Purpose Internal iliac artery ligation (IIAL) has been used as a damage control procedure to treat hemodynamically unstable pelvic fracture for many years. However, there is ongoing debate regarding the effectiveness and safety of this hemostatic method. Therefore, we performed a systematic literature review to assess the efficacy and safety of IIAL for pelvic fracture hemostasis. Methods Three major databases, PubMed, Embase, and Google Scholar, were searched to screen eligible original studies published in English journals. Two reviewers independently read the titles, abstracts, and full texts of all literature. Articles were included if they reported the use and effects of IIAL. Results A total of 171 articles were initially identified, with 22 fully meeting the inclusion criteria. Among the analyzed cases, up to 66.7% of patients had associated abdominal and pelvic organ injuries, with the urethra being the most frequently injured organ, followed by the bowel. The outcomes of IIAL for achieving hemostasis in pelvic fractures were found to be satisfactory, with an effective rate of 80%. Hemorrhagic shock was the leading cause of death, followed by craniocerebral injury. Notably, no reports of ischemic complications involving the pelvic organs due to IIAL were found. Conclusion IIAL has a good effect in treating hemodynamically unstable pelvic fracture without the risk of pelvic organ ischemia. This procedure should be considered a priority for hemodynamically unstable pelvic fracture patients with abdominal organ injuries.

INTRODUCTION:Delayed intraperitoneal bladder rupture is a rare clinical occurrence, frequently overlooked and misdiagnosed due to its nonspecific clinical manifestations. However, literature provides only a limited number of cases reporting delayed intraperitoneal bladder rupture resulting from blunt abdominal injury.PATIENT CONCERNS:A 72-year-old female pedestrian was struck by a vehicle and experienced sudden, severe abdominal pain on the 8th day following the injury. Abdominal B-ultrasound revealed a significant accumulation of peritoneal effusion. The abdominal puncture retrieved serosanguinous ascites. Then the patient was promptly transferred to our hospital. Upon transfer, the physical examination revealed the patient vital signs to be stable, accompanied by mild abdominal distension, slight tenderness, tension, and an absence of rebound tenderness. Urinalysis detected microscopic hematuria, while contrast-enhanced computed tomography (CT) revealed considerable fluid accumulation in the abdominal cavity, without evidence of solid organ damage, and the bladder was adequately filled.DIAGNOSIS:The diagnosis of delayed intraperitoneal bladder rupture primarily relied on intraoperative observations.INTERVENTIONS:An emergency exploratory laparotomy was performed, revealing a linear rupture at the dome of the bladder. Subsequently, the bladder rupture was repaired.OUTCOMES:Postoperative cystography demonstrated full recovery and the patient was discharged 28 days post-surgery. The postoperative recovery was uneventful without any complications.CONCLUSIONS:A well-distended bladder observed in CT does not definitively rule out the potential for bladder injury. False negatives may occur due to incomplete bladder filling during CT cystography. Retrograde cystography can identify cases missed by CT cystography. In cases of substantial intra-abdominal free fluid, surgical intervention should be actively considered for patients with blunt abdominal trauma without concurrent solid organ damage.

The duodenum is mostly a retroperitoneal structure, composed by 4 segments (D1-D4) and surrounded by other vital organs like pancreas or great vessels. Injuries to this organ are rare and difficult to diagnose, with an incidence of 1–5% in cases of abdominal trauma. The most common causes of duodenal injuries are gunshot wounds and stabbing. Duodenal injuries are often associated with other organ injuries, thus delaying diagnosis in some cases and increasing the risk of complications. When diagnosed at optimum timing, it can be treated with relatively low mortality rates. Great number of repair techniques exist and the treatment of choice depends on the surgeon’s experience and hemodynamic stability of the patient, with the goal of preserving life and preventing a major complication such as leak or fistula. Outcomes are good, and the prognosis is tightly ligated to associated injuries, thus high index of suspicion and applying ATLS and surgery trauma principles are essential.

