Among all the road traffic injuries(RTI ),limb and spine fractures have a very high inci-dence.They can be caused by a variety of traumatogenic mechanisms,of whi ch crash is the most common.The distribution of types of fracture in RTI assumes a centrifugation-like p attern.Multiple fractures,homola teral limb injuries and violence-conducted in juries are common.The priority in RTI emergency is to treat serious concu rrent injuries and life-threatening comp lications.Only after the overall condition of the victim get stabilized can open injuries and fractures be treated ac tively.To treat victims of fracture s caused by RTI,especially those with a poor overall condition or an old age,appl ication of external fixation,espec ially a unilateral one,is a good consider-ation.And application of lockable i ntramedullary nailing to treat long tubular bone fractures has proved ve ry satisfactory.As for pelvis fractur es caused by RTI,external fixation c an be used initially while massive hemor-rhage resulted from the injury shoul d be treated vigorously.Internal fixation should be adopted as soon as th e vital signs get stabilized.To treat spine and spinal cord injuries,titanium a lloy is the first choice for fixation material.In most cases,anterior cervical fix ation and fusion with steel plate and screw is advisable for treatment of f ractures of cervical spine,while posterior i mmobilization with screw through pedicle of vertebra is usually suggested for treatment of fracture-dislocation of thoracolumbar vertebrae.

0.05). Conclusion Our finding suggests that it is reasonable to operate on elderly patients with lumbar stenosis who are different in body mass index, because little relation has been found between body mass and surgery outcome.

Objective To prevent wrong diagnosis and treatment of chronic inflammatory demyelinating polyneuritis(CIDP) by analyzing the clinical characteristics of CIDP and spine degeneration disorders. Methods In order to distinguish CIDP from spine degeneration diseases, we retrospectively reviewed 16 CIDP patients from December 2000 to December 2003 (male 10, female 6; range 38-58 years old, mean 49.1 years old) who were misdiagnosed as spine degeneration diseases. The duration of the disease was 2 months to 2 years and 8 months, with an everage of 106 months. All clinical data of the 16 patients were analyzed. The data included clinical manifestation, physical examination, protein content of cerebrospinal fluid (CSF) and upper-lower extremity electrophysiologic study(EPS). Comparing the clinical charateristics of CIDP with those of spine degeneration disease. Results All 16 patients of CIDP sufferred limbs sensory disturbance or abnormality, walking difficulty. Upper or lower extremity were involved at equal pace and symmetry; limb tendon reflexes weakened or dissappeared, but limbs muscular atrophy were not significant. X-ray showed degeneration of cervical or thoracic and lumbar spine; MRI showed that there were disc herniation in different intervertebral. The content of protein of CSF remarkably increased(mean 479.9 mg/L). There were significant deviation compare to normal. Electrophysiology study found that sensory nerve action potential(SNAP) wave amplitude were descending; motor nerve conduction velocity(MNCV) were slower. Conclusion We could rightly diagnose and distingnish CIDP from spine degeneration diseases by analyzing clinical manifestation, physical examination, cerebrospinal fluid and electrophysiological study. [

[Objective]To discuss the clinical problems of meniscal transplantation based on 2 cases clinical practical results including the harvest and preserved methods of meniscal allograft,operative procedure,rehabilitation plan and side-effect,combining with literature review,so as to provide reference for further clinical practice and research.[Method]The meniscal allograft were perfumed with arthroscopic technique on 2 patients,younger than 50 years,suffering from severe meniscus tear or defect at the time of other procedures.The initial clinical results about relieving of symptoms,recovery of functions were evaluated after short time rehabilitations.[Result]There was no operative side-injury and signs of knee instability.The incisions healed well without exudation.The knee joint swelling disappeared in 6 weeks.Rejection reaction was not observed in all of laboratory tests.The VAS were 8,6 preoperatively and 3,2 postoperatively.The processes of rehabilitation were normal.[Conclusion]Considering the difficult in maintaining severe tear meniscus and the characteristics of immune evasion of meniscus,meniscal allograft may be expectable option in the future.Very many researches have provided theoretical base.The results of long-time following-up should be further observed and wany clinical problems need to be further solved.

[Objective] To investigate the establishment of the Allograft Menisci Bank so as to provide suitable allograft meniscus for clinical study of allograft meniscus transplantation.[Method]The allograft menisci from the plentiful donors of the tissue bank were achieved and preserved with the deep-frozen technique.Clinical use of allograft menisci should be based on practical requirement of patients and the data recorded in the Menisci Bank.[Result]From 2005 to the end of 2006,an Allograft Menisci Bank was established which consisted with about 300 different-sized menisci and 14 allograft menisci were provided for clinical study.[Conclusion]Establishment of the Allograft Menisci Bank can provide a base for clinical meniscus transplantation.The short-term effects of the allograft menisci transplantation are satisfactory,but the long-term outcomes need more cases and further observation.

