OBJECTIVETo observe and compare the therapeutic effects of two methods to lumbar disc herniation treated by manipulation combined with Chinese herbs and traction with Western medicine.

METHODSA multi-center with a central district unit was used to study the patients with lumbar disc herniation from November 28th, 2008 to May 7th, 2010. All the patients were divided into treatment group and control group. The treatment group had 100 cases, including 45 males and 55 females, averaged (43.43 +/- 9.18) years. The treatment group was treated by manipulation combined with Chinese herbs; Control group had 100 cases (5 cases were fall off), including 38 males and 57 females, averaged (42.29 +/- 9.78) years. The control group was treated by traction with Western medicine. The course of treatment was 3 weeks. VAS, M-JOA, LMS (lower limb muscle strength) and classification efficacy was used to evaluate outcome and therapeutic effects before and after treatment.

RESULTSVAS and M-JOA were improved after the treatment both in treatment group and control group; there was no significant difference in LMS before and after treatment in both groups. VAS and M-JOA in treatment group was superior to those of control group after treatment. There was no significant difference in LMS. According to classification efficacy, 41 cases got excellent result, 34 good, 13 fair and 12 poor in treatment group; in control group, 35 cases obtained excellent results, 16 good, 19 fair and 25 poor. The effect of treatment group was better than that of control group.

CONCLUSIONBoth of two methods can improve the score of VAS, M-JOA, and treatment group is better than that of control group. While for the improvement of LMS, both of two methods have no obvious effects.

Adult ; Case-Control Studies ; Chronic Disease ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Male ; Manipulation, Orthopedic ; Middle Aged ; Traction

OBJECTIVESA retrospective study was used to evaluate the short to intermediate outcomes of open reduction and internal fixation of acute Lisfranc joint injuries.

METHODSFrom January 2003 to December 2009, 47 patients with Lisfranc injuries were treated in the study,41 patients were analyzed in current study with an average age of thirty-one years old. All of patients were treated with open reduction and internal fixation. According to the Myerson classification system, there were 9 type-A fractures, 7 type-B1, 11 type-B2, 10 type-C1, 5 type-C2. The AOFAS scale and VAS scale were used for the outcome measurement at the final follow-up.

RESULTSThere were 41 patients with 42 operations were followed up and with a mean time of 36 months (ranged, 12 to 71 months). The mean AOFAS score was (84.2 +/- 2.8) points (ranged, 65 to 100 points), with an excellent and good rate of 81 percent. The mean VAS score was (2.6 +/- 0.5) points (ranged, 0 to 6 points). Three patients developed superficial infection, and two developed skin necrosis. Nineteen patients had weight-bearing or walking pain. All of the patients had radiographic evidence of degenerative change, four with malunion of the second tarsometatarsal joint, and two of the patients with hallux valgus deformity change.

CONCLUSIONAccording to the results of the study, anatomic reduction and internal fixation can get the satisfactory results for the treatment of acute Lisfranc injuries during a short to intermediate follow-up time. All of the patients would have different degree of tarsometatarsal joint degenerative changes, but these changes are non-progressive and associated with minimal loss of function.

Acute Disease ; Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; surgery ; Ligaments, Articular ; injuries ; Male ; Metatarsal Bones ; surgery ; Middle Aged ; Retrospective Studies ; Tarsal Joints ; injuries ; surgery

OBJECTIVETo study the morbidity factors of bilateral intertrochanteric fractures by analyzing medical records, so as to provide evidences for preventing the multiple intertrochanteric fractures.

METHODSFrom Janurary 2000 to June 2009, 68 patients with bilateral intertrochanteric fractures were studied, including 31 males and 37 females, ranging in age from 42 to 95 years with an average age of 75 years. There were type A1 in 24 hips, type A2 in 96 hips, and type B3 in 16 hips. One hundred and twenty-eight hips had received surgical treatment, 8 hips were treated with conservative method. On the first injury, 67 patients discharged after treatment, 1 patients discharged after treatment in other department. On the second injury, 58 patients discharged after treatment, 2 patients died of complications, 8 patients dischagred after treatment in other department. The risk factors including age, cause of injury, fractures type, complications, osteoporosis and treatment were analyzed.

