[Efficacy of compound Xiatianwu tablets in elderly patients with osteoporotic distal radius fractures].

Xiatianwu tablet is based on the theory of traditional Chinese medicine (TCM), combined with modern TCM pharmacology and selected 33 famous traditional Chinese crude drugs to compose. Its recipe helps cure rheumatism, relax tendons, promote blood circulation to relieve pain, et al. Although Xiatianwu tablets are widely applied to clinical remedy such as rheumatic arthritis, lumbar disc hernia, osteoarthritis and so on, there is no report about its application in fracture. This article is to observe the efficacy of compound Xiatianwu tablets in elderly patients with osteoporotic distal radius fractures and its impact on the wrist function and complications. 180 elderly patients with osteoporotic distal radius fractures, from January 2011 to June 2014, were divided into observation group and control group by the method of random number table, each group had 90 cases. The control group were gave Caltrate D after manipulative reduction and plaster immobilization, observation group were treated with compound Xiatianwu tablets in the basis of the control group. Efficacy, wrist function and complication rates were observed in two groups after treatment. The excellent and good rate was 95.56% in observation group better than 77.78% in control group, the difference was statistically significant (χ2 = 4.712, P < 0.05). The complication rate in observation group was significantly lower compared with the control group (P < 0.05). This study shows that compound Xiatianwu tablets can improve the efficacy in elderly patients with osteoporotic distal radius fractures, reduce the incidence of complications and relieve the pain of patients which plays a significant role in improving the quality of life.

[Clinical Efficacy of Supplementary Treatment of Gukang Capsules to the Elder Patients with Fracture of Distal Radius].

OBJECTIVE: To study the clinical efficacy of supplementary treatment of tukang Capsules to the elder patients with fracture of the distal radius. METHODS: A total of 108 elder patients with fracture of the distal radius diagnosed by X-ray,who visited orthopedics department of Pu' ai Hospital in January 2012 - December 2013, were randomly divided into observation group and control group. Cases in both groups received the operation of internal fixation by T-type plate. Cases in control group received oral Calcium Carbonate Tablets, and cases in observation group received Gukang Capsules besides Calcium Carbonate Tablets. Treatment duration was four weeks. The painful and swelling degree of wrist joints, levels of type I propeptide carboxy-terminal procollagen (P I CP) and bone glaprotein(BGP) in serum were compared. Hospitalization and fracture healing time, as well as recovery condition of wrist joints in the sixth month after operation were compared. RESULTS: The VAS of both groups was not significantly different before operation and in the 28th day after operation(P >0. 05), but the VAS in observation group was significantly lower than that in control group in the 3rd,5th, 7th, 14th and 21th day after operation(P <0. 01). The swelling scale of both groups was not significantly different before operation and in the 28th day after operation(P >0. 05), but the swelling scale in observation group was significantly lower than that in control group in the 3rd, 5th, 7th, 14th and 21th day after operation(P <0. 01). The levels of P I CP and BGP in serum of both groups were not significantly different before operation(P >0. 05), but the levels of P I CP and BGP in serum of observation groups were significantly higher than that in control group one and two months after operation (P <0. 01). Hospitalization and fracture healing time in observation group was significantly shortened compared with control group (P <0. 05). The effective ratio in observation group was 79. 63%, significantly higher than that in control group (P <0. 05). CONCLUSION: Gukang Capsules supplementary to internal fixation by T-type plate has favorable efficacy to fracture of the distal radius, which can reduce pain and swelling, increase levels of P I CP and BGP in serum, as well as promote the heal of fracture and recovery of wrist joints function.

Effect and nursing study of traditional Chinese medicine preparation huayu zhitong powder in the treatment of distal radius fracture.

This paper aims to discuss the effect of traditional Chinese medicine preparation Huayu Zhitong powder in the treatment of distal radius fracture. In this paper, 200 patients with distal radius fracture were randomly divided into treatment group and control group. Patients in treatment group orally took Huayu Zhitong powder, while patients in control group were treated with traditional Shangke Jiegu tablets with traditional Chinese medicine composition. After fixed in a cast plaster, patients in the two groups were supervised the disappearance time of pain by adopting NRS (Numerical rating scale) from scale 0 to 10. Besides, they returned at day 5 and day 8 respectively, and then they were observed the swelling affected part. At day 14, day 28, and day 56 after reduction they respectively took an x-ray. Then they would be graded according to the growth of osteotylus and the clinical effects were evaluated based on the grade. Finally, the treatment group worked better in relief effect than the control group. At day 8, the treatment group worked better in detumescence than the control group. At day 28, the recovery effect in treatment group was found to be better than the other. From these, it is shown that the traditional Chinese medicine works much better in the treatment of distal radius fracture than traditional treatment medicine. Thus it is of great worth spreading for use.