BACKGROUND The number of patients with bronchial trauma (BT) who survived to hospital admission has increased with the improvement of prehospital care; early diagnosis and treatment should be considered, especially among blunt trauma patients, whose diagnosis is frequently delayed. AIM To describe the early recognition and surgical management considerations of blunt and penetrating BTs, and to elaborate the differences between them. METHODS All patients with BTs during the past 15 years were reviewed, and data were retrospectively analyzed regarding the mechanism of injury, diagnostic and therapeutic procedures, and outcomes. According to the injury mechanisms, the patients were divided into two groups: Blunt BT (BBT) group and penetrating BT (PBT) group. The injury severity, treatment procedures, and prognoses of the two groups were compared. RESULTS A total of 73 patients with BT were admitted during the study period. The proportion of BTs among the entire cohort with chest trauma was 2.4% (73/3018), and all 73 underwent thoracotomy. Polytrauma patients accounted for 81.6% in the BBT group and 22.9% in the PBT group, and the mean Injury Severity Score was 38.22 ± 8.13 and 21.33 ± 6.12, respectively. Preoperative three-dimensional spiral computed tomography (CT) and/or fiberoptic bronchoscopy (FB) were performed in 92.1% of cases in the BBT group (n = 38) and 34.3% in the PBT group (n = 35). In the BBT group, a delay in diagnosis for over 48 h occurred in 55.3% of patients. In the PBT group, 31 patients underwent emergency thoracotomy due to massive hemothorax, and BT was confirmed during the operation. Among them, 22 underwent pulmo-tractotomy for hemostasis, avoiding partial pneumonectomy. In this series, the overall mortality rate was 6.9% (5/73), and it was 7.9% (3/38) and 5.7% (2/35) in the BBT group and PBT group, respectively (P > 0.05). All 68 survivors were followed for 6 to 42 (23 ± 6.4) mo, and CT, FB, and pulmonary function examinations were performed as planned. All patients exhibited normal lung function and healthy conditions except three who required reoperations. CONCLUSION The difference between blunt and penetrating BTs is obvious. In BBT, patients generally have no vessel injury, and the diagnosis is easily missed, leading to delayed treatment. The main cause of death is ventilation disturbance due to tension pneumothorax early and refractory atelectasis with pneumonia late. However, in PBT, most patients require emergency thoracotomy because of simultaneous vessel trauma and massive hemothorax, and delays in diagnosis are infrequent. The leading cause of death is hemorrhagic shock.

严重骨盆骨折患者早期容易出现大出血、消耗性凝血病及其他部位合并损伤,后期容易出现各种并发症,导致病死率、致残率居高不下.近年来外固定支架、兜带固定、造影栓塞、腹膜外盆腔填塞及主动脉球囊阻断技术取得了长足的进步,多学科协同规范治疗已成为处理严重骨盆骨折的共识.本文对近年来国内外严重骨盆骨折大出血治疗的进展进行综述.

In recent years, the incidence of blunt cardiac injury (BCI) has increased rapidly and is an important cause of death in trauma patients. This study aimed to explore early diagnosis and therapy to increase survival. All patients with BCI during the past 15 years were analyzed retrospectively regarding the mechanism of injury, diagnostic and therapeutic methods, and outcome. The patients were divided into two groups according to the needs of their condition—nonoperative (Group A) and operative (Group B). Comparisons of the groups were performed. A total of 348 patients with BCI accounted for 18.3 per cent of 1903 patients with blunt thoracic injury. The main cause of injury was traffic accidents, with an incidence of 48.3 per cent. In Group A (n = 305), most patients sustained myocardial contusion, and the mortality was 6.9 per cent. In Group B (n = 43), including those with cardiac rupture and pericardial hernia, the mortality was 32.6 per cent. Comparisons of the groups regarding the shock rate and mortality were significant ( P < 0.01). Deaths directly resulting from BCI in Group B were greater than those in Group A ( P < 0.05). In all 348 patients, the mortality rate was 10.1 per cent. When facing a patient with blunt thoracic injury, a high index of suspicion for BCI must be maintained. To manage myocardial contusion, it is necessary to protect the heart, alleviate edema of the myocardium, and control arrhythmia with drugs. To deal with those requiring operation, early recognition and expeditious thoracotomy are essential.

