Thoracolumbar compression fractures (TLFs) are common spinal injuries. Due to prolonged bed rest, pain-induced stress, and other factors, the incidence of constipation in affected patients exceeds 70%, which hinders rehabilitation. This study describes the operational procedures of acupoint application for the treatment of such constipation. To do this, acupoints were selected, including Tianshu (ST25), Daheng (SP15), Zusanli (ST36), Shangjuxu (ST37), and Zhigou (TE6), Chinese medicinal herbs such as Rheum officinale were ground into a paste for application, with a frequency of 1x a day, 6 h per session, and 2 weeks as one treatment course. Efficacy and safety were evaluated using the time interval to the first defecation after treatment, Patient Assessment of Constipation Symptom, Patient Assessment of Constipation Quality of Life, Visual Analog Scale scores, and adverse reactions. Forty-two patients with TLFs complicated by constipation were enrolled and randomly divided into an experimental group and a control group. After 2 weeks, constipation was improved in both groups, with all efficacy indicators of the experimental group being superior to those of the control group (p <0.05). No severe adverse reactions were observed in either group. The study indicates that acupoint application can effectively improve constipation in patients with high safety, providing a non-invasive intervention protocol. In the future, it is planned to expand the sample size to conduct multi-center studies, optimize the medicinal formula and treatment course, and explore the mechanism of action to support clinical promotion.

Background Arthroscopic repair is a promising, minimally invasive surgical technique for patients with Palmer type 1B peripheral triangular fibrocartilage complex (TFCC) tears. Although several arthroscopic techniques are effective for repairing Palmer type 1B TFCC tears, some shortcomings remain. So, we report an arthroscopic repair technique for the treatment of Palmer type 1B Atzei class 1 TFCC tears using an intracapsular suture: an outside-in transfer all-inside repair. Methods A retrospective analysis of 38 Palmer type 1B TFCC injury patients admitted to our hospital were randomly divided into 2 groups. The group A was sutured from the outside to the inside, with a total of 21 cases; the group B was sutured with the new arthroscopic repair technique, with a total of 17 cases. Observe and compare the VAS scores and modified Mayo wrist function scores of all patients before 3, and 6 months after the operation and evaluate the incidence of thread knots in patients with different treatment methods. The methodology was performed an arthroscopic intracapsular suture using an outside-in transfer, all-inside repair technique, which is a modified method of the outside-in and all-inside technique using the needle of a 10-mL sterile syringe, for Palmer type 1B TFCC tears. A No. 2 polydioxanone suture was threaded through the needle and entered the wrist joint. Next, the needle was withdrawn carefully along the suture to the proximal tear ulnar surface of the TFCC and penetrated the TFCC, exiting the articular cavity surface of the ulnar side of the torn TFCC. Finally, arthroscopic knotting was performed. Results This new treatment was as effective as the previously arthroscopic techniques and had the advantages of no additional incision and decreased risk of operation-related complications. The incidence of thread knots in the group A (28.57%) was significantly higher than that in the group B (0%), and the difference was statistically significant ( P = 0.024). There was no significant difference in VAS score and modified Mayo wrist function scores between the two groups ( P > 0.05). Conclusions The outside-in transfer, the all-inside repair technique is suitable for Palmer type 1B Atzei class 1 TFCC tears. We recommend this technique as a useful alternative to the conventional methods of repairing Palmer type 1B TFCC tears.

目的 探讨腕关节镜下"一针一线"缝合法治疗Palmer ⅠB型三角纤维软骨复合体(TFCC)浅层损伤的近期临床疗效.方法 回顾性分析2017年8月至2021年6月该院收治的113例Palmer ⅠB型TFCC损伤患者为研究对象,根据腕关节镜下修复术缝合方法分为对照组(54例)和观察组(59例),对照组采用由外向内缝合法,观察组采用"一针一线"缝合法.比较两组术前、术后6个月疼痛视觉模拟评分(VAS)和改良Mayo腕关节功能评分,评价两组线结反应发生率及腕关节活动度.结果 两组术后6个月VAS低于术前,改良Mayo评分高于术前,差异有统计学意义(P＜0.05);两组间VAS、改良Mayo评分比较,差异无统计学意义(P＞0.05).观察组线结反应发生率低于对照组(1.69％vs.14.81％),差异有统计学意义(P＜0.05).观察组无局部红肿刺痛,术后两组腕关节活动均良好.结论 "一针一线"缝合法可有效治疗Palmer ⅠB型TFCC浅层损伤,且可以有效避免线结反应的发生.