[Case-control study on tibetan Baimai ointment (see symbol in text) for the treatment of wrist-dysfunction after distal radius fracture].

OBJECTIVE: To evaluate efficacy and safety of Baimai ointment (see symbol in text) in the treatment of wrist-dysfunction after distal radius fracture. METHODS: From April, 2011 to June, 2012, 43 patients with distal radius fracture were treated with plaster fixation. All the patients were divided into two group: test group and control group. Twenty-one patients in test group and 22 in control group, and the baseline was balance (P > 0.05). The 21 patients in test group were treated with Baimai ointment (see symbol in text), fomentation, functional exercises. The 22 patients in control group were treated with placebo, fomentation, functional exercises. Foment affected side wrist with wet towel in 20 min before medication, with the temperature between 50 degrees C and 60 degrees C. Smear drugs uniformly in range of 3 cm in the vicinity of palm stripes after drying (about 3 g) and take functional exercises for the activities of wrist and hand. Continuous follow the program per 8 hours once and follow-up for 8 weeks. The Wrist's pain was assessed with VAS. The wrist's activities were measured with the protractor of orthopedic. Measure The grip strength was measured with dynamometer. The wrist's function were assessed with the table of Cooney. RESULTS: The test group had a significantly better results than those of control group in the extent of wrist's pain throughout the treatment (P < 0.001), and grip strength on the 28th day and the 56th day (P < 0.05), and Cooney functional assessment on the 56th day (P < 0.05). Wrist's activities had no significane difference throughout the 8 weeks (P > 0.05). There were no drug adverse reactions occurred. CONCLUSION: Tibetan Baimai ointment (see symbol in text) has the treatment of wrist-dysfunction after distal radius fracture for external use, which can reduce the extent of wrist's pain, promote grip strength recovery in the middle and late of process, promote wrist's function recovery latterly, and safety for external use.

[Clinical randomized controlled trial on splint external fixation combined with Chinese herbs in treating distal radius fractures of elderly patients].

OBJECTIVE: To explore the effects of Yishen Zhuanggu decoction ([Chinese characters: see text], YSZGD) on the fracture healing and function of wrist joint in osteoporotic distal radius fractures (ODRF) of elderly patients. METHODS: Ninety patients of ODRF were treated with splint external fixation and YSZGD, including 28 males and 62 females, with an average age of 63 years (ranged, 61 to 91 years). According to AO classification, all the patients were classified as type A or B1. Among the patients, 80 patients had a type of Colles fracture,7 patients were with a type of Smith fracture,and 3 patients had a type of Barton fracture. They were randomly divided into three groups included TCM, Western medicine and control group (30 cases each group) after the fractures were fixed manually by splint. Patients in TCM group took YSZGD orally, one potion and two time each day; the patients in Western medicine group treated with Calcitonin (50 units, intramuscular, 2 times each week), Caltrate D (1 tablets, taken orally, one time each day) and Alfacalcidol Soft Capsules (0.5 units, taken orally, one time each day); and the patients in control group took no medicine. X-ray examination on the fractured wrist was taken at the 4, 6, 8, 12th weeks after treating to observe, the fracture healings, the evaluation of wrist function and comparision of curative effects were taken at the 2nd month. RESULTS: The fracture healing time in TCM group was 7.12 +/- 2.32 weeks and that in the Western medicine group was 9.25 +/- 3.05 weeks, showing significant differences between them (PC < 0.05), and that in the control group was 11.57 +/- 1.93 weeks which was longer thant in that in the two medicine groups (P < 0.05); According to Dienst wrist rating system, the excellent and good rates of three groups were 93.3%, 86.7% and 60% respectively which showing significant differences between medicine groups and control group (P < 0.05), and the curative effects of medicine groups were more excellent than that of control group through Ridit analysis. CONCLUSION: YSZGD can promote the fracture healing evidently and shorten the healing time, whose curative effect surpassed Western medicine and promoted the restoration of wrist function.

