Abstract:All kinds of diseases or injury involving the extremity might lead to its deformity with disability of the patient. In the past, more attention was paid to the correction and functional compensation of the limb deformity only, which cost a lot and had a poor effect. In the past decade, the general notion of limb deformity correction has been constantly updated, with more emphasis on the correct treatment and rehabilitation of primary disorder and injuries to prevent deformity early. In addition, the idea has been put up, including the early de- tection of malformations and early intervention, regaining the joint stability and range of motion, as well as reconstruction of ligamentous sta- bility and muscle balance on the basis of restoring the normal alignment of the limb, and the combination of various surgical corrections with patients' active participation in rehabilitation. This paper reviews the causes, evaluation, correction principles and treatment options of lower limb deformities, and gives a brief introduction of the works of the Orthopaedics and Rehabilitation Committee for Physical Disability, China Association of Rehabilitation of Disabled Persons in the past ten years.

Abstract:[Objective] To evaluate the significance of personalized combined gap balancing technique in total knee arthroplasty (TKA) . [Methods] A retrospective study was done on 68 patients who received TKA for knee osteoarthritis in our department from July 2019 to November 2019. According to the doctor-patient communication, 34 patients underwent TKA with personalized external rotation re- section of posterior femoral condyle combined with gap balancing technique (combined group) , while the remaining 34 patients had conven- tional posterior femoral condyle cutting at 3° external rotation (conventional group) . The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups were successfully operated on without obvious complications. The initial flexion gap imbalance was found in 3 cases of the combined group, whereas 11 cases in the conventional group, which proved statistically significant (P＜0.05) . The combined group had significantly less perioperative blood loss than the conventional group (P＜0.05) , although there were no significant differences in operative time, total incision length, intraoperative fluoroscopy times, ambulation time, incision heal- ing grade and hospital stay between the two groups (P＞0.05) . With the follow-up time of (25.91±1.20) months, the VAS significantly de- creased (P＜0.05) , while KSS score and ROM significantly increased in both groups (P＜0.05) . There were no statistically significant differ- ences in the abovementioned indexes between the two groups preoperatively (P＞0.05) . However, the combined group proved significantly superior to the conventional group in term of VAS score at 12 months after surgery and the last follow-up (P＜0.05) , whereas KSS score and knee range of motion (ROM) at all matching time points postoperatively (P＜0.05) . Radiographically, the femorotibial angle (FTA) and medi- al proximal tibial angle (MPTA) significantly improved in both groups postoperatively compared with those preoperatively (P＜0.05) . Howev- er, there were no statistically significant differences in FTA, MPTA, α angle, β angle, sagittal femoral angle (SFA) and sagittal tibial angle (STA) between the two groups at any corresponding postoperative time points (P＞0.05) . [Conclusion] The personalized external rotation re-section of posterior femoral condyle combined with gap balancing technique in total knee arthroplasty is beneficial to achieve gap balance of knee flexion, with better short-term clinical outcomes over the conventional posterior condyle resection in fixed 3° of external rotation.

Abstract:[Objective] To compare the clinical efficacy of lateral approach (LA) versus olecranon osteotomy approach (OOA) for open reduction and internal fixation (ORIF) of Dubberley type II-IIIB humeral capitellum fractures. [Methods] A retrospective study was con- ducted on 39 patients who underwent ORIF for Dubberley type II-IIIB capitellum fractures in our hospital from December 2014 to Decem- ber 2019. According to the results of preoperative doctor-patient communication, 21 patients had ORIF performed by the LA, while the re- maining 18 patients were by the OOA. The perioperative, follow-up and imaging data of the two groups were compared. [Results] All the pa- tients in both groups had ORIF finished smoothly without serious complications, such as neurovascular injury. The LA group was signifi- cantly superior to the OOA group in terms of incision length, operation time and intraoperative blood loss (P＜0.05) , while the OOA group proved significantly superior to the LA group in terms of intraoperatively fluoroscopic times and time to resume active motion postoperative- ly (P＜0.05) , despite of no a statistically significant difference between them in term of hospital stay (P＞0.05) . With time of follow-up peri- od lasted for (18.74±2.65) months on an average, the VAS scores decreased significantly (P＜0.05) , whereas the elbow flexion extension range of motion (ROM) and Mayo Elbow Performance Score (MEPS) increased significantly in both groups (P＜0.05) . However, the OOA group proved significantly superior to the LA group in terms of VAS and MEPS scores, as well as elbow flexion-extension ROM one month postoperatively (P＜0.05) , whereas which became not statistically significant between the two groups at 6 and 12 months postoperatively (P＞ 0.05) . Radiographically, the OOA group also proved significantly superior to the LA group in terms of fracture reduction quality and frac- ture healing time (P＜0.05) . [Conclusions] Compared with the LA, the OOA used for ORIF of Dubberley type II-IIIB fractures does facili- tate fracture reduction and has more stable internal fixation, which allow active elbow motion earlier to achieve better clinical outcomes.

