 16 patients with burn-blast combined injury and experience of organization for early care were summarized and analyzed. Results The plan for emergency care of mass casualties was implemented in time and well organized, as a result all the wounded survived the shock stage. 10 wounded servicemen were safely transported to other hospitals. Cardiac and respiratory arrest occurred in 1 case during transportation by ambulance, but was successfully resuscitated. Conclusions Timely deployment of plan for emergency treatment, with the organization of a task force including the director of the hospital and clinical specialists are pivotal in the success of taking care of mass casualties. Correct understanding of the clinical characteristics of burn-blast combined injury, effective fluid resuscitation in early stage of injury, and measures to prevent multiple organ dysfunction syndrome were essential in the treatment.

Objective To study the cumulative radiation dose of multiple trauma patients during their hospitalization and to analyze the dose influece factors.Methods The DLP for CT and DR were retrospectively collected from the patients during June,2009 and April,2011 at a university affiliated hospital.The cumulative radiation doses were calculated by summing typical effective doses of the anatomic regions scanned.Results The cumulative radiation doses of 113 patients were collected.The maximum,minimum and the mean values of cumulative effective doses were 153.3,16.48 mSv and(52.3 ± 26.6) mSv.Conclusions Multiple trauma patients have high cumulative radiation exposure.Therefore,the management of cumulative radiation doses should be enhanced.To establish the individualized radiation exposure archives will be helpful for the clinicians and technicians to make decision wheather to image again and how to select the imaging parameters.

Objective To evaluate the results of modified Ludloff osteotomy for the treatment of severe hallux valgus. Methods Fifty six patients (63 feet) with severe hallux valgus were treated with modified Ludloff osteotomy in combination with other procedures during 1999-2000. There were three males (3 feet) and fifty three females(60 feet); the average age of the patients was 46 years old (range from 16 to 65 years old). The severe hallux valgus patients whose first intermetatarsal angles were larger than 16? were treated with modified Ludloff osteotomy. In addition to modified Ludloff osteotomy, combined Reverdin osteotomies were performed in 4 feet, and Akin osteotomies in another three. All patients were followed up for an average of 10 months (6 to 18 months), and evaluated with Maryland clinical rating systems of AOFAS. Weight bearing X-ray films were taken and measured as well. A comparison study was made between the commonly used osteotomies. The advantages and disadvantages as well, of modified Ludloff osteotomy, were evaluated.Results There was no nonunion, delayed union or infection. Based on hallux metatarsophalangea interphalangeal scale of Maryland rating system, 41 feet (65%) were in the score range from 90-100, 17 feet (27%)80-89, 5 feet (8%) 70-79. The rate of excellent or good was 92%. Conclusion Modified Ludloff osteotomy has the advantages of less shortened metatarsal, rapid healing, ability to correct deformity and earlier weight-bearing. It is a perfect procedure for severe hallux valgus patients whose first intermetatarsal angles are larger than 16?, but their first metatarsophalangeal joints are without signs of osteoarthritis.