[Morphometry of osteoclasts in experimental fracture healing of rabbits].

This study was designed to investigate the effects of some Traditional Chinese Medicine (TCM) agents on bone resorption and morphometric features of osteoclasts as well as their relationships. TCM ShengGuZaiZaoSan and XianLingGuBao, were used to treat the experimental fracture. Thirty 6-month-old Chinchilla rabbits were used for the establishment of animal models each with a 3 mm bone defect in the middle of left radius as well as of right radius. These models were divided randomly into 3 groups : ShengGuZaiZaoSan Group (Group A), XianLingGuBao groups (Group B) and control-group (Group C). Every group was further divided into 2 subgroups: a former sacrificed group (14 days after operation) and a latter sacrificed group (31 days after operation). After the rabbits being killed, the samples of their undecalcified calli were subjected to the morphometry study of bone resorption and osteoclasts. Group A had more bone resorption, compared with Group B and C. Both Groups A and B exhibited some changed morphometric features of osteoclasts as compared with Group C (P < 0.05). Simple correlation analysis indicated that bone resorption is mainly correlated with osteoclast numbers, and that in individual group, bone resorption is correlated with osteoclast form factor, area and mean photodensity (P < 0.05). These allow us to conclude that ShengGuZaiZaoSan can increase bone resorption and accelerate bone remodeling by increasing osteoclast numbers at the former stage and can enhance osteoclast function at the latter stage. These changes are beneficial to fracture healing.

Effect of bovine bone morphogenetic proteins on radius fracture healing in rabbits

PURPOSE: To investigate the effect of bovine bone morphogenetic proteins (bBMPs) bound to hydroxyapatite plus collagen in the healing of unstable radius fractures. METHODS: A transverse fracture was induced at the mid of the diaphysis in both radii on 15 Norfolk rabbits with average age of 5.5 months and 3.5kg. A mixture of bBMPs bound to thin powdered hydroxyapatite (bBMP-HA) and bovine collagen as agglutinant was applied to the right radius fracture site. The left radius fracture was considered control and no treatment was used. After 30, 60 and 90 days (5 rabbits/period) the rabbits were euthanized and the radii were collected for histological analysis. RESULTS: The descriptive histological analysis revealed that repair was similar for both forelimbs. The histomorphometric analysis showed that the mean area of newly formed bone was 867442.16 mm², 938743.00 mm² and 779621.06 mm² for the control forelimbs, and 841118.47 mm², 788038.76mm² and 618587.24 mm² for the treated forelimbs at 30, 60 and 90 days, respectively. Thus the newly formed bone area was 12.17 percent larger in the forelimbs treated with bBMP-HA/collagen than in the control forelimbs (p<0.05, Tukey test) in the 60-day period after surgery. In both forelimbs the newly formed bone area increased throughout the experimental period until the complete fracture healing. CONCLUSION: Based on the result obtained here we concluded that bBMP-HA/collagen induced a lower but significant improvement in fracture consolidation.

OBJETIVO: Investigar a influência de Proteínas Morfogenéticas Osseas de origem bovina (bBMPs) ligadas a hidroxiapatita mais colágeno na consolidação de fraturas instáveis do rádio. MÉTODOS: Em 15 coelhos com aproximadamente 5,5 meses de idade e peso médio de 3,5kg foi realizada uma fratura transversa na porção média da diáfise do rádio de ambos os membros. Na fratura do rádio direito foi aplicada mistura de bBMPs ligadas à hidroxiapatita (bBMP-HA) e colágeno bovino como aglutinante e na do rádio esquerdo, considerada controle, nenhum tratamento foi usado. Os coelhos (cinco por período) foram submetidos à eutanásia aos 30, 60 e 90 dias após a cirurgia para realização do processamento histológico e análise microscópica. RESULTADOS: A análise histológica descritiva revelou que a consolidação foi similar para os membros tratado e controle. Pela análise histomorfométrica, a área de novo osso foi em média 867442,16 mm², 938743.00 mm² e 779621,06 mm² para os membros controles e 841118,47 mm², 788038,76mm² e 618587,24 mm² para os membros tratados, aos 30, 60 e 90 dias, respectivamente. Desta forma, aos 60 dias de pós-operatório a área de novo osso foi 12.17 por cento maior no membro tratado com bBMP-HA/colágeno em relação ao membro controle (p<0.05, teste de Tukey). Em ambos os membros a área de novo osso aumentou durante o período experimental até a total consolidação da fratura. CONCLUSÃO: Baseado nos resultados obtidos foi possível concluir que a mistura de bBMP-HA/colágeno induziu pequena, porém significante melhora na consolidação da fratura.

Effect of bovine bone morphogenetic proteins on radius fracture healing in rabbits.

PURPOSE: To investigate the effect of bovine bone morphogenetic proteins (bBMPs) bound to hydroxyapatite plus collagen in the healing of unstable radius fractures. METHODS: A transverse fracture was induced at the mid of the diaphysis in both radii on 15 Norfolk rabbits with average age of 5.5 months and 3.5 kg. A mixture of bBMPs bound to thin powdered hydroxyapatite (bBMP-HA) and bovine collagen as agglutinant was applied to the right radius fracture site. The left radius fracture was considered control and no treatment was used. After 30, 60 and 90 days (5 rabbits/period) the rabbits were euthanized and the radii were collected for histological analysis. RESULTS: The descriptive histological analysis revealed that repair was similar for both forelimbs. The histomorphometric analysis showed that the mean area of newly formed bone was 867442.16 mm2, 938743.00 mm2 and 779621.06 mm2 for the control forelimbs, and 841118.47 mm2, 788038.76 mm2 and 618587.24 mm2 for the treated forelimbs at 30, 60 and 90 days, respectively. Thus the newly formed bone area was 12.17% larger in the forelimbs treated with bBMP-HA/collagen than in the control forelimbs (p<0.05, Tukey test) in the 60-day period after surgery. In both forelimbs the newly formed bone area increased throughout the experimental period until the complete fracture healing. CONCLUSION: Based on the result obtained here we concluded that bBMP-HA/collagen induced a lower but significant improvement in fracture consolidation.

[Clinical observation on effects of qianggu capsules in treating radius distal osteoporotic fractures].

OBJECTIVE: To explore the effects of qianggu capsules (QGC) on the fracture healing and the bone mineral density (BMD) in radius distal osteoporosis fracture (RDOF) patients. METHODS: Bone mineral density (BMD) of femoral neck in 65 patients with RDOF was detected after the fracture was fixed manually. They were then randomly divided into two groups. Thirty-three patients in the treated group took QC, 1 capsule (180 mg) each time, three times a day, while 32 patients in the control group took D-Cal Biocal 2 tablets (1500 mg) each time, once daily. The therapeutic course for both groups was three months. X-ray examination on the broken end of the fractured bone was taken every month to observe the bony callus formation for comparing the curative effect, and BMD of femoral neck were detected again after patients were treated for 3 months. The bony callus appeared earlier, more in volume with thicker cortex in the treated group after 2 months of treatment versus that in the control group. The fracture healing time in the treated group was 9.4 +/- 2.5 weeks and that in the control group was 12.5 +/- 2.9 weeks, showing significant difference between them (P < 0.05). BMD in the treated group before treatment was 0.621 +/- 0.085 g/cm2, which was lower than that after treatment (0.646 +/- 0.090 g/cm2) with significant difference showing between them (P < 0.05), while no significant change of BMD was found in the control group between before and after treatment, and significant difference was found in BMD between the two groups after treatment (P < 0.05). CONCLUSION: QGC can promote the formation of bony callus ahead of time, increase the volume of bony callus and BMD, improve the bone structure, and thus the time of external fixation in treating RDOF could be reduced.

[Experimental study on effect of shengguzaizaosan on rabbits fracture healing].

