ObjectiveTo study the rehabilitation for the forearm rotation function handicap after the fracture of radius. Methods53 patients with the forearm rotation function handicap after operation for the fracture of radius were reviewed. ResultsThe patients were followed up for 2～7 years. The angles of pronation and supination in forearm were 23.47° and 34.42° before treatment, and were 66.59° and 78.56° after treatment （P<0.01）. The patients with the course of disease less than 2 months procured better forearm rotation function the those more than 2 months （P<0.01）. ConclusionThe forearm rotation function need to be prevented and rehabilitated early after the fracture of radius.

Objective To study the characteristics and classifications of the fractures of the talar neck as well as to define the appropriate treatments and its complications. Methods 47 patients of the fractures of the talar neck were referred to our department of orthopaedics from July 1996 to November 2001. There were 32 males and 15 females with an average age of 31.6 years. The injuries were caused by fall in 13, traffic accident in 28, and others in 6. According to Hawkins classification, there were type Ⅰwith nondisplaced vertical fracture in 6 patients, which were treated non-operatively, and immobilized with a non weight bearing short leg cast; type Ⅱ in 26 patients, and type Ⅲ in 15 patients, all of which were treated in emergency with anatomic reduction and fixation with 4.0 mm lag screws through anteromedial or anterolateral approaches of the ankle. Otherwise, the arthrodesis of subtalar joint in type Ⅲ fracture were primarily performed as well. The ankles were immobilized until the fracture healed. Results The patients were followed up 2 to 5 years (average, 3.6 years). By the assessment of clinical effects depending on the complaints, functions and radiological results of the ankle and subtalar joint, 17 patients were rated as excellent, 22 patients good, 5 fair, and 1 poor, the total rate of excellent and good was 83.0%. Osteonecrosis occurred in 8 patients with 3 of type Ⅱ and 5 of type Ⅲ fractures. 3 of 4 patients with talar displacement were found with osteonecrosis or painful arthritis. The subtalar arthrosis occurred in 6 patients, 4 of which were associated with ankle arthrosis. 3 patients underwent arthrodesis because of painful arthritis of the subtalar joint or osteonecrosis of the talar body. Anteromedial skin necrosis of the ankle developed in 1 patient. Conclusion If the fracture of talar neck is not managed appropriately as early as possible, its complications are common, the fractures should be treated in emergency to reduce the incidence of posttraumatic osteonecrosis, arthrosis and malunion of the fractures.

Objective In order to reveal the effect of extracorporeal shock wave therapy (ESWT) with ultrasonic orientation for soft tissue disorders of the shoulder. Methods 151 cases of severe disorders of the shoulder were treated with ESWT. The course of disorders was longer than 3 months. Among them, 65 cases were of subacromial bursitis (SB) and 86 of tenosynovitis of long-tendon of biceps muscle (ILBM). The treatment point of ESWT was oriented with color Doppler ultrasonography, while the pain-point was determined with tenderness combining with local anatomic markers. The energy density of ESWT was 0.12-0.16 mJ/mm2, and 1-2 shock-points were selected for each treatment, the number of shock waves were 800-1000 times, each course consisted of 2-5 times, with an interval of 5 days. 25 of 65 cases of SB were refered for ESWT by ultrasonic orientation, other 40 by pain-point orientation; 31 of 86 cases of ILBM were refered for ESWT of ultrasonic orientation, other 55 by pain-point orientation. The satisfactory rate of SB and ILBM with ESWT were compared between 2 different orientation cases. Results Through 6 months follow up, the satisfactory rates of SB and ILBM with ESWT were 89.6% and 92.3% respectively in cases of ultrasonic orientation, while in cases of pain-point orientation, the satisfactory rates of SB and ILBM with ESWT were 67.6% and 73.6% respectively, the difference of satisfactory rates was significant between 2 groups. Conclusion The effect of the ESWT with ultrasonic orientation is better than the ESWT with pain-point orientation both for SB and ILBM. The ultrasonic orientation plays an important role in promoting the satisfactory rates of ESWT.

[Objective]To demonstrate mechanism of ESW in curing osteogetic disorders,we studied expression of some osteogenetic factors in human mesenchymal stem cells(hMSCs)when exposed to ESW.[Method]After success in marrow aspiration,isolation and obtainment optimal experimental energy,a dose of 5kV and 100 times of ESW was applied to hMSCs of passage 1.The expression of IGF-Ⅰ and TGF-?1 were examined by immunocytochemical staining.[Result]The cytochemical staining results showed that expression of IGF-Ⅰ and TGF-?1 appeared at different passage of hMSCs after ESW intervention.Appearance of IGF-Ⅰ was earlier than TGF-?1 which didnt express until passage 7.At the same interval,the expression of IGF-Ⅰ and TGF-?1 in control group difference is lower than ESW group,respectively(P

Objective To study the forearm angulation deformities and observe its influence on the rotation function of the forearm.The importance of the interosseous to forearm rotation function was also analyzed. Methods Eight human cadaver specimens, with the forearm superfical and deep fascia, antebranchial extensor and flexor groups dissected off were used to study the origin and insertion of the pronator teres and supinator, and the movements of the fibers of the interosseous membrane and oblique cord during forearm rotation. Single and double fracutures of the radius and the ulna were produced in ten other human cadaver upper limb specimens with the pronator teres， supinator， interosseous membrane， oblique cord， proximal and distal radio-ulnar joint preserved. The fractures were fixed with plates and screws, and were made into models with different directions and degrees of angulation deformity. The upper limb were fixed with elbow at 90? of flexion in order to observe the effects of angulation deformities upon the forearm rotation function. Results The oblique cord and the upper third interosseous membrane fibres control the excessive pronation of the forearm while the middle and lower third interosseous membrane fibres control the excessive supination; so the oblique cord and interosseous membrane limited the rotation range of the forearm. The forearm angulate deformity resulted from single or double fractures are both be able to cause the forearm rotational disturbance; when the angular deformity exceeds 5? , disturbance of rotational function of the forearm will occur. The disorder of interosseous membrane and the oblique cord, the slope of the articulus radio-ulnaris distalis and proximalis and the osseous obstruction are the main causes of the disturbance of rotation function. Conclusion The interosseous membrane limits the scope of forearm rotation and the deformity of angulation can cause the hindrance of the forearm rotation.

