Although fractures of distal radius are very common in clinic,new ideas,devices and methods in their treatment are constantly emerging.This review summarizes their classifications and treatment methods,including closed reduction and external fixation,percutaneous internal fixation,external fixation,open reduction and internal fixation,wrist joint arthroscopy and bone grafting.At last,the author puts forwards his opinions about the treatment based on AO classification:Close reduction and cast immobilization should be the first choice for type A fractures.Open reduction and internal plate fixation may be needed for type B and C1 ones when close reduction can not be satisfactory.Internal plate fixation and external fixation may be suitable for C2 and C3 ones.The locking compression plate may be used for old people with osteoporosis.The methods of treatment for distal radial fractures should vary according to the specific type of the fracture.Bone grafting may be considered on the condition of large bone defect or severe osteoporosis.

Objective To explore regional characteristics of road traffic injury in urban Beijing through analysis of the investigation by a single hospital. Methods Using Emergent Road Traffic Injury Questionnaire we designed, we performed a survey for 2 weeks on all the patients with road traffic injury who had sought medical care in the emergency department of our hospital. A comparison was made between them and other patients at the emergency department at the same period. Results From 8:00 on 25 April 2006 to 8:00 on 8 May 2006, 18 emergent cases of road traffic injury were treated. They accounted for 0.54% of all the emergency patients and 4.5% of all the trauma patients. They were 7 males and 11 females, with an average age of 48.3±14. 3 years. The average time to hospital was (26.8±14.4) rain. Seventeen cases of injury happened in the street, 1 in the highway;15 in Xicheng District, 1 in Haidian District, and 2 in the suburbs. They included 8 pedestrians, 9 riders, and 1 passenger. They were injured by 12 light vehicles, 2 heavy vehicles, 2 special vehicles, and 2 bicycles. Twelve patients had injury at extremity, 3 at spine, and 3 at multiple sites, They received treatment only in Emergency Department. No one was dead or hospitalized. Conclusions Contrary to common belief, road traffic injury patients seem to account for a small part of trauma patients and the injury tends to be moderate. Females and extremities may be more likely to get injured.

Fracture healing is regulated by a complex array of factors,of which calcitonin gene-related peptide(CGRP) has been shown to play an anabolic role in bone metabolism.It has been reported that CGRP-containing sensory nerve fibers increased apparently at bone fracture site.CGRP is an important sensory neuropeptides expressed in bone tissue,although the primary function of this neuropeptides is to induce vasodilatation and blood flow,substantial evidence has shown that targeted expression of CGRP to mouse osteoblasts increased bone density,stimulated cancellous bone formation in vivo,especially the presence of CGRP receptors on rat osteoblast provides further evidence for a direct role for CGRP in modulating the function and growth of bone.CGRP is also proved to be a neuropeptide with proinflammatory activities,it may play a direct role in initiating the local inflammatory cell infiltration in the fracture site.Although it has been recognized that CGRP plays an important role in bone repair and reconstruction,the mechanism of this activation still remains to be elucidated.

SUMMARY Peripheral nerve defects are still a major challenge in clinical practice,and the most com-monly used method of treatment for peripheral nerve defects is nerve transplantation,which has certain limitations and shortcomings,so new repair methods and techniques are needed.The peripheral nerve is elongated in limb lengthening surgery without injury,from which we got inspirations and proposed a new method to repair peripheral nerve defects:peripheral nerve elongation.The peripheral nerve could be elongated by a certain percent,but the physiological change and the maximum elongation range were still unknown.This study discussed the endurance,the physiological and pathological change of peripheral nerve elongation in detail,and got a lot of useful data.First,we developed peripheral nerve extender which could match the slow and even extension of peripheral nerve.Then,our animal experiment result confirmed that the peripheral nerve had better endurance for chronic elongation than that of acute elonga-tion and cleared the extensibility of peripheral nerve and the range of repair for peripheral nerve defects. Our result also revealed the histological basis and changed the rule for pathological physiology of peri-pheral nerve elongation:the most important structure foundation of peripheral nerve elongation was Fon-tana band,which was the coiling of nerve fibers under the epineurium,so peripheral nerve could be stretched for 8.5% -10.0% without injury because of the Fontana band.We confirmed that peripheral nerve extending technology could have the same repair effect as traditional nerve transplantation through animal experiments.Finally,we compared the clinical outcomes between nerve elongation and perfor-mance of the conventional method in the repair of short-distance transection injuries in human elbows, and the post-operative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group.On the whole,all of these experimental re-sults revealed the physiological phenomenon of peripheral nerve elongation,and described the physiologi-cal change and stretch range in detail.The systematic research results have filled the blank in this field, which is very helpful for clinical limb lengthening surgery,the design of elongation surgery and the evalu-ation of the peripheral nerve stretch injury.Peripheral nerve elongation will become an innovative treat-ment technology in repairing peripheral nerve defects.