Abstract:[Objective] To compare the efficacy of ulna osteotomy with and without internal fixation for old Monteggia fractures in chil- dren. [Methods] From July 2018 to July 2020, a total of 79 children underwent ulnar osteotomy and open radiocapitellar reduction com- bined plaster cast fixation for old Monteggia fractures. According to preoperative doctor-patient communication, 42 children had osteotomy site fixed with internal implant (fixation group) , while the other 37 had osteotomy performed only without internal fixation (the non-fixation group). The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients had the operations complet- ed successfully. The non-fixation group proved significantly superior to the fixation group in terms of operation time, incision length, times of fluoroscopy, incision healing and hospital stay (P<0.05) . All the patients were followed up for more than 12 months. The non-fixation group resumed full weight-bearing activity significantly earlier than the fixation group (P<0.05) . Th range of motions (ROMs) , including pronation, supination, elbow flexion and extension, as well as Mayo elbow score significantly increased over time in both groups (P<0.05) , however, there were no statistically significant differences in abovesaid items between the two groups at any corresponding time points (P> 0.05) . Radiographically, the alignments in term of radiocapitellar line (RCL) and extent of radiocapitellar congruence (RCC) significantly improved in both groups over time (P<0.05) , which in the non-fixation group was significantly superior to those in the fixation group at the latest follow-up (P<0.05) . In addition, the non-fixation group got bony healing of the osteotomy site on images significantly earlier than the fixation group (P<0.05) . [Conclusion] The clinical outcomes of ulna osteotomy without internal fixation are considerably better than those with internal fixation in the surgical treatment of old Monteggia fractures in children.

Abstract:[Objective] To compare the clinical outcomes of external fixator versus plate internal fixation for humeral shaft fracture sec- ondary to hand grenade throwing. [Methods] A retrospective study was done on 60 patients who underwent surgical treatment for humeral shaft fracture secondary to hand grenade throwing from January 2016 to January 2020. According to the doctor-patient communication pre- operatively, 30 patients had the fracture fixed with an external fixator, if necessary, lag screws by a small incision were added (the EF group) , while the remaining 30 patients were treated with plate for internal fixation (the IF group) . The preoperative general data, periopera- tive conditions, follow-up results and imaging data of the two groups were compared. [Results] The intraoperative radial nerve injury hap- pened in 1 case of the EF group, while 6 cases of the IF group, which was statistically significant (P<0.05) . The EF group proved signifi- cantly superior to the IF group in terms of incision length and intraoperative blood loss (P<0.05) . During the follow-up lasted for (14.23± 1.89) months, the EF group resumed active activity and full weight-bearing activity significantly earlier than the IF group (P<0.05) . The el- bow flexion- extension range of motion (ROM) , shoulder forward lifting ROM, MEPS and Constant-Murley score improved gradually in both groups. The EF group was significantly superior to the IF group in elbow ROM and MEPS scores (P<0.05) , but there was no signifi- cant difference in shoulder ROM and Constant-Murley score between the two groups at 6 and 12 months postoperatively (P<0.05) . Radio- graphically, although no a significant difference in fracture reduction quality was found between the two groups (P>0.05) , the EF group had fracture healing on images significantly earlier than the IF group (P<0.05) . [Conclusion] Both external fixator and plate internal fixation are suitable techniques for the treatment of humeral shaft fracture secondary to hand grenade throwing. By comparison, the EF has the ad- vantages of minimizing surgical trauma, declining complications and earlier fractur healing.