[Objective]To study and evaluate the result of the surgical treatment for arthroscopic reconstruction of anterior cruciate ligament(ACL) with double-bundle semitendinosus.[Method]Thirty-one cases who underwent surgical treatment of arthroscopic reconstruction of ACL with double-bundle semitendinosus during 1990～1998 were analyzed retrospectively.The mean follow up time was 127.36 months(98～168 months).Among them,11 case was simplicity ACL injury,15 cases associated with medial meniscus injury,8 cases combined with lateral meniscus injury,6 cases combined with medial collateral ligament injury,2 case combined with lateral collateral ligament injury.All the patients with medial collateral ligament injury were associated with medial meniscus injury.The analysis was performed on the symptom,physical sign,Lysholm score system and IKDC score pre and postoperation recently.[Result]All the patients had good clinical results with no click,locking,"give way",extra-extension pain,and floating patella test were negative.There were no other complications correlated with semitendinosus grafting.But mild pain were seen in 11 cases,Lachman test were positive in 3 cases,anterior drawer test were positive in 8 cases without complications of instability.The Lysholm score:preoperation was 49.62?8.22 and 76.60?7.68 in follow-up time(P

[Objective] To determine the relationship between the adjacent segment degeneration(ASD)and the clinical outcome after lumbar spine fusion.[Methods]Totally 436 patients undergoing posterolateral lumbar fusion were followed up for 58.13 months(26~114 months).The patients were divided into 3 groups according to the number of the fusion segments:1 segment,2 segments and 3 or more segments.UCLA grading scale was used to evaluate the degeneration of the adjacent segments.Cinical outcome was evaluated according to the criteria established by Hou SH.[Results]Adjacent segment degeneration(ASD)occurred in 58 patients,including 14 in group A,27 in group B and 17 in group C.Forty-nine patients had their ASD above the fusion level and 9 below the fusion level.For all the 14 patients in group A,the degenerative grade increased by 1 grade.Of the 27 patients in group B,16 increased by 1 grade,7 by 2 grades,and 4 by 3 grades.Of the 17 patients in group C,4 increased by 1 grade,8 by 2 grades and 5 by 3 grades.For the clinical outcome,7 patients in group A increased by 1 grade.In group B,13 patients increased by 2 grade and 5 patients increased by 3 grades.For the clinical effect degrees,7 cases decreased by 1 degree in group A.In group B,13 cases decreased by 1 degree and 6 decreased by 2 degrees.[Conclusion]No significant relationship was found between the adjacent segment degeneration and the clinical outcome.Careful attention is needed for avoidance of multi-segmental fusion.

D and the differences between groups were statistically significant(P0.05).Proliferation index increased in the early phase and reached the peak at the 4th post-operative week.Level of proliferation index in four groups was gradiently decreased from group A to group D.At the 4th post-operative week,differences of proliferation index were statistically significant between groups(P0.05).The changing trend of ratio of CD4+/CD8+ was similar to that of proliferation index.Histological observations showed inflammatory cells infiltrated in early phase gradiently decreased from group A to group D.At the 4th post-operative week,histological observations showed neovascularization in group D.At the 8 weeks post-operatively,more new bone formation was observed in group D. The correlation analysis showed significant positive correlation between proliferation index,CD4+/CD8+ ratio at the 4th post-operative week and the content of total lipid (P

[Objective]To evaluate the indications,efficacy and safety of posterior total laminectomy decompression and reduction with pedicle screws for lower cervical fracture and dislocation.[Method]From June 2005 to February 2008,41 patients with lower cervical fracture and dislocation received posterior total laminectomy decompression and reduction with pedicle screws.The patients(M=32,F=9)were 22-47 years old,with an average of 33.5 years old.There were 38 fresh and 3 old injuries.[Result]All the patients were operated on successfully without severe complications during perioperative period.Totally 252 (89%) screws were exactly implanted in the cervical pedicle.The everage surgery time was 3.1 h (2.5-4 h).The average blood loss during the operation was 460 ml (250-950 ml). The average time of follow-up was 27.5 months(24-36 months). All patients had satisfiactory reduction and no internal fixator failure.Thirty-two patients who were followed up for more than 24 months had complete fusion. The motor and sensory score (ASIA92) were improved significantly at 2 years follow-up(P

[Objective]To explore the influence of defatting procedure on osteogenicity of cancellous bone allograft.[Method]Thirty inbred Lewis rats were killed.Distal femoral metaphyses were resected as cancellous bone grafts.Grafts were randomly divided into four groups which were treated by four different procedures,respectively.Content of total lipid and total protein in grafts were measured.Twelve inbred Fisher344 rats were randomly divided into four groups according to different grouped grafts which were transplanted into femoral metaphysis bone defects of the recipients.Two different fluorochrome dyes were given subcutaneously to the recipients at 14th and 4th days before sacrifice respectively.All rats were killed at the 8th postoperative week.The experimental distal femoral metaphyses were harvested and nondecalcified sections were prepared.Sections were observed with a fluorescent microscope and bone histomorphometries were studied.The correlation analysis was performed between mineral apposition rate(MAR) and the content of total lipid.[Result]Results of measurement showed content of total lipid in four grouped grafts were different and the difference between groups were statistically significant(P