Abstract:Artificial joint replacement has a history of nearly 100 years, and is the most effective method to treat end-stage diseases of hip and knee caused by various reasons. Since the 18^th National Congress of the CPC, with the development of China's economic construc- tion, the increase of health insurance base, and the progress in surgical technique, the number of artificial joint replacement surgeries per- formed in China has increased exponentially in the past 10 years, and the trend of growth will continue as China's aging population intensi- fies. Compared with European and American countries, the development changes with each passing day in China although the artificial joint replacement starts later in this country. Various new techniques, new methods and advanced perioperative management concepts are spreading and applying widely in China. With development in the inheritance and innovation, the artificial joint replacement surgery system based on our national conditions is gradually formed. The Joint Surgery of Orthopedic Medicine Department of General Hospital of PLA is one of the first units to carry out artificial joint replacement in China, takes in the leading position in terms of the number of joint replace- ment operations and operating difficulty. This article reviewed research and development regarding to prosthetic design, complex joint re- placement, management of perioperative complications, and intelligent orthopaedic by tracing the research and clinical practice in the past 10 years in the Joint Surgery of General Hospital of PLA progress as the main line, and highlighted the great achievements of orthopedic medical staff in setting heart to serve the army and the people.

Abstract:[Objective] To compare the clinical outcomes of femoral neck system (FNS) versus cannulated screw (CS) for femoral neck fractures in young and middle- aged. [Methods] A retrospective study was conducted on 137 young and middle- aged patients who had been surgically treated for femoral neck fracture at our hospital from June 2019 to January 2021. Based on preoperative doctor-patient com- munication, 64 patients had the fractures fixed with FNS, while the remaining 73 patients were with CS. The perioperative, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups had operation performed smoothly without seri- ous complication. The FNS group proved significantly superior to the CS group in terms of operation time, fluoroscopy frequency, postopera- tive partial weight-bearing time, as well as VAS scores at 3, 7, and 30 days postoperatively (P<0.05) . All the patients in both groups were followed up for more than 12 months, and the revision surgery of total hip arthroplasty was performed in 1 case only (1.56%) in the FNS group, whereas 2 cases (2.7%) in the CS group. The Harris score, flexion-extension and internal-external rotation range of motions of the hip (ROMs) increased significantly in both groups over time postoperatively (P<0.05) , which in the FNS group proved significantly superior to those in the CS group at all corresponding time points (P<0.05) . With respect to radiographic evaluation, although there were no signifi- cant differences in term of Garden index, neck shortening and neck-shaft angle between the two groups immediately postoperatively (P> 0.05) , the FNS group proved significantly superior to the CS group in terms of radiographic fracture healing time, as well as femoral neck shortening, neck-shaft angle and internal fixation loosening at the latest follow up (P<0.05) . [Conclusion] The FNS has an advantage of firm fixation of the fracture, which facilitates fracture healing and functional recovery for femoral neck fractures in young and middle-aged over the CS.

Abstract:[Objective] To compare the clinical efficacy of medial patellofemoral ligament (MPFL) reconstruction by suture anchor ver- sus double bone tunnel fixations on patellar side for recurrent patellar dislocation. [Methods] A retrospective study was done on 42 patients who received MPFL reconstruction for recurrent patellar dislocation in our department from January 2016 to December 2020. According to doctor-patient communication, 23 patients had tendon graft fixed on the patellar side by suture anchors, while the other 19 patients were double bone tunnels. The perioperative, follow-up and imaging documents were compared between the two groups. [Results] All patients in both groups were operated on successfully without serious complications. The anchor group consumed significantly shorter operation time than the tunnel group (P＜0.05) . During the follow-up lasted for more than 12 months, all patients in both groups achieved good functional recovery without patellar dislocation again, except one case in the tunnel group who got patella fracture. The anchor group resumed full weight-bearing activity significantly earlier than the tunnel group (P＜0.05) . The Kujala and Lysholm scores, as well as knee extension-flex- ion range of motion (ROM) increased significantly (P＜0.05) , whereas VAS score decreased significantly (P＜0.05) in both groups over time, whereas which proved not statistically significant between the two groups at any corresponding time points (P＞0.05) . Radiographically, the patellar title (PT) and patellar displacement (PD) were significantly reduced in both groups after surgery compared with those before surgery (P＜0.05) , which were not significantly different between the two groups at any corresponding time points (P＞0.05) . [Conclusion] Both the patellar fixation methods have achieved satisfactory clinical outcomes in MPFL reconstruction. In comparison, the anchor fixation has the advantages of shortening operation time, reducing complication risk and enhancing recovery.

