Objective To discuss the curative effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treatment of comminuted fracture of metaphyseal tibia. Methods The study involved 38 patients with comminuted fracture of metaphyseal tibia treated by indirect reduction and MIPPO. Results All patients were followed up for 10-30 months (average 18.6 months), which showed one stage union in all patients. The time for bony union was 4.2-7.8 months (mean 5.4 months). The operation lasted for 50-130 minutes (average 75 minutes). According to Johner-Wruhs system, the outcome was excellent in 26 patients, good in 10 and fair in two, with satisfactory rate of 95%. Conclusion MIPPO takes advantages of minor trauma, few complication, simple manipulation, high success rate and satisfactory recovery of joint function recovery and bony union, and hence is a safe and effective treatment for comminuted fracture of metaphyseal tibia.

Objective To discuss the application of longitudinal reduction of Chinese traditional medicine in surgical treatment of distal radius comminuted fractures in the elderly. Methods Before the operation, the 54 elderly patients with the fracture were reduced by longitudinal direction under anesthesia, then they were treated with minimally invasive plate osteosynthesis in the approach upon the reduction condition and fracture types. Results After 12-month follow-up, the fractures were all healed. The mean healing time of the fractures was 8 weeks (6-12 weeks). At the end of follow -up, the mean range of motion of the wrist was at 50°of flexion, 45°of extension, 30° of ulnar deviation, at 20° of radial deviation. According to the criteria of Gartland and Werley, the results were excellent in 35 cases, good in 17 cases, fair in 2 cases and poor in 0 case. Conclusions It is vital to provide a Chinese traditional longitudinal reduction before invasive surgical plate fixation in treatment of distal radius comminuted fractures, to avoid large-area exposure of fracture site, minimize the damage to the soft tissue, maintain reduction of post operation and achieve good wrist function.

Objective To explore the treatment method for femoral neck fracture in the young adult patients and discuss the corresponding curative efficacy.Methods Closed reduction and internal fixation with hollow screws were carried out in treatment of 58 young adult patients with femoral neck fracture.There were 37 males and 21 females at age range of 19-56 years(average 37.5 years).According to Garden classification,there were seven patients with type Ⅰ fractures,19 with type Ⅱ,23 with type Ⅲ and nine with type Ⅳ.Results Follow-up lasted for 0.5-7.0 years(average 3.8 years),which showed the average one stage healing time of 5.8 months in 50 patients.Nonunion occurred in three patients and avascular necrosis of the femoral head(ANFH)in five patients,of which six patients were treated with two stage sartorius pedicled iliac graft,with fracture healing in three patients.According to Harris evaluation,the result was rated as excellent in 29 patients,good in 22,fair in two and poor in five,with excellence rate of 88％.Conclusions Closed reduction and internal fixation with hollow screw takes advantages of minor wound,few complications,high healing rate and satisfactory function recovery,and is effective in treatment of femoral neck fracture in the young adult patients.Open reduction and internal fixation with sartorius pedicled iliac graft can be used as remedial treatment for fracture nonunion and avascular necrosis.