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ObjectiveTo compare the short-term effectiveness of the three different manipulations for atlantoaxial joint disorders and their effects on surface electromyography of sternocleidomastoid muscle. MethodsNinty patients with atlantoaxial joint disorders were randomly divided into the tendon relaxing manipulation group， the tendon relaxing plus rehabilitation manipulation group， and the conventional manipulation group， with 30 cases in each group， and each group of patients received the corresponding manipulation treatment for 2 weeks. The changes of visual analogue score （VAS） of occipital neck pain， evaluation scale for cervical vertigo （ESCV）， and averaged electromyography （AEMG） of surface electromyography of bilateral sternocleidomastoid muscles before and after the treatment were observed， and the clinical effectiveness and safety of the patients were compared among groups. ResultsThe VAS scores of patients in each group decreased， and the ESCV scores increased after treatment （P＜0.01）， and the tendon relaxing manipulation group and the tendon relaxing plus rehabilitation manipulation group were significantly better than the conventional manipulation group （P＜0.01）. The AEMG of the bilateral sternocleidomastoid muscles of the three groups increased after treatment （P＜0.01）； when compared among the three groups， the AEMG of the bilateral sternocleidomastoid muscles of the tendon relaxing plus rehabilitation manipulation group was higher than that of the tendon relaxing manipulation group， and the tendon relaxing manipulation group was higher than that of the conventional manipulation group （P＜0.05 or P＜0.01）. The cure and markedly effective rates of the tendon relaxing manipulation group， the tendon relaxing plus rehabilitation manipulation group， and the conventional manipulation group were 56.67%， 86.67%， and 36.67% respectively， showing statistically difference （K=10.21， P＜0.01）. ConclusionThe tendon relaxing manipulation and tendon relaxing plus rehabilitation manipulation can effectively improve the symptoms of vertigo， headache， and neck pain for patients with atlantoaxial joint disorders， and can improve the contraction function of sternocleidomastoid muscle， whose effectiveness are better than that of conventional manipulation.
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Dermatomyositis is an autoimmune disease involving the skin and muscles. At the onset of dermatomyositis, it is difficult to make an early diagnosis due to atypical clinical manifestations and lack of serological markers. Skin and muscle lesions are associated with disease activity and prognosis in patients with dermatomyositis or clinical amyopathic dermatomyositis. Computed tomography, magnetic resonance imaging, ultrasonography, dermoscopy and other imaging techniques may be used to assess skin and muscle involvements, which can not only improve the accuracy of early diagnosis of dermatomyositis, but also provide important reference for the assessment of disease activity and prognosis.
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Current classifications of tibial plateau fractures include three-pillar classification, four-quadrant classification, eight-segment classification, ten-segment classification, and four-column & nine-segment classification. This article reviews the various CT classifications of tibial plateau fractures, their advantages and disadvantages and surgical approaches as well. The essence of the CT classifications is to pay more attention to the coronary fracture line, especially the posterior coronal fracture fragments. A classification which combines the four-quadrant idea of the articular surface of the tibial plateau with the four-column idea of the peripheral cortex of the tibial plateau, and is supplemented by descriptions of non-articular surface structures (intercondylar spine, tibial tubercle and fibula head), may provide a more comprehensive understanding of a specific tibial plateau fracture, but may therefore be too complicated and difficult to use clinically due to too many combinations that need matching.
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It has become a research hotspot in the field of trauma orthopedics how to fix intertrochanteric fractures effectively,especially the head-neck fragment,so that the osteoporotic fracture ends can be stabilized.In order to reduce fixation failure,application of bio-reinforced materials is another promising mothod in addition to improving the design of internal fixation.This paper reviews the research history,characteristics,current research into the biomechanics and clinical application of bone reinforced cement materials,intending to help surgeons understand the principles,surgical techniques and application scope of bone bio-reinforced materials for internal fixation.