Abstract:[Objective] To compare the clinical outcomes of open reduction and internal fixation (ORIF) with proximal humeral locking plate (PHLP) through the anterolateral deltoid-split (DS) approach versus deltopectoral (DP) approach for Neer type Ⅲ and Ⅳ proximal hu- meral fractures with glenohumeral dislocation. [Methods] A retrospective study was conducted on 33 patients who received ORIF with PHLP for Neer type Ⅲ and Ⅳ proximal humeral fractures with glenohumeral dislocation in our department from January 2014 to December 2020. According to preoperative doctor- patient communication, 16 patients were through DS approach, while the other 17 patients were through DP approach. The perioperative period, follow- up and imaging data of the two groups were compared. [Results] Operation were done successfully in both groups. The DS group showed a significant better result in hospital stay and intraoperative blood loss and incision length (P＜0.05) , however, the former had significantly longer operation time than the latter (P＜0.05) . There was no significant difference in active motion time of injured shoulder between the two groups (P＞0.05) . All patients were followed up over 12 months, and there was no sig- nificant difference in the time of full weight-bearing activity between the two groups (P＞0.05) . At 3 months after operation, the DS group was significantly superior to the DP group in Constant-Murley score (P＜0.05) , but the DP group showed a significant better result in Con- stant-Murley score at 12 months postoperatively (P＜0.05) . Although there was no significant difference in forward flexion and lift range of motion (ROM) and abduction and lift ROM between the two groups at 3 months postoperatively (P＞0.05) , the DP group showed a signifi- cant better result in forward flexion and lift ROM and abduction and lift ROM at 12 months postoperatively (P＜0.05) . Radiographically, the DS group was significantly inferior to the DP group in quality of fracture reduction (P＜0.05) . During follow-up, the fractures healed time showed no significant difference between the two groups (P＞0.05) . However, the DS group had significantly higher incidence of late ad- verse imaging findings than the DP group (P＜0.05) . [Conclusion] The deltopectoral approach used for ORIF of Neer type Ⅲ and Ⅳ proxi- mal humeral fractures with glenohumeral dislocation has the advantages of facilitated fracture reduction, short operation time and less com-plications at elderly aged less than 70 years.

Abstract:Lung cancer is one of the most common causes leading to cancer-related death worldwide with high mortality, and its poor prognosis is directly related to tendency of metastasis, but in other word metastasis is an important sign of advanced lung cancer. Although skeletal system is common metastatic site of lung cancer, the delayed diagnosis or misdiagnosis likely happen if the imaging findings of bone metastasis in lung cancer is atypical, including unusual radiographic presentation and rare site. In this review, the imaging patterns and pitfalls of the atypical presentation of lung cancer metastasis to bone were summarized, additionally a prospect about new techniques was made in order to improve our knowledge of the atypical imaging findings of bone metastasis in lung cancer and improve the early cor- rect diagnosis.

Abstract:For relieving pain and restoring joint function and gait of end-stage hip and knee arthritis and partial severe joint trauma, joint arthroplasty is one of the most effective treatments currently, despite of the fact that the patients may still have pain and abnormal gait in some extent postoperatively. Three-dimensional gait analysis system is a set of gait evaluation tool with the advantages of comprehensive- ness, objectivity, high accuracy, high efficiency, and is widely used in the clinical research related to the human nervous system and motor system. With the help of this system, it does accurately measure and analyze the biomechanical and kinematic data during the movement process before and after hip and knee arthroplasty, providing data support for diagnosis, treatment and rehabilitation training. This paper briefly summarizes the application of three-dimensional gait analysis system in hip and knee arthroplasty and following rehabilitation train- ing, providing a reference for the further application of three-dimensional gait analysis system in optimizing the preoperative, intraoperative and postoperative treatment plan.