Abstract:[Objective] To compare the clinical outcomes of intramedullary nail versus locking plate for open reduction and internal fix- ation (ORIF) of Neer two- and three-part proximal humeral fractures. [Methods] From February 2018 to February 2021, 99 patients re- ceived ORIF for Neer two- and three- part proximal humeral fractures. According to preoperative doctor- patient communication, 57 pa- tients were treated with intramedullary nail (IMN group) , while the other 42 patients had locking plate used (LP group) . The documents re- garding to perioperative period, follow- ups and radiographs were compared between the two groups. [Results] All the patients in both groups had ORIF performed successfully. The IMN group proved significantly superior to LP group in terms of incision length, intraopera- tive blood loss, operation time and hospital stay (P<0.05) , although there was no significant difference in the incidence of early complica- tions between the two groups (P>0.05) . All patients were followed up for 14~31 months, with an average of (20.88±4.86) months. The IMN group got clinical fracture healing significantly earlier than LP group (P<0.05) . The VAS score, forward flexion and lifting range of motion (ROM) , abduction and lifting ROM, Constant-Murley score, and abductor strength were significantly improved in both groups over time (P< 0.05) , which were not statistically significant between the two groups at any corresponding time points (P>0.05) . Radiographically, there was no significant difference in fracture reduction quality between the two groups (P>0.05) , however, the IMN group achieved fracture heal- ing on images significantly earlier than LP group (P<0.05) . Compared with those preoperatively, the neck-shaft angle (NSA) of the humer- us was significantly increased in both groups postoperatively (P<0.05) , whereas which proved not statistically significant between the two groups at any matching time points (P>0.05) . [Conclusion] Both intramedullary nail and locking plate do achieve satisfactory clinical out- comes of internal fixation of Neer two- and three-part proximal humeral fractures. In comparison, intramedullary nail takes advantages of less trauma and faster fracture healing over the plate.

Abstract:[Objective] To compare the clinical outcomes of pedicle screw fixation with or without screw placement in the fractured ver- tebrae for simple thoracolumbar burst fractures. [Methods] A retrospective study was done on 96 patients who underwent surgical treatment for simple thoracolumbar burst fracture in our hospital from March 2017 to March 2020. According to the results of doctor-patient commu- nication preoperatively, 50 patients had pedicle screw fixation performed with screw placement at the fractured vertebrae (the SPFV group) , while the remaining 46 patients received pedicle screw fixation without screw placement at the fractured vertebrae (the non-SPFV group) . The documents regarding to perioperative period, follow-up and radiographs were compared between the two groups. [Results] All the patients in both groups were operated on successfully without serious complications. Although the SPFV group consumed operative time, intraoperative blood loss, and incisive length significantly greater than the non-SPFV group (P＜0.001) , the former resumed postopera- tive ambulation significantly earlier, associated with significantly shorter hospital stay than the latter (P＜0.001) . All patients were followed up for (15.52±3.41) months, and the SPFV group recovered full weight-bearing activity significantly earlier than the non-SPFV group (P＜ 0.001) . VAS and ODI scores decreased significantly over time in both groups (P＜0.001) . There were no statistically significant differences in VAS and ODI scores between the two groups before surgery (P＞0.05) , however, the SPFV group proved significantly superior to the nonSPFV group in the VAS and ODI scores postoperatively (P＜0.001) . Radiographically, the anterior height ratio of the injured vertebrae sig- nificantly increased (P＜0.001) , while the local kyphotic Cobb's angle significantly decreased postoperatively compared with those preopera- tively in both groups (P＜0.001) . Nevertheless there were no statistically significant differences in the anterior height ratio of the injured ver- tebrae and local kyphotic Cobb's angle between the two groups before operation (P＞0.05) . Campared with those at 3 days after operation and the last follow-up, the above imaging indexes were lost in both groups, which proved not statistically significant in the SPFV group (P＞ 0.05) , whereas statistically significant in term of anterior height ration of the injured vertebrae in the non-SPFV group (P＜0.05) . [Conclusion] The pedicle screw fixation with SPFV is considerably superior to that without SPFV in traditional way in terms of fracture reduction quality and fixation stability for simple thoracolumbar fractures.