Objective To analyze epidemiologie and injury characteristics of traffic injuries in Shenzhen through emergency department. Methods A questionnaire was pre-designed to collect data of patients admitted to six general emergency departments of six district in Shenzhen from January 2007 to December 2007 for clinical analysis. Results There were 1 328 patients with road traffic injuries, at age range of 2-84 years (average 31 years). According to occupation, most patients were local workers and migrant workers (57.8%). The accidental vehicles were mostly cars (48.5%). Most accidents (78.6%) occurred in urban streets. As for time distribution of traffic injuries, most injuries happened on Friday and Saturday (accounting for 17.8% and 18.7% respectively), especially on Friday (r = 0.166 0, P <0.01). There was central tendency around 15:35 p.m. in one day (r = 0.285 6, P < 0.01). The age of male was (32.36±8.70) years and that of female (29.96±4.32) years, with statis-tical differences (P < 0.05). Of patients followed up, 84.4% patients could work on their original jobs, 8.5% needed ehange of their jobs and 7.1% lost the ability of work. Conclusions It is neeessary to strengthen road safety education among local workers and migrant workers to improve their awareness of road safety. Traffic administrators and road safety marks should be added in the chief period and districts where road traffic injuries happen most frequently. Controlling the number of small cars may be effective to reduce traffic accidents.

Objective To understand the mechanism of extracts of Hedysarum ploybotrys hand Ma22 on Schwann cell,we studied the effects of the extracts on protein tyrosine kinase (PTKs) in vitro Methods Getting sciatic nerve by operation from SD rats and cultured them in PRMI 1640 medium with 15% embryo bovine serum and with Hedysarum Ploybotrys Hand Ma22 at rate of 1∶1 600,1∶3 200,1∶6 400,1∶12 800 or with nerve growth factor (NGF) NGF as positive control and normal medium as negative one After 48,72 and 96 hours cultures,the sciatic nerve been captured separately and used to examine the activity of PTKs by [? 32 P] ATP incorporation test using protein tyrosine kinase assay system Result In normal culture condition,there are no active PTKs Cultured with NGF and Hedysarum Ploybotrys Hand Ma22,the activity of PTKs increases notable The peak of NGF group appears at 48th hours and 96th hours were 0 0636 and 0 1548 respectively. Hedysarum Ploybotrys Hand Ma22 at 48th hours were 0 4460,0 3326 and 0 4169 at concintration of 1∶1 600,1∶3 200,1∶6 400, and decrease after it. Rank sum test show the correlations to time were negative ( P

Objective To evaluate the diagnostic value of enlargement of the anterior space of the right branch of portal vein in early cirrhosis.Methods 37 cases with early cirrhosis and 42 cases with type B hepatitis proved by pathology as well as 40 health cases underwent MDCT examinations.The width of the anterior space of right branch of portal vein(RBPV)and the diameters of RBPV in each group were measured on CT imaging,then the results were analysed comparatively.Results The width of anterior space of RBPV and the diameters of RBPV were(5.5±2.4)mm and(11.84±1.91)mm in health group,(13.6±5.8)mm and(12.36±61.97)mm in early cirrhosis group,(5.7±3.1)mm and(12.13±1.89)mm in type B hepatitis group,respectively.There were significant differences in the width of the anterior space of RBPV between three groups(P＜0.0001).However,there were not significant differences in the width of RBPV among these three groups(P＞0.05).While,there were significant differences of the width of the anterior space of RBPV and the diameters of the RBPV between normal control and type B hepatitis(P＞0.05).Conclusion CT sign of the anterior space of RBPV increased is of important value in diagnosis of early cirrhosis.

