Objective To investigate the clinical efficacy of lengthened proximal femoral nail antirotation (PFNA) and Gamma nail treatment of proximal femoral fractures (including the intertrochanteric and inferior intertrochanteric area) combined with ipsilateral femoral shaft fractures.Methods A retrospective case control study was made on 68 cases of proximal femoral fractures combined with ipsilateral femoral shaft fractures received from January 2013 to October 2014.According to the operation mode,the patients were assigned to PFNA group (30 cases) and Gamma nail group (38 cases).Between-group differences were compared in aspects of surgical condition,treatment effect,Visual Analogue Scale (VAS),postoperative hip function (Harris score) and living ability (Barthel index).Postoperative complications were recorded as well.Results Duration of follow-up was 12-24 months [(20.8 ± 1.9) months].Incision length in PFNA group was (5.4 ± 1.2) cm versus (7.3 ±1.7) cm in Gamma nail group (P ＜ 0.01).Operative time in PFNA group was (96.8 ± 24.7) min versus (153.5 ±30.4)min in Gamma nail group (P ＜0.01).Blood loss in PFNA group was (151.5 ±16.8) ml versus (184.7 ± 22.7) ml in Gamma nail group (P ＜ 0.01).Healing time of proximal femur fractures and femoral shaft fractures in PFNA group [(16.1 ± 2.5) weeks,(19.5 ± 3.4) weeks] were significantly less than that in Gamma nail group [(18.9 ± 2.6) weeks,(22.6 ± 2.6) weeks] (P ＜0.01).VAS was (3.4 ±0.5) points in PFNA group versus (6.2± 1.3) points in Gamma nail group (P ＜ 0.01).At postoperative 2 weeks,6 months and 12 months,Harris score in PFNA group [(62.4 ±4.9),(73.7 ± 6.3),(86.4 ± 3.7) points] were significantly higher than that in Gamma nail group [(50.1 ± 4.7),(65.5 ± 6.1),(81.0 ± 3.5) points] (P ＜ 0.01).At postoperative 6 months and 12 months,Barthel index in PFNA group (76.4 ± 6.3,88.1 ± 7.0) were significantly higher than that in Gamma group (70.4 ±5.4,81.3 ±6.9) (P ＜0.01).No implant failure,screw cut-out,coxa vara or fracture displacement occurred.One patient (3％) in Gamma nail group had surgical wound infection compared to PFNA group (P ＞ 0.05).Conclusion In treatment of proximal femoral fractures combined with ipsilateral femoral shaft fractures,the lengthened PFNA fixation has advantages over Gamma nail in terms of minor trauma,rapid postoperative recovery and significant effect.

Objective To compare Endobutton plating and clavicular hook plating for acromioclavicular joint dislocation.Methods The clinical data of 46 patients with acromioclavicular joint dislocation were retrospectively analyzed who had been treated at Department of Orthopaedics,The Seventh Affiliated Hospital to Sun Yat-Sen University from October 2015 to December 2017.They were 35 men and 11 women,aged from 18 to 60 years (mean,36.3 years).All dislocations were unilateral,involving the left side in 20 cases and the right side in 26.By the Rockwood classification of dislocations,there were 18 cases of type Ⅲ,24 cases of type Ⅳ and 4 cases of type Ⅴ.Of them,22 were treated with clavicular hook plating and 24 with Endobutton plating.The 2 groups were compared in terms of operation time,incision length,intraoperative blood loss,operation cost,visual analogue scale (VAS) and Constant-Murley scores.Results The 2 groups were comparable because there were no significant differences between them in the general clinical data before operation (P ＞ 0.05).The Endobutton plating group was significantly better than the hook plating group in the incision length (5.3 ± 0.6 cm versus 8.0±1.7 cm) and intraoperative blood loss (101.0±12.3 mL versus 135.0±8.1 mL),but significantly poorer than the latter in the operation cost (RMB 21,343 ±965.2 yuan versus RMB 16,849 ±919.7 yuan) (all P ＜ 0.05).The Endobutton plating group was also significantly superior to the hook plating group in the VAS scores (2.3 ±0.8 versus 3.6 ±0.9) and Constant-Murley scores (96.2 ±4.4 versus 89.3 ±5.2) at 6 months after operation (both P ＜ 0.05).Conclusion In the treatment of acromioclavicular joint dislocation,Endobutton plating may lead to better functional recovery of the shoulder,better pain relief and freedom from secondary surgical removal of the implant.

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, posing an enormous threat to public health and safety. Traditional Chinese medicine (TCM), in combination with Western medicine (WM), has made important and lasting contributions in the battle against COVID-19. In this review, updated clinical effects and potential mechanisms of TCM, presented in newly recognized three distinct phases of the disease, are summarized and discussed. By integrating the available clinical and preclinical evidence, the efficacies and underlying mechanisms of TCM on COVID-19, including the highly recommended three Chinese patent medicines and three Chinese medicine formulas, are described in a panorama. We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19, but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.