Abstract:[Objective] To investigate the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on early postop- erative sleep quality and incidence of delirium in elderly patients who received spinal surgery under general anesthesia. [Methods] A total of 70 elderly patients who were undergoing spinal surgery were randomly divided into two groups, with 35 cases in each group. The TEAS group received percutaneous electrical stimulation at Baihui, Anmian, Shenmen and Sanyinjiao 1 day before surgery, before anesthesia and 1 day after surgery, while the control group received electrical stimulation in the corresponding non-acupoint part. The sleep was continu- ously monitored for 3 nights after operation, additionally, satisfaction to postoperative sleep and occurrence of delirium within 7 days after operation was evaluated. [Results] Of them, only 66 patients were got complete data, including 32 patients in the TEAS group and 34 pa- tients in the control group. There were no significant differences in terms of age, height, BMI, operation time, anesthesia time and preopera- tive PSQI between the two groups (P>0.05) . Regarding postoperative sleep quality monitoring, the TEAS group proved significantly superi- or to the control group in terms of sleep initiation time, total sleep time, sleep efficiency, steady sleep duration, steady sleep proportion and proportion of rapid eye movement sleep on the 1^st to 3^rd night after surgery (P<0.05) . In addition, TEAS group was also significantly better than the control group in term of the overall sleep satisfaction postoperatively (P<0.05) . Postoperative delirium mainly occurred within 3 days after surgery, which in total incidence of TEAS group (6.25%) was lower than that of control group (14.70%) , but the difference was not statistically significant (P>0.05) . [Conclusion] Perioperative percutaneous electrical acupoint stimulation at Baihui, Anmian, Shenmen and Sanyinjiao acupoints do improve postoperative sleep quality and reduce the incidence of postoperative delirium in elderly patients in perioperative period of spinal surgery under general anesthesia.

Abstract:[Objective] To explore the risk factors of proximal femoral nail anti-rotation (PFNA) failure for internal fixation of femoral intertrochanteric fractures. [Methods] A retrospective study was performed on 110 patients who received PFNA for femoral intertrochanter- ic fractures in our hospital from January 2017 to January 2020. The patients were divided into failure group and success group according to whether internal fixation failure occurred during follow-up. Univariate comparison and binary multiple logistic regression analysis were con- ducted to explore the risk factors of the internal fixation failure. [Results] All the 110 patients had PFNA fixation performed smoothly, and were followed up for 12~16 months. During follow-up, 12 patients were proved internal fixation failure, accounting for 10.91%, while the re- maining 98 patients got successful fixation, accounting for 89.09%. Patients were divided into two groups according to whether internal fixa- tion failure occurred. There were no significant differences in gender, age, body mass index, side of injury, tip-apex distance (TAD) be- tween the two groups (P>0.05) . However, the failure group had a significantly higher ratio of incomplete lateral wall (P<0.05) , significantly higher ratio of poor fracture alignment (P<0.05) , significantly higher ratio of the negative support of medial cortex (P<0.05) , and signifi- cantly higher ratio of poor spiral blade placement than the success group (P<0.05) . As result of multivariate logistic regression, the incom- plete lateral wall (OR=14.424, P=0.007) , poor fracture alignment (OR=6.578, P=0.033) , negative support of medial cortex (OR=17.17, P= 0.005) , and poor spiral blade placement (OR=8.403, P=0.005, P=0.038) were the independent risk factors for internal fixation failure. [Conclusion] Incomplete lateral wall, poor reduction alignment, negative medial cortical support, and poor position of spiral blade are risk factors for PFNA failure.

Abstract:Calcaneal fracture is common but complex fracture, while improper treatment will significantly impact patients' quality of life. Although open reduction and internal fixation through the lateral L-shaped incision is considered the "gold standard" for surgical treat- ment for this fracture, the minimally invasive surgery is the research hotpoint for many scholars because the classical surgical technique might be accompanied by serious soft tissue complications. Calcanail? was reported as a kind of interlocking nail for calcaneal fractures re- cently, which was used by minimally invasive surgery way for calcaneal fractures with good outcomes and less soft tissue complications. This paper reviewed the current application of Calcanail? for calcaneal fracture

Abstract:Spinal cord injury (SCI) is a serious and irreversible central nervous system damage without effective treatment method at present. Electrospinning is a common technique for preparing nano-scale fiber membrane materials, with advantages of high porosity, ad- justable pore size, high surface-to-volume ratio, and corresponding to the shape of extracellular matrix, which is widely used in the field of biomedicine. This article reviews the characteristics and the preclinical research progress of electrospinning for spinal cord injury, in order to explore a new idea for the treatment of spinal cord injury.