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Objective:To report the effect of a new method to reconstruct the sensory function of sural flap and to share the experience.Methods:From May, 2018 to November, 2019, 12 patients with hand and foot injuries were treated with sural flap. Blood vessel CDFI examination was performed on 24 shanks of 12 patients before operation. The perforator site was 6.8 -20.5 cm from the lateral malleolus apex, with an average of 12.5 cm. The inner diameter of the root was 1.0-1.8 mm, with an average of 1.35 mm. Before operation, the velocity of blood flow velocity at the vascular root was 28.7-51.6 m/s, with an average of 38.8 m/s. In order to reconstruct the sensation of flap, in the design of free sural skin flaps of 8 patients, the distal sural nerve or medial and lateral sural cutaneous nerve of the perforating branch was anastomosed with the cutaneous nerve of the recipient region. In 2 cases of propeller sural flap, the severed end of sural nerve on the small propeller side was directly anastomosed or bridged with the cutaneous nerve on at the proximal edge of the skin flap donor site. In 2 cases of distal fascial-pedicled sural flap, the lateral malleolus was cut in a distal longitudinal shape to separate the sural nerve and accompanying blood vessels. After distal cutting and rotation, the sural flap was anastomosed with the superficial peroneal nerve in the recipient site or the medial cutaneous nerve of the dorsum of the dorsal foot. This method of reconstructing sensory function by anastomosing the original distal cutaneous nerve of the flap was defined as retrograde neurorrhaphy.Results:All patients were followed-up for 6 months to 1.5 years. The mechanism recovery of the peripheral pathway was excluded in the sensory function examination of flap. According to the evaluation standard for sensory function established by the British Medical Research Council in 1954, sensory recovery was as follows: 1 case for S 4; 8 cases for S 3+; 2 cases for S 3; and 1 case for S 2. Conclusion:Retrograde neurorrhaphy has definite therapeutic effects in reconstructing the sensory function of sural skin flap, and can be able to significantly increase the chances of sensory function reconstructing reconstruction the sensory function of such kind of flaps.
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Objective: To summarize the evolving concept and research progress on stability reconstruction in the surgical treatment of intertrochanteric fracture. Methods: Related literature and author's own experience concerning the surgical treatment of intertrochanteric fracture were reviewed and analyzed in terms of fracture pathoanatomy, stable and unstable pattern, adequate and in-adequate reduction, primary and secondary stability, postoperative stability evaluation, and early weight-bearing. Results: Intertrochanteric fracture occur at the translational area of cervico-trochanteric junction, which has a nature tendency to varus instability. Fracture reduction quality is the paramount factor and is evaluated by two views, the anteroposterior and lateral Garden alignment and cortex apposition between the head-neck fragment and the femoral shaft. Rather than the posteromedial lesser trochanteric frag ment, the cortical support concept (positive, neutral, negative) emphasizes the reduction of anteromedial cortex to a nonanatomic positive apposition or an "anatomic" neutral apposition in intraoperative fluoroscopy. Postoperative radiographic stability score provides a quantitative assessment for early weight-bearing standing and walking. However, some fractures may lose cortical contact and buttress (negative) during the process of postoperative telescoping and secondary stability. Further studies are needed to elucidate the risk factors such as tilting, swing or rotation of the head-neck fragment, and propose new preventive methods. Conclusion: Stability reconstruction of intertrochanteric fracture requires adequate fracture reduction with Garden alignment and anteromedial cortical support apposition, and reliable sustainment by internal fixation implants. Early weight-bearing standing and walking is safe in patients with perfect postoperative stability score.
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Objective To compare the biomechanical stabilities among different combinations of anterior and medial cortical supports after intramedullary nailing for unstable intertrochanteric fractures.Methods Twenty-seven synthesized femur specimens were used to create models of unstable intertrochanteric fracture of type 31A2.1 according to AO/ASIF classification.They were divided into 9 groups (n =3) according to 9 combinations of anterior and medial cortical supports on the anteroposterior and lateral X-ray films:positive-positive,positive-neutral,positive-negative,neutral-positive,neutral-neutral,neutral-negative,negative-positive,negative-neutral,negative-negative groups.After all the fractures were fixated with the newly adapted femoral intertrochanteric nails (FITN),static loadings were applied for tests of fatigue and destruction to investigate the relative displacements and yield loads of the head-neck fragments.Results For the positive-positive,positive-neutral,positive-negative,neutral-positive,neutral-neutral,neutral-negative,negative-positive,negative-neutral,negative-negative groups,the vertical displacements of the head-neck fragments under fatigue loading were respectively 5.33 ±0.58 mm,7.83 ±0.29mm,7.73 ±0.15 mm,8.17 ± 0.29 mm,8.33±1.15 mm,8.83±0.29 mm,9.33±0.58 mm,9.67±1.15 mm and 12.0±1.0 mm,showing significant differences (P ＜ 0.05).The smallest displacement was observed in the positive-positive group,significantly smaller than that in any other groups (P ＜ 0.05).For the above 9 groups,the yield loads were respectively 4,967 ± 153 N,4,467 ± 58 N,3,717 ± 76 N,2,767 ± 58 N,2,533 ± 58 N,2,267 ± 58 N,1,833 ± 58 N,1,667 ± 58 N and 1,333 ± 58 N,showing significant differences between any 2 groups (P ＜ 0.05).In the destruction test,bone interface loosening in the femoral head happened in 2 cases,bone interface loosening in the intertrochanteric zone in 15 cases,split fracture at the zone of distal locking nail in 2 cases,and loosening and breakage of the internal fixator in the distal femur in 8 cases.Conclusions The medial cortical support plays a major role and the anterior cortical support plays a secondary role in the stability of unstable intertrochanteric fracture.In the surgical procedure,surgeons should avoid the medial cortical negative support as much as possible.
