Abstract:[Objective] To explore the risk factors of death after surgical treatment for hip fractures in the elderly. [Methods] A retro- spective study was conducted on 177 elderly patients who received surgical treatment for hip fractures in our hospital from January 2017 to January 2019. The general data, involving age, gender, clinical examination, activity of daily living (ADL) score and survival state were re- corded. Based on whether the patient died in 2 years, the patients was divided into two groups. Univariate comparison of the two groups and Cox survival regression were conducted to search the risk factors related to death. [Results] Among 177 patients, 147 cases were completely followed up, whereas 30 cases were lost to follow-up, accounted for 16.95%, in a mean follow-up period of (18.59±7.70) months. Of them, 123 patients survived at 1 year after operation with survival rate of 83.67%, and 109 patients survived at 2 years after operation with the sur- vival rate of 74.15%. In term of death causes of the 38 patients, pulmonary infection was the main cause, accounting for 44.74%, followed by cardiac failure, accounting for 31.58%. As results of univariate comparison, the patients in the death group were significantly older, had more complicated underlying diseases, lower proportion of family care, worse preoperative ADL score and lower preoperative hemoglobin and albumin than those of the survival group, which were statistically significant (P＜0.05) . In term of Cox survival regression, the family care (OR=0.382, P=0.008) , preoperative ADL score (OR=0.982, P=0.023) , preoperative hemoglobin (OR=0.978, P=0.004) and preopera- tive albumin (OR=0.845, P＜0.001) were protective factors, whereas the preoperative number of underlying diseases (OR=3.926, P=0.002) was a risk factor for death after surgical treatment for hip fractures in the elderly. [Conclusion] Family care, high preoperative ADL score, and high preoperative hemoglobin and albumin are the protective factors, while the number of underlying diseases is a risk factor for death after surgical treatment of hip fractures in the elderly.

Abstract:[Objective] To search the factors related to death within one year after internal fixation with proximal femoral nail anti-rota- tion (PFNA) for femoral intertrochanteric fractures in the elderly in two hospitals of southern Jiangsu. [Methods] A retrospective study was conducted on 864 patients who received PFNA for femoral intertrochanteric fracture from August 2014 to January 2021 in the two hospitals. Based on whether or not died within one year after operation, the patients were divided into two groups. Univariate comparison and binary multivariate logistic regression were done to explore the factors related to death. In addition, receiver operator characteristic (ROC) curve analysis was used to evaluate the value of the main factor for predicting the death. [Results] Among the 864 patients, 144 died within one year after operation, accounted for 16.7%, with the main death cause of pulmonary infection. In term of univariate comparison, the death group was significantly older (P＜0.05) , had significantly longer interval between injury and operation (P＜0.05) , significantly longer hospi- tal stay (P＜0.05) , significantly worsened ASA grade (P＜0.05) and significantly lower albumin level than the non-death group (P＜0.05) . As result of logistic regression, the advanced age (OR=2.895, P=0.002) , low albumin (OR=0.418, P=0.004) , pulmonary disease (OR= 2.221, P=0.023) , long hospital stay (OR=2.989, P＜0.001) and worsened ASA grade (OR=2.504, P=0.019) were the independent risk fac- tors for death within one year after operation for femoral intertrochanteric fracture in the elderly. Regarding to ROC analysis, the aera under curve (AUC) was ranked up-down in sequence of hospital stay (0.885) , age (0.841) and low albumin (0.654) . [Conclusion] The advanced age, hypoalbuminemia, underlying pulmonary diseases, prolonged hospital stay, and worsened ASA grade are main factors related to death within one year after surgery for intertrochanteric fractures in the elderly over 65 years old in this study.