Background Blunt cardiac injury (BCI) increases with traffic accidents and is an important cause of death in trauma patients. In particular, for patients who need surgical treatment, the mortality rate is extremely high unless the patient is promptly operated on. This study aimed to explore early recognition and expeditious surgical intervention to increase survival. Methods All patients with BCIs during the past 15 years were reviewed, and those who underwent operative treatment were analyzed retrospectively regarding the mechanism of injury, diagnostic and therapeutic methods, and outcome. Results A total of 348 patients with BCIs accounted for 18.3% of 1903 patients with blunt thoracic injury (BTI). Of 348 patients, 43 underwent operative treatment. The main cause of injury was traffic accidents, with an incidence of 48.8%. Of them, steering wheel injuries occurred in 15 patients. In 26 patients, a preoperative diagnosis was obtained by echocardiography, CT scanning, etc. In the remaining 17, who had to undergo urgent thoracotomy without any preoperative imaging, a definitive diagnosis of BCI was proven during the operation. The volume of preoperative infusion or crystalloid was <1000 ml in 31 cases. Preoperative pericardiocentesis was not used in anyone. In 12 patients, the operation commenced within 1 h. Overall mortality was 32.6%. The death was caused by BCI in 9. Conclusions Facing a patient with BTI, a high index of suspicion for BCI must be maintained. To manage those requiring operations, early recognition and expeditious thoracotomy are essential. Preoperatively, limited fluid resuscitation is emphasized. We do not advocate preoperative pericardiocentesis.

Objective To study the early diagnosis,surgical treatment options,prevention and management of complications in patients with duodenal trauma.Methods All patients with duodenal trauma treated operatively from January 2009 to December 2018 were studied retrospectively.Factors including sex,age,cause of injury,AAST grading,diagnostic method,operative procedure,therapeutic effectiveness,complications,and factors related to death were analyzed.The "double-tube gastrostomy" technique consisting of duodenal decompression and jejunal feeding as recommend by the authors were used in severe cases.Results Blunt trauma occurred in 66 of 86 patients (76.7％).The diagnosis of duodenal trauma was made preoperatively based on abdominal signs,peritoneocentesis,and imaging in 32 patients (37.2％).The remaining 54 patients (62.8％),with duodenal injury was detected during emergency laparotomy.All the 86 patients underwent surgical intervention which included simple suturing,pedicled jejunal flap,segmental resection and anastomosis,Roux-en-Y duodenojejunostomy,diverticularization,and Whipple's procedure using the principle of Damage Control Surgery (DCS).Postoperative morbidity occurred in 15 patients (17.4％).There was a high incidence of duodenal (or pancreatic,biliary) fistulae.The overall mortality rate was 12.8％ (in 11 patients).The causes of deaths were mainly massive bleeding and poly-trauma.Conclusions To decrease morbidity and mortality rates,early diagnosis and surgical intervention were critical.The choice of surgical treatment procedures should be based on the duodenal trauma grading and whether there were associated injuries.For patients with a combined pancreaticoduodenal trauma,DCS is a wise procedure to adopt.The double-tube gastrostomy technique as recommended by the authors is beneficial to severe cases in decreasing the incidences of postoperative duodenal and jejunal obstruction.

目的 探讨快速血栓弹力图凝血激活时间(ACT)与普通血栓弹力图凝血反应时间(R)在急诊严重创伤患者救治中的应用与差异.方法 选择重庆市急救医疗中心2016年7月至2017年6月收治的61例严重创伤患者[创伤严重度评分(ISS评分)≥16分]为研究对象,ISS<25分(A组)23例,ISS≥25分(B组)38例.对其同步进行快速血栓弹力图和普通血栓弹力图检测,记录ACT值、R值、出血量、用血量,用SPSS19.0对数据进行统计分析.结果 ACT值与ISS评分、出血量和用血量的相关系数r分别为:0.293,0.343,0.554(P<0.05);R值与ISS评分、出血量和输血量无相关性.死亡组患者的ACT显著高于生存组,差异有统计学意义(P<0.05);两组患者R值比较,差异无统计学意义(P>0.05).B组患者的ACT显著高于A组患者,差异有统计学意义(P<0.05);两组的R值比较,差异无统计学意义(P>0.05).结论 快速血栓弹力图ACT值对急诊创伤患者的伤情判断和快速科学救治具有重大意义.

