Objective:To evaluate the clinical efficacy of the V-shaped bone tunnel technique at the base of the distal phalanx for treating tendinous mallet finger.Methods:A retrospective analysis was conducted on clinical data from patients with tendinous mallet finger treated in the Department of Hand and Foot Surgery at Linyi People’s Hospital between August 2022 and November 2023. Two oblique bone tunnels were created in a V-shaped configuration at the dorsal base of the distal phalanx, adjacent to the extensor tendon insertion, using a 0.8 mm Kirschner wire. A 4-0 double-needle monofilament tendon suture was passed through the tunnels to secure the ruptured extensor tendon to the base of the distal phalanx, followed by fixation of the distal interphalangeal (DIP) joint with a 1.0 mm Kirschner wire. The Kirschner wire was removed at 4 weeks postoperatively to initiate functional exercises. Regular follow-up was conducted to monitor wound healing and functional recovery of the DIP joint. At the final follow-up, the range of flexion and extension of the DIP joint was measured, and treatment outcomes were evaluated using Crawford’s mallet finger evaluation criteria, which classified results into four grades: excellent, good, fair, and poor.Results:Fifteen patients (16 fingers) were included, comprising 11 males and 4 females, with a mean age of 44.5 years (range: 17-65 years). The injured fingers included 2 index, 4 middle, 5 ring, and 5 little fingers, all presenting with DIP joint flexion deformity and limited active extension. Postoperative follow-up ranged from 6 to 28 months (mean: 17 months). All wounds healed primarily without complications such as infection or skin necrosis, and no cases of tendon re-rupture occurred. At the final follow-up, the measurement results of flexion and extension range of motion of the affected fingers at the DIP joint were as follows: the maximum flexion angle of all 16 fingers was 45°, among which 7 fingers had an extension angle of 0°, 8 fingers had limited extension ranging from 1° to 10°, and 1 finger had limited extension of 15°. Among the 16 fingers, 7 fingers were rated as excellent, 8 fingers as good and 1 finger as fair.Conclusion:The V-shaped bone tunnel technique for tendon-to-bone reattachment of the extensor tendon insertion is a simple and effective method for treating tendinous mallet finger. It provides satisfactory functional recovery, improves finger appearance, and is associated with minimal complications.

Objective:To evaluate the clinical efficacy of the V-shaped bone tunnel technique at the base of the distal phalanx for treating tendinous mallet finger.Methods:A retrospective analysis was conducted on clinical data from patients with tendinous mallet finger treated in the Department of Hand and Foot Surgery at Linyi People’s Hospital between August 2022 and November 2023. Two oblique bone tunnels were created in a V-shaped configuration at the dorsal base of the distal phalanx, adjacent to the extensor tendon insertion, using a 0.8 mm Kirschner wire. A 4-0 double-needle monofilament tendon suture was passed through the tunnels to secure the ruptured extensor tendon to the base of the distal phalanx, followed by fixation of the distal interphalangeal (DIP) joint with a 1.0 mm Kirschner wire. The Kirschner wire was removed at 4 weeks postoperatively to initiate functional exercises. Regular follow-up was conducted to monitor wound healing and functional recovery of the DIP joint. At the final follow-up, the range of flexion and extension of the DIP joint was measured, and treatment outcomes were evaluated using Crawford’s mallet finger evaluation criteria, which classified results into four grades: excellent, good, fair, and poor.Results:Fifteen patients (16 fingers) were included, comprising 11 males and 4 females, with a mean age of 44.5 years (range: 17-65 years). The injured fingers included 2 index, 4 middle, 5 ring, and 5 little fingers, all presenting with DIP joint flexion deformity and limited active extension. Postoperative follow-up ranged from 6 to 28 months (mean: 17 months). All wounds healed primarily without complications such as infection or skin necrosis, and no cases of tendon re-rupture occurred. At the final follow-up, the measurement results of flexion and extension range of motion of the affected fingers at the DIP joint were as follows: the maximum flexion angle of all 16 fingers was 45°, among which 7 fingers had an extension angle of 0°, 8 fingers had limited extension ranging from 1° to 10°, and 1 finger had limited extension of 15°. Among the 16 fingers, 7 fingers were rated as excellent, 8 fingers as good and 1 finger as fair.Conclusion:The V-shaped bone tunnel technique for tendon-to-bone reattachment of the extensor tendon insertion is a simple and effective method for treating tendinous mallet finger. It provides satisfactory functional recovery, improves finger appearance, and is associated with minimal complications.