Abstract:Thoracolumbar fractures complicated with severe craniocerebral injuries are common trauma caused by falling from height, car accidents and other reasons. They often occur together, with the characteristics of serious condition, rapid progress, high disability rate and high mortality, which impact the quality of life of patients seriously. Accelerating rehabilitation surgery achieves the advantages of re- ducing complications, shortening hospital stay and reducing medical costs by optimizing the perioperative period. At present, the nursing re- searches on accelerated rehabilitation in thoracolumbar fracture complicated with craniocerebral injuries have made some progress, but re- main not perfect. This paper reviews the perioperative nursing progress of accelerated rehabilitation for thoracolumbar fractures accompa- nied with severe craniocerebral injuries to provide some references for clinical promotion and application.

Abstract:[Objective] To evaluate the biomechanical properties of a novel lumbar reverse anterolateral pedicle screw fixation by the fi- nite element analysis. [Methods] A finite element model of normal human lower lumbar spine (L₃~S₁) was established with its effectiveness verified. Subsequently, five internal fixation models were established after L_4/5 discectomy and cage placement, including (1) lateral verte- bral screw fixation (LVS) ; (2) unilateral pedicle screw (UPS) ; (3) bilateral pedicle screw (BPS) ; (4) anterolateral pedicle screw-rod (ALP- SR) and (5) anterolateral pedicle screw-plate (ALPSP) . As axial preload of 400 N with a torsional torque of 7.5 N · m were applied to the upper surface of the L3 vertebral body in conditions of lumbar flexion, extension, left bending, right bending, left rotation and right rotation, the range of motion (ROM) , Von Mises stresses on the upper endplate and cage were measured. [Results] The finite element model of the lower lumbar spine (L₃~S₁) was established and verified successfully. Compared with the intact model, the ALPSP model got the best restric- tion of forward flexion and lateral bending, while the BPS model got the best restriction of backward extension and lateral rotation, followed by the ALPSP model. The pressure peak Von Mises stress on the upper endplate in the ALPSP model was the lowest under forward flexion and left and right bending, whereas which was the lowest in BPS under backward extension and lateral rotation, followed by the ALPSP mod- el. The stress on the cage also presented a corresponding trend, with the ALPSP model corresponding to the BPS model. [Conclusion] The novel lumbar reverse anterolateral pedicle screw fixation, ALPSP, provides good biomechanical stability and has similar biomechanical properties to BPS, which is significantly superior to LVS and UPS.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of arthroscopic release and implant re- moval for previous open reduction and internal fixation of proximal humeral fractures. [Methods] The patient, male, 73 years old, had im- plant retention of the right proximal humeral fracture accompanied with limited motion for 30 months. Conventional shoulder arthroscopy approach was used to clean up the adhesion scar and hyperplasia of synovial tissue in glenohumeral and subacromial spaces, and acromio- plasty. A small incision was added on the lateral side, as soft tissue covered on implants was debrided under arthroscopic direct vision to ex- pose the plate and screws, the internal fixation device was completely removed. [Results] One month after surgery, the patients got signifi- cant improvement in terms of range of motion and the function, with flexion of 140 degrees, extension of 45 degrees, external rotation of 70 degrees, internal rotation of 60 degrees, abduction of 150 degrees, and UCLA score of 32. [Conclusion] The arthroscopic release and im- plant removal are simple, minimally invasive and effective for previous open reduction and internal fixation of proximal humeral fractures with satisfactory clinical results.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of 3D printed personalized prosthesis re- vision replacement of previous prosthetic failure complicated with complex acetabular bone defect. [Methods] A total of 11 patients under- went revision arthroplasty using 3D printed personalized acetabular prosthesis for previous prosthetic failure complicated with complex ace- tabular bone defects. As all patients were routinely taken thin-slice CT scan of the hip preoperatively, 3D digital model was established, and then personalized prosthesis was designed and made. In addition, a surgical simulation was performed on the real 3D printed models preoperatively. During the operation, the loosened prosthesis was exposed and removed, the personalized 3D printed personalized prosthe- sis was placed with multi-dimensional screw fixation of the acetabular component to reconstruct the anatomical position relationship, and the residual space between the prosthesis and the host bone was filled with granular bone allograft. [Results] All the 11 patients had the re- vision THA performed successfully without serious complications. As time went during the follow-up lasted for (39.18±3.37) months, the VAS scores decreased significantly (P＜0.05) , whereas the Harris score significantly increased (P＜0.05) , with survival rate of the custom- ized acetabular prosthesis of 100% 36 months after surgery. [Conclusion] The 3D printed personalized prosthesis has good clinical efficacy in revision of previous failure with complex acetabular bone defects.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of free-bone- fragment replantation com- bined with platelet-rich plasma in the second stage for bone defect secondary to open tibial fractures. [Methods] A total of 15 patients re- ceived free-bone- fragment replantation combined with platelet-rich plasma in the second stage for bone defect secondary to open tibial fractures. In the first-stage operation, the fractures were fixed by an external fixator after a thorough debridement, the bone defect was filled with antibiotic bone cement, while the free bone fragments were implanted into the muscle space between the rectus femoris and vastus late- ralis on ipsilateral middle thigh. After the wound healed without obvious signs of infection, the second-stage operation was performed. After the external fixator was removed, the tibial fracture was fixed internally with a bridge plate. The free bone fragments fostered on the thigh were harvested and crushed into granules by rongeur forceps, and then mixed with platelet-rich plasma (platelet-rich plasma, PRP) , im- planted back into the bone defect. [Results] All the 15 patients were followed up for 12~24 months. No infection happened in anyone of them after operation, whereas all the patients had fractures healed smoothly in 10~15 months. [Conclusion] The free-bone- fragment re- plantation combined with platelet-rich plasma in the second stage proves a simple and effective treatment for bone defect secondary to open tibial fractures.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of the tendon-bone graft harvested from the fifth metacarpal base used for repair composed defect of the proximal phalangeal base. [Methods] A total of 6 patients received surgical repair for composed defect of proximal phalangeal base. As the X-ray examination was conducted to measure the area of the bone defect at the proximal phalangeal base preoperatively, osteotomy was designed on the fifth metacarpal base. A longitudinal incision was made on the dorsal side of the fifth metacarpocarpal joint with protection of the dorsal branch of the ulnar nerve, and then the tendon-bone graft with part of the extensor carpi ulnar tendon and the base of the fifth metacarpal was cut according to the osteotomy designed preoperatively. Fi- nally, the graft was trimmed to meet the phalangeal base defect, implanted on the receipt site and fixed with Kirschner wires or screws. [Results] All patients had operation completed successfully without serious complications, such as vascular and nerve injury, whereas with the stable and painless repaired metacarpophalangeal joints after operation. The fracture healing of receipt site achieved from 2.7 to 3.4 months on the standard of X-ray, with a stable donor fifth metacarpocarpal joint. At the latest follow-up lasted for 6~12 months, the clinical out- comes were marked as excellent in 4 cases and good in 2 cases according to the hand function criteria of Hand Surgery Society of Chinese Medical Association. [Conclusion] The tendon-bone graft harvested from the fifth metacarpal base is effectively used to repair the com- posed osteochondral defect, involving the extension tendon insertion, on the proximal phalanx base.

