For thousands of years, Chinese medicine has made indelible contributions to the health of our people, especially the treatment of fracture by Chinese medicine is unique, relieving the patients’ pain and preserving the labor force. In recent years, with the development of modern medicine, the histocompatibility of internal fixation materials has gradually improved. The surgical treatment of fractures has gradually taken a dominant position, and there is a tendency to gradually expand the indications for surgery. The one-sided pursuit of anatomical repositioning and firm internal fixation, manual orthopedic treatment is known for “less pain, faster recovery and less money”, which not only brings physical recovery to the general public, but also achieves many goals of today’s people-friendly medical treatment. Zhang Baofeng of the Department of Orthopaedics of Jinan Traditional Chinese Medicine Hospital has been recognized by the people for his unique treatment methods and remarkable curative effects. After the exploration of the combination of Chinese and Western medicine, the predecessors summarized four principles of fracture treatment, namely, the combination of fixation and activity (dynamic and static combination); bone and soft tissue together (tendon and bone together); both local and systemic treatment and fixation (both internal and external fixation); and close cooperation between medical measures and the patient’s subjective motivation (doctor-patient cooperation). Modern medical personnel have the unique advantage of mastering orthopedic manipulation. On the one hand, they try to learn and inherit the technique of fracture correction by Chinese medicine, on the other hand, they master the knowledge of human anatomy of modern medicine, and master the normal relationship between bone and bone, bone and surrounding soft tissue. During the manual orthopaedic treatment, he is able to understand the anatomical atlas. As said by the Golden Guide to Medicine, “Therefore, we must know the body phase and its parts, so that once the evidence is in front of us, the machine touches the outside and the skill is born inside, the hand follows the heart and the law comes out from the hand.” The treatment of fracture by manual repositioning, small splint fixation, internal herbal medicine and external ointment can strengthen both bone and soft tissue, repositioning and fixation and functional exercise, and protect local soft tissue and the role of human body in fracture healing. The effect of less equipment, faster healing, better function, less complications and less cost is received. The high cost of surgery brings a heavy economic burden to the patient’s family and society. Low cost is one of the advantages of orthopedic manipulation. In the case of lower limb fracture, for example, the cost of orthopedic manipulation is only 150 RMB in the same tertiary care hospital. Surgical orthopedics includes 1000 RMB for surgery, 300 RMB for anesthesia, and 200 RMB for dressing. Intraoperative electric knife, electric drill, use of automatic tourniquet, monitoring, oxygen and intraoperative medication is about 500 RMB. The internal fixation material is about 3000 RMB as well as postoperative prophylactic application of antibiotics. Even after the orthopedic manipulation, the patient was admitted to the hospital for proper care and timely adjustment of the fracture site. The difference between the cost of surgical orthopedics and the cost of manipulative orthopedics is about 8,000 yuan when fracture healing drugs are applied. However, what is puzzling is that the operated patients and their families are grateful to the doctors, and some of them even invite guests and send gifts. After the manual orthopedic patients, when told to pay 150 yuan treatment fee, but will be wide-eyed exaggerated: eat people ah, a little move to charge more than 100 yuan, this is what hospital, you are what doctor! I do not know how much practical experience and knowledge is contained in this simple technique, and how much medical costs are saved for the patient! Practice has proven that in addition to the high cost of surgical treatment of fractures, there are many complications that can seriously affect fracture healing and functional recovery. Surgery can damage the outer membrane of the bone and the surrounding soft tissues, affecting the local blood supply and fracture healing. We all know the saying: it takes 100 days to break a bone. But when you look back at the fracture healing of a surgical patient, you will see that the fracture healing time is much longer than 100 days. Why? It turns out that fracture healing depends on the regeneration of the fracture tissue, and the strength of the fracture tissue regeneration is related to the strength of the local blood supply. At the time of fracture, the surrounding soft tissues have been damaged to different degrees. When the fracture is orthopedically treated, the fracture still retains the original blood supply after the trauma. If the trophoblastic artery is destroyed during surgery, the blood supply to the fracture will be more extensively damaged and ischemic necrosis will occur on a large scale. The fracture healing time is prolonged, and even non-healing of the fracture occurs. Modern metallic internal fixations, although biocompatible with the body, can still be reactive. The physical properties of the internal fixation are affected, which can bend and break the internal fixation, and fracture re-displacement and non-healing can occur. The reason for the development of internal fixation is inseparable from the development of natural science and industry. Internal fixation started long before the last century. However, due to the poor compatibility of currently used materials with human tissue. Insufficient mechanical strength, insufficient design and processing technology, as well as the concept of aseptic technique and imperfect surgical instrumentation equipment have failed to promote its application. In recent years, due to the development of metallurgy, the strength and tissue compatibility of the internal fixation have been greatly improved. However, through a large number of clinical observations, patients’ rejection of internal fixation still accounts for a considerable proportion. Patients have unexplained postoperative hyperthermia, increased periosteal reaction at the fracture site, and nail marks. Local skin pigmentation. Even local rupture with sterile discharge. The internal fixation has to be removed early, making the internal fixation fail. Firm internal fixation will cause stress masking and severe osteoporosis of the entire bone segment, which can lead to re-fracture. The