Abstract:Anterior cruciate ligament (ACL) is the most common involved ligament in knee injury. Prevention of ACL injury and identi- fication of risk factors related to ACL injury have become research hotspots in recent years. Studies have shown that knee anatomical varia- tion are the main risk factors for non-contact ACL injury, including anatomical variations of femur and tibia. Previous studies have mostly focused on the anatomical differences of the femur, while the anatomical variations related to the tibial plateau are rarely involved. The re- sult and conclusion of most studies are based on some specific morphological parameters of the tibial plateau measured on MRI or X-ray images. Therefore, this article reviews the relationship between anatomical variations of tibial plateau and ACL injury to provide a reference for clinicains.

Abstract:Lumbar disc herniation might cause severe radicular symptoms, which should be treated by lumbar discectomy if patients was refractory to conservative treatment. However, there is a certain risk of recurrent herniation after lumbar discectomy, which leads to re- vision surgery. Barricaid bone-anchored annular closure device (ACD) has been proved to effectively reduce the recurrence rate and reoper- ation rate, especially for the large annulus fibrosus defect after discectomy. In order to provide a reference for the clinical application of the Barricaid bone-anchored ACD, this article reviews this ACD in terms of indications and contraindications, biomechanical characteristics, clinical efficacy, postoperative complications and recurrence and reoperation situation, and so on.

Abstract:[Objective] To investigate the effect of LncRNA HIF1A-AS2 on osteogenic differentiation of human bone marrow mesen- chymal stem cells (hMSCs) . [Methods] The hMSCs were divided into six groups, including blank group, osteoinduction group, AS2 NC overexpression group, AS2 overexpression group, AS2 NC interference group and AS2 interference group. The later four groups were respec- tively transfected with the corresponding LncRNA HIF1A-AS2 lentivirus vector in vitro, and then the hMSCs except the blank group were cultured for osteogenic induction. The cell apoptosis, cell proliferation and cell calcification were detected, in addition, the mRNA expres- sion levels of HIF1A-AS2, MMP2 and VEGF165 and the protein expression levels of MMP2 and VEGF165 were detected. [Results] RTPCR showed that the time of maximum osteogenic differentiation was 7 d after the culture. The apoptosis rate was ranked from high to low as blank group > AS2 interference group > AS2 NC overexpression group > AS2 NC interference group > osteoinduction group > AS2 over- expression group, with statistically significant differences among them (P<0.05) . The OD value of cell proliferation was arranged from low to high as blank group < AS2 interference group < AS2 NC interference group < osteoinduction group < AS2 NC overexpression group < AS2 overexpression group, with the statistically significant overall difference (P<0.05) . The deposition of calcified nodules revealed by aliz- arin red staining was more significant in the AS2 overexpression group, whereas which was less in the AS2 interference group. The mRNA and protein expression levels of MMP2 and VEGF165 in the AS2 overexpression group were significantly higher than those in the AS2 inter- ference group (P<0.05) . [Conclusion] The LncRNA HIF1A- AS2 overexpression promotes cell proliferation, inhibit cell apoptosis, in- crease the expression levels of MMP2 and VEGF165, and promote the differentiation of hMSCs into osteoblasts.

Abstract:[Objective] To evaluate the efficacy of calcium phosphate cement (CPC) / fibrin glue (FG) / mechano-growth factor (MGF) / bone marrow mesenchymal stem cells (BMSCs) tissue engineered artificial bone in repairing osteoporotic bone defects in rats. [Methods] The CPC/FG (scaffold) , CPC/FG/BMSCs (scaffold-cells) and CPC/FG/MGF/BMSCs (fully composed) were constructed in vitro. Fifty-four Sprague-Dawley female rats were randomly divided into 3 groups. The rats were firstly treated with bilateral ovariectomies, 3 months later had a 4 mm radial bone defect in length created, then CPC/FG, CPC/FG/BMSCs and CPC/FG/MGF/BMSCs filled respectively. Radiograph- ic check, histological observation and ALP immunohistochemistry were conducted 4 weeks and 8 weeks postoperatively. [Results] Com- pared with those at 4 weeks after operation, all the 3 groups of animals got significant increases in terms of radiographic and histological scores (P<0.05) , whereas the IOD values of ALP immunohistochemistry decreased significantly at 8 weeks postoperatively (P<0.05) . At all the corresponding time points, the radiographic and histological scores, as well as the ALP immunohistochemistry IOD value was all ranked up-down as: the fully composed group > scaffold cell group > scaffold group, with statistical significances in total (P<0.05) . [Conclusion] Compared with the pure scaffold or scaffold-cell materials, fully composed material containing mechano-growth factor has better capacity to repair osteoporotic bone defect.