Objective To discuss the application value of external fixator to treat the fractures of children according to the characteristics of the fracture of chidren. Methods 25 cases of different complicated fractures of children were treated with external fixator from Jan,1999 to Aug.2001, and given function exercises in the earlier periode after operation. Results The mean follow up time was 10 months. All the fractures healed.The recovery of function was excellent in 88%cases.The long effect is to be observed. Conclusions Using of external fixator to treat the complicated unstable fractures of children can make definite reduction,help to observe and manage the limb and skin after operation,and greatly meet the needs of the fractures of children.The external fixator has a great clinical application value in treating different complicated fractures of children.

Objective To investigate the effects of artificial semi-shoulder joint replacement for humerus proximal fractures in the aged patients. Methods From January 2004 to February 2007, 42 elderly patients who had been diagnosed as three or four-part fractures of proximal humerus received humeral head replacement. The rotor cuffs were repaired during operation, and the lesser tuberosity and greater tuberosity were reconstructed. Early functional exercise was carried out according to the Neer rehabilitation principles. Results All the patients were followed up for 10 to 28 (mean, 12.7) months postopera-tively. Their shoulder functions were assessed by the ASES (American Shoulder and Elbow Surgeon) score. Obvious pain relief was observed. Eleven cases were excellent, 24 good, 4 fair and 3 poor. The good-to-excellent rate was 83.3%. No prosthetic loosening was noted in this group, but upward shift of the shoulder prosthesis occurred in 3 cases, slight limitation of upward movement in 1 case and absorption of lesser or greater tuberosity in 4 cases. Conclusion Artificial semi-shoulder replacement can be applied for three or four-part fractures of proximal humerus in the aged patients.

ObjectiveSystematically evaluate the clinical efficacy and complications of olecranon osteotomy and bilateral approach through triceps brachii for the treatment of intercondylar humeral fractures. MethodsTo search the domestic and foreign literatures published from January 1980 to March 2008 about the treatment of intercondylar humeral fractures, which use olecranon osteotomy approach and bilateral ap-proach through triceps brachii. Systematically evaluate these literatures using the methods of systematic re-view provided by the Cochrane collaboration. ResultsAfter the screening and evaluation to the literatures, 33 published literatures that met the inclusive criteria of this study were collected. There were a total of 876 cases of patients whose follow-up data was integrity (olecranon osteotomy approach group for 509 cases;bilat-eral approach through triceps brachii group for 367 cases) and these cases had provided the postoperative scores of elbow joint function. The excellent and good rates of postoperative score of elbow joint function for the type C2 and C3 fracture patients in the olecranon osteotomy approach group were 82.32% and 79.38% respectively; while those in the bilateral approach through triceps brachii group were 70.59% and 64.71% respectively. The former was significantly higher than the latter. The excellent and good rate of the type C1 fracture patients between two approaches groups showed no statistical significant. Fourteen literatures provid-ed the data about postoperative complications, the incidence of complications of patients that received ole-cranon osteotomy approach was 4.72%(95%CI 4.70%-4.74%), and the results also showed that compared with bilateral approach through triceps brachii (8.17%, 95%CI 8.13%-8.21%). ConclusionTo treat inter-condylar humeral fractures, postoperative efficacy of olecranon osteotomy approach is better than that of the bilateral approach through triceps brachii. Using olecranon osteotomy approach can get adequate exposure, easy open reduction and internal fixation, quick recover and less complication.