BACKGROUND:Nonspecific low back pain (NLBP) is a common disabling disease that cannot be attributed to a specific, recognizable pathology. The use of acupuncture for NLBP is supported by several guidelines and systematic reviews. However, the efficacy of different acupuncture methods for NLBP management is still debated. This study ranked the effectiveness of acupuncture methods using network meta-analysis to screen out the optimal acupuncture methods and expound the current controversies for their effective application in health policies as well as guiding clinical operations.METHODS:The following databases were searched for relevant randomized controlled trials (RCTs) from inception to December 20, 2020: China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, WANFANG Database, Chinese biomedical literature service system, PubMed, Web of Science, Embase, and Cochrane Library. Relevant registration platforms, including the International Standard Randomised Controlled Trial Number Register (ISRCTN) and Chinese Clinical Trial Registry (ChiCTR), were also searched. Manual retrieval and tracking of references was also performed. Pairwise meta-analysis and Bayesian network meta-analysis using Revman and ADDIS, respectively, were performed and standardized mean differences examined. The primary outcome was visual analog scale (VAS) score and the secondary outcome was Oswestry Disability Index (ODI) score. Safety was defined as the incidence of adverse events.RESULTS:A total of 30 trials with 3196 participants were analyzed; 16.67% of which showed a high risk of bias. The results indicated that fire acupuncture plus manual acupuncture, auricular needling, and electroacupuncture plus warm acupuncture were most effective in reducing VAS score. The most effective interventions for reducing ODI score were manual acupuncture plus conventional medicines, followed by moxibustion and manual acupuncture plus moxibustion. Manual acupuncture plus moxibustion was dominant in the cluster ranking. Acupuncture showed a lower incidence of adverse events (7.70%) than other interventions (conventional medicines, routine care, and placebo; 12.24%).CONCLUSION:We found that manual acupuncture plus moxibustion is the most effective way to reduce NLBP pain and disability. Acupuncture is safer than other interventions. However, more direct comparative evidence from high-quality, large-sample, multicenter RCTs is needed to validate these findings.

目的 探讨采用双动全髋关节假体行初次全髋关节置换术治疗老年股骨颈骨折的早期临床疗效.方法 我院行初次全髋关节置换患者45例,分为双动全髋关节置换组23例和普通全髋关节置换组22例.比较两组术中出血量、手术时间、术前及术后Harris髋关节评分及髋关节活动范围.结果 两组均临床随访,手术切口均一期愈合,双动全髋关节置换组出血量、手术时间少于普通全髋关节置换组;术后Harris评分、屈伸活动度、内外展活动度、内外旋活动度均高于普通全髋关节置换组(P<0.05).普通全髋关节置换组中有1例术后2月出现了髋关节假体脱位;其余患者均未出现并发症.结论 双动全髋关节假体初始稳定性良好,术后髋关节活动范围大,假体脱位率很低,早期临床疗效显著,明显优于普通全髋关节置换.

肩关节钙化性肌腱炎(rotator cuff calcific tendinosis,RCCT)是肩关节疼痛的常见原因之一,发病率为2.7％-20.0％[1].上臂上举、外展时冈上肌腱易受肩峰、喙肩韧带摩擦和挤压,引起肌腱水肿、渗出、粘连,乃至纤维化、钙化.肩袖钙盐沉积后,导致粘连加重、活动受限、劳动耐力下降[2].近年来国内外大量研究证实,体外冲击波治疗(extracorpore-al shock wave therapy,ESWT)在治疗骨关节及软组织疾病上疗效显著[3-4],但冲击波治疗的频率、能流密度、能量积累大小及作用时间的差异可直接影响临床治疗效果,并且缺乏相关临床标准进行参考[5].本项研究基于控制ESWT总能量相同的情况下,观察高、中不同能流密度对钙化性肌腱炎治疗的前中期临床效果,由此探讨ESWT相关的作用机制及临床应用,现报告如下.