Abstract:[Objective] To investigate the clinical outcomes of interrupted vertical mattresses suture for comminuted fractures of the lower patellar pole. [Methods] From August 2018 to November 2020, 34 patients received internal fixation of comminuted fractures of the lower patellar pole by interrupted vertical mattresses suture with No. 5 ethibond. The clinical and imaging findings were evaluated. [Results] All the 34 patients had operation performed successfully without complications such as injuries to important nerves and blood ves- sels, while with well incisions healing. The patients were followed up for (12.88±0.91) months on an average. At 12 months after operation, the VAS score of anterior knee pain was of (0.82±1.14) , and the Bostman function score for patellar fracture was of (27.68±2.27) . The clini- cal results were marked as excellent in 29 cases, good in 5 cases, with an excellent and good rate of 100%. Radiographically, no re-dis- placement of the fracture was found in anyone of them, whereas the fracture healed from 12 to 16 weeks with a mean Insall-Salvati index of (1.02±0.08) . [Conclusion] Interrupted vertical mattresses sutures with No. 5 ethibond are not only simple in technique, but also achieve satisfactory clinical outcomes for comminuted fracture of the lower patellar pole.

Abstract:[Objective] To compare the clinical efficacy of arthroscopic suture hook versus fast-fix system in suture of lateral meniscus horizontal tears at the popliteal hiatus. [Methods] A retrospective study was conducted on 37 patients who received arthroscopic surgeries for lateral meniscus horizontal tears at the popliteal hiatus in our hospitals from January 2018 to October 2020. According to preoperative doctor-patient communication, 18 patients had the torn meniscus repaired by suture hook technique (SH group) , while the remaining 19 pa- tients underwent meniscus repair by the fast-fix system (FF group) . [Results] All the patients in both groups had corresponding arthroscop- ic procedures performed smoothly without serious intraoperative complications. The SH consumed significantly longer operative time, whereas significantly lower hospitalization cost than the FF group (P＜0.05) . All patients in both groups were followed for at least 6 months. The knee extension-flexion range of motion (ROM) and Lysholm score were significantly increased (P＜0.05) , whereas the VAS score de- creased significantly over time in both groups (P＜0.05) , which proved not significantly different between the two groups at any correspond- ing time points (P＞0.05) . [Conclusion] Both techniques of arthroscopic suture of lateral meniscus horizontal tears at the popliteal hiatus do achieve good and comparable clinical outcomes, but the suture hook technique is more cost-efficient than the Fast-fix system.

Abstract:[Objective] To explore the survival and risk factors of death after femoral head replacement for femoral intertrochanteric fracture in elderly. [Methods] A retrospective study was done on 131 elderly patients who underwent femoral head replacement for femoral intertrochanteric fractures in our hospital from January 2015 to October 2019. As survival outcomes were obtained by follow-up, univariate comparison and Cox proportional hazard regression were performed to search the risk factors for death. [Results] Of them, 8 patients died one year after operation accounting for 6.11% with the 1-year survival rate of 93.89%, while a total of 22 cases died in 2 years, accounting for 16.79%, with 2-year survival rate of 83.21%. Compared with the non-death group, the death group was significant older, had significant- ly lower BMI, preoperative hemoglobin (Hb) , higher ratio of 2 or more preoperative comorbidities, longer operation time and time to resume walking postoperatively and lower Harris score 3 months postoperatively, which all proved statistically significant (P<0.05) . As results of Cox proportional hazard regression, the advanced age was a risk factor for death (HR=1.117, P=0.001) . [Conclusion] The risk of death is higher after femoral head replacement for femoral intertrochanteric fractures in the elderly, especially for those with advanced age and multi- ple comorbidities preoperatively, which should be paid attention to.

