Among all the road traffic injuries(RTI ),limb and spine fractures have a very high inci-dence.They can be caused by a variety of traumatogenic mechanisms,of whi ch crash is the most common.The distribution of types of fracture in RTI assumes a centrifugation-like p attern.Multiple fractures,homola teral limb injuries and violence-conducted in juries are common.The priority in RTI emergency is to treat serious concu rrent injuries and life-threatening comp lications.Only after the overall condition of the victim get stabilized can open injuries and fractures be treated ac tively.To treat victims of fracture s caused by RTI,especially those with a poor overall condition or an old age,appl ication of external fixation,espec ially a unilateral one,is a good consider-ation.And application of lockable i ntramedullary nailing to treat long tubular bone fractures has proved ve ry satisfactory.As for pelvis fractur es caused by RTI,external fixation c an be used initially while massive hemor-rhage resulted from the injury shoul d be treated vigorously.Internal fixation should be adopted as soon as th e vital signs get stabilized.To treat spine and spinal cord injuries,titanium a lloy is the first choice for fixation material.In most cases,anterior cervical fix ation and fusion with steel plate and screw is advisable for treatment of f ractures of cervical spine,while posterior i mmobilization with screw through pedicle of vertebra is usually suggested for treatment of fracture-dislocation of thoracolumbar vertebrae.

Objective To prevent wrong diagnosis and treatment of chronic inflammatory demyelinating polyneuritis(CIDP) by analyzing the clinical characteristics of CIDP and spine degeneration disorders. Methods In order to distinguish CIDP from spine degeneration diseases, we retrospectively reviewed 16 CIDP patients from December 2000 to December 2003 (male 10, female 6; range 38-58 years old, mean 49.1 years old) who were misdiagnosed as spine degeneration diseases. The duration of the disease was 2 months to 2 years and 8 months, with an everage of 106 months. All clinical data of the 16 patients were analyzed. The data included clinical manifestation, physical examination, protein content of cerebrospinal fluid (CSF) and upper-lower extremity electrophysiologic study(EPS). Comparing the clinical charateristics of CIDP with those of spine degeneration disease. Results All 16 patients of CIDP sufferred limbs sensory disturbance or abnormality, walking difficulty. Upper or lower extremity were involved at equal pace and symmetry; limb tendon reflexes weakened or dissappeared, but limbs muscular atrophy were not significant. X-ray showed degeneration of cervical or thoracic and lumbar spine; MRI showed that there were disc herniation in different intervertebral. The content of protein of CSF remarkably increased(mean 479.9 mg/L). There were significant deviation compare to normal. Electrophysiology study found that sensory nerve action potential(SNAP) wave amplitude were descending; motor nerve conduction velocity(MNCV) were slower. Conclusion We could rightly diagnose and distingnish CIDP from spine degeneration diseases by analyzing clinical manifestation, physical examination, cerebrospinal fluid and electrophysiological study. [

0.05). Conclusion Our finding suggests that it is reasonable to operate on elderly patients with lumbar stenosis who are different in body mass index, because little relation has been found between body mass and surgery outcome.

[Objective]To treat stenosing tenosynovitis by a kind of mini-invasion operation with endscopy assisted,and to observe the clinical results,and to discuss the problem of open and percutaneous A1 pulley release.[Method]Eleven cases,suffering from stenosing tenosynovitis,were treated by the technique of mini-invasion operation with endscopy assisted with a kind of special release knife.The clinical results was investigated and the operative methods was investigated.[Result]All of the patients showed relieving of symptoms of disfunction and trigger finger.There was no serious complication,such as injury of nerves,infection,wound ununion and hand disability.None recurrent case in the follow-up period of 6 to 36 months.[Conclusion]The method of miniinvasion surgical treatment of stenosing tenosynovitis by endscopical technique assisted is safe,effective and low-cost with few complications,which fit for treating stenosing tenosynovitis,specially for those patients with cortisone injection,diabetes and thumb stenosing tenosynovitis.

Objective To study the short-term outcome of transforaminal posterolateral endoscopic discectomy and radiofrequency annuloplasty in patients with discogenic low back pain. Methods A total of 25 patients with discogenic low back pain,who were diagnosed by provocative discography,received transforaminal posterolateral endoscopic discectomy and radiofrequency annuloplasty in our hospital. The VAS scores determined before and 6 months after the operation were compared in the patients. Their MacNab scores were also evaluated at 6 months postoperation. Results After the surgery,2 patients who had ruptured intervertebral discs (L5-S1) developed sunburn syndrome,and then was relieved by pulsed electrical stimulation for one week. The patients were followed up for 6-10 months,during which no other postoperative complications occurred. The mean VAS score of this series decreased significantly after the treatment,and kept being reduced in 6 months [preoperation:6.24?0.97,1,3,6 months after the operation:0(0~2); Kruskal-Wallis rank-sum test,H=61.680,P=0.000]. Four patients showed lower limbs pain before the treatment and were relieved after the surgery. The evaluation of MacNab score showed excellent in 11 pateints,good in 12,and fair in 2,suggesting an effective rate of 92.0%(23/25). Conclusions Transforaminal posterolateral endoscopic discectomy plus radiofrequency annuloplasty is effective for discogenic low back pain in a short term.

