Objective To explore the effect of Jianbu-Huqian ointment combined with proximal femoral nail antirotation for the elderly patients with intertrochanteric fracture of femur with osteoporosis. Methods A total of 85 elderly patients with intertrochanteric fracture of femur with osteoporosis were randomly divided into the control group (40 patients) and the observation group (45 patients. Both groups of patients were treated with proximal femoral nail antirotation, and the observation group was added with Jianbu-Huqian ointment. The pain, fracture healing, joint function, bone mineral density and complications were compared between the two groups. Results The VAS pain score at 1st week (6.2 ± 1.6 vs. 7.9 ± 1.6; t=3.683, P<0.05), 3rd week (3.1 ± 1.1 vs. 5.4 ± 1.4; t=4.239, P<0.05) and 7th week (2.3 ± 0.9 vs. 4.0 ± 1.3; t=3.571, P<0.05) after operation of the observation group were significantly lower than those of the control group. The occurrence time (42.4 ± 5.9 d vs. 49.2 ± 6.2 d; t=4.139, P<0.05), walking time (6.9 ± 1.1 weeks vs. 8.7 ± 1.2 weeks;t=3.695, P<0.05), fracture healing time (13.9 ± 2.2 weeks vs. 16.2 ± 3.1 weeks, t=3.473, P<0.05) of the observation group were significantly lower than those of the control group. Harris hip score (89.8 ± 7.21 vs. 81.4 ± 5.93; t=3.728, P<0.05) in the observation group was significantly higher than that in the control group. The bone density of the femur (0.782 ± 0.142 g/cm2 vs. 0.691 ± 0.135 g/cm2; t=3.759, P<0.05) and the area of ward (0.628 ± 0.071 g/cm2 vs. 0.513 ± 0.059 g/cm2; t=4.386, P<0.05) of the observation group were significantly lower than those of the control group. The incidence of postoperative complications in the observation group was 15.0%(6/40), and the control group was 37.8% (17/45). The difference was statistically significant (χ2=5.567, P<0.05). Conclusions The Jianbu-Huqian ointment combined with proximal femoral nail antirotation could reduce the pain, promote fracture healing, and prevent the occurrence of postoperative complications for the elderly patients with intertrochanteric fracture of femur with osteoporosis.

In July 2016, we used free superficial palmar branch of radial artery flap to repair one case of complete dissection of the thumb with skin defect, and achieved good result .

Objective To explore the surgical technique of applying the pedicle composite tissue flap based on superficial palmar branch of the radial artery to repair the soft tissue defect of thumb and evaluate the clinical ef-fect. Methods From February,2013 to March, 2016, 5 cases of the soft tissue and tendon defect of thumb were treated with the pedicle composite tissue flap based on superficial palmar branch of the radial artery. The flap was de-signed at wrist not exceeding the wrist rasceta and the donor site was sutured directly. The size of the harvested flaps was between 3.0 cm ×2.2 cm to 4.2 cm ×3.2 cm, and the sensation of thumb or the flap was reconstructed via median nerve cutaneous branch. The Extensor pollicislongus muscle tendon defect was repaired via palm tendon carried by composite tissue flap. Postoperative follow-up was done termly. Results All transfering flaps survived and all cases were followed-up for 4 to 11 months. The donor site got primary healing with a linear scar. The appearance and tex-ture of the flap was satisfactory. The two-point discrimination ranged from 8 to 11 mm. The appearance of thumb re-covered well and the digit joint had a good motion. Conclusion The pedicle composite tissue flap based on superfi-cial palmar branch of the radial artery is easy to harvest and its vascular anatomy is constant, which is masked and a small incision for the donor site. When necessary, palm tendon or median nerve cutaneous branch can be contained in the flap to form a composite transplant. It is an ideal method for repair of thumb soft tissue defect.

Objective:To explore the surgical method and therapeutic effect of repairing soft tissue defect of digit-tip with single subcutaneous pedicle V-Y advancing flap combined with skin grafting.Methods:From August 2013 to December 2020, 25 soft tissue defects of digit-tip were repaired by a single subcutaneous pedicle V-Y advancing flap combined with pedicle skin grafting. The area of the defects was 0.8 cm× 0.8 cm to 1.6 cm× 1.4 cm. The flaps were harvested from palm or lateral side of the wound and the area of flap was 0.5 cm×1.0 cm to 0.8 cm×2.5 cm. In order to make the flap transfer to a further distance, the subcutaneous fibre connection of the flap was cut-off during the operation. At the same time, cut off 1 side of subcutaneous pedicle. Finally, the advanced distance of the flap reached 0.5-1.2 cm. After the flap harvested, the medium thickness skin was removed for graft to close the donor site from the wrist striations. After the surgery, follow-up visits were conducted regularly by outpatient clinic, or via telephone or WeChat review or by home visit. Throughout the follow-up, the flap appearance, sensation and recovery of the function of digital joint were observed, together with the patient satisfaction. Results:After the surgery, the postoperative follow-up lasted for 4 months to 8 years. All 25 flaps and skin grafts were survived in first stage wound healing. The flaps and skin grafting areas had excellent texture. The fingerprint had been reconstructed with good appearance. The TPD was 4-9 mm, the functions of digital joint recovered well, and there was no complain about a discomfort at the donor site. According to the evaluation standard of Michigan hand function questionnaire, all 25 patients were very satisfied with the overall appearance and function of the hand. According to Total Angle of Motion (TAM) evaluation standard, finger mobility was excellent in all 25 patients.Conclusion:Subcutaneous V-Y advancing flap combined with skin grafting is an ideal method for repairing soft tissue defect of digit-tip. The surgery characterises a simple flap cutting, less traumatic damage, long advancing distance of flap and good repair effect.

Objective:To investigate the surgical method and therapeutic effect of reconstruction of distal blood supply of multiple segments of severed finger body by ortho phalanx artery bridge transfer.Methods:Between November, 2005 and February, 2019, 7 finger body was replanted in 7 cases with 3 segments. Due to the short middle finger body and severe bruising, the power could not pass through the middle section after the proximal finger artery anastomosis. For the long section of blood supply, in order to prevent the skin and blood vessels from separating too much and causing the middle internal artery to separate from the phalanx, after anastomosis of the middle artery, the blood supply was provided by anastomosis with the distal phalanx artery by means of the adjacent phalanx artery bridge. Four cases with vascular pedicle grafts. The skin was sewn into tube in 3 cases, and separate fingers between 3.5 and 6.0 months after operation. Four cases of posterior artery recalcitration and 3 cases of direct adjacent artery transposition. The appearance, sensation and total motion of finger joints were observed and the satisfaction of patients was investigated to evaluate the therapeutic effect.Results:Seven patients with replantation finger were all alive after operation, and the follow-up time was 5 to 40 months respectively. The total range of motion of flexion and extension of finger joints was 100°-170°, and the TPD of finger pulp was 7-12 mm, with an average of 9.6 mm. According to Michigan's functional questionnaire, 7 patients were satisfied with the overall appearance and function of their opponents. According to the evaluation standard of the replantation function of the broken finger of the Chinese Medical Association, 3 cases were excellent and 4 cases were good.Conclusion:It is a simple and effective way to reconstruct the blood supply of multi-segment severed fingers by means of adjacent finger artery bridge transfer.