Many clinical bone nonunion or delayed union often appear in the early stage of bone healing,but they have been always found too lately.Before X-ray films of visual changes indicates salt content inbones reaching 25%,the very early changes of clinical significance can not be observed.This paper introduces the theory of fracture healing and the definition of bone nonunion and the significance of the basic multicellular unit (BMU) and the OPG-RANKL-RANK system in bone reconstruction.Many technologies such as ultrasonic testing,vibration analysis,mechanical impedance analysis,the bone marrow cavity imaging technologiy,high-resolution CT etc,have been reported in study on the bone,as well as early diagnosis of fracture nonunion.However,the molecular level of early diagnosis is deficiency.

[Objective]To treat the low limb comminuted fracture with biological osteosynthesis as a guide in order to decrease damage of periosteal blood supply and increase the bone healing.[Method]For all types of long bone comminuted fracture in low limbs,the operation was taken for keeping connection of bone fragment with periost,indirect reduction through mechanical line,relative stable fixation and there is no need for anatomical reduction.Eighteen cases of intertrochanteric comminuted fractures and 16 cases of low femoral comminuted fractures were treated with DCS.Twenty-six cases of subtrochanteric comminuted fractures and 24 cases of low femoral fractures were fixed with anatomical steel plate in less screws.Twenty-seven cases of femoral shaft comminuted fractures and 31 cases of tibia and fibula comminuted fractures were fixed with compressive plate in less screws.Twenty-six cases of comminuted fractures of femoral shaft and 22 cases of tibia ones were fixed with LC-DCP in less screws.Twenty-five cases of comminuted fractures of femoral shaft and 18 cases of tibia ones were fixed with locking intermedullary nails.One hundred and three cases of comminuted fractures of tibia and fibula were fixed with extra-fixture.Fifty-six cases of comminuted fractures of tibia and fibula were fixed by unilateral multi-purpose external fixing.Twenty-one cases of comminuted fractures of tibia and fibula were fixed by unilateral multi-purpose external fixing with limited screws and plaster.[Result]A total of 413 cases had been treated and followed up within 6～18 months(average 10.5 months).Four hundred and eight cases had bone union and accounted for 98.46% in all cases.One case had nounion and two cases had malunion in femoral fracture.Two cases had delayed union and four cases had nounion in tibia fractures.[Conclusion]It is useful for the bone blood supplying and healing with biological osteosynthesis of reducing bone fracture indirectly and fixing one relatively,especially for comminuted fracture of long bone shaft.

BACKGROUND: Although bone mineral density can diagnose osteoporosis, it cannot reflect the existing bone metabolism of the subjects; bone turnover markers cannot diagnose osteoporosis, but it can timely reflect the current bone turnover rate of the subjects. OBJECTIVE: To summarize osteoporotic fracture risk predicted by bone turnover markers and bone mineral density, and to theoretically analyze the feasibility of fracture healing after operation. METHODS: With bone turnover, biochemical marker, osteoporosis in English for the search terms, Pubmed database from January 1999 to January 2009 was retrieved; With bone turnover, bone metabolism, biochemical markers, bone mineral density, osteoporosis, fractures in Chinese for the search terms, CNKI database from January 1999 to January 2009 was searched. Literatures were limited to English and Chinese languages. Inclusive criteria: the article closely related to predict fracture risk with bone turnover markers and bone mineral density; Exclusive criteria: duplicated documents. RESULTS AND CONCLUSION: Totally 631 literatures were screened out by computer, according to inclusion and exclusion criteria, 31 documents of which were involved for analysis. Osteoporosis is one of the main causes of elderly disease and death. Early prediction of osteoporotic fracture risk has a great significance. This article describes the bone metabolism, the type of bone biochemical markers, bone mineral density measurement, multi-cell basic unit and the OPG-RANKL-RANK system in bone reconstruction after a long-term fixation; focuses on the use of bone turnover markers and bone mineral density to prognosticate the fracture risk in osteoporosis or after long-term fixation by domestic and foreign academician, and theoretically analyze the feasibility of predicting postoperative fracture healing.

Many clinical bone nonunion or delayed union often appear in the early stage of bone healing,but they have been always found too lately.Before X-ray films of visual changes indicates salt content inbones reaching 25%,the very early changes ofclinical significance can not be observed.This paper introduces the theory of fracture healing and the definition of bone nonunionand the significance of the basic multicellular unit(BMU)and the OPG-RANKL-RANK system in bone reconstruction.Many technologies such as ultrasonic testing,vibration analysis,mechanical impedance analysis,the bone marrow cavity imaging technologiy,high-resolution CT etc.have been reported in study on the bone,as well as early diagnosis of fracture nonunion.However,the molecular level of early diagnosis is deficiency.

Objective To investigate the therapeutic effect of vascular pedicle bone graft and compound bone matrical gelatin (Co BMG) in treatment of nonunion of femoral neck fracture . Methods 28 cases of femoral neck fracture who had been treated with operation and traction and observed for 6 to 9 months suffered from nonunion. The 28 cases of nonunion were treated by vascular pedicle bone graft and compound bone matrical gelatin. The progress of bone healing, complications such as necrosis of femoral head, and joint function were followed up after operation. Results All the 28 cases healed. The function of joint was evaluated according to Jacobs criteria. It was excellent in 19 cases, fine in 7 cases, and poor in 2 cases. Conclusion The vascular pedicle bone graft combined with BMG is the effective choice for treatment of nonunion of femoral neck fracture in adolescents and adults, because it has the double effects of bone grafting and bone induction.