Abstract:[Objective] To investigate the clinical outcomes of bone grafting combined with long oblique pedicle screw on the injured vertebrae in pedicle screw fixation of thoracolumbar burst fractures. [Methods] From February 2013 to February 2018, 42 patients under- went abovementioned surgical treatment for thoracolumbar burst fracture in our hospital. The perioperative, follow- up and imaging data were summarized. [Results] All the 42 patients were successfully operated on without serious complications. As time went during the fol- low-up lasted for (22.45±1.45) months, the VAS and ODI scores were significantly decreased (P<0.05) . In term of ASIA grade for neurolog- ical function, of the 12 cases who were grade B before operation, 8 cases improved to grade E and 4 cases to grade D at the latest follow-up, while all the 30 cases who were marked as grade C preoperatively recovered to grade E at the latest follow up (P<0.05) . Radiographically, the ratio of anterior height of injured vertebrae significantly increased (P<0.05) , while the local kyphotic Cobb's angle significantly de- creased postoperatively compared with those preoperatively (P<0.05) . [Conclusion] This bone grafting combined long oblique pedicle screw on the injured vertebrae in pedicle screw fixation of thoracolumbar burst fractures does improve nerve function, reconstruct the height of injured vertebrae, reduce residual kyphosis and maintain the correction effectively.