problems of bone ischemia, bone resorption and delayed plasticity of bone scabs due to stress protection and stress concentration caused by firm internal fixation, especially firm and thick internal fixation, have attracted attention. It was found that the hard internal fixation plate causes the normal physiological load to pass through the plate itself instead of the fracture end, forming a “bypass”, which protects the fracture end from stress and causes it to lose its normal load, resulting in disuse atrophy and loosening of the bone. After the fracture is healed, the internal fixation is removed and the normal load is restored to the original fracture. If care is not taken to protect the fracture, the affected limb, especially the lower limb, may fracture again within six months due to torsional force or large external force. This kind of fracture has poor re-healing ability and most of them need bone graft. This fracture has a serious impact on the patient’s physiology, heart and economy, and it is not uncommon in clinical practice. After surgical internal fixation, most of them still need to use long-term external fixation, which still hinders joint movement, causes joint adhesions and affects joint function. Originally, one of the advantages of surgical incisional internal fixation over manipulation is that after incisional internal fixation, it is possible to move early and prevent joint adhesions. However, this is not the case. Due to the patient’s age, cooperation, fracture site, fracture comminution, strength of internal fixation material and technical operation, most of the patients still have to use long-term external fixation after internal fixation until more bone scabs appear. This inevitably causes adhesions in the adjacent joints and affects joint movement. In other words, this advantage is not realized in most cases. Surgical incision and internal fixation can become infected, resulting in chronic osteomyelitis, which can persist for a long time and, in severe cases, can lead to amputation. Aseptic technique is very important for any surgery and is especially important for orthopedic surgery. Orthopedic surgery often requires the implantation of various foreign bodies with good histocompatibility with the human body, such as artificial joints, bone cement, artificial bone, various internal fixations, etc.. These foreign bodies are compatible with human tissues under aseptic conditions. Once infection occurs, they become foreign bodies that are incompatible with human tissue. If not removed, the infection is difficult to cure. If removed it will lead to limb deformity. Severe infections can cause osteomyelitis. As we all know, sterility is relative and germiness is absolute. Even if the operating room is isolated at all levels, advanced sterilization facilities and air laminar flow equipment are used, surgeons wash their hands before surgery, wear sterile gowns, and the surgical site is strictly sterilized. It is still not guaranteed to avoid infection. In 1979, Rüedi reported that the infection and non-healing rates of plate fixation were 8% and 14%, respectively, and in 1984, Johnson, Johnston and Parker reported that the infection and non-healing rates of incisional intramedullary nail fixation were 13% and 22%, respectively. Acute osteomyelitis is characterized by localized redness, swelling, and pain in the affected limb, with obvious signs of systemic toxicity. Improper or untimely treatment can lead to chronic osteomyelitis. The crust outside the dead bone is often eroded by pus, forming a fistula, and often purulent secretions flow from the fistula. Due to the lack of blood supply, the body’s antibacterial ability and medicine is difficult to reach, and bacteria often remain, and the fistula is sometimes healed and the purulent discharge is sometimes stopped. Bone is often hyperplastic and hardened, and pathological fractures occur; there is dense scarring of the surrounding soft tissues. The skin near the sinus tract is stimulated by inflammatory secretions for a long time, which may become cancerous in the long run. The success rate of fracture revision by combining Chinese and Western medicine is high, and thus the indications for open fracture reduction have been narrowing. Some people think that the reason why some internal fixation with incision is not effective in China is that some hospitals are not modern enough in terms of surgical instruments, internal fixation materials and operating room equipment. Is this the reason or not? I will answer this question by quoting a passage from Orthopaedic Surgery. Professor Zhu Tongbo was invited to visit the world-famous Lorenz-Berle Trauma Hospital in Vienna, Austria. After a relatively long period of in-depth observation and repeated thinking, he found that the essence of the problem was not like that. The trauma hospitals in Austria are run by insurance companies. Each hospital is required to submit a regular bulletin to the company. This reflects the quality of treatment, the length of treatment (including recovery time) and the cost of medical treatment for various traumas. The previous director, Lorenz BÖhler, preferred to treat fractures with closed reduction external fixation and was known for his good results. jÖrg BÖhler succeeded as director and was enthusiastic about incisional reduction internal fixation. The long treatment time, many complications, and poor efficacy at significantly higher costs resulted in losses for insurance companies and caused dissatisfaction from all sides. In the same hospital, the medical equipment and staff level are exactly the same, only the treatment methods are different, and the contrast is so obvious. This illustrates that the essence of the problem lies in how to master the correct treatment method. Professor Zhu Tongbo has observed many surgical sites in various famous modern hospitals in the West over the years. It was found that many cases underwent incisional internal fixation surgery in addition to the original trauma, but also had to endure the huge damage caused by the surgery again. In some cases, accidents even occurred. Although all conditions are highly modernized, it is futile. Our combined Chinese and Western medicine treatment method, in addition to good efficacy and low cost, can also ensure safety. Our department uses the combination of Chinese and Western medicine with manipulation and rehabilitation as the main method and surgical treatment as the auxiliary method, which not only relieves the pain for the majority of patients but also saves a lot of medical expenses. This minimally invasive treatment method will definitely be accepted and respected by the majority of patients.