BACKGROUND:According to worldwide statistics, internal fixation was commonly selected to treat patients with distal femoral fractures and acromioclavicular joint dislocation. The firmness of Kirschner wire is poor during fixation, so needle withdrawal easily appears, and the fixation would be failure. To reduce complications after fixation, AO/ASIF clavicular hook plate as a novel fixator has been used in treatment of distal clavicle fractures and acromioclavicular joint dislocation. OBJECTIVE:To explore the safety and effectiveness of AO/ASIF clavicular hook plate in the treatment of distal clavicle fractures and acromioclavicular dislocation, and to compare with Kirschner wire tension band.METHODS:100 patients with distal clavicle fractures and acromioclavicular joint dislocation, who were treated in the Department of Orthopedics of Tongcheng People’s Hospital from June 2010 to December 2013, were enrol ed in this study. They were equal y assigned into Kirschner wire tension band group and AO/ASIF clavicular hook plate group according to different fixation methods. The excel ent and good rate of shoulder function recovery, shoulder function score and upper limb functional recovery were observed and compared between the two groups after fixation. RESULTS AND CONCLUSION:The excel ent and good rate of shoulder function recovery was 98%in the AO/ASIF clavicular hook plate group after fixation, which was significantly higher than Kirschner wire tension band group (64%). The incidence of acromioclavicular re-dislocation was 0 after removal of fixator in the AO/ASIF clavicular hook plate group, which was lower than Kirschner wire tension band group (12%), showing significant differences between groups (P<0.05). Japanese Orthopaedic Association score was significantly higher at 5 and 10 weeks after fixation in both groups compared with pre-fixation. Japanese Orthopaedic Association score was significantly higher in the AO/ASIF clavicular hook plate group than in the Kirschner wire tension band group (P<0.05). The ranges of motion of adduction, abduction, flexion and extension were significantly higher in the AO/ASIF clavicular hook plate group than in the Kirschner wire tension band group at 10 weeks after fixation (P<0.05). Above results suggested that AO/ASIF clavicular hook plate is a safe effective fixator for repair of distal clavicle fractures and acromioclavicular joint dislocation, and characterized by smal incision, reliable fixation, and early shoulder activities.

AIM: To study the effect of low-dose baclofen on inflammatory factors and oxidative stress in patients with trigeminal neuralgia. METHODS: A total of 112 patients with trigeminal neuralgia treated in our hospital from Jan. 2017 to Jan. 2019 were selected as the subjects; they were divided into test group (n=56) and control group (n=56) according to random number table method. The control group was treated with oxcarbazepine, while the test group was treated with low-dose baclofen on the basis of the control group; the clinical total effective rate, visual analogue scale (VAS), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) levels and the incidence of adverse reactions were compared between the two groups. RESULTS:The clinical total effective rate of the test group was significantly higher than that of the control group (P<0.05); the VAS score of the two groups was significantly lower than that before treatment (P<0.05), and the VAS score of the test group was significantly lower than that of the control group (P<0.05); the levels of TNF-α, IL-6 and in the two groups were significantly lower than those before treatment (P<0.05), and the levels of TNF-α, IL-6 and in the test group were significantly lower than those in the control group (P<0.05); the levels of MDA in the two groups were significantly lower than those before treatment (P<0.05), SOD and GSH-Px were significantly higher than those before treatment (P<0.05), and the levels of MDA in the test group were significantly lower than those in the control group (P<0.05), while the levels of SOD and GSH-Px were significantly higher than those in the control group (P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSION:Low-dose baclofen adjuvant therapy has good clinical efficacy for patients with trigeminal neuralgia, which can effectively relieve pain, reduce inflammation and oxidative stress.

Objective To evaluate ultrasound-guided posterior approach to intercostal block for herpetic neuralgia. Methods Forty-eight patients with herpetic neuralgia after appearance of rashes on the back of chest (the coursc ＜ 30 days) aged 56-84 yr received intercostal block performed via posterior approach under the guidance of ultrasound with a mixture of 0.75% ropivacaine, glucocorticoid and methylene blue. Pain was assessed with visual analogue scale (VAS) before block and at 1, 2, 4 and 8 weeks after block. Pain relief (PAR) was cal-culated (PAR= (VAS score before block- VAS score after block) ÷ VAS score before block × 100%). Results No patient developed dyspnea and pneumothorax. VAS scores were reduced significantly, quality of life was improved and PAR increased at 1, 2, 4 ancl 8 weeks after block ( P ＜ 0.05 or 0.01). Concluslon Ultracound-guided posterior approach to intercostal block is safe and effective for the treatment of herpetic neuralgia.

The talus fracture is a rare kind of fracture in clinical work in the department of orthopedics due to the special structure of the talus.It is usually caused by high altitude falling accidents and serious violence,etc.Associated with the economic development,the talus fracture cases are found with increasing trend caused by serious traffic and building accidents.In this review,we will summarize the main progresses contributed to knowledge of anatomy and blood supply,damage mechanism and classification,and especially the diagnosis and treatment of talus fracture.

Objective To evaluate the efficacy of ultrasound guided transversus abdominis plane block for elderly herpetic neuralgia located in anterior abdominal wall.Methods A total of 112 elderly patients aged 65-75 years with less than 30 days of herpes zoster neuralgia located in anterior abdominal wall were enrolled for receiving a treatment of transversus abdominis plane block.Patients were randomly allocated into two groups:the control group (n =56) taking gabapentin and celebrex,and the observation group (n =56)receiving transversus abdominis plane block (three times per week for two weeks) as add on therapy to gabapentin and celebrex.Morphine 10 mg was ready for oral application in breakthrough pain.Pain was evaluated by McGill scores assessed by short-form of Mcgill pain questionnaire(SF-M PQ)and visual analogue scale(VAS)before(T0)and after 1 (T1)and 2 weeks(T2)of transversus abdominis plane block,and 1 (T3)and 8(T4)weeks after end of the treatment.Pain relief(PAR)was calculated by the formula:PAR=(VAS score before block-VAS score after block)/ VAS score before block × 100％.The morphine consumption and sleep quality were observed during the treatment and 1 week after treatment.Analgesic efficacy was graded 8 weeks after end of treatment.The effective rate and good response rate were calculated.Incidences of complications were recorded.Results There was no significant difference in the VAS score between the two groups before treatment(t =0.419,P ＞0.05),while VAS scores after treatment were lower in the observation group than in the control group(t =17.925,19.662,12.580 and 13.987,respectively,P＜0.05).Before treatment,there was no significant difference in the total score of McGill between the two groups(t =0.544,P＞0.05).After treatment,the total scores of McGill were lower in the observation group than in the control group(t =18.612,20.135,13.213 and 12.356,respectively,P ＜0.05).The pre-therapy scores of sleep quality after treatment were decreased in the observation group as compared with the control group(t =7.798,9.545,10.335 and 16.318,respectively,P ＜0.05).Before treatment and at different time points of T1,T2,T3,T4,the morphine consumptions were not significant different between two groups(t =1.939,P＞0.05).While after treatment,the morphine consumptions were decreased in the observation group versus in the control group(t =22.341,16.758,17.827,15.541 respectively,P ＜0.05).No punctures of abdominal cavity,chest cavity,internal organs or blood vessels by mistake occurred.Conclusions Ultrasound-guided transversus abdominis plane block is effective and has less adverse reactions in treating herpetic neuralgia located in anterior abdominal wall.