[Conservative treatment of supination and external rotation for type â ¢ and â £ankle fracture by bone setting].

OBJECTIVE: To explore curative effect of conservative treatment of supination-lateral rotation (SER) with type Ⅲ and Ⅳ ankle fracture by bone setting technique. METHODS: From January 2017 to December 2019, 64 patients diagnosed with SER with type Ⅲ and Ⅳ ankle fracture were treated with manipulative reduction and conservative treatment (manipulation group) and surgical treatment with open reduction and internal fixation (operation group), 32 patients in each group. In manipulation group, there were 17 males and 15 females, aged from 15 to 79 years old with an average of (51.42±13.68) years old;according to Lauge-Hansen classification, there were 8 patients with supination external rotation type Ⅲ and 24 patients with type Ⅳ. In operation group, there were 13 males and 19 females, aged from 18 to 76 years old with an average of (47.36±15.02) years old;7 patients with type Ⅲ and 25 patients with type Ⅳ. Displacement of ankle fracture was measured by Digimizer software, and compared before treatment, 3 and 12 months after treatment between two groups. Lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement were measured and compared between two groups. Mazur score was used to evaluate ankle joint function. RESULTS: All patients were followed up from 12 to 36 months with an average of (17.16±9.36) months. There were statistical differences in lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement in manipulation group before and after reduction(P<0.05). Compared with operation group, there were no statistically significant differences in lateral malleolus shift, lateral malleolus shift, lateral malleolus contraction shift(P>0.05), while there were statistically significant differences in lateral malleolus shift, posterior malleolus shift up and down (P<0.05). Mazur scores of ankle joint at 3 months after treatment in manipulation group and operation group were 68.84±13.08 and 82.53±7.31, respectively, and had statistical differences(P<0.05), while there was no difference in evaluation of clnical effect(P>0.05). There were no differences in Mazur score and evaluation of clnical effect between two groups at 12 months after treatment (P>0.05). CONCLUSION: Bone setting technique could effectively correct lateral displacement of medial malleolus, lateral displacement of medial malleolus, lateral displacement of lateral malleolus and lateral contraction displacement of lateral malleolus in supination lateral rotation type Ⅲ and Ⅳ ankle fracture, and has good long-term clinical effect, which could avoid operation for some patients and restore ankle function after fracture.

Evaluating the Exfoliation Efficiency of Quasi-2D Metal Diboride Nanosheets Using Hansen Solubility Parameters.

Non-van der Waals (non-vdW) solids are emerging sources of two-dimensional (2D) nanosheets that can be produced via liquid-phase exfoliation (LPE), and are beginning to expand our understanding of 2D and quasi-2D materials. Recently, nanosheets formed by LPE processing of bulk metal diborides, a diverse family of layered non-vdW ceramic materials, have been reported. However, detailed knowledge of the exfoliation efficiency of these nanomaterials is lacking, and is important for their effective solution-phase processing and for understanding their fundamental surface chemistry, since they have significant differences from more conventional nanosheets produced from layered vdW compounds. Here in this paper we use Hansen solubility theory to investigate nanosheets of the metal borides CrB2 and MgB2 derived from LPE. By preparing dispersions in 33 different solvents, we determine Hansen solubility parameters (δD, δP, δH) for both these metal diborides. We find that they exhibit notably higher δP and δH values compared to conventional vdW materials such as graphene and MoS2, likely as a result of the types of bonds broken in such materials from exfoliation which allows for more favorable interactions with more polar and hydrogen-bonding solvents. We apply the solubility parameters to identify cosolvent blends suitable for CrB2 and MgB2 that produce dispersions with concentrations that match or exceed those of the top-performing individual solvents for each material and that have markedly higher stability compared to the constituent solvents of the blends alone. This work provides insight into the exfoliation effectiveness of different solvents for preparation of nanosheets from metal diborides and non-vdW materials in general. Such knowledge will be crucial for developing liquid-phase exfoliation strategies for incorporating these materials in applications such as nanocomposites, inks, and coatings.