目的 探讨骨盆型严重多发伤伴失血性休克时损伤控制复苏的可行性和疗效.方法 对1995 年1月至2003年2月及2007年1~7月笔者科室收治的骨盆型严重多发伤伴失血性休克病例临床资料进行回顾性分析.其中1995 ~2003 年未采用损伤控制复苏 ( DCR) 治疗的62例作为对照组; 2007 ~2017年按照DCR 技术治疗的86 例作为治疗组.对照组均行Ⅰ期手术治疗;治疗组按DCR 技术治疗即限制性液体复苏、止血性复苏,损伤控制性手术,Ⅰ期急诊先行髂内动脉断血术以控制出血,伴脏器损伤者同时行相应手术控制出血并阻断污染,然后转往ICU复苏、生命器官支持治疗,生命体征平稳后行确定性手术.结果 对照组发生创伤性凝血病发生率37. 1% (23/62) 死亡率40. 3% (25/62).治疗组中创伤性凝血病发生率18. 7% (16/86) 死亡率22. 1% (19/86).急诊行髂内动脉断血术,其中39例行双侧髂内动脉栓塞, 47行双侧髂内动脉结扎, 81例加用骨盆外固定支架. 49 例合并腹部脏器伤.主要并发症包括盆腹腔感染8 例、 ARDS 13例、 MODS7 例、腹腔间隙综合征 5 例、深静脉血栓形成 4 例.主要死因为失血性休克.结论 早期应用DCR可提高骨盆型严重多发伤伴失血性休克患者的生存率.

Objective To summarize treatment methods for severe liver trauma associated with trauma-in-duced coagulopathy .Methods The clinical data of 32 sustained severe liver trauma patients associated with trau-ma-induced coagulopathy were collected from Feb .2010 to Apr.2016 in Chongqing Emergency Medical Center . There were 23 males and 9 females with an average age of 37.4(15-84) years.Seventeen cases (56.3%) were in-jured from road traffic accidents ,10 were from high falling/falling,3 were from crushing and 2 were from other causes . The methods of damage control resuscitation and treatment results were analyzed retrospectively .Results All the 32 cases had multiple injuries .The rapid assessment of the severity of injury was done in admission according to the principle of"CRASH PLAN",while the establishment of venous access and coagulation function ,cross matching and other tests were performed ,and the cases were resuscitated according to the principle of damage control resuscitation (DCR).Preoperative coagulation dysfunction occurred in 19 cases.Massive blood transfusion was achieved in 22 cases by fresh frozen plasma(FFP),packed red blood cells(PRBC) in the ratio of 6-10u, respectively and 10u of cryoprecitation.Liver trauma was grade Ⅳ in 20 cases,and was grade Ⅴin 12 cases.Damage control surgery in-cluding debridement hepatectomy was performed in 22 cases and improved peri-hepatic packing was performed in 13 cases.The operative time was 30min-1.5h.In this group,24 cases were survived ,and the overall mortality rate was 25%(8/32).Six (18.8%,6/32)cases died of liver injury with or without complications .Besides associated inju-ries inside and outside the abdomen , exsanguination due to liver trauma and coagulopathy was the main cause of death.Conclusion Trauma-induced coagulopathy would easily develop in patients with liver trauma of grade Ⅳand gradeⅤ.DCR is the main protocol in treating such patients .Improved perihepatic packing and debridement hepatectomy are the main damage control measures in treating severe liver trauma associated with trauma -induced coagulopathy .

Objective To summarize managing methods for pelvic fractures associated with trauma induced coagulopathy.Methods A retrospective analysis was done on the clinical data of 423 cases of severe pelvic frac-tures treated by damage control surgery(DCS) and damage control resuscitation(DCR) from Jan.2007 to Dec. 2015.Another 198 cases,as the control group,were treated without DCS or DCR from Jan.1995 to Feb.2003.And the former was as the study group.The control group underwent definitive operation initially.The study group un-derwent internal iliac arteries devascularization in the first place, followed by surgical interventions for hemostasis and blocking contamination.Patients were then transferred to ICU for further resuscitation based on DCR protocol. Definitive operations were performed only when patients became stable.Results Traumatic induced coagulopathy developed in 52 patients in the control group,including 23 deaths among them.And the mortality was 44.23%(23/52) .In the study group,there were 382 cases with ongoing hemorrhage,and trauma induced coagulopathy occurred in 86 cases.A total of 382 patients with ongoing hemorrhage underwent emergent internal iliac arteries devascular-ization,206 of whom received pelvic external fixation.In patients associated with visceral injuries,laparotomy was performed in accordance with DCS.Abiding by the principle of damage control resuscitation,hemostatic resuscitation measures were performed,and blood products and coagulation factor were transfused in the first place.The definitive surgery was performed when vital signs got stable after further resuscitation in ICU.The main complications included 17 cases of sepsis of pelvic and abdominal cavity,22 cases of abdominal compartment syndrome,12 cases of fat em-bolisation syndrome,and 30 cases of deep venous embolism.The death rate of the study group was 22.09%(19/86).The main cause of death was hemorrhagic shock.Conclusion Trauma induced coagulapathy would easily develop when pelvic fractures are severe.It would be greatly helpful in treating such patients with DCR protocol, combined with internal iliac arteries devascularization and pelvic external fixation to control hemorrhage,and the sur-vival rate will be improved obviously.