Abstract:[Objective] To investigate the clinical efficacy of simultaneous arthroscopic reconstruction and repair for anterior cruciate ligament (ACL) rupture combined with lateral meniscus radial tear (LMRT) . [Methods] From January 1, 2019 to December 30, 2020, 14 patients received arthroscopic ACL reconstruction with I.D.E.A.L femoral insertion positioning and tendon autograft, and LMRT suture treatment for ACL rupture complicated with LMRT. The consequences regarding to perioperative period, follow-up and images were ana- lyzed. [Results] All the 14 patients were successfully operated on without infection, neurovascular injury and other complications. With time of follow-up lasted for (16.80±2.31) months, the Lysholm and IKDC scores, as well as knee range of motion (ROM) significantly in- creased (P＜0.05) , moreover, the presentations in terms of Lachman test, anterior drawer test, McMurray test and pivot shift test significant- ly improved (P＜0.05) . However, the Kellgren -Lawrence grade for osteoarthritis remained unchanged at the latest follow- up (P＞0.05) . [Conclusion] Arthroscopic ACL reconstruction with I.D.E.A.L femur positioning and horizontal mattress plus vertical mattress suture for lateral meniscus radial tear are effective for ACL rupture complicated with LMRT,.

Abstract:[Objective] To evaluate the clinical outcomes of single intramedullary Kirschner wire for fixation of re-fracture of the fifth metacarpal neck secondary to primary internal fixation. [Methods] From January 2015 to June 2021, 10 patients received internal fixa- tion with a single 2.0 mm intramedullary Kirschner wire for re-fracture of the fifth metacarpal neck. The perioperative, follow-up and imag- ing data were summarized. [Results] All studied patients had operation completed successfully with operation time of (18.60±2.88) min, whereas without serious complications such as reduction loss, infection, bone nonunion, tendon stimulation and joint stiffness. As time went in follow-up lasted for 3~6 months with a mean of (4.90±1.10) months, VAS and DASH scores, as well as metacarpophalangeal range of mo- tion (ROM) significantly improved (P＜0.05) . Radiographically, the excellent fracture reduction at 3 months after operation and the last fol- low-up was 90%, additionally, fracture healing achieved in 40% at 3 months, while 100% at the last follow-up (P＜0.05) . [Conclusion] The single intramedullary Kirschner wire fixation for re-fracture of fifth metacarpal neck does achieve satisfactory clinical consequences.

Abstract:[Objective] To compare the clinical outcomes of two sequences of open reduction and internal fixation (ORIF) of Pilon frac- ture accompanied with fibular fracture. [Methods] A retrospective study on 150 patients who underwent ORIF for OA/OTA type B and C Pi- lon fractures complicated with fibular fracture from January 2018 to January 2021. According to preoperative doctor-patient communica- tion, 74 patients had the fibula treated first, while the remaining 76 patients had the tibia treated first. The clinical and imaging data were compared between the two groups. [Results] All the patients in both groups were operated on successfully. The fibular group proved signifi- cantly superior to the tibial group in terms of the operation time, total incision length, times of fluoroscopy, intraoperative blood loss, and in- cision healing (P<0.05) . However, there was no significant difference in the time to resume full weight-bearing activity between the two groups (P>0.05) . The active ankle range of motion (aROM) and AOFAS scores significantly increased over time in both groups (P<0.05) , whereas no significant differences were noted in abovesaid items between the two groups at the matching time point (P>0.05) . Radiographi- cally, there were no significant differences in fracture reduction quality, fracture healing time, and changes of internal fixators at the last fol- low-up between the two groups (P>0.05) . [Conclusion] For open reduction and internal fixation of OA/OTA type B and C Pilon fractures accompanied by a fibular fracture, prioritizing the fibula can significantly reduce surgical trauma and improve surgical efficiency.