Objective To study the effect of extracorporeal shock wave therapy with percutaneous autogenous bone marrow grafting in the mannagement of long bone nonunion.Methods After success in marrow aspiration from patients' iliac crest,19 cases of patients accepted the treatment of bone marrow grafting and ESWT.Then,it's therapeutic effect was compared with 23 cases of single ESWT group,such as average rate of bone union and average healing time during follow-up period.The data of this study was analyzed by independent-samples t test,and a P value of

Objective To explore the pathogenesis of femoral head ischemic necrosis(FHIN),and to observe the clinical therapeutic effects of extracorporeal shock waves therapy(ESWT) for FHIN in soldiers.Methods With exclusion of the femoral head necrosis sAbsequent to femoral neck fracture,108 cases of FHIN in ARCO stage Ⅰ-Ⅲ period,induding 86 males and 22 females,with aged ranged from 17 to 25 years,were involved in the present study,and the treatment modality was chosen by patients voluntarily.In 50 patients,ESWT combined with drilling decompression procedure(ESWT group) was chosen,and 9-12kV(0.16-0.22mJ/mm2) of extracorporeal shock wave was applied on the second day after drilling decompression.X-ray and MRI of bilateral hip joints were taken and Harris hip score(HHS) was estimated at 6 and 12 months after treatment.58 patients chose the treatment of simple drilling decompression served as controls.The results of the two groups were analyzed by Student's paired t test.Results No aggravation of FHIN occurred in the two groups.The average ratio of necrosis zone in ESWT group was diminished by 22.9%,32.8% and 34.3%,respectively,in the stages of ARCO Ⅰ,Ⅱ and Ⅲ,and the improvement was better in ARCO Ⅱ and Ⅲ stages than that in control group(P

To explore the effect of allogenic achilles tendon on one-stage reconstruction of antedor/postedor cruciate ligaments,3 cases with ruptured anterior/posterior cruciate ligaments and received allogenic achilles tendon reconstruction,at Department of Orthopaedics,General Hospital of Chinese People's Armed Police Forces,from June 207 to April 2008,were collected.A more than 6-month follow-up showed that all cases could walk at 12 weeks postoperatively.Anterior andposterior drawing tests,as well as inversion and extroversion stress test were negative,with 100° movement ranges.In addition,no serious complication occurred.The Lysholm knee fuction scores were 87,83 and 85,respectively.The results suggest that the allogenic achilles tendon seems to be a satisfactory treatment option for one-stage anterior/posterior cruciate ligaments reconstruction,which has merits of easy operation,small trauma and good short-term results.However,further research is needed to determine the role of allogenic achilles tendon in knees with multi-ligament injury.

Objective To explore the morphological changes of human mesenchymal stem cells(hMSCs) after exposure to extracorporeal shock wave(ESW).Methods An optimal experimental energy dose of ESW was applied to hMSCs of passage one.The morphological changes were examined by using inverted phase contrast microscope(IPCM),transmission electron microscope and cytochemical staining.Results ESW of 5kV and 100 times could raise the viability and proliferation of the cells.In the hMSCs of passage 3-5,the multiplicative division was speeded up,and the cells in the nuclear fission phase were increased.In the hMSCs of passage 7-9,the volume of the cells increased,and the endoplasmic reticulum was expanded.The Golgi's apparatus was developed and the matrix of the cells was bunchy.In the hMSCs of passage 11,the multiplicative division was also detected.Conclusion The proliferation and differentiation of the hMSCs can be improved by the treatment of ESW.

BACKGROUND:No method is ideal for treating traumatic avascular necrosis of talus up to now.Extracorporeal shock wave therapy(ESWT)is a micro-traumatic,simple,and effective method to treat musculoskeletal diseases;however,the therapeutic effect on necrosis of talus needs to be further studied.OBJECTIVE:To evaluate the therapeutic effect of liquid-electric extracorporeal shock wave on traumatic avascular necrosis of talus,and to explore new treatments of traumatic avascular necrosis of talus METHODS:A total of 34 patients with traumatic avascular necrosis of talus were selected from the Affiliated Hospital of Medical College of Chinese Armed Police Force from September 2004 to June 2009.The patients were randomly divided into ESWT and control groups,with 17 patients per group All patients were treated with pain point positioning combined with surface X-ray localization,theworking voltage of 8-10 kV,energyflowdensity of 0.12-0.16mJ/mm2,impact frequency of 40-50 times/min,and impact of 800-1000 times,once a week,for 3-5 cycles.Pain was evaluated with VAS before and after treatment,function of ankle was evaluated with AOFAS standards,and MRI of ankle was re-checked at 18 months after treatment to compare necrotic area before and after treatment.RESULTS AND CONCLUSION:VAS pain,function of ankle,and necrotic area of ankle in the ESWT group were significantly improved compared to those in the control group at 18 months after treatment(P<0.01).Activity of one case in the control group was limited by severe pain due to traumatic arthritis in the first 15 weeks after ankle arthrodesis surgery.This suggested that significant effect and fewer complications,for treating traumatic avascular necrosis of talus.