Chinese Journal of Orthopaedic Trauma(CJOT) was started in S eptember, 1999 as a quarterly of 80 pages. It was published domestically and abr oad in 2002. CJOT has been included in the the Statistics-Source Periodical of Chinese Scientific Papers as one of Chinese Scientific Core Periodicals since 20 03. In the past five years, CJOT was edited for five volumes, 17 issues, in whi ch 568 papers were published. CJOT has promptly reported the important advances in clinical practice and scientific research on Orthopaedics and Traumatology i n China and the newest devlopment in the world. CJOT has been exchanged with 18 international journals. The six programs or symporia on new techniques of Orthop aedics and Traumatology were sponsored or co-sponsored by CJOT. The general edi torial office of CJOT is located at Nanfang Hospital, Guangzhou. The Beijing edi torial office of CJOT and Shanghai editorial office of CJOT, have been respectiv ely set up at Jishuitan Hospital, Beijing and at sixth Peoples Hospital of Sha nghai in 2003. CJOT has set up a good co-operation with AO and AO Alumni Associ ation Chinese Chapter. CJOT will be expanded from 2004 into a monthly publicatio n of 120 pages per issue so as to better facilitate the academic exchange and co -operation among surgeons and researchers of Orthopaedics and Traumatology in C hina, even in the world.

scientific papers concerning peripheral nerve surgery of upper extre mity were presented at the5th Congress of the Asian Pacific Fed eration of Societies for Surgery of t he Hand.Adult brachial plexus injur y,ob-stetric brachial plexus palsy,other nerves injuries of upper extremity,and experimental research on perip heral nerve were explored.For nerve root avulsion in adult brachial plexus injury,MR myelography is an effective evaluation method,and the nerve transfers of extra-plexus or intra-plexus are majo r treatment techniques.Progress in clinical or basic research on peripheral nerve h as been made in the following:modified Oberlin' s procedure for the treatment of upper brachial plexus injury,contr alateral C7transfer and phrenic nerve transfer,double free muscle tran splantation(Dois procedure)for the reconstruction of prehensio n in total root avulsion,late functional reconstruction of OBPP,skeletal muscle recovery following microsurgical restoration of intra muscular innervation,and promotin g effect of im-munosuppressant FK506on periphera l nerve regeneration. [

The concept of Pilon fractures was firstly introduced by Destot of France in 1911. Although the medial, lateral, and posterior malleoli may be involved, the definitive feature of Pilon fracture is involvement of the supra-articular metaphysis of distal tibia, which typically exhibits various degrees of impaction and comminution, combined with articular cartilage damage and joint surface incongruity. The most widely used and accepted classification methods for Pilon fractures are R?edi-Allgwer’s classification (1969) and AO/OTA comprehensive classification system (1996). In the former system, Pilon fractures are subdivided into types Ⅰ,Ⅱ, and Ⅲaccording to the increasing severity of joint surface comminution and displacement, while in the AO system, there are 2 types(43-B and 43-C), 4 groups (43-B3, 43-C1, 43-C2, 43-C3), and 12 subgroups. Burwell-Charnley’s(1965)radiographic criteria of reduction and Tornetta's (1993)criteria for clinical results have been devised for evaluation of the treatment of Pilon fractures. Mazur’s ankle evaluation grading system (1979) and Baird-Jackson’s ankle scoring system(1987)are also used.

In order to further popularization and promotion of microsurgery, Chinese Journal of Microsurgery, insisting on inheritance and encouraging innovation, has built a new academic communication platform——Chinese Microsurgery Inheritance and Innovation Forum. Basing on this platform, we focus on creating a new brand for micro-surgery academic communication, devote to cultivate a core of young-and-middle-aged microsurgeons working on the front line and look for potential talents to strengthen the team and benefit patients, participate in academic communications actively at home and abroad and reinforce international cooperation, and make unremitting efforts to establish an international magazine with Chinese characteristics. Still, we are striving to make Chinese microsurgery sustainably develop, move toward the world and integrate into the world academic family.

Tibial plateau fractures belong to the articular fractures of proximal tibia. The main classification methods of the tibial plateau fractures include Hohls revised classification (1991), Schatzkers classification (1979), and AO classification (1990). The fractures are divided into 6 groups and 18 subgroups in two types(41 B and 41 C)in AO classification. The detailed and complete AO division is advantageous to data accumulation. The AO system of classification has been advocated by JBJS in 2000 and is used as the standard by the Orthopaedic Trauma Association for its meetings and by J Orthop Trauma for all its publications.The most widely used and accepted classification is what was proposed by Schatzker, in which there are 6 types. For the functional assessment of the treatment, Rasmussens functional grading system and The Hospital for Special Surgery (HSS) knee rating score are used mostly. For the radiological assessment, Rasmussens anatomical grading system at the early stage postoperatively and Resnick Niwoyamas criteria on the degenerative grading scale at the late stage are used respectively.