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Objective To evaluate the clinical efficacy and safety of planed conversion from temporary external fixation to internal fixation for open fractures of tibial shaft.Methods We retrospectively reviewed 31 patients with high-energy open fracture of tibial shaft who had been treated from October 2008 to October 2016 at Department of Orthopaedics,in our hospital.They were 20 males and 11 females,with an average age of 38.7 years (from 15 to 79 years).By the Gustilo classification,2 cases were type Ⅰ,9 type Ⅱ,17 type ⅢA and 3 type ⅢB;by the AO/OTA classification,3 cases were type 42A,10 type 42B,and 18 type 42C.External fixation was temporally applied for the fracture ends after thorough debridement to recover the tibial length and alignment.The wounds were closed directly in 23 cases and covered with vacuum sealing drainage in 8.The external fixators were removed after their systemic condition and/or local condition of soft tissue recovered.After plaster casts were maintained for 4 to 7 days to allow for healing of the pin tracts,conversion into secondary definite internal fixation started.Plating was applied in 24 patients and intramedullary nailing in 7 patients.Results The 31 patients gained fellow-up from 13 to 61 months (mean,22.3 months).All fractures gained bony union after an average of 18.7 weeks (from 14 to 31 weeks).No wound complication or infection was observed.According to the Johner-Wruh's criteria,24 cases were rated as excellent,4 as good and 3 as fair,giving an excellent to good rate of 90.3％.Conclusion The staged conversion from temporary external fixation to internal fixation is effective and safe for open fractures of tibial shaft,leading to limited complications of soft-tissue and a high rate of fracture union.
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The value of fracture classification lies in describing fracture features,representing injury severity,guiding treatment choice and predicting outcomes.The OA/OTA fracture classifications system (its first edition in 1996 and its second edition in 2007) is accepted worldwide.Its third revised edition published in 2018 has completely renewed the classification of femoral per/inter-trochanteric fractures,in which the cortical lateral wall is used as the secondary key element to replace the former lesser trochanter.The new classification gives clear directions for selecting extramedullary side-plate fixation (e.g.dynamic hip screw,DHS) for intact lateral wall (31A1) and intramedullary nailing (cephalomedullary nail) for vulnerable (31A2) or broken lateral wall (31A3).This paper will interpret and discuss the new classification.We believe that this classification system will be more accurate with high inter/intra-observer agreement if more 3D-CT images are supplemented.
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Currently, immune checkpoint inhibitors (ICPIs) are the most compelling approach in cancer therapy, which expanded the boundary of treatment of cancer to immune-based therapy. Compared to traditional chemotherapy, immunotherapy significantly pro-longs survival while conferring fewer side effects. Because of the new mechanism of the ICPIs with good clinical efficacy, they have been approved for sale in a short time. However, the mechanism of immune-related adverse events have yet fully understood for a standardized management strategy. With further development of immunotherapy and possible combination therapy, adverse events of ICPIs gain more attention. Here, we focuses on the reported adverse events and the treatment experience to provide theoretical ba-sis for their treatment.
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Objective: To summarize the progress in the treatment of hyperextension tibial plateau fractures.
