Distal radius fracture is one of the most common injuries of human beings, particularly in young males and elderly females. There are various classifications among which classification by author' names and the AO fracture classification system are most frequently used. Although the latter one is overall and consummate, a precise classification system with complete description of the fracture remains to be raised. Recently, with the development of wrist biomechanics and microscope anatomy, more and more studies were made to treat distal radius fracture. Good reduction and fixation are the key points for treatment. In tenns uf treatment, several options exist. Nonoperative management consists of closed replacoment and external fixation. Operative treatments includes intrafocal pinning ,non-bridging and bridging external fixation , various methods of open reduction internal fixation and hone or bone substitute transplantation. Besides, arthroscopic-assisted external fixation and artificial joint for wrist become a new hot spot. However,any single therapy could not treat all sorts of distal radius fractures. Therefore, it is better to institute individualized therapy according to different fracture characteristics of each patient in order to achieve the best curative effect. This review aims to make a conclusion about advancement in distal radius fractures, in aspects of epidemiology, classification and treatment.
External Fixators ; Fracture Fixation, Internal ; Humans ; Radius Fractures ; classification ; epidemiology ; surgery

OBJECTIVETo explore the mechanical behavior of lumbar spine loaded by stress and provide the mechanical basis for clinical analysis and judgement of lumbar spine fracture classification, mechanical distribution and static stress.

METHODSBy means of computer simulation method, the constructed lumbar spine three-dimensional model was introduced into three-dimensional finite element analysis by software Ansys 7.0. The lumbar spine mechanical behavior in different parts of the stress loading were calculated. Impact load is 0-8000 N. The peak value was 8000 N. The loading time is 0-40 minutes. The values of the main stress, stress distribution and the lumbar spine unit displacement in the direction of main stress were analyzed.

RESULTSThe lumbar spine model was divided into a total of 121 239 nodes, 112 491 units. It could objectively reflect the true anatomy of lumbar spine and its biomechanical behavior and obtain the end-plate images under different stress. The stress distribution on the lumbar intervertebral disc (L(3)-L(4)) under the axial, lateral flexion and extension stress, and the displacement trace of the corresponding processus articularis were analyzed.

CONCLUSIONIt is helpful to analyze the stress distribution of lumbar spine and units displacement in static stress loading in the clinical research of lumbar spine injury and the distribution of internal stress.

Adult ; Biomechanical Phenomena ; Female ; Finite Element Analysis ; Humans ; Lumbar Vertebrae ; physiology ; Sacrum ; physiology ; Stress, Mechanical

OBJECTIVETo observe the effective of the injectable artificial bone combined with plate fixation for reconstructing the collapse tibial plateau fracture.

METHODSFrom June 2005 to January 2008,21 cases of collapse tibial plateau fracture of type Schatzker II, III were treated by injectable calcium sulfate bone substitute combined with supportive plate reconstruction including 16 males and 5 females with an average age of 35.3 years ranging from 27 to 62 years. The disease course was from 3 to 7 days (means 4 days). According to Schatzker classification, there were 17 cases of type II, 4 of type III. All patients preoperatively underwent radiography, CT scanning and three-dimensional reconstruction in order to accurately understand the extent of fracture and fracture collapse and the shattered fragments of the flip direction. All the fracture with collapse > 3 mm, without joint degeneration were selcected for surgical treatment. The knee joint function after fracture healing and recovery were evaluated by Lysholm scoring.

RESULTSAll patients were followed-up for from 6 months to 2.5 years (means 1.5 years). The X-ray films and features of all fractures showed anatomic reduction or near anatomic reduction, except one case of grade II severe comminuted fracture occurred a high degree of loss and platform reset ineffective after 6 months. The Lysholm scoring of knee function showed that the mean score was (88.3 +/- 5.2). The results were excellent in 12 cases,good in 7 cases, fair in 2 cases.

CONCLUSIONMinimally invasive injectable calcium sulfate bone combined with plate fixation for reconstructing the collapse tibial plateau fracture of type II, III can effectively prevent the further loss after reduction, to improve the long-term results. Minimally invasive injectable calcium sulfate as an artificial bone substitute materials has good prospects for clinical application.

Adult ; Bone Plates ; Bone Substitutes ; administration & dosage ; Calcium Phosphates ; administration & dosage ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Injections ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Tibial Fractures ; surgery

OBJECTIVETo discuss the diagnosis and treatment of peripheral nerve injury in the earthquake.

METHODSFourteen patients with peripheral nerve injury injured in the earthquake were involved the retrospective study. All cases accepted the timely diagnosis and treatment including anastomosis and repair of the nerve and other conservative treatments. Then the therapeutic effects were observed.

RESULTSAll 14 patients got short-term follow-up and attained the improvement in their symptoms of nerve injury.

