Objective To explore the effect and safety of compression and distraction technique by external fixation without grafting in treatment of noninfectious nonunion of tubular fractures.Methods 43 patients were randomly divided into 2 groups by visiting sequence with random number,odd into the observation group,even into the control group.The observation group(22 cases) adopted the external fixation retractor pressure treatment,the control group(21 cases) was given extemal fixation combined with locking plate treatment.The efficacy of two groups was compared.Results 43 patients were followed up for 6 ～ 15 months,average 7.5 months.The bone healing time was 3 ～ 14 months,average 5.1 months.43 patients were all healed.The total effective rate of the observation group was 81.8％,which was significandy higher than 66.7％ in the control group (Z =9.654,P =0.001).There were no significant differences in adverse reactions and complications between the two groups (x2 =0.068,P =0.795).Conclusion The compression and distraction technique by external fixation in the treatment of noninfectious nonunion of tubular fractures has obvious curative effect,it can be widely used in clinical practice.

Objective:To investigate the efficacy and safety of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) in the treatment of staghorn calculi.Methods:From November 2016 to November 2019, 80 patients with staghorn calculi admitted to the First People's Hospital of Yongkang were selected in this research.They were randomly divided into two groups: RIRS group( n=40) and PCNL group( n=40). They were treated with RIRS and PCNL respectively.The stone removal rate, bleeding and operation time were compared between the two groups. Results:The amount of bleeding during operation, the amount of hemoglobin decrease after operation, the total cost of hospitalization and the time of hospitalization after operation in the RIRS group were less than those in the PCNL group, and the operation time was longer than that in the PCNL group, the differences were statistically significant( t≤25mm=84.306, 5.105, 2.617, 39.219, 7.488, t>25mm=24.630, 5.602, 2.586, 36.172, 6.895; all P<0.05). There was no statistically significant difference in the success rate of stone removal between the two methods for staghorn calculi with diameter ≤25mm(91.30% vs.90.91%)(χ 2=0.002, P>0.05). The success rate of debridement in the PCNL group was significantly higher than that in the RIRS group (94.4% vs.64.71%)(χ 2=4.833, P<0.05). The incidence of complications in the RIRS group was lower than that in the PCNL group (20.00% vs.45.00%), the difference was statistically significant(χ 2=5.698, P<0.05). Conclusion:RIRS and PCNL have their own advantages and disadvantages.For patients with staghorn calculi whose diameter is less than or equal to 25mm, RIRS is the first choice for treatment, with less bleeding during operation, less hospitalization cost and high safety.For patients with staghorn calculi whose diameter is more than 25 mm, PCNL is the best choice, which can significantly improve the removal rate of one-time calculi.