Abstract:[Objective] To compare the clinical results of two fixations for displaced proximal humeral fractures in children and adoles- cent. [Methods] A retrospective study was conducted on 71 patients who underwent surgical treatment for remarkably displaced proximal humeral fractures in our hospital between August 2010 and May 2018. According to consequences of preoperative patient-surgeon commu- nication, 34 patients received closed reduction and percutaneous Kirschner wire fixation (the K-wire group) , while the remaining 37 pa- tients had closed reduction and internal fixation with elastic stable intramedullary nail performed (the ESIN group) . The preoperative, fol- low-up and radiographic documentations were analyzed and compared between the two groups. [Results] All patients in both groups had surgical procedures finished smoothly without serious complications, such as neurovascular injury. The K-wire group was significantly su- perior to the ESIN group in terms of operation time and incision length (P＜0.05) . All patients in both groups achieved bony union without malunion and premature epiphyseal closure. At 3 months postoperatively and the latest follow-up, no significant differences were seen be- tween the two groups in terms of forward flexion range of motion (ROM) of the shoulder, Constant-Murley score and Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) (P＞0.05) . With respect to radiographic evaluation, there were no significant differences in the fracture reduction quality and fracture healing time between the two groups (P＞0.05) . The humeral neck-shaft angle significantly improved postoperatively compared with that preoperatively in both groups (P＜0.05) , but no a significant difference was noted between the two groups at any matching time point (P＞0.05) . [Conclusions] Both K-wire and ESIN are effective for treating considerably displaced proxi- mal humeral fractures in children and adolescents, with comparable clinical outcomes.

Abstract:[Objective] To explore the risk factors of delirium after surgical treatment of hip fractures in the elderly. [Methods] A retro- spective study was conducted on 346 patients who received surgical treatments for hip fractures in our hospital from December 2016 to De- cember 2019. According to whether or not postoperative delirium happened , the patients were divided into two groups. The univariate com- parison and binary multiple logistic regression were done to search the risk factors related to the postoperative delirium. [Results] Of the 346 patients, 48 patients were definitively diagnosed of postoperative delirium, accounted for 13.87%, which occurred within 2~7 days after surgery. As results of the univariate analysis and logistic regression, the advanced age (OR=2.329, P=0.024) , low education level (OR= 1.957, P=0.036) , stroke history (OR=3.007, P=0.001) , living alone (OR=1.933, P=0.037) , history of sleep disturbance (OR=2.789, P= 0.005) , preoperative bed time (OR=2.056, P=0.026) , general anesthesia (OR=2.196, P=0.013) , longer anesthesia time (OR=2.229, P= 0.013) , ICU stay (OR=2.352, P=0.008) were independent risk factors of postoperative delirium. [Conclusion] Postoperative delirium is a common complication after surgical treatment for hip fractures in the elderly, which does affect the prognosis. Advanced age, low education level, living alone, stroke history, sleep disturbance history, long bed time before surgery, general anesthesia, long anesthesia and ICU stay are the main risk factors, clinicians must pay more attention to them.

Abstract:[Objective] To explore the cause of delayed diagnosis of spinal fractures in ankylosing spondylitis (AS) . [Methods] The pa- tients with delayed diagnosis(DD) for spinal fracture were searched in our hospital from 2008 to 2019. The fracture characteristics and the causes of DD were analyzed. [Results] From 2008 to 2019, a total of 63 573 patients with spinal diseases were admitted to our department, and among them 3 363 patients (5.29%) were finally diagnosed with spinal fractures. Of the 3 363 patients with spinal fracture, 166 patients (4.94%) were finally diagnosed AS. Among 157 patients who were finally diagnosed of AS spinal fracture, 7 patients were of delayed diagno- sis, accounting for 4.67%, including 3 cases who were misdiagnosed initially in other hospitals, accounting for 1.91%, and 4 cases who were misdiagnosed primarily in our hospital, accounting for 2.25%. The ratio of no definite trauma history in the delayed diagnosis group was sig- nificantly higher than in the confirmed diagnosis group, with a statistically significant difference (P＜0.05) . Among the 7 delayed diagnosed patients, 3 patients had one fracture misdiagnosed because of multiple spinal fractures, 2 patients were slightly delayed due to non-obvious symptoms of trauma, 1 case was treated for local malformation due to thoracolumbar fracture during spinal cord injury rehabilitation, 1 case of cervical vertebra facture was misdiagnosed due to incomplete malformation on imaging examination. [Conclusion] Delayed diagnosis of spinal fracture in AS often occurs in patients with multiple spinal fractures, additionally, overlooked occult fracture and delayed presenta- tion are also common reasons for initial misdiagnosis.