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This study was aimed to analyze the application of non-pharmacotherapy in treating cervical radiculopathy (CR) in real-world,and to provide clinical reference for CR non-pharmacotherapy.The clinical real-world data of CR was extracted by using information sharing system of traditional Chinese medicine (TCM) and clinical research.Six hundred and twenty-eight inpatients and outpatients with CR were enrolled from December 2012 to July 2014 in the information system database of Wangjing Hospital.Basic characteristics of the non-pharmacotherapy groups were analyzed by statistical description method.The node degree and mutual information value were recorded for non-pharmacotherapy application of all patients by using liquorice software.Complex network diagrams were generated.The results showed that 47％ of CR patients received non-pharmacotherapy (294/628),including 67 males and 227 females.The average age of patients was 49 years old,and the prevalence of the disease was the highest from 45 to 65 years old.In all patients,the usage of manipulation and cervical traction was higher,and the combination of manipulation and acupuncture was the most.Within outpatients,the proportion of cervical traction was higher,and the combination of manipulation and acupuncture was the most frequently.Within inpatients,the proportion of manipulation and cervical traction was higher,and the combination of comprehensive physical therapy and exercise therapy was the most frequently.It was concluded that non-pharmacotherapy has been commonly used in clinical treatment of CR.Cervical traction and manipulation was the widest applications.The combination treatment was in wide application.Future studies should increase the sample size of CR patients from different regions,and enhance gradually the level of evidence of clinical research for non-pharmacotherapy treating CR.
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Intertrochanteric fracture,a common kind of injury in orthopaedic surgery,often requires surgical intervention,especially the unstable ones.Since far back in 1995,Baumgaertner et al.recommended using the distance between the screw tip and femoral head apex (tip-apex distance,TAD) as a predictor of the risk of lag screw cutout,the importance of TAD has been recognized by orthopaedic surgeons.This concept has been widely accepted in practice,and even used as a standard in determining the helical blade position.It is not clear,however,whether the helical blade system is equal to lag screws in terms of TAD.After the limitations of TAD had been reported,Kuzyk et al.proposed a tip-apex distance referenced from the calcar (Cal-TAD) as a predictor of lag screw cutout to improve the concept further.In this article,these concepts and the latest clinical applications of TAD and Cal-TAD are reviewed based on the publications available.
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Objective To investigate the relationship between the parameters of the red blood cells and the corresponding param‐eters of mature red blood cells .Methods Blood samples of 112 healthy males and 110 healthy females were tested for these reticu‐locyte parameters by using Siemens Advia2120 hematology analyzer .Reference intervals were established .Comparisons between these reticulocyte parameters and the corresponding parameters of mature erythrocytes were drawn .Results Reference intervals for the healthy group recruited in this study were determined as follows .Females ,percentage of reticulocyte (Retic% ):0 .45% ~1 .76% ,absolute reticulocyte number(Retic#):(22~86)× 109/L ,mean corpuscular hemoglobin content of reticulocyte(CHr):30 . 1~36 .4 pg ,mean corpuscular volume of reticulocyte(MCVr):99 .5~113 .7 fL .Male ,Retic% :0 .54% ~1 .93% ,Retic# :(29~104)× 109/L ,CHr :32 .6~36 .6 pg ,MCVr :97 .6~112 .7 fL .The absolute reticulocyte of male is significantly higher than that of female;MCVr was significantly larger than mean corpuscular volume of mature erythrocytes ,which was also slightly larger in male than that in female;CHr was significantly higher than mean corpuscular hemoglobin of mature erythrocytes while mean corpuscular hemoglobin concentration of large reticulocytes was lower than that of mature erythrocytes;red blood cell volume distribution width of reticulocytes was lower than that of mature erythrocytes;the hemoglobin content distribution width of mature erythrocytes has a higher uniformity compared with reticulocytes .Conclusion The reference ranges of not commonly used parameters of reticulocytes were established ,and were compared with the corresponding parameters of red blood cells .
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Objective To investigate the clinical efficacy of mini-plate fixation for ulnar coronoid process fracture via anteromedial approach.Methods A retrospective review was made on 28 cases of ulnar coronoid process fracture treated with open reduction and mini-plate fixation from April 2010 to December 2014.There were 18 males and 10 females,with age range of 21-60 years (mean,34.3 years).Causes of injury were falls in 21 cases and traffic accidents in 7 cases.According to the O' Driscoll classification,there were 14 cases of type Ⅰ,11 cases of type Ⅱ and 3 cases of type Ⅲ.Time from injury to operation was 2-10 d (mean,3.7 d).Reduction loss,fracture healing time and complications were documented.Elbow function was evaluated at the last follow-up by Mayo elbow performance score (MEPS) and Broberg & Morrey score.Results All cases were followed up for 12-25 months (mean,15.1 months).Restricted elbow activity was initiated one week after operation.Bone united in mean 10.6 weeks (range,8-14 weeks).No nerve injury or fracture redisplacement occurred.At the final follow-up,mean flexion was (124 ± 15)° (range,90°-140°),mean extension loss was (18 ± 20) °(range,0°-50°),mean pronation was (65 ± 18)°(range,40°-85°),and mean supination was (63 ±16)°(range,35°-85°),showing significant difference in comparison with the preoperative measure (P＜0.05).According to the MEPS,the results were excellent in 17 cases,good in 8,fair in 2 and poor in 1.According to the Broberg & Morrey score,the results were excellent in 16 cases,good in 8,fair in 3 and poor in 1.Conclusion Through anteromedial approach,mini-plate fixation of the ulnar coronoid process fracture provides rigid fixation,which benefits joint stability and bone union,and allows early functional exercise.