RESULTSThe average age of two fractures were (73.6 +/- 9.25) and (76.7 +/- 6.74) years; the major injury cause was fall; the A2-type fractures went up to 80.88% on the secondary injury;and the proportion of complications was high, mainly geriatric cognitive disorders, hemiplegic paralysis, and dysopia. Bone mineral density measurement of 16 cases showed marked osteoporosis.

CONCLUSIONOsteoporosis and fall injury contribute mostly to the multiple intertrochanteric fractures. Complication was the dominating risk factor. Treatment of osteoporosis, intensive care, postoperative rehabilitation and effective initial surgery are the key to prevent the secondary intertrochanteric fractures in old people.

Accidental Falls ; Adult ; Aged ; Aged, 80 and over ; Female ; Hip Fractures ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Morbidity ; Osteoporosis ; complications ; Risk Factors

OBJECTIVETo introduce the characteristics and its clinical effects of Hennipen external rotation procedure for reduction of acute anterior shoulder dislocation.

METHODSFrom March 2007 to March 2010, 72 patients with acute anterior shoulder dislocation were treated with manipulative reduction in our department. All the patients were divided into two groups: the Hippocratic group with 44 patients receiving regular Hippocratic procedure, and the Hennipen group with 28 patients receiving Hennipen external rotation procedure. Clinical manifestation and radiology were used to diagnose. After reduction procedures, external fixation was applied for another 3 to 4 weeks. The reduction course, complication and function recovery at follow-up were recorded and compared. The student test was used to analyze the difference between groups.

RESULTSThirty-two patients in the Hippocratic group and 3 in Hennipen received intravenous anesthesia. Manipulation time of the Hippocratic group ranged from 2 to 5 minutes with a mean of (3.9 +/- 1.2) minutes, obviously different from that of Hennipen,which ranged from 0.5 to 2 minutes with a mean of (1.3 +/- 0.7) minutes. Complications occurred in 2 cases of the Hippocratic group and none of the Hennipen group. The UCLA scores of shoulder joint at follow-up were 34.2 +/- 2.1 and 33.8 +/- 1.0 respectively in two groups, with no significant difference.

CONCLUSIONCompared with Hippocratic procedure, Hennipen external rotation procedure is easier to manipulate, bring less complications and the same effect. It is worth further clinical applications.

Acute Disease ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Rotation ; Shoulder Dislocation ; therapy

OBJECTIVETo investigate the relationship between body mass index and lower limb alignment of patients with knee osteoarthritis.

METHODSFrom July 2008 to June 2010, 78 patients who suffered from severe knee osteoarthritis were treated with total knee replacement, including 17 males and 61 females, ranging from 41 to 85 years old, with an average age of 68.1 years. The Chinese average adult body mass index (BMI) classification standard was used to classify the patients into three groups: normal group, BMI<24.0, including 3 males and 11 females, totalized 14 patients (28 knees), with the mean age of (69.5 +/- 4.7); overweight group, 24.0 < or = BMI<28.0, including 4 males and 25 females, totalized 29 patients (58 knees), with the mean age of (66.4 +/- 7.9) years; and obese group, BMI > or = 28.0, including 10 males and 25 females, totalized 35 patients(70 knees), with the mean age of (69.1 +/- 8.3) years. The limb X-ray film measuring system was used to measure the lower limb alignment at the supine and weight-bearing position.

RESULTSThere were no statistical significances between the normal group and the overweight group in the knee varus angle at the supine and weight-bearing position (P>0.05). However, keen varus angle of the overweight group increased compared with the other two groups at the supine position,and the angle of the weight-bearing position increased nearly 2 degrees, but no statistical significance. There was no statistical significance between supine and weight-bearing position in the three groups of BMI, but the knee varus angle at the supine position was more than the weight -bearing position in the three groups.

CONCLUSIONThe knee varus angle of obese patients with osteoarthritis in the weight-bearing position increases obviously. It indicates that obesity is an important factor increasing the angle of lower limb alignment.