Abstract:[Objective] To evaluate the clinical outcome of percutaneous vertebral body stent (VBS) for osteoporotic vertebral compres- sion fracture (OVCF) , by comparison with percutaneous kyphoplasty (PKP) . [Methods] A total of 62 patients admitted our hospital from January 2019 to January 2020 for OVCF were included into this study, and divided into two groups based on results of preoperative doctorpatient communication. Among them, 30 patients received VBS, while the remaining 32 patients underwent PKP. The perioperative, followup and imaging data were compared between the two groups. [Results] All the 62 patients had corresponding surgical procedures completed successfully. The bone cement leakage was of 4/30 (13.33%) in the VBS group, whereas 10/32 (31.25%) in the PKP group, which was not statistically significant between the two groups (P＞0.05) . Intraoperative balloon rupture was of 5/60 (8.33%) in the VBS group, whereas 0/ 64 (0%) in the PKP group, with a statistically significant difference (P＜0.05) . There was no significant difference between the two groups in terms of operation time, intraoperative fluoroscopy, bone cement injection volume, postoperative ambulation time and hospital stay (P＞ 0.05) . All the patients were followed up for 12~16 months, with an average of (14.11±1.29) months. The VBS group resumed the level of pre-injury weight-bearing activity significantly earlier than the PKP group (P＜0.05) . The VAS and ODI scores significantly decreased at the latest follow-up compared with those preoperatively in both groups (P＜0.05) . However, the differences in VAS and ODI scores at the corresponding time points were not statistically significant between the two groups (P＞0.05) . Regarding to imaging assessment, the relative vertebral height increased significantly (P＜0.05) , while the local Cobb angle decreased significantly (P＜0.05) in both groups at the latest follow-up compared with those preoperatively. The VBS group was significantly superior to the PKP group in terms of the relative height of the vertebral body and the local Cobb angle at the latest follow-up (P＜0.05) . [Conclusion] For OVCF treatment, the VBS is considerably better than PKP in correcting vertebral deformities.

Abstract:[Objective] To compare the clinical outcomes of a modified suture bridge versus traditional suture bridge in arthroscopic re- pairing of moderate rotator cuff tears. [Methods] A retrospective study was conducted on 70 patients who underwent arthroscopic repairing of rotator cuff tear from September 2019 to March 2020 in Department of Sports Medicine, Affiliated Hospital of Qingdao University. Ac- cording to the consequences of preoperative patient-doctor communication, 36 patients received the modified bridge suture, while the re- maining 34 patients underwent the traditional bridge suture. The perioperative, follow-up and imaging documents were compared between the two groups. [Results] The operation was successfully completed in both groups without serious complications. There were no significant differences in operative time, intraoperative blood loss, total length of incision, normal saline irrigation volume intraarticularly, incision healing and hospital stay between the two groups (P＞0.05) . The patients in both groups were followed up for more than 15 months. The mod- ified group resumed full weight bearing activity significantly earlier than the traditional group (P＜0.05) . Compared with those before opera- tion, the VAS score significantly decreased (P＜0.05) , while abduction range of motion (ROM) , forward flexion ROM, external rotation ROM, UCLA score, Constant-Murley score and ASES score significantly increased in both groups at the latest follow up (P＜0.05) . Al- though there were no statistically significant differences in the abovementioned items between the two groups preoperatively (P＞0.05) , the modified group proved significantly superior to the traditional group in terms of abduction ROM, flexion ROM, external rotation ROM, VAS score, UCLA score and Constant-Murley score at the latest follow-up (P＜0.05) , whereas no a statistically significant difference was noted in ASES score between them (P＞0.05) . Radiographically, the Sugaya's classification on MRI images was not statistically significant differ- ent between the two groups before surgery (P＞0.05) , whereas which in the modified group became significantly better than the traditional group at the latest follow-up (P＜0.05) . [Conclusion] Modified suture bridge technique does achieve considerably better clinical outcomes than traditional suture bridge technique.

