It has been over two decades from the discovery of extracorporeal shock wave(ESW).The therapy of ESW has been proved effective in improving fracture healing,and has been developed quickly both in the choice of indications and in the medical equipments research.The status quo of ESW research,application in orthpedic trauma and treatment mechanism are summarized in this paper.Successful cases are reviewd in treating post-traumatic nonunion,renovation of artificial joints,and traumatic osteonecrosis of the femoral head.Common complications and its preventive measures are given.Detailed description of ESW operating principles and selection of working parameters are also described,with the expectation of wider range of clinical applications of ESW.

Objective To compare the results of different operative methods for old acromioclavicular dislocation. Methods Forty three patients with old acromioclavicular dislocation were treated with three different operative methods: 1)open reduction plus Kirschner wire fixation (9 cases); 2)open reduction plus reconstruction of acromioclavicular ligament (14 cases) and 3)open reduction plus modified Dewar s operation (20 cases). After surgery, the subjective symptoms of the arm, muscular contraction power, function of the shoulder joint and space of acromioclavicular joint in 43 cases were followed up for an average 4.8 years. Results The excellent results following three operative methods were seen in 33％ , 50％ and 74％ respectively. There was no significant difference between Kirschner wire fixation and reconstruction of acromioclavicular ligament (P > 0.05). Modified Dewar's operation was better compared with Kirschner wire fixation and reconstruction of acromioclavicular ligament (P< 0.05). Conclusion A satisfactory surgical procedure for treatment of old acromioclavicular dislocation should accomplish the following points: removal of scar tissue and intra articular cartilaginous fragments, reconstruction of joint stability and effective internal fixation until complete healing of the ligament structures.

objective To analyze the causes of defective nonunion of femoral shaft and to evaluate interlocking intramedullary nails in treatment of shortened limb deformity following nonunion of femoral shaft. Methods 12 patients with shortened limb deformity following nonunion of femoral shaft were treated with autograft of ilium to fill up the defects and fixation by interlocking intramedullary nails. The patients were followed up for an average of 20 months. Results All the 12 patients healed by first intention after an average of 22 months. The limbs were lengthened averagely by 3.2cm. No failure occurred due to bent or broken major nails or intramedullary nails. Conclusions The main cause of shortened limb deformity following femoral shaft nonunion is bone resorption due to unreliable fixation. Interlocking intramedullary nails are an ideal device for shortened limb deformity following femoral shaft nonunion, though the union process is slow. In bone graft, care should be taken to avoid the complication of bone defect and weight bearing should be carried out some time later.

OBJECTIVE To evaluate the effects of psoraleae crude polysaccharide(PPS) on metabolism and toxicity/efficacy relationship of coumarin components of Psoraleae Fructus(CCPF) by zebrafish integrated evaluation. METHODS Zebrafish(1-6 days post fertilization, dpf) was used to evaluate the safety of CCPF, PPS and their combination; the morphologies of zebrafish organs was observed and the number of deaths was recorded and the half death concentration of zebrafish(LC50) was calculated. Zebrafish(1-6 dpf) were exposed to CCPF and its combination with PPS; the dynamic changes of psoralenoside and isopsoralenoside and their metabolites psoralen and isopsoralen were analyzed. The zebrafish osteoporosis model was induced with 25 μmol·L-1 prednisolone; microscopic observation and digital imaging of zebrafish larvae of each treatment group cultured to 8 dpf were performed using alizarin red, and the bone staining area was quantitatively analyzed by image software to evaluate the anti-osteoporosis activity of above samples. RESULTS Evaluation of the safety of CCPF, PPS and their combination by interaction with zebrafish juveniles. The toxicity of the combination of CCPF and PPS to zebrafish was greater than that of CCPF or PPS alone, and the toxicity increased with the increase of the proportion of PPS: PPS reduced the poisoning concentration of zebrafish, causing serious morphological distortion of zebrafish organs, shortening the death time of zebrafish and increasing the death rate of zebrafish. PPS obviously accelerated the deglycosylation of psoralenoside and isopsoralenoside in CCPF into psoralen and isopsoralen, which were potential metabolites of liver injury. CCPF and its combination with PPS increased the mineralized area and cumulative optical density of zebrafish skull and the combination had a certain synergistic effect, which suggested that PPS increased the anti-osteoporosis activity of CCPF to some extent. CONCLUSION Based on the integrated evaluation of zebrafish, the effects of PPS on the metabolism and toxicity/efficacy relationship of CCPF are revealed, which provides an efficient method and idea for revealing the toxicity/efficacy relationship action of PPS on other structural components.