Background: Single-row (SR) and double-row (DR) techniques are 2 kinds of widely used approaches for the arthroscopic repair of rotator cuff. This retrospective clinical trial was performed to address the question of whether a DR rotator cuff anchor repair gives results superior to a SR anchor repair in clinical outcome scores and complication rates. Methods: This study was performed and reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology checklist. We retrospectively reviewed our database, which was collected prospectively. From 2014 to 2017, 264 patients underwent arthroscopic rotator cuff repair by an experienced single shoulder surgeon with the SR and DR techniques. This study was approved by the institutional review board in our hospital and was registered in the Research Registry. Outcome measures included Constant-Murley score, muscle strength, patient satisfaction, passive range of motion, and retear rates. Results: The hypothesis was that the DR technique would achieve better functional scores and fewer complications as compared to the SR technique in treatment of rotator cuff tears.

目的:探讨川芎茶调散合身痛逐瘀汤加减配合针灸治疗坐骨神经痛的疗效.方法:选取坐骨神经痛患者共153例,对照组75例接受常规西药及针灸治疗,观察组78例在其基础上加用川芎茶调散合身痛逐瘀汤加减治疗,比较两组临床总有效率、神经传导速度、疼痛程度评分及致痛物质水平.结果:观察组总有效率89.74％(70/78)显著高于对照组73.33％(55/75,P<0.05);观察组腓肠神经感觉神经传导速度SCV、腓肠神经运动神经传导速度MCV及病变侧胫神经运动神经传导速度MCV显著高于对照组(P<0.05);观察组腰骶部、臀部、大腿外侧、腘窝、小腿外侧VAS评分显著低于对照组(P<0.05);观察组血浆5-羟色胺(5-HT)和P物质(SP)水平显著低于对照组(P<0.05).结论:川芎茶调散合身痛逐瘀汤加减配合针灸治疗坐骨神经痛具有良好的临床疗效,能够对有效提高患者神经传导速度,减少致痛物质的合成及分泌,缓解疼痛.

单纯性骨囊肿(simple bone cyst)又称单房性骨囊肿(unicameral bone cyst)或孤立性骨囊肿(solitary bone cys),是一种好发于儿童及青少年长骨干骺端的局限性破坏性骨病损,男女比约2∶1,以疼痛、肿胀和骨折为主要症状[1-3].本文报告1例64岁女性患者,门诊行X片检查意外发现右侧股骨近端瘤样物,考虑巨大单纯性骨囊肿,给予植骨内固定术,术后6个月复查愈合,无复发囊肿,现报道如下.

目的 观察中药热敷联合经皮椎间孔镜下髓核摘除术对腰椎间盘突出症的疗效.方法 2018年01月～2019年01月期间于成都中医药大学附属医院国际病房骨科住院的腰椎间盘突出症患者60例,均行经皮椎间孔镜下髓核摘除术,术后随机分为2组,每组各30例.对照组采用常规西医治疗,观察组在对照组的基础上加用中药热敷,2组患者均进行2周治疗,通过视觉模拟评分(VAS)、日常生活能力评分(ADL)进行疗效评估.结果 观察组治疗后VAS评分下降程度及ADL评分上升程度均优于对照组.结论 中药热敷联合经皮椎间孔镜下髓核摘除术对腰椎间盘突出症的疗效确切.

BACKGROUND:This systematic review aims to evaluate the effectiveness and safety of silver acupuncture in treatment of myofascitis. METHODS:Electronic databases of all silver acupuncture for myofascitis will be searched at PubMed, Cochrane Library, Springer, Embase, China National Knowledge Infrastructure, Wanfang, and Chinese Biological Medical disc from inception to March 31, 2020, with language restricted in Chinese and English. The primary outcome is visual analog scale, a short pain scale with sensitivity and comparability. Secondary outcomes included Clinical Assessment Scale for Cervical Spondylosis, Japanese Orthopaedic Association Scores, Oswestry dysfunction index, American Orthopaedic Foot and Ankle Society-Ankle Hindfoot scale, Foot and Ankle Ability Measure, The Cumberland ankle instability tool, Pittsburgh sleep quality index, self-rating anxiety scale, self-depression rating scale, and follow-up relapse rate. The systematic review and searches for randomized controlled trials of this therapy for myofascitis. The Cochrane RevMan V5.3 bias assessment tool is implemented to assess bias risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). Mean difference, standard mean deviation, and binary data will be used to represent continuous results. RESULTS:This study will provide a comprehensive review and evaluation of the available evidence for the treatment of myofascitis with this therapy. CONCLUSION:This study will provide new evidence to evaluate the effectiveness and side effects of silver acupuncture for myofascitis. Due to the data are not personalized, no formal ethical approval is required. ETHICS AND DISSEMINATION:There is no requirement of ethical approval and it will be in print or disseminated by electronic copies. PROSPERO REGISTRATION NUMBER:CRD42020151476.