CONCLUSIONPeripheral nerve injury has a high incidence in the earthquake. Prevention is very important. The timely and effective treatment should be taken according to spot situations and traumatic conditions of casualties in earthquake.

China ; Earthquakes ; Female ; Follow-Up Studies ; Humans ; Male ; Peripheral Nerve Injuries ; Peripheral Nerves ; surgery ; Peripheral Nervous System Diseases ; diagnosis ; prevention & control ; surgery ; therapy ; Retrospective Studies

Glucocorticoid is a kind of steroids hormone secreted by the adrenal cortex zona fasciculate or artificially synthesized. It can mediate the synthesis and metabolism of carbohydrate, lipid and protein and has the function of inhibiting immune response and anti-inflammation, anti-toxic and anti-shock effects. However, long-term intake of corticostereoid hormone will result in bone loss, even severe osteoporosis, and increase the risk of fracture. As a result the research on the mechanisms of osteoporosis become more and more necessary. Now, according to the differences in establishment methods, there are three approaches, i. e. pellet implantation, drinking water and injection. As a result of the only partial similarity between different osteoporosis models and humans, there is a special application of each type of animal model of osteoporosis. The osteoporosis in glucocorticoid-induced model is mainly caused by modulating incretion, promoting bone absorption and inhibiting the osteoblast differentiation. In the meanwhile, compared with the other animal models, genes in mice are closer to humans, and they have many advantages in cost, gene and cell techniques. Therefore, glucocorticoid-induced mouse models of osteoporosis has a great significance in osteoporosis research. This article will review the establishment methods of glucocorticoid-induced mouse models of osteoporosis.

OBJECTIVETo investigate the clinical effect of Seinsheimer type V subtrochanteric femoral fractures with dynamic hip screw and shape memory alloy bow-teeth screw.

METHODSTwelve patients with Seinsheimer type V subtrochanteric femoral fractures were retrospectively analyzed. There were 8 males and 4 females with an average age of 53 years (range 31 to 65 years). Seven cases were caused by traffic accident, 4 cases by falling from hight, 1 case by heavy object. According to the Seinsheimer classification, all the cases were type V fractures. All the cases accepted the surgical treatment with dynamic hip screw and shape memory alloy bow-teeth screw fixation.

RESULTSThe mean period of follow-up was 28 months (range 20 to 38 months). All the cases obtained bone union in average 3.3 months (from 3 to 4.5 months). There were no complications such as deep infection, deep vein thrombosis, pulmonary embolism and bone nonunion. The results of clinical evaluation according to Merle d'Aubigne scores were 16.75 +/- 1.14 and excellent in 4 cases, good in 8 cases.

CONCLUSIONApplication of dynamic hip screw and shape memory alloy bow-teeth screw as a superior option can get satisfactory reduction with reliable fixation and will be one of a better choice for fixation of Seinsheimer type V subtrochanteric femoral fractures.

Adult ; Aged ; Alloys ; Bone Screws ; Female ; Femoral Fractures ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Follow-Up Studies ; Hip ; surgery ; Humans ; Male ; Mechanical Phenomena ; Middle Aged ; Recovery of Function ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo investigate the clinical effects of PHILOS plate with injectable artificial bone for the treatment of proximal humeral fractures in elderly patients.

METHODSFrom March 2007 to March 2009,17 patients who suffered from proximal humeral fractures were retrospectively studied. There were 7 males, 10 females, with an average age of 71 years (ranged, 66 to 81 years). Nine patients were caused by falling, seven patients were caused by traffic accidents,and one patient was hit by heavy object. According to the Neer classification, 9 patients were type III and 8 patients were type IV. All the patients were treated with PHILOS plate internal fixation combined with injectable artificial bone. Assessment was based on the Constan-Murley shoulder score and percentage Constant-Murley score.

RESULTSThe mean period of follow-up was 16 months (ranged, 8 to 25 months). All the patients obtained bone union in an average of 3 months (2.5 to 3.5 months). There were no complications such as deep infection, nonunion or failure of fixation. The Constant-Murley score of the injured side was mean (86.50 +/- 10.50) (ranged, 75 to 95). The clinical outcomes were excellent in 9 cases, good in 6 cases, moderate in 2 cases.

CONCLUSIONThe treatment of proximal humeral fractures in elderly patients with application of PHILOS plate combined with injectable artificial bone can get satisfactory clinical effect especially suitable for osteoporosis and comminuted proximal humeral fractures.

Aged ; Aged, 80 and over ; Bone Plates ; Bone Transplantation ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Retrospective Studies ; Shoulder Fractures ; surgery ; Treatment Outcome

OBJECTIVETo investigate the therapeutic effects of closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children.

