Objective Evaluation of the effect of manual reduction with small external fixation on the treatment of elderly Barton fractures.Methods A total of 244 elderly patients with Barton fractures were divided into conservative group (n=126) and operation group (n=118) according to random number table. The conservative group was treated by with manual reduction with small external fixation, and the operation group was treated with open reduction and internal fixation. The complications of the patients, the time of fracture healing, hospitalization time and treatment cost were recorded.The wrist function was evaluated by PRWE wrist score system and Wrightington wrist function score system.The clinical efficacy was evaluated by Gartland-Werley Colles fracture evaluation method.Results The excellent and good effect rate was 91.3% (115/126) in the conservative group and 97.5% (115/118) in the operation group. There was no significant difference between the two groups(χ2=0.857,P=0.354). One year, 6 months, 3 months and 6 weeks after treatment, in the conservative group, the PRWE score (10.4 ± 7.9, 19.1 ± 8.0, 40.5 ± 7.8, 55.7 ± 8.1vs. 80.8 ± 8.2,F=113.665), wrightington score (8.2 ± 3.7, 13.2 ± 4.0, 21.4 ± 3.9, 26.3 ± 4.2vs. 30.1 ± 4.2,F=121.348) were significantly lower than those before treatment (P<0.01). And in the operation group, the PRWE score (10.2 ± 7.8, 15.0 ± 8.0, 26.5 ± 8.0, 44.7 ± 8.2vs. 79.6 ± 8.6,F=81.411), Wrightington score (8.1 ± 3.8, 12.1 ± 4.0, 16.5 ± 4.0, 20.6 ± 4.3vs. 29.8 ± 4.6,F=69.113) were significantly lower than those before treatment (P<0.01). But there was no significant difference in PRWE score and Wrightington scores between the two groups after treatment (t=0.149, 0.104,P=0.881, 0.917, respectively). In the conservative group, the hospitalization time (5.28 ± 2.10 dvs. 12.8 ± 2.21d,t=25.260) was significantly shorter than that of the control group (P<0.01), and the treatment cost (3.26 ± 0.93 thousandvs. 28.66 ± 1.04 thousand,t=200.369) was significantly lower than that in the control group (P<0.01). The overall incidence of complication was 8.7% (11/126) in the conservative group and 17.8% in the surgery group (21/118). There was significant difference between the two groups(χ2=4.396,P=0.036).Conclusions The manual reduction with small splint external fixation was simple, low cost, small trauma, short hospitalization time, and less complications.

Objective To observe the effect of Chinese herbal fumigation combined with CPM promote the function recovery after Postoperative Patellar Fracture. Methods Eighty patients with patellar fracture were randomly divided into treatment group (40 cases) and control group (40 cases). The control group was treated with CPM. The treatment group was treated with Chinese Herbal Fumigation and CPM. After 8th weeks, the clinical curative effect, knee range of motion and KSS knee score were observed and compared. Results The effect rate of the treatment group was 87.5% (35/40), and the control group was 65.0% (26/40). The difference was statistically significant (χ2=5.591, P<0.01). After treatment, the range of motion of knee joint (138.38°± 7.82°vs. 0.29°± 7.83°, t=10.338), KSS knee function score (88.38 ± 9.52 vs. 3.46 ± 9.36, t=2.330) of the treatment group were higher than those in the control group (P<0.01 or P<0.05). Conclusions The Chinese medicine fumigation combined with CPM functional exercise could accelerate the recovery of knee function and reduce the complications of fracture after patellar fracture.

AIM To investigate the effects of Sanqi Huayu Oral Liquid (Notoginseng Radix et Rhizoma,Corydalis Rhizoma) on femoral shaft comminuted fracture caused by trauma in perioperative period of high-risk groups.METHODS One hundred and twenty patients meeting the inclusion criteria were randomly and equally divided into treatment group and control group.The control group was treated by low molecular weight heparin calcium injection,while the treatment group was additionally given Sanqi Huayu Oral Liquid.Two groups' levels of serum IL-6,TNF-α and D-D were detected on pre-operation and the 1 st,3rd,7th after operation,respectively.Additionally,the adverse drug reactions were also observed.RESULTS There were no statistically significant differences in the levels of serum IL-6,TNF-α and D-D between the two groups before operation.The first day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups showed increasing trends,which had similar elevated levels without statistically significant differences.The third day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups presented downward trends,but those in the treatment group were decreased more markedly with statistically significant differences.Furthermore,the seventh day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups were lower than those before the operation,and these indices in the treatment group were lower than those in the control group with statistically significant differences.CONCLUSION Sanqi Huayu Oral Liquid can not only effectively reduce the levels of serum IL-6,TNF-α and D-D in perioperative period of high-risk groups,but also prevent the formation of deep vein thrombosis.

Objective To analyze the reliability and reproducibility of three different classification systems of Tile,Young Burgess and AO in pelvic fracture.Methods One hundred cases of pelvic fractures conforming to the inclusion standard and with intact imaging data were selected and classified according to these 3 classification methods by the orthopedic surgeons.The retyping was performed at 8 weeks after disorganizing the order.Then reliability and reproducibility analysis was performed by using the Kappa values and typing consistency.Results The reliability Kappa values during the two periods before and after the Tile classification were 0.743 and 0.745 respectively,and the reproducibility Kappa value was 0.771;the reliability Kappa values during the two periods before and after the Young-Burgess classification were 0.587 and 0.590 respectively,and the reproducibility Kappa value was 0.691;the reliability of Kappa values during the two periods before and after the OA classification were 0.402 and 0.406 respectively,and the reproducibility Kappa value was 0.498.Conclusion the Tile classification has better reliability and reproducibility than the other two classifications in pelvic fracture,which is easy to master and apply.