Objective To evaluate the biomechanical featu res of the HOIST in the treatment of lumbar spondylolisthesis.Methods Seven fresh cadaver specimens from L 2 to sacrum was used in the study.Each specimen was tested in five states:intact state as the control,spon dylolisthesis model by Panjabi meth od without fixation,spondylolisthesis model fixed with HOIST device,fatigued test of the HOIST and fixed with DICK system.During the experiment,the flexion,extension,bilateral bending and axial rotation loading we re applied to the specimens and measure d with three dimensional analysis ap paratus.A fatigue process of HOIST device was carried out with multifunctional test system(MTS 858,American).The ranges of motion(ROM)of spinal segments were determined with two special cameras and t test was used in statistical analysis.Results The ROM in spondylolisthesis state was significantly greater than that o f the others(P0.05).The difference among two HOIST grou ps and DICK group was not significant at the0.05level except the ROM of left axia l rotation(P

Objective To observe the expansion of transverse width of post screw-implantation in the pedicle and assess the effect of the relative diameter and BMD on the expansive rate. Methods There were 48 vertebral bodies, and 96 pedicles, obtained from 4 human cadaveric T2～L1 specimens (the mean age of 41 years). The BMD(A), pedicle width (B) and height were measured respectively. According to groups of BMD(A1:0.44～0.52 g/cm2;A2:0.52～0.70 g/cm2;A3:0.70～0.92 g/cm2 and the relative diameter(screw/pedicle)(B1:40%～55%;B2:55%～70%;B3:70%～85%), the tests were classified into 9 groups (A1B1?A1B2 ?A1B3?A2B1?A2B2?A2B3?A3B1?A3B2 and A3B3). The implantation procedure was carried out under the uniform standard. Results The number of valuable date was 85, while 11 dates were excluded, including 4 burst pedicles in A3B3 group. According to the statistical analysis, the pedicle width was expanded after implantation. The expansive rate of pedicle width was influenced significantly by the relative diameter and BMD(P

[Objective]To discuss the clinical problems of meniscal transplantation based on 2 cases clinical practical results including the harvest and preserved methods of meniscal allograft,operative procedure,rehabilitation plan and side-effect,combining with literature review,so as to provide reference for further clinical practice and research.[Method]The meniscal allograft were perfumed with arthroscopic technique on 2 patients,younger than 50 years,suffering from severe meniscus tear or defect at the time of other procedures.The initial clinical results about relieving of symptoms,recovery of functions were evaluated after short time rehabilitations.[Result]There was no operative side-injury and signs of knee instability.The incisions healed well without exudation.The knee joint swelling disappeared in 6 weeks.Rejection reaction was not observed in all of laboratory tests.The VAS were 8,6 preoperatively and 3,2 postoperatively.The processes of rehabilitation were normal.[Conclusion]Considering the difficult in maintaining severe tear meniscus and the characteristics of immune evasion of meniscus,meniscal allograft may be expectable option in the future.Very many researches have provided theoretical base.The results of long-time following-up should be further observed and wany clinical problems need to be further solved.

[Objective] To investigate the establishment of the Allograft Menisci Bank so as to provide suitable allograft meniscus for clinical study of allograft meniscus transplantation.[Method]The allograft menisci from the plentiful donors of the tissue bank were achieved and preserved with the deep-frozen technique.Clinical use of allograft menisci should be based on practical requirement of patients and the data recorded in the Menisci Bank.[Result]From 2005 to the end of 2006,an Allograft Menisci Bank was established which consisted with about 300 different-sized menisci and 14 allograft menisci were provided for clinical study.[Conclusion]Establishment of the Allograft Menisci Bank can provide a base for clinical meniscus transplantation.The short-term effects of the allograft menisci transplantation are satisfactory,but the long-term outcomes need more cases and further observation.

[Objective]To study and evaluate the result of the surgical treatment for arthroscopic reconstruction of anterior cruciate ligament(ACL) with double-bundle semitendinosus.[Method]Thirty-one cases who underwent surgical treatment of arthroscopic reconstruction of ACL with double-bundle semitendinosus during 1990～1998 were analyzed retrospectively.The mean follow up time was 127.36 months(98～168 months).Among them,11 case was simplicity ACL injury,15 cases associated with medial meniscus injury,8 cases combined with lateral meniscus injury,6 cases combined with medial collateral ligament injury,2 case combined with lateral collateral ligament injury.All the patients with medial collateral ligament injury were associated with medial meniscus injury.The analysis was performed on the symptom,physical sign,Lysholm score system and IKDC score pre and postoperation recently.[Result]All the patients had good clinical results with no click,locking,"give way",extra-extension pain,and floating patella test were negative.There were no other complications correlated with semitendinosus grafting.But mild pain were seen in 11 cases,Lachman test were positive in 3 cases,anterior drawer test were positive in 8 cases without complications of instability.The Lysholm score:preoperation was 49.62?8.22 and 76.60?7.68 in follow-up time(P