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Objective To investigate the dementia caregivers' awareness of dementia diagnosis for patients aged≥80 years in veterans community in Beijing.Methods Patients aged 80 years and over who were diagnosed as dementia were selected from Dec.2009 to Jul.2011 in the veterans community in Beijing.A face-to-face interview and questionnaire survey were conducted in dementia caregivers individually,including basic social demographic data (gender,age,educational background),awareness rate of dementia,treatment and drug use situation and their attitude to dementia patients.Results A total of 118 caregivers were investigated individually.The caregivers in this study were mainly the spouse of the patients,and most of them were elderly people.46.6％ (55/118) of caregivers were the spouse of the patients,and 52.5％ (62/118) of caregivers were 65 years old and over.The caregivers' awareness rate of dementia was 32.3％ (38/118) when patients were diagnosed as dementia.There was no correlations of gender,age and educational background with the awareness rate of dementia diagnosis (all P＞0.05).50％ of dementia patients received the dementia treatment,and only 17.8％ (21/118) of patients got the first line drug treatment for dementia (acetylcholinesterase inhibitors and / or memantine).98.3 ％ (116 / 118) of caregivers agreed that the dementia patients should be treated kindly.Conclusions The dementia caregivers are mainly patients' spouse in veterans community and most of them are the elderly.The awareness rate of dementia diagnosis is low among the caregivers.Most patients do not take the formal treatment.The social support for the dementia caregivers should be strengthened.
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ObjectiveTo introduce the operative technique of pedicle evolution from isolated perforator to perforator-plus-adipofascial,and investigate its clinical results in venous drainage and safety in distallybased sural flaps.MethodsAfter identifying the proper viable perforators,the whole flap was designed in an eccentric propeller shape,with the perforating vessels corresponding to the pivot point.The proximal larger blade was a fasciocutaneous flap, while the distal smaller blade was a subdermal vascular plexus flap,preserving at least a quarter area of adipofascial tissue around the perforator.From January 2008 to December 2010,we performed distally perforator-adipofascial pedicled sural fasciocutaneous propeller flap in 12 patients,with 180 degrees rotation to cover foot and ankle defects.Postoperatively,flap swelling,survival and functional recovery were evaluated. Results There were 7 posterior tibial artery perforator flaps from the posteromedial and 5 peroneal artery perforator flaps from the posterolateral sural region. The proximal fasciocutaneous flap measured 4 cm × 8 cm-6 cm × 18cm, and the distal cutaneous flaps measured 2 cm × 2cm-4 cm × 4 cm.Flap swelling was noted under grade 2 in 9 cases,grade 3 in 2 cases,and grade 4 in 1case with some distal superficial skin necrosis,which occurred in the largest flap in our series.All flaps survived eventfully.After average 13 months follow up,the wound were cured successfully,and all patients recovered walking and shoe wearing function. ConclusionPedicle evolution by keeping some adipofascial tissue around the pivot perforator, can preserve more venous return routes and relieve flap swelling. This technique should be recommended in perforator pedicled propeller flaps,as it enhances flap safety,and without increasing the difficulty of 180 degrees rotation.