Abstract Background: With advancements in our understanding of meniscal function, treatment options for meniscal injuries have evolved considerably over the past few decades. The aim of the current study was to compare the all-inside and inside-out techniques with regard to retear rate, functional outcomes, and perioperative complications in patients who had undergone arthroscopic meniscus repair. We hypothesized that there was no significant difference between the 2 groups in terms of postoperative outcomes after arthroscopic meniscus repair. Methods: This study was a prospective randomized blinded study, with a parallel design and an allocation ratio of 1:1 for the treatment groups. This study was approved by the Institutional Review Board in our hospital and written informed consent was obtained from all subjects participating in the trial. It was carried out in accordance with the principles of the Helsinki Declaration. A total of 70 patients who meet inclusion criteria are randomized to either all-inside or inside-out group. The primary outcome measure was retear rate. Retear was determined by repeat arthroscopic evaluation of patients with follow-up for symptoms of persistent or new pain, catching, or locking that was possibly related to the meniscal repair. Secondary outcomes included disease-specific quality of life measurement with the Western Ontario Meniscal Evaluation Tool, range of motion, operative time, and adverse events at surgery or throughout the follow-up period. Results: This study has limited inclusion and exclusion criteria and a well-controlled intervention. Trial registration: This study protocol was registered in Research Registry (researchregistry5589).

Objective To observe the short-term clinical efficacy of wrist arthroscopy in the treatment of Palmer ⅠB type triangular fibrocartilage complex ( TFCC) injury.Methods From March 2016 to January 2017, 12 patients with Palmer ⅠB TFCC were admitted to the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,including 5 males and 7 females,with an average age of 38.5 years.After examination and imaging exami-nation,the diagnosis was confirmed.After full preoperative preparation , the patients underwent arthroscopic repair under wrist arthroscopy.The VAS score and modified Mayo wrist joint function score before and after surgery were tested to evaluate the clinical efficacy after 6 months.Results Twelve patients underwent successful operation and with no postoperative complications.The patients were followed up.The VAS scores before and after surgery were (4.08 ±0.90)points and (1.33 ±0.88)points,respectively,the difference was statistically significant (t＝8.37,P＝0.000).The modified Mayo wrist joint function scores were (48.33 ±7.48)points and (87.91 ±5.41)points before and after surgery,and the difference was statistically significant ( t＝12.05,P＝0.000).Conclusion Arthroscopic repair of Palmer Ⅰb type TFCC has less trauma and quick recovery ,and the clinical short-term result is satisfactory.

Objective Observe the Influence of proprioception with exercise therapy after Anterior Cruciate Ligament Reconstruction. Methods 51 patients after Anterior Cruciate Ligament reconstruction were divided into treatment group(23 patients) and observation group(28 patients). Each group received rehabilitation treatment, while the treatment group received addition exercise therapy after operation. Lysholm and proprioceptive score were recorded in 6 months and 12 months after operation. Lysholm and proprioception scores were recorded in 6 months and 12 months when postoperative follow up. Results There was significant difference in proprioception, no difference in Lysholm score between the the treatment group and the observation group. Conclusion Exercise therapy has a significant effect on promoting proprioception after Anterior Cruciate Ligament Reconstruction.

目的:观察杵针对部分肩袖撕裂的治疗效果.方法:回顾性分析78例部分肩袖撕裂患者的治疗效果,以杵针配合熏洗、康复训练,并在3月,末次随访(＞6月)时记录肩关节Constant评分.结果:经治疗后,患者Constant评分较前有显著提高,患者疼痛、肩关节活动范围及功能得到了明显改善,末次随访时较3月时的评分,无明显差异性.结论:采用杵针等传统中医药治疗PTRCT患者具有较好的疗效.