Adult ; Aged ; Aged, 80 and over ; Biomechanical Phenomena ; Body Mass Index ; Bone Malalignment ; etiology ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Obesity ; complications ; Osteoarthritis, Knee ; complications ; Supine Position

Adult ; Aged ; Aged, 80 and over ; Colles' Fracture ; surgery ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Middle Aged ; Splints

Aged ; Aged, 80 and over ; External Fixators ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Middle Aged ; Radius Fractures ; therapy ; Splints

OBJECTIVETo evaluate the effects of combined fixation with splints and plaster after closed reduction for the treatment of distal fractures of radius in elderly patients

METHODSFrom January 2009 to January 2011, 122 patients with distal fractures of radius were treated by the united fixation with splints and plaster after closed reduction. There were 43 males and 79 females, ranging in age from 60 to 86 years with an average of 74 years. Among the patients, traffic accident injury was in 12 cases and fall injury was in 109 cases; all fractures were closed, the time form injury to visit was for 30 min to 7 days. The X-rays, wrist pain, functional status, range of motion and grasp force of patients were observed at follow-up. Cooney modified Green-O'Brien standard was used to evaluate the clinical effects.

RESULTSAll the patients were followed up from 3 months to 2 years with an average of 15.4 months. Re-displacement occurred in 8 cases (including 4 cases radial displacement, 3 cases dorsal displacement, 1 case palmaris displacement) and re-reduction occurred in 4 cases, surgical treatment was in 2 cases, refused to reset or surgical treatment in 2 cases. Radial shorten in 13 cases middle-later period. All fractures obtained healed. According to the Green-O'Brien standard, 46 cases got excellent results, 65 good, 6 fair, and 5 poor.

CONCLUSIONThe combined fixation with splints and plaster after closed reduction is a effective method in treatment of distal fractures of radius in elderly patients, which can more overcome redisplacement of distal fractures of radius, recover function of wrist joint.

Aged ; Aged, 80 and over ; Casts, Surgical ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Middle Aged ; Radius Fractures ; therapy ; Splints

OBJECTIVETo evaluate the clinical effects of external fixator in treating comminuted fracture of distal radius.

METHODSFrom Mar.2008 to Dec.2009, 37 patients with comminuted fracture of distal radius were treated with external fixator or assisted with Kirschner wire and T-shape locking compression plate (T-LCP) fixation. There were 14 males and 23 females, ranging in age from 30 to 79 years, with an average of 59.1 years. According to AO typing, type C1 was in 3 cases, type C2 was in 11 cases and type C3 was in 23 cases. Function of wrist joint and X-ray films were observed according to Gratland-Werley system at different months.

RESULTSAll patients were followed up from 8 to 24 months with an average of 12 months. All fractures had healing with an average time of 8 weeks. According to Gratland-Werley system, 16 cases obtained excellent result, 17 good, 4 fair, the rate of excellent and good was 89.0%.

CONCLUSIONExternal fixator can obtained satisfactory clinical effect in treating comminuted fracture of distal radius.

Adult ; Aged ; External Fixators ; Female ; Fracture Healing ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius Fractures ; physiopathology ; surgery ; Wrist Joint ; physiopathology

OBJECTIVETo analysis and compare the clinical characteristics of Colles fractures between patients with osteoporotic and without osteoporotic.

METHODSFrom June 2007 to June 2009, 260 patients with Colles fracture were reviewed, including 60 males and 200 females, with a mean age of 66.5 years old. According to Cooney classification: 44 patients were type I, 83 patients were type II, 92 patients were type III and 41 patients were type IV. Among the patients, 96 patients were osteoporotic Colles fractures, and 164 patients without osteoporotic. The general information, invalidiation rate and short-term clinical results were compared between two groups.

RESULTSThere were no statistically difference of age, gender and fracture position between the two groups. There were more patients with type III and type IV, and higher invalidiation rate in osteoporotic Colles fracture group compared to those of no osteoporotic Colles fracture group (P<0.01). At the 6 months after treatment, the clinical effects of no osteoporotic Colles fracture group was better than that of osteoporotic Colles fracture group (P<0.01).

CONCLUSIONThe senile-osteoporotic Colles fracture has different clinical characteristics, which should be given special treatment, frequent review and communication between doctors and patients during the period of treatment.

Aged ; Case-Control Studies ; Colles' Fracture ; surgery ; External Fixators ; Female ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery