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BACKGROUND: After the treatment of femoral shaft fracture with the intramedullary nail, the third fracture open reduction indications are controversial. Some scholars believe that limited open reduction can achieve anatomical reduction, conducive to fracture healing; but some scholars believe that no open reduction of the third fracture still has a high fracture healing rate. OBJECTIVE: To investigate the effect of the circumference and displacement of the third fragment on fracture healing after intramedullary nailing of femoral shaft fractures with the third fragment. METHODS: A retrospective cohort study was conducted to analyze the clinical data of 142 patients suffered a femoral shaft fracture with a third fragment admitted to the Affiliated Lianyungang Hospital of Xuzhou Medical University from February 2016 to December 2021. The fracture were classified into three types according to the circumference of the third fracture with reference to the diaphyseal circumference at the fracture site: type 1 in 71 cases, type 2 in 52 cases, and type 3 in 19 cases. Referring to the diaphyseal diameter, the fractures were classified into three degrees according to the degree of the third fragment displacement: degree I in 95 cases, degree II in 31 cases, and degree III in 16 cases. All patients were treated with femoral interlocking intramedullary nails, and no intervention was performed for the displaced third fragment during the operation. Postoperative follow-up was performed to compare the fracture healing rate, healing time, and the modified Radiographic Union Scale for Tibia at month 9 after surgery in each group. The effect of third fracture fragment circumference and degree of displacement on fracture healing was assessed. RESULTS AND CONCLUSION: (1) All 142 patients were followed up for at least 12 months, with a mean of (14.7±4.1) months, and the overall healing rate was 73.4%. (2) When the third fragment was displaced by degree I, the healing rate, healing time, and modified Radiographic Union Scale for Tibia score at month 9 were not statistically significant among the three sub-groups of circumference classification. (3) When the third fragments were displaced by degree II or III, the healing rate and healing time were not statistically significant among the three subgroups of circumference classification; the modified Radiographic Union Scale for Tibia score at month 9 in the type 1 group was higher than that in the type 2 and 3 groups (P = 0.017). (4) Logistic regression analysis showed that a greater third fragment displacement and circumference were associated with lower fracture healing rates (P < 0.05). (5) These findings indicate that in the treatment of femoral shaft fractures with third fragment by intramedullary nails, when the fracture fragment is displaced to degree I, the circumference size has little effect on fracture healing, and no intervention is required during surgery. When the third fragment is displaced to degree II or III and the circumference of which is type 1, a higher modified Radiographic Union Scale for Tibia score can still be obtained with no intervention of the third fragment. However, when the circumference is of type 2 or type 3, it significantly affects the fracture healing. Consequently, intraoperative intervention to reduce the distance of displacement of the fragment is required to lower the incidence of nonunion. The displacement of the third fracture fragments has a greater impact on fracture healing than their circumference. [ABSTRACT FROM AUTHOR]

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In order to explore the content and spatial distribution of soil organic matter to implement zonal fertilization, the study took the strawberry industry in Changfeng County, Hefei City, Anhui Province, as an example, used the organic matter data from 1 986 soil sampling sites that collected by the soil testing formula project of Changfeng County and chose three prediction models of Ordinary Kriging(OK), Random Forest(RF)and Random Forest with Residual Kriging(RFRK)with six environmental covariates of terrain and vegetation related to soil formation as auxiliary information to predict the spatial distribution of soil organic matter in the study area, drew the spatial distribution map, divided the fertilization zones according to the content of organic matter and proposed different fertilization schemes for strawberry in each area. The results showed that the overall distribution trend of soil organic matter predicted by the three models was the same, with the characteristics of high distribution in the north and low distribution in the south, and the overall content of organic matter ranged from 8-30 g·kg-1 . According to the abundance and deficiency of soil organic matter, the areas with organic matter content in the range of 15-25 g·kg-1 were medium fertilizer areas and recommended to apply 45.0-52.5 t·hm-2 of farm manure. The areas with organic matter content higher than 25 g·kg-1 were low fertilizer areas, applying 37.5-45.0 t·hm-2 of farm manure. The areas with organic matter content lower than 15 g·kg-1 were high fertilization areas, applying 52.5-60.0 t·hm-2 of farm manure. Therefore, according to the predicted spatial distribution of soil organic matter, it provided the basis for strawberry fertilization zoning, made fertilization schemes, and provided guidance and reference for strawberry planting in different areas. [ABSTRACT FROM AUTHOR]

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Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)