Objective To summarize managing methods for severe pelvic fracture and its complications ac-cording to the principle of damage control surgery.Methods The data of 299 patients with severe pelvic fractures from 1998 to 2011 was retrospectively analyzed.Among them 172 were males and 127 were females;the mean age was(47.3 ±8.2)years(19-83) years.The control group consisted of 116 cases without DCS during Jan.1998 and Jan.2004 and the study group consisted of 183 cases during Feb.2004 and Jan.2011 undergoing treatment with DCS.The control group underwent decisive operation initially.The study group underwent internal iliac arteries de-vascularization initially;89 of them were performed pelvic external fixation.In patients with visceral injuries,repair of stomach or intestineand cystostomy was performed to control contamination, and splenectomy and repair of the liv-er were conducted to control bleeding.All patients in the study group were transferred to ICU for resuscitation.The definitive surgery including repair of the pelvis,posterior urethra and rectum was performed when vital signs got sta-ble.Results The survival rates in the control group and the study group were 75.86%( 88/116 ) and 87.98%(161/183) ,respectively.Postoperative complications included hemorrhagic shock in 74 cases,sepsis of pelvic and abdominal cavity in 27,abdominal compartment syndrome in 22,fat embolism in 12,and deep venous embolism in 30.The main causes of death were hemorrhagic shock,multiple organ dysfunction syndrome(MODS),and septic shock.Conclusion The survival rate of severe pelvic fractures was obviously improved by DCS principles.DCS, including initial control of bleeding and contamination ( including fecal and urinary rechanneling ) for simplifying early surgical intervention,is applied by combining with pelvic external fixation.Damage control resuscitation was performed in ICU as well as dealing with complications.Only if the vital signs get stable,the definitive operations such as pelvic,posterior urethra and rectum reconstruction could be done.

Objective To analyze the clinical effect of vacuum sealing drainage (VSD) on skin and soft tissue injury in elderly patients.Methods A total of 75 patients with severe skin and soft tissue injury who met the inclusion criteria were enrolled in this study.They were divided into two groups based on admission dates:the observation group (n =40,receiving VSD treatment,oddnumber date admission) and the control group (n=35,receiving routine dressing changes,even number date admission).The clinical indexes including pain score,wound healing time,infection rate and complications were analyzed and compared between the two groups.Results There was a significant difference in the average length of hospitalization between the two groups (21.3 days vl 30.7 days,t=7.60,P=0.0000).The infection rate was lower in the observation group than in the control group (12.5％ or 5/40 vs.54.3％ or 19/35,x2=13.12,P=0.0003).The incidence of complications was lower in the observation group than in the control group (15.0％ or 6/40 vs.42.9％ or 15/35,x2=5.87,P=0.0154).There were no deaths in the observation group,but one patient died from acute pulmonary embolism in the control group during hospitalization.Conclusions VSD can alleviate pain,reduce the infection rate,shorten the length of hospitalization and decrease bedridden complications in elderly patients with severe skin and soft tissue injury,and has valuable applications in clinical practice.

Objective To investigate the effect and mechanism of tripterygium wilfordii combined with aescine in treatment of acute lung injury (ALI) following trauma.Methods A total of 120 patients with posttraumatic ALI were divided into four groups:tripterygium wilfordii + aescine group (combined group),tripterygium wilfordii group,aescine group,and control group according to random number table,with 30 patients per group.Regardless of the same conventional therapy,the patients in combined group were treated by orally or gastrically administered tripterygium wilfordii multiglycoside as well as aescine intravenously,once a day for 12 days; on the contrary,the same method but only with tripterygium wilfordii or aescine was respectively performed in tripterygium wilfordii and aescine groups.Blood gas analysis before and after treatment,length of ICU stay,fatality rate and incidence of ARDS in each group were observed.Changes in levels of inflammatory mediators (TNF-oα,IL-1,IL-6 IL-8,etc)were detected at days 4,8,and 12 after medication.Results Shorter length of ICU stay and lower ARDS incidence as well as 12-day fatality rate were detected in each treatment group as compared with control group,especially in combined group (P ＜ 0.05).Respiratory rate,PaO2 and oxygenation index (PaO2/FiO2) in each treatment group presented better amelioration than those in control group and especially better results were observed in combined group (P ＜ 0.05).Plasma levels of TNF-α,IL-1,IL-6,and IL-8 in each treatment group were lower than those in control group (P ＜ 0.05).Conclusions Tripterygium wilfordii and aescine havetherapeutic effect on posttraumatic ALI.Moreover,synergetic use of the two drugs achieves synergistic effect and better outcome.