OBJECTIVE: To study the effect of shengguzaizaosan on experimental fracture healing. METHODS: Thirty six-month-old Chinchilla rabbits were made the models with 3 mm bone defect in the middle of two-side radius and were divided randomly into 3 groups: shengguzaizaosan group (group A, n = 10), xianlinggubao group (group B, n = 10) and control group (group C, n = 10). Five rabbits were sacrificed 14 days and 31 days after operation respectively. The double marks with tetracyslin hydrochloride were given on the 4th day and the 5th day for the first mark and on the 11th day and the 12th day for the second mark in the rabbits sacrificed 14 days later, and on the 20th day and the 21st day for the first mark and on the 28th day and the 29th day for the second mark in the rabbits sacrificed 31 days later. The samples were taken to make the bone histomorphometry study. RESULTS: When compared group A with group C, there were significant differences (P<0.01) in osteoid area density, osteoid mean width, active osteoblastic surface, mineralization surface and dynamic parameters after 14 days, and in mean width of mineralization callus, active osteoblastic surface and mean depth of lacunae after 31 days. There was a approximate effect between group B and group C. when compared group B with group A, there were significant differences (P<0.05) in osteoclastic index, mineralization surface, bone formation rate after 14 days, and in osteoid surface, mean depth of lacunae and bone formation rate after 31 days. CONCLUSION: Shengguzaizaosan can increase osteoid, accelerate mineralization rate and bone formation rate, and reduce mineralization lag time at early period of fracture. It can increase mineralization callus width and resorption of osteoclast at later period of fracture. To some extent, shengguzaizaosan can accelerate the experimental fracture healing.

Velvet antler polypeptides promoted proliferation of chondrocytes and osteoblast precursors and fracture healing.

AIM: To study the effects of velvet antler (VA) total polypeptides (VATP) and VA polypeptides, VAP-A, VAP-B, and VAP-C on proliferation of chondrocytes and osteoblast precusors. METHODS: Chondrocytes (rabbit and human fetus) and osteoblast precusors (chick embryo) were incubated in the culture medium containing VATP or VAP-A, VAP-B, and VAP-C. [3H]TdR incorporation into DNA was measured. Fracture healing-promoting action of VATP was determined in rats. RESULTS: VATP 50-200 mg.L-1 and VAP-B 12.5, 25, and 50 mg.L-1 showed most marked proliferation-promoting activity for rabbit costed chondrocytes and increased incorporation of [3H]TdR from (73 +/- 9) Bq (control group) to (272 +/- 55), (327 +/- 38), and (415 +/- 32) Bq, respectively (P < 0.01). The activity of VAP-A was weaker than that of VAP-B, and VAP-C had no activity. VATP 10 and 20 mg.kg-1 by local injection into the cross-section fracture area accelerated healing of radial fracture. The healing rate of VATP-treated group was higher (75%) than that of control group (25%) (P < 0.05). CONCLUSION: VATP accelerated fracture healing by stimulating proliferation of chondrocytes and osteoblast precursors.

[The effect of wumingyi chongji on BMP content in callus].

A kind of Chinese herb medicine--Wumingyi chongji could promote fracture healing had been proved. In order to disclose the mechanism, a standard fracture model was produced in 50 healthy male Newzealand rabbits. The animals were randomly divided into experimental group and control group. Another 5 rabbits without operation act as nomal. By immunohistochemical study, the bone morphogenetic protein (BMP) content in callus was calculated by computerized interacive morphometry (CIM) in the 1st, 2nd, 3rd, 4th, 5th week after fracture. The results were: BMP in callus was much more than in nomal (P < 0.01); BMP in callus increased from the 1st week to the 3rd week, decreased from 4th week to 5th week, and was more in experimental group in the 1st and 2nd week than in the control group (P < 0.01). The highest BMP content appeared in the 2nd week in the experimental group, while in the 3rd week in the control group. It was concluded that Wumingyi chongji could promote osteoblast to synthetize BMP, BMP induce preosteoblast change into osteoblast. Thus the rate of fracture healing could be increased.

[Effect of carbostimulin and its mixture with vitamin D3 on the mineralization process of the bone callus in rabbits]. / Vliianie karbostimulina i smesi ego s vitaminom D3 na protsess mineralizatsii kostnoi mozoli krolikov.

Mineralization of rabbit bone callus was studied within 15 days after resection of the upper part of radius bone inder conditions of treatment with carbostimuline and its mixture with vitamin D3. Content of calcium in the bone regenerate was increased by 40.8% after administration of carbostimuline and--by 70.5% after treatment with mixture containing vitamin D3. These preparations caused only slight effects on the phosphorus content. Dry residue in the regenerate os f animals, treated with the preparations, was increased approximately 2-fold (43% and 23%, respectively, p less than or equal to 0.001) as compared with control group. Content of citric acid was distinctly higher in the bone tissue of the treated animals. Within 15 days after the operation content of sialic acids wanormalized in blood serum of the animals. The data obtained were corroborated by X-ray and histologic examinations.