Abstract:[Objective] To investigate the clinical outcomes of posterior osteotomy for old thoracolumbar fracture kyphosis. [Methods] From September 2006 to June 2019, 41 adult patients, including 32 males and 9 female aged (42.72±12.22) years, underwent posterior oste- otomy, involving SPO, PSO, BDBO and PVCR for kyphotic deformity secondary to old thoracolumbar fractures in our hospitals. The clinical and imaging consequences were evaluated. [Results] All patients had surgical procedures completed successfully, with operation time of (4.20±1.34) hours and intraoperative blood loss of (1 800.25±240.50) ml. At 12 months postoperatively and the latest follow-up lasted for (36.72±7.38) months on average, the VAS and ODI scores significantly decreased (P＜0.05) , while body heights significantly increased (P＜ 0.05) , and ASIA grade for neurological function grade significantly improved compared with those preoperatively (P＜0.05) . In terms of im- aging, the postoperative local kyphotic Cobb angle, SVA and sagittal diameter of the parietal vertebral canal significantly improved com- pared with those before surgery (P＜0.05) , with the kyphotic correction rate of 78.56%, and bone healing in all patients. [Conclusion] Poste- rior osteotomy does effectively correct the kyphotic deformity due to old thoracolumbar fracture in this study

Abstract:[Objective] To summarize the surgical strategy and clinical outcomes of terrible triad of the elbow (TTE) . [Methods] A ret- rospective study was conducted on 53 patients who underwent surgical treatment in our department for TTE from July 2017 to March 2020, including 34 males and 19 females aged from 16 to 63 years with an average of (40.98±10.34) years. A single lateral incision was used to fix the fractures and repair the ligament in layers. The clinical and imaging consequences were evaluated. [Results] All the patients were suc- cessfully operated on without serious complications. With time of the follow-up lasted for (19.00±4.65) months, the VAS scores decreased significantly (P＜0.05) , whereas MEPS score, elbow flexion-extension range of motion (ROM) and forearm rotation ROM significantly in- creased (P＜0.05) . At the latest follow-up, all the 53 patients got negative results in term of adduction and abduction stress tests. Radio- graphically, all the patients had radial axis passed through the capitulum, center, with symmetrical bilateral humeroulnar space, however, 14 patients were noted ectopic ossification at 3 months postoperatively and at the last follow-up. [Conclusion] The surgical fracture fixation and ligament repair by a single lateral incision does achieve satisfactory clinical outcomes for TTE in this study.

Abstract:[Objective] To investigate the value of fracture liaison service (FLS) for osteoporotic vertebral compression fracture (OVCF) in the elderly. [Methods] A total of 66 elderly patients who received percutaneous kyphoplasty (PKP) for OVCF from March 2021 to Novem- ber 2021 were randomly divided into conventional group (n=33) and FLS group (n=33) , the latter was added FLS treatment on the basis of the conventional group. The results of hospitalization and follow- up were compared between the two groups. [Results] The FLS group proved significantly superior to the conventional group in terms of hospital stay, hospitalization cost and patient satisfaction (P<0.05) . The VAS and EFS scores decreased significantly (P<0.05) , while SF-36 scores significantly increased over time in both groups (P<0.05) . At discharge and 6 months after discharge, the FLS group was significantly better than the conventional group in abovesaid scores (P<0.05) . However, there was no significant difference in the incidence of refracture between the two groups (P>0.05) . [Conclusion] Fracture liaison service does reduce hospital stay and hospitalization costs, relieve the pain and frailty, and improve the quality of life and satisfaction of the patients.

Abstract:[Objective] To evaluate the clinical outcomes of posterior plate placement for internal fixation of mid-distal tibial fractures accompanied with anterior soft tissue injury. [Methods] From July 2014 to June 2021, a total of 16 patients received posterior plate place- ment for internal fixation of mid-distal tibial fractures accompanied with anterior soft tissue injury. [Results] All the 16 patients had opera- tion performed successfully without complications, such as neurovascular injuries, and got incisions healed well without early complica- tions, such as severe joint swelling, infection and thrombosis. All the patients were followed up for (14.16±5.21) months, with time to return to full weight-bearing activities of (21.33±3.26) weeks. The VAS score significantly decreased (P<0.05) , while AOFAS score and ankle range of motion (ROM) significantly increased at the latest follow-up compared with those 3 months after surgery (P<0.05) . Radiographical- ly, fracture reduction was marked as excellent in 13 cases, fair in 3 cases, and poor in 0 case with anatomical reduction rate of 81.25%. In addition, fracture healing achieved in all of them from 5 to 7 months postoperatively. [Conclusion] This posterior plate placement is a reli- able and effective method for internal fixation of mid-distal tibial fractures accompanied with anterior soft tissue injury.