Proximal femoral fractures mainly include femoral neck fracture, intertrochanteric fracture, and femoral head fracture. The most widely used and accepted classification methods for proximal femoral fractures are Gardens classification of femoral neck fracture(1961), Jensens modification of Evansclassification of inertro chanteric fracture (Evans Jensens classification,1975), Pipkins classification of femoral head fracture (1957), and AO comprehensive classification (1990). There are 3 types, 9 groups, and 27 subgroups in AO classification of proximal femoral fractures, in which the intertrochanteric ones belong to 31 A , the femoral neck ones to 31 B , and the femoral head ones to 31 C. Because of the complexity of proximal femoral fractures, discrimination between the stable ones and unstable ones is very important. For functional assessment of treatment of proximal femoral fractures, Harriship rating scale system(1969)and Sanderstraumatic hip rating scale modified from the Hospital for Special Surgery (HSS) hip rating score (1988)are mainly used.

Objective To observe and study the distribution and histological feature of the fascicular groups to deltoid muscle in axillary nerve at the level of quadrilateral zone. Methods 12 adult human cadavers (24 upper limbs)embalmed by formalin were used,, and microsurgical longitudinal contradissection of the axillary nerves by tracing their terminal branches were processed. At the level of quadrilateral zone,distrabution of the fscicular groups to deltoid muscle in the never trunk were recorded and their diameters were measured;Another 6 upper extremities (3 right and 3 left) of fresh-frozen human cadavers were obtained.Axillary nerves and their fascicular groups were exposured, and the segments at the level of qusdrilateral zone gotten, then histological cross section was done, acetycholinesterase (ACHE) stained with the method of Karnovsky Roots and myelin stained with the method of Loyezs. Defferent never fibres were distinguished under microscope and the fiber number was counted with IAS . Results At the level of quadrilateral zone,fasciculars were divided into two groups.The fascicular group of anterior branch to deltoid muscle was in the lateral of the nerve trunk . Its cross sectional area was (2.449?1.327)mm2 ,occupied 55.4%?9.3%of the axillary nerve trunk ;Its most fibers were motor fibers;The number of fibers is (2112?631), occupied 45.6 %?1.1%of all fibers of axillary nerve . Conclusions In the treatment of root avulsion of brachial plexus injury, selective suture donor nerve with the lateral fascicular group should be processed to repair the function of shoulder abduction,fibers loss would be reduced and rate of functional restoration improved .

The distal humeral fractures are difficult to treat because of the nature of the injury. Although numerous operative approaches have been describe d for them,satisfactory results are difficult to achieve because of the postoper ative complications.We have reviewed relative literature to discuss the incidenc e,cause,prophylaxis and treatment of different complications to deepen the knowl edge of distal humeral fractures.

Objective To provide histology base for the microsurgical repair of the free gracilis muscle transplantation after brachial plexus.Methods Totally 6 fresh male adult cadaveric inferior extremities were obtained.The gracilis muscle nerve were exposed and divided with the microdissection.Specimens were got from different segment after marked direction.All specimens was faced in 4％ formaldehyde solution and then crossing sections were cut by cryoultramicrotome.All slides were stained use the technique of Kamovsky-Roots AchE histochemical.The result of never tissue staining and the distribution of individual functional fascicular group were observed on each cross-section.According to the result of staining combined with the microdissection and the order of different branches branching off the nerve trunk,the distribution of individual functional fascicular group were observed on each cross-section.The 5 μm-thick routine waxed crossing sections were made and stained according to the myelin technique of Loyez.These histological sections were analyzed by using image analysis system.For each histological section,the number of the medullated nerve fibers and the section areas of the each nerve tracts and trunks were measured and calculated.Then the proportion of nerve tracts and connective tissue were calculated.The proportion of each connective tissue was adopting paired-samples t test.Results Under low power lens most of the gracilis muscle nerve were positive reaction,only a few sparse block-shape enzyme staining regions were shown.Under high power lens,the gracilis muscle nerve have clear outline,enzyme staining limited at neuraxis,no staining at myelin sheath and connective tissue.Quantitative analysis shows that the total myelinated fiberscilis nerve was about (1958 ± 375) radix.The branches arising from the posterior subdivision were more than that from the anterior (P =0.000).There were statistical difference between the number of the medullated nerve fibers and the section areas of the anterior and posterior subdivisions,the posterior subdivision were more than that of the anterior (P ＜ 0.05).There also had statistical difference between different section areas of the connective tissue in the gracilis nerve trunk (P ＜ 0.05),the section areas of the connective tissue of the distal were more than that of proximate.Conclusions The motor fascicles characteristic of the gracilis muscle nerve can be distinguished clearly by using AchE histochemical staining,combin with the microanatomy results,we can gain the distribution of the fascicular groups on each crossing sections.Using Loyez staining and quantitative analysis,we can ensure the number of the medullated nerve fibers.It is helpful to select the suitable donor nerve and ensure the dialyneury matching each other.

Objective To demonstrate the mapping of the brachial plexus by means of high resolution sonography. Methods Eight healthy adult volunteers (three women and five men) underwent bilateral sonographic examination to assess the nerve structures of the brachial plexus from the extraforaminal part to the axillary part. Results A satisfactory sonographic demonstration was shown in all the volunteers. The subclavian and deep cervical arteries were useful landmarks for this mapping. Sonography was also reliable in depicting the level of the C7 vertebra because of the absence of the anterior tubercle from its transverse processes. Conclusion The brachial plexus can be mapped with high resolution sonography, for it may increase the diagnostic rate of brachial plexus injury.