目的:观察杵针治疗寒湿证型腰椎间盘突出症的临床疗效.方法:将200例寒湿证型腰椎间盘突出症患者,随机分为治疗组和对照组,每组各100例.两组患者均配合中药熏洗、牵引治疗,治疗组以杵针治疗,对照组采用常规针刺治疗.以JOA评分为观察指标,比较两组的治疗效果.结果:治疗组优良率为78.13％,对照组优良率为76.29％,两组间临床疗效无明显差异.结论:杵针治疗与传统针刺疗效一致,但具有无创伤,无痛苦的优点.

目的：探讨关节镜对痛风性膝关节炎的诊治价值。方法对19例痛风性膝关节炎患者进行关节镜检查并取滑膜病理送检，同时行关节腔内尿酸盐结晶及痛风石清理，大量生理盐水关节冲洗。术后常规服用治疗痛风的药物及功能锻炼，观察手术疗效。结果5例术前诊断不明确者术后确诊为痛风性膝关节炎，14例术前初步诊断为痛风性膝关节炎患者术中确诊。术后切口均甲级愈合。随访6~15个月，术后膝关节疼痛VAS平均得分明显低于术前；手术后膝关节功能Lysholm平均得分显著高于术前。手术前后比较，差异均有统计学意义（ P﹤0.05）。结论关节镜对痛风性膝关节炎可作出明确诊断，可明显缓解疼痛及改善膝关节功能障碍，具有临床诊治价值。

目的:评价股骨近端防旋髓内钉(PFNA)与动力髋螺钉(DHS)治疗稳定型股骨粗隆间骨折的临床疗效.方法:将在我院治疗的稳定型股骨粗隆间骨折患者分为PFNA治疗组24例和DHS治疗组24例,观察并比较两组患者的手术时间、术中出血量、引流量及术后髋部疼痛VAS评分及 Harris髋关节功能评分、术后并发症.结果:43例患者术后获得随访,随访时间6个月～20个月.两组患者在手术时间、术中出血量、引流量、及术后不同时间点髋部疼痛VAS评分及Harris髋关节功能评分差异均无统计学意义(P＞0.05).PFNA组治疗过程中发生l例深静脉血栓形成及1例肺栓塞.结论:对于稳定型股骨转子间骨折,PFNA与DHS均可获得良好的临床疗效,但PFNA并发症相对较多.