Abstract:[Objective] To compare the clinical outcomes of two dural sealing methods for prevention of cerebrospinal fluid leakage. [Methods] A retrospective study was conducted on 72 patients who underwent surgical treatment for intraspinal subdural tumors from Janu- ary 2015 to December 2018. Of them, 32 patients received gelatin sponge coverage on the dural after tumor resection and dural suture (the GS group) , while the remaining 40 patients underwent fat combined with gelatin sponge coverage on the dural (the combined group) . The clinical results were compared between the two groups. [Results] There were no significant differences in operative time, intraoperative blood loss, length of dural incision and incidence of surgical site infection between the two groups (P>0.05) . However, the combined group proved significantly superior to the GS group in terms of postoperative drainage volume, drainage time, postoperative hospital stay and inci- dence of cerebrospinal fluid leakage (P<0.05) . As time went during the follow-up lasted for (28.24±4.63) months, the VAS scores in both groups decreased significantly (P<0.05) , which proved not statistically significantly different between the two groups at any matching time points (P>0.05) . In addition, there was no statistical significance in the clinical outcomes in term of modified Macnab criteria between the two groups (P>0.05) . [Conclusion] For intraspinal subdural tumors resection, fat tissue combined with gelatin sponge coverage on dual is superior to the coverage with gelatin sponge only for prevention of cerebrospinal fluid leakage.

Abstract:[Objective] To investigate the clinical efficiency of a novel traction table for closed reduction and cannulated screw fixation of femoral neck fractures. [Methods] From February 2019 to August 2020, 58 patients with femoral neck fracture were enrolled in this study. According to preoperative doctor-patient communication, 28 patients were treated with new traction table (the novel group) , while the remaining 30 patients were treated with traditional traction table (the traditional group) . The clinical and imaging results of the two groups were compared. [Results] The novel group proved significantly superior to the traditional group in term of body positioning time (P< 0.05) , but there were no significant differences in closed reduction time, operation time, intraoperative blood loss and fluoroscopic times be- tween the two groups (P>0.05) . In addition, there was no significant difference in the time to return fully weight-bearing between the two groups (P>0.05) . Compared with those 3 months after surgery, extension-flexion ROM and Harris score significantly improved in both groups at the latest follow-up (P<0.05) , but which was not statistically significant between the two groups at any corresponding time points (P>0.05) . In terms of imaging evaluation, there were adverse changes in Garden index, head -neck shortening and neck-shaft angle in both groups at the latest follow-up compared with those immediately postoperatively, which was not statistically significant in Garden indext (P> 0.05) , whereas statistically significant in head -neck shortening and neck-shaft angle (P<0.05) . There were no significant differences in abovementioned 3 items between the two groups at any corresponding time points (P>0.05) , additionally there was no significant difference in fracture healing time between the two groups (P>0.05) . [Conclusion] The new traction table does effectively reduce the positioning time and improve the operation efficiency.

Abstract:[Objective] To evaluate the imaging outcomes of intraoperative three- dimensional real-time navigation assisted pedicle screw placement. [Methods] From March 2016 to March 2019, 62 patients underwent thoracolumbar pedicle screw fixation. During the op- eration, one side was randomly selected to use three-dimensional real-time navigation screw placement, while the contralateral side had screw placed by conventional freehand technique. The accuracy of pedicle screw placement on images was evaluated and compared be- tween the two sides. [Results] A total of 204 screw were placed in 62 patients. Of the 62 screws in thoracic vertebrae, the screw placement accuracy rate was 93.55% (29/31) on the navigation assisted side, while 77.42% (24/31) on the freehand side, which was statistically signifi- cant (P＜0.05) . Of the 142 screws in lumbar vertebrae, the accuracy of screw placement was 97.18% (69/71) on the navigation assisted side, whereas 80.28% (57/71) on the freehand side, with a statistically significant difference between the two sides (P＜0.05) . [Conclusion] The intraoperative three-dimensional real-time navigation does considerably improve the accuracy of pedicle screw placement