Objective To investigate the therapeutic effect of VSD combined with external fixator in the treatment of open tibial and fibular fractures in Tibet plateau. Methods From August 2014 to August 2015, totally 16 cases of open tibial and fibular fractures were treated in our department, including 12 males and 4 females with an average 39. 4 years-old. There were 4 cases of proximal and mid tibial fractures while 12 cases were distal fractures. Debridement, vacuum sealing drainage combined with external fixator for stabilization of fractures was performed in all patients after general condition was improved. A vacuum sealing drainage change or second stage wound closure or soft tissue coverage was undergone after 7 days. Bone union time by X-ray and complications were recorded. Results All wounds were healed by second stage. Twelve patients months were followed up ( by calling back to the hospital ) for an average 18 months ( 12 to 24 months ) , 4 cases were lost to follow-up. X-ray demonstrated that bone union was obtained at a mean 5. 5th month (3 to 7 months). There were 9 cases (75%) obtained a first phase of fracture healing, while 3 cases ( 25%) of delayed healing. Pin-track infection was occurred in two patients and was cured by conservative treatment. No complications of deep infection, graft skin or flap necrosis, malunion, nonunion or osteomyelitis was seen during follow-up. Conclusions Vacuum sealing drainage combined with external fixator for treatment of open tibial and fibular fracture in Tibet can rapidly and effectively stabilize the fracture, and simultaneously safely and effectively seal the wound, reduce the wound healing time, promote fracture healing and lower the complication rates.

Objective To explore the characteristics and differences of the distribution of skeletal muscle content between the Han adult population in Tibet and Liaoning Han adult population. Methods Randomly selected healthy adults of Han worked in Tibet and Liaoning Han nationality as the research object, a total of 223 Han adults worked in Tibet ( 95 males, 128 females); 302 adults of Han nationality in Liaoning (126 males, 176 females) were selected by body composition analyzer. The body weight, total muscle mass, trunk muscle mass, left upper limb muscle mass, right upper limb muscle mass, left lower limb muscle mass, and right lower limb muscle mass of the subject were measured. All the result were input into SPSS 22. 0 statistical analysis, and related statistical processing such as independent sample t test was applied. Results The body weight, trunk muscle mass, left upper limb muscle mass, right upper limb muscle mass, left lower limb muscle mass, and lower right muscle mass of the Tibetan Han population were lower than those of the Han adults in Liaoning, and the comparison result was significantly different (P<0.01 or P<0.05), the Han adults in Liaoning and the Tibetan Han population, male muscle mass was greater than the female adults (P<0.01 or P<0.05). Conclusion After the Han people in Liaoning entered the Tibetan Plateau, the muscle mass of each part of the body decrease significantly. The change of human body composition can be affected by various factors such as gender and high altitude hypoxia environment.