Objective To observe the application and the curative effects of vacuum sealing drainage(VSD) in the treatment of skin injury of trauma surgery.Methods The 50 cases with severe traumatic skin injury treated with VSD were compared with traditional dressing group(control group 50 cases) to observe the curative effect of the two groups.Results Compared with control group,VSD group improved the success rate of follow-up skin graft.Good skin graft in VSD group were obvious more than the control group(P<0.01).Conclusion The VSD can improve the success rate of skin graft,accelerate wound healing.At the same time,VSD can avoid the pain due to reducing the times of changing dressings.It is a good method of treating severe traumatic skin injury.

患者男性,53岁.2008年8月27日下午5点30分进行矿井作业时被煤斗车拖拽数十米,腹部被轨道和地面矿石反复撞击,腹壁破裂脏器脱出.伤后30 min被送入当地医院,立即全身麻醉下急诊剖腹探查.手术发现上腹25.0 cm长横行破口,胃和横结肠脱出.胃幽门前后壁各有3.0 cm×3.0 cm全层破口,横结肠中部、升结肠肝曲下方各有2.5 cm×3.5 cm全层破口,小肠3处1.5 cm×1.5 cm～3.0cmx3.0 cm全层破口,腹腔有胃肠液、食渣和粪性污染,积血200 ml。

Objective To expand DCS theory from traditional simple abdominal injury to combined therapy of polytrauma.Methods Retrospectively analyzing 586 cases of polytrauma with abdominal injury.DCS was conducted in 138 cases,which accounted for 24.3%(138/568).The first priority of DCS was hemorrhage control: abdomial packing(AP) was performed in 34 cases,bilateral internal iliac artery ligation in 56 cases,bilateral internal iliac artery embolization in 8 cases,proper artery ligation or embolization in 48 cases(4 cases underwent embolization),spleen artery embolization in 2 cases,intra-abdominal blood vessel repair or ligation in 32 cases(25 cases of internal iliac artery ligation).The second purpose of DCS in first phase was contamination control: partial pancreatectomy or internal/external drainage was performed in 24 cases,duodenum repair or diverticularization in 15 cases,bladder repair or cystostomy in 36 cases.Following the above simplified operation,patients were transferred to ICU for resuscitation.Definitive operation should be done in 72 hours.Results In this group of 586 patients,545 cases survived.All cases were cured.Mortality was 26.8%(37/138).The average ISS value of death group was 41.6.In the early phase,3 cases died of cranial injury,22 cases acute massive bleeding,2 cases high paraplegia induced by cervical injury.Conclusion DCS technique should be rationally used.That's the key point to improve achievement ratio for saving severe traumatic patients.

Objective To investigate the indication and effect of fast establishment of artificial airway.Methods Retrospectively analyze the effect and complication of 240 patients in whom single use cuff trachea cannula was inserted during emergent or regular tracheotomy.Results In these 240 cases of fast establishment of artificial airway post-tracheotomy,180 cases were cured without severe complications,except for 60 death cases.Conclusion Tracheotomy is a salvage measure for relieving airway obstruction due to multiple causes.The applicance of single use cuff trachea cannula is time-saving,also is an important measure to maintain patients′ airway unobstructed.

Objective To observe the therapeutic effect of glucosamine in treating traumatic arthritis.Methods 32 patients were treated by oral glucosamine hydrochloride for 6 weeks.Lequesne index was counted respectively before and after the treatment.Statistical methods were used to analyze the Lequesne index.Results The cases of remission,obvious effect and effect were 8,18 and 5,respectively.The total percentage of effect was 96.88% .The Lequesne index before and after the treatment had significance difference (P < 0.01).Conclusion Glucosamine has good effect on traumatic arthritis.