OBJECTIVE:To provide reference for rational use of essential medicines of TCM preparations.METHODS:The utilization of essential medicines of TCM preparations was analyzed statistically in 21 hospitals of Yancheng area in Jiangsu province during Oct.2015-Jun.2016.RESULTS:The utilization rate of essential medicines of TCM preparations was 66.82％ in first-level hospital,and 34.64％ in second-level hospitals and 12.50％ in third-level hospitals.Top 5 essential medicines of TCM preparations in the list of consumptions sum were all TCM injection,which were mainly used for promoting blood circulation to dissipate blood stasis,invigorating qi,clearing away heat and toxic substances.Irrational use of essential medicines of TCM preparations included unsuitable usage and dosage,unsuitable solvent,drug use without indications.CONCLUSIONS:The utilization of essential medicines of TCM preparations are in good condition in 21 hospitals of Yancheng,but it is necessary to pay more attention to irrational use of them so as to promote safe and rational drug use.

OBJECTIVE:To establish the Evaluation Criteria on Rational Use of Human Serum Albumin(HSA)in our hospi-tal,and to provide refereuce for rational use of HSA. METHODS:Referring to drug utilization evaluation(DUE)criteria of WHO and developed countries,based on the guideline of HSA use,Human Serum Albumin,Non-protein Colloid and Crystalloid Solu-tion Guidelines of USA University Hospital Consortium,Blood Products Prescription Evaluation Guideline of Beijing area,etc., Evaluation Criteria on Rational Use of HAS was established through experts discussion,and the use of HAS in 420 patients of our hospital were evaluated. RESULTS:The Evaluation Criteria on Rational Use of HSA mainly included indication,contraindication, usage and dosage,drug combination,incompatibility,etc. 414 patients (98.57%) detected serum albumin concentration before treatment;167 patients(39.76%)were in line with the indication;56 patients(13.33%)had contraindication in using HSA;352 patients(83.81%)met the criteria in usage and dosage,duration of treatment;there were 17 cases(4.05%)of unreasonable drug combination and 3 cases(0.71%)of incompatibility. CONCLUSIONS:The established criteria has strong practicability,and some problems and insufficiencies can be found in the clinical practice,is conducive to promote rational drug use in the clinic.

Objective To analyze the effect of ankle joint proprioceptor injury on the functional ankle instability. Methods The study enrolled 18 ( 13 males) with chronic ankle instability treated with ligament reconstruction operation. The American Orthopaedic Foot and Ankle Surgeons (AOFAS)score was used for evaluation of the function before and after operation and the balance system evaluate the proprioception function. The two ankle ligament specimens from fresh frozen body and the tissue samples from operation were used for investigation of the structure and distribution of the sensory corpuscles by using histology and immunohistoehemical staining. Results The sections were evaluated with a microscope and an image analyzer. Labeled nerve endings were mapped, measured and categorized. Type Ⅰ ( Ruffini-like ending) , type Ⅱ ( Pacinin-like corpuscle ) and type Ⅳ- (noncorpuscular) nerve endings could be identified in all the lateral ankle ligaments, with majority of types Ⅰ and Ⅱ nerve endings.These receptors were distributed primarily over the superficial ligament and near the bony attachments.There was statistical difference between preoperative and postoperative sway distance as well as between preoperative and postoperative AOFAS score. Conclusions This study suggests that the longer history,severer symptoms and lower AOFAS score may lead to the severer injury of the mechanical proprioceptors.The proprioceptor injury is correlated with ankle joint instability and the ligament reconstruction is effective to avoid the repeated injury of the proprioceptor.