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Objective To observe the matching between the straight short femoral cephalomedullary nail (PFNA-Ⅱ) and the femoral anterior bow in Chinese patients with intertrochanteric fracture. Methods A retrospective study was performed to analyze the postoperative lateral X-rays of 158 patients with intertrochanteric fracture who had been treated by PFNA- Ⅱ between August 2009 and December 2010.They were 35 men and 123 women,with a mean age of 77.2 years.The relationships between the distal tip of the medullary nail and the anterior cortex of the femur were observed according to a self-designed 6-grade scale (grade 0:central location of the nail tip in the medullary canal; grade 1:deviated location without contact with the cortex; grade 2:contact＜ 1/3 cortex thickness; grade 3:contact ＞ 1/3, ＜ 2/3 cortex thickness; grade 4:contact ＞ 2/3 cortex thickness; grade 5:perforation; posterior deviations in grades 1 to 5 presented as minus).The theoretical distance was measured as if the anterior protrusive nail tip had been placed back to the central axis.The degree of the curvature and its corresponding radius were calculated by the geometric method. Results Of the 158 patients,the distal tip of PFNA- Ⅱ was located centrally along the axis of femur canal in 30 cases(19.0％ ),posteriorly to the central axis in 10 cases(6.3％ ),and anteriorly to the central axis in 118 cases (grades 1 to 3; 74.7％ ),of which 55 cases experienced irritation caused by the contact between the distal tip and the anterior cortex (grades 2 to 3％ ).The mean theoretical distance needed to put back the nail tip to the canal central axis was 1.42 ± 0.18 mm in the 17 cm nails,1.77 ± 0.39 mm in the 20 cm nails,and 2.46 ±0.20 mm in the 24 cm nails.Their corresponding curvature arcs were 2.51° ±2.40°,2.13° ± 1.65° and 2.09° ± 0.98°,and their curvature radii were 1483 ± 818 mm,2329 ± 1293 mm,and3710 ± 1957 mm,respectively. Conclusions There is a significant mismatch between the current short straight celphalomedullary nail (PFNA- Ⅱ) and the femoral anterior how in Chinese population.A curvature design is needed for the short cephaiomedullary nails to match the femoral anterior how of Chinese population.
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ObjectiveTo evaluate the clinical outcome of new proximal femoral nail antirotation (PFNA) in treatment of subtrochanteric fractures. MethodsThere were 31 patients with traumatic subtrochanteric fractures intramedullarily fixed with PFNA. The patients included 14 males and 17 fe-males at a mean age of 54.6 years (range 34-90 years). According to Seinsheimer classification of sub-trochanteric fractures, 14 patients were with type Ⅱ fractures (including four patients with type ⅡA,seven with type ⅡB and three with type ⅡC), 12 with type Ⅲ fractures (including eight with type ⅢA and four with type ⅢB), two with type Ⅳ fractures and three with type Ⅴ fractures. Close reduction was performed under traction and C-arm fluoroscopy in 26 patients and open reduction through a mini-incision before inserting the nail in five patients due to difficult close reduction. ResultsThe operation lasted for a mean time of 72.5 minutes (range 45-120 minutes), with mean blood loss of 127.5 ml (range 100-350 ml). Of all, 27 patients (87.1%, 27/31) were followed up for a mean duration of 14.3 months (range 8-24 months), which showed fracture union in all patients, with a mean union period of 17.4 weeks (range 10-21 weeks). According to Harris Hip Rate Scale, the results were. excellent in 21 pa-tients, good in two and fair in four, with excellence rate of 85.2% (23/27). ConclusionsPFNA is an effective device for treatment of subtrochanteric fracture, with a high union rate and a low complication rate, for it has advantages of easy use and minor trauma, low bleeding and stable fixation in operation.
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BACKGROUND: To summarize the feature and clinical application of various injectable bone substitutes.DATA SOURCES: The computer-based research was done in Pubmed database for articles concerning various injectable bone substitutes published from January 1995 to May 2009 with the key words of "injectable bone substitute, bone injury" in titles and abstracts. Literatures of the same fields published in recent years or in authorized journals were selected.DATA SELECTION: Latest literatures addressing feature and clinical application of various injectable bone substitutes were selected; old and repetitive studies were excluded. Finally, 21 articles were included.MAIN OUTCOME MEASURES: Feature and clinical application of various injectable bone substitutes were measured.RESULTS: Present various injectable bone substitutes contained complex hydroxyapatite bone substitutes, complex calcium sulfate bone substitutes, and complex calcium phosphate bone substitutes. Addition of bone morphogenetic protein-2 etc. in injectable bone substitute could significantly elevate bone union speed, promote osteoblastic proliferation, and overcome disadvantage of physical bone substitute to some degrees. Addition of platelet-rich plasma could promote repair effect of injectable bone substitute on bone defects, and promote differentiation of bone marrow stromal stem cells and proliferation of osteoblasts. Addition of cells could make up the insufficiency of physical materials to great degrees.CONCLUSION: The compound injectable bone substitute has a bright perspective of clinical application. Injectable bone substitutes combined with cells (especially stem cells) will be a new direction for biomaterial development in the future.