BACKGROUND:For the treatment of distal tibial fractures, open reduction and plate fixation, minimal y invasive percutaneous plate fixation and intramedul ary nail fixation are effective, but each has advantages and disadvantages. OBJECTIVE:To compare the effects of intramedul ary nail combined with blocking screws versus minimal y invasive percutaneous plate fixation in treating distal tibial fractures. METHODS:Fifty-one cases of distal tibial fractures were divided into two groups. The blocking screw group (23 cases) was treated with closed reduction and internal fixation with interlocking nail combined with blocking screws. The plate fixation group (28 cases) was treated with minimal y invasive percutaneous plate fixation. Fracture healing time, recovery of tibial function and complication occurrence were observed during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 8 to 32 months. (1) Except one patient in the plate fixation group, the other patients had bony union. The healing time was (4.6±1.7) months in the blocking screw group and (6.9±2.3) months in the plate fixation group. Significant differences in healing time were detected between the two groups (P<0.05). (2) The excel ent and good rate of tibial function recovery was significantly higher in the blocking screw group (100%) than in the plate fixation group (82%) (P<0.05). (3) No significant difference in the incidence of adverse events was determined between the blocking screw group (13%) and plate fixation group (18%) (P>0.05). (4) Results suggested that interlocking intramedul ary nail combined with blocking screw fixation in the treatment of distal tibial fractures can promote fracture healing and joint function recovery.

Objective:To observe the lipid oxidation rates in spinal cord injury (SCI) patients with different exercise intensities.Method:Thirty sedentary patients with SCI were selected to perform incremental exercise load tests (baseline test and Fatmax test) with upper limb power vehicle.Meanwhile,both tests included respiratory gas analysis.In baseline tests,the workload was started at 5W and increased by 10W every 3 min,with 60 rmp until patients exhausted.The Fatmax test included 5 stages of workload and every stage kept 6 min.The initial workload was 5W,the fifth workload was corresponded to the load when respiratory quotient was 1 in the baseline test,the other workload was set according to the average of the initial and fifth workload.All lipid oxidation rates were measured by oxygen uptake (VO2) and respiratory quotient (RQ) in the tests.Result:With the increase of exercise intensity,lipid oxidation rates in SCI patients increased at first and then decreased.The peak of lipid oxidation rates (5.46±0.75 μmol/kg/min) arrived at the intensities of 34.9％±2.3％ VO2 peak.After that the lipid oxidation rates decreased significantly as 3.92±0.69,2.85±0.61,0.58±0.19 μmol/kg/min at 41.83±2.18,52.29±1.73 and 61.32±1.98％ VO.2 peak accordingly(P＜0.05).Conclusion:During the rehabilitation of SCI patients,we should pay attention to the intervention from low intensity exercise to maximize lipid oxidation rates,reducing the incidence of obesity in SCI patients.