Background As the artificial joint technology and material become matured gradually,the humeral head replacement starts to play an important role in the clinical treatment of severe lesion of shoulder joint,which can effectively relieve pain and recover the passive range of motion of the shoulder joint after operation,but its active motion still depends on the shoulder muscle strength,so the early postoperative rehabilitation training has become the key treatment measures after the humeral head replacement.This paper discusses the effect of early rehabilitation training on the shoulder joint recovery after artificial humeral head replacement.Methods From February 2010 to June 2013,1 1 cases of severe shoulder joint lesion received the artificial humeral head replacement operation.Among them,3 were males,8 were females;aged 46 to 73 years old,averagely 52.1 years old.The cause of injury:9 cases of proximal humeral fractures,1 case of ischemic necrosis of the humeral head and 1 case of giant cell tumor of proximal humerus.With the contralateral shoulder as control,preoperative routine anteroposterior,oblique and axillary plain X-ray of shoulder joint were required,and also the shoulder MRI examination,in order to assess the damage of skeletal and soft tissue.Use the beach chair position under general anesthesia.Then routinely do the skin preparation and draping.We take the deltoid and pectoralis major muscle interval approach,then release the deltoid along the shaft of humerus,and retract the conjoint tendon medially,incise the subscapularis tendon and the anterior capsule,adjust the hypsokinesis angle according to the joint stability,cut off it and measure the diameter of humeral head to determine the size of prosthesis,carefully clean the broken ends of the proximal humerus fracture patients.Install the suitable size of test model after largening the medullary cavity,check the ROM and soft tissue tension after the reduction of the shoulder.Remove the template if it is ideal,pulse flushing the medullary cavity,use the bone cement to stabilize the prosthesis,reset the shoulder joint,use the Ethibond suture to fix the subscapularis and tubercules,carefully repair of the rotator cuff,at last make sure the shoulder joint function is good without impingement.Rinse the wound again and place a plasma drainage,finally close the incision layer by layer.Keep the drainage according to the amount of blood in 24-48 h,protect the limb with a wrist neck sling for 3-6 weeks.The rehabilitation training started the first day after the operation,operated by specialized rehabilitation physicians in different stages.Passive activities are in the main position during the early stage,then gradually transit to the active and strength training.The first stage:do the hand,wrist,elbow flexion and extension training,passive shoulder flexion and lateral external rotation exercise 1 to 2 weeks postoperatively.According to the individual tolerance, gradually increase the amount of activity.The second stage:the shoulder swelling is gone and the pain is relieved,also the surgical suture is removed after 3-6 weeks,patients were instructed to gradually strengthen the shoulder internal rotation,muscle isometric and active anti resistance training in the clinic.The third stage:the tendon has healed and the activity of shoulder joint has improved after 7-12 weeks,mainly do the active muscle strength exercise to increase the range of motion.The fourth stage:12 weeks later,on the basis of former training,further strengthen the strength resistance training,and selectively focus on some muscle and joint assess the patient′s houlder function before operation and 6 and 12 weeks post operatively.The modified UCLA score is taken in evaluation of pain relief,joint function,range of motion and muscle recovery.In 35 total points:34-35 is excellent, 29-33 is good;29 or less is poor.Results 1 patient died of tumor metastasis 6 months after operation, the other 10 cases were followed up for averagely 1 5.4 months (12-40 months).The incision of all the patients were healed without infection,2 cases complained the shoulder pain,which was relieved by symptomatic treatment.All the 1 1 patients got X-ray examinations the first day after operation, before leaving the hospital,after 6 and 12 months.It showed a good position of prosthesis and there was no sign of loosening, joint instability, shoulder impingement, joint stiffness and other complications.The patients were satisfied with their shoulder joint function.After 6 weeks,the active ROM of shoulder improved significantly,compared with it before the surgery,the difference was statistically significant (t =7.32,P <0.05);the shoulder AROM further recovered after 12 weeks, then they can look after themselves,the difference was statistically significant in each direction′s activity,compared with 6 weeks after operation (t = 5.56,P < 0.05 ).The difference of shoulder direction was statistically significant,compared with the healthy side (t =2.05,P <0.05).We use a modified UCLA score to evaluate the shoulder function :excellent in 8 cases,good in 2 cases,poor in 0 cases,the average score was 33.6.For the data processing,we use SPASS 1 7.0 software to deal with the statistics,all the data are expressed by (s)before and after treatment,using one sample t test,P <0.05 means the difference was statistically significant.Conclusions The early rehabilitation training activities is good to maintain the ROM of the reconstructed joint,promote the recovery of muscle strength and improve the function of joint.It plays a key role in the long-term effect of humeral head replacement.

目的 探讨采用手法复位结合外固定治疗AO分型A型、B型闭合性肱骨干骨折的临床疗效,评价患肢肩、肘关节功能恢复的情况.方法 本组病例47例,男性36例,女性11例;年龄为17 ～ 66岁,平均38.3岁.致伤原因为:车祸33例,摔伤6例,运动损伤5例,生活损伤3例.右侧为29例,左侧为18例.骨折分型(AO分型)为A型或B型,其中A型为30例,B型为17例.上段骨折9例,中段骨折30例,下段骨折8例.对于移位较大者,在麻醉下行手法复位,不强求解剖复位,达到功能复位即可.复位固定后早期规范化的进行康复训练.结果 本组47例患者,解剖复位15例,功能复位22例.临床愈合时间最短为3周,最长为11周,平均时间为8.3周.患者均经过6个月以上的随访,47例患者无再骨折,无骨折端残留疼痛.患者邻近关节功能恢复良好,肩关节功能Constant评分为优者为34例,3例为良,平均分为86.7分;肘关节Mayo评分均为优,平均分为91.1分.结论 肱骨干骨折是非负重骨,能够耐受较大的旋转、成角、短缩移位,手法复位外固定创伤少,患者早期即可以进行康复训练,患肢肩、肘关节功能恢复良好,治疗效果满意.