METHODSFrom June 2007 to December 2008, 27 patients with Gartland III supracondylar fractures were treated with closed reduction and percutaneous Kirschner wire fixation combined with plaster support. Among the patients, 18 patients were male and 9 patients were female, ranging in age from 6 to 12 years,with an average of 8.1 years. Fifteen patients were extension type, 12 patients were buckling type; fourteen patients were ulnar deviation, 13 patients were radial deviation. The duration from injury to treatment ranged from 0.5 to 8 days, averaged 3.6 days.

RESULTSTwenty-seven patients were followed up, and the duration ranged from 6 to 24 months, averaged 13.5 months. The healing time ranged from 4 to 6 weeks after surgery, with a mean of 4.5 weeks. Complications including implants loosening, fracture re-displacement, Volkmarm contraction, needle point or deep infection, ulnar nerve injury, myositis ossificans were found during follow-up. Two patients had postoperative elbow varus, but the varus angle was not more than 15 degree,which may be due to inappropriate functional exercise or early removal of external fixation. According to Flynn criteria, 19 patients got an excellent result, 5 good, 2 poor and 1 bad.

CONCLUSIONClosed reduction and percutaneous Kirschner wire fixation combined plaster support for the treatment of unstable supracondylar fractures in children has advantages including little trauma, reliable fixation, good elbow function and appearance.

Bone Wires ; Casts, Surgical ; Child ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male

OBJECTIVETo compare therapeutic effects between moxibustion and infrared therapy for the treatment of knee osteoarthritis.

METHODSFrom January 2007 to June 2008 period, 65 patients with knee osteoarthritis were divided into treatment and control groups randomly uniform random number table generated from SAS statistical software. Among 35 patients in the treatment group, 17 patients were male and 18 patients were female, ranging in age from 45 to 75 years, with an average of (61.2+/-6.4) years; the course of disease ranged from 9 to 43 months, with a mean of (23.6+/-13.8) months; the preoperative Lysholm score ranged from 19 to 28 scores, averaged (24.3+/-3.3) scores. In the control group, there were 30 patients, including 13 males and 17 females, ranging in age from 47 to 79 years, with an average of (62.5+/-9.3) years; the course of disease ranged from 8 to 45 months, with a mean of (24.6+/-16.6) months; the preoperative Lysholm score ranged from 20 to 29 scores, averaged (25.9+/-3.0) scores. The patients in the treatment group were treated with moxibustion, and the patients in control group were treated with infrared therapy. All the patients were followed up for 4 weeks. The Lysholm scores were compared between the two groups.

RESULTSAccording to Lysholm score for clinical efficacy, treatment group got (87.5+/-5.6) scores and the control group were (85.9+/-3.5) scores, the Lysholm score of the treatment group was higher than that of the control group (P<0.05). Among pain score, joint flexion and extension score, joint stability score, and up and down stairs score, the pain and joint stability scores of patients in the treatment group were higher than those of control group (P<0.05).

CONCLUSIONCompared with infrared therapy, moxibustion treatment for knee osteoarthritis can get better joint function, which is effect to alleviate the patient's pain, improve joint stability, improve the efficacy, and is valued to be promoted.

Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; methods ; Multicenter Studies as Topic ; Osteoarthritis, Knee ; therapy ; Treatment Outcome

OBJECTIVETo investigate and research WHOQOL-BREF evaluation of the clinical effect of application of moxibustion for treatment of knee osteoarthritis, to provide clinical according for the treatment.

METHODSFrom January 2007 to June 2008, 90 cases of knee osteoarthritis were randomly divided into treatment group and control group. In treatment group there were 45 cases included 16 males and 29 females with an average age of (62.5 +/- 7.4) years; the average course was (26.5 +/- 14.6) months; Lysholm score of knee function before treatment was (65.5 +/- 3.5) hours on average. In control group, there were 45 cases included 11 males and 34 females with an average age of (62.5 +/- 9.3) years;the average course was (24.6 +/- 16.6) months; Lysholm score of knee function before treatment was (66.3 +/- 2.3) hours on average. Applied Quality of Life Scale WHOQOL-BREF in line with the inclusion criteria of the study evaluation. While applied Lysholm scoring of knee joint for supporting the evaluation criteria. All data were statistical analyzed by package SPSS 11.5.

RESULTSMoxibustion was applied to treat the knee osteoarthritis and the quality of life was evaluated according to the WHOQOL-BREF scale score. The scores of the physical state, psychological state, as well as their own general health status of subjective feeling, and so on in treatment was significantly higher than that in control group (P < 0.05). According to Lysholm scoring, the score in treatment group was significantly higher than that of control group, too (t = 0.65, P < 0.05).

CONCLUSIONApplication of moxibustion for treatment of knee osteoarthritis is a simple, economical and practical, and can avoid the further development of the disease, but also to improve the joint function and improve quality of life.

Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Osteoarthritis, Knee ; pathology ; physiopathology ; therapy ; Quality of Life ; Treatment Outcome ; World Health Organization