Abstract:[Objective] To compare the clinical efficiency of traditional and minimally invasive sutures for acute closed Achilles tendon rupture. [Methods] From May 2016 to November 2019, 64 patients (64 feet) underwent surgical repair for acute closed Achilles tendon rup- ture in our hospitals. According to the results of preoperative doctor-patient communication, 30 patients were treated with traditional open suture, while the other 34 patients had the tendon sutured by channel-assisted minimally invasive repair (CAMIR) . The perioperative, fol- low-up and imaging documents were compared between the two groups. [Results] The CAMIR group proved significantly superior to the traditional group regarding to operation time [ (56.40±4.21) min vs (78.24±8.75) min, P＜0.05] , incision length [ (3.75±0.50) cm vs (12.90± 1.77) cm, P＜0.05] and intraoperative blood loss [ (12.29±1.75)ml vs (24.5±2.92) ml, P＜0.05] . The postoperative follow-up period lasted for (23.80±3.75) months on average. The VAS scores decreased significantly (P＜0.05) , while the AOFAS and ATRS scores increased sig- nificantly in both groups at the latest follow-up compared with those before operation (P＜0.05) . At the latest follow-up, the CAMIR group was significantly better than the traditional group in terms of VAS score [ (0.99±0.30) vs (1.34±0.28) , P＜0.05] and AOFAS score [ (81.15± 3.28) vs (77.27±2.21) , P＜0.05] , nevertheless there was no a statistically significant difference in ATRS scores between the two groups (P＞ 0.05) . [Conclusion] Compared with traditional open suture, the minimally invasive suture by using CAMIR has the advantages of less trau- ma and better postoperative functional recovery.

Abstract:Unicompartmental knee arthroplasty (UKA) is an effective treatment for medial unicompartmental knee osteoarthritis.Largenumber of literatures have proved that the UKA does relieve joint pain, correct joint deformity and restore joint function, However, UKAleads to biomechanical changes of the knee in some extent despite of its satisfactory clinical outcomes.This paper will systematically reviewpostoperatively biomechanical variations of Oxford mobile- bearing medial UKA, involving cadaveric study, finite element analysis, gaitanalysis and others.

Abstract:Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine that occurs most often in adolescent fe- males. At present, posterior spinal three-dimensional correction surgery remains the effective treatments for moderate and severe AIS. The quality-of-life evaluation of patients after correction of AIS has been paid more and more attention by patients and spinal surgeons. Howev- er, AIS usually occurs in young women and most of them are before the childbearing age. Currently, there are few studies on pregnancy-re- lated issues in female patients after surgery for AIS, and the results of existing studies are also somewhat contradictory. This paper summa- rizes the research in this area, and provides a reference for the medical workers in the further research and exploration.

Abstract:Intervertebral disc degeneration (IDD) is a common clinical degenerative disease of the musculoskeletal system. About 70% to 85% of people will experience low back pain at least once in their life span, which seriously affects the quality of life of patients, and brings a heavy financial burden to their families. However, the specific pathogenesis of IDD is not fully understood currently. Nuclear factor E2 related factor 2 (Nrf2) is an important transcription factor that regulates the oxidative stress response of cells, and maintains cell homeo- stasis as a central regulator. Current studies have shown that Nrf2 can inhibit oxidative stress, inhibit inflammation, improve mitochondrial function, etc., on the other hand, Nrf2 is regulated by noncoding RNAs (ncRNAs) to alleviate the progress of IDD. This article reviews the structure of Nrf2 and its role in IDD to provide a reference for following related research.

Abstract:[Objective] To explore the biomechanical effect of T₁-slope (T1S) on intervertebral mobility and disc stress secondary to C5/6 fixation with zero profile intervertebral fusion system (Zero-P) . [Methods] Two patients with C_5/6 disc herniation and T₁S≤18° and T₁S＞18° were selected, and had preoperative spiral CT scanning performed from C₁ to T₂. Three dimensional finite models of cervical vertebrae, in- cluding T₁S≤18 °and T₁S＞18° with Zero-P fixation, as well as the normel cervical vertebrae were established by using mimics 14.0, Geo- magic studio 10.0 and Cero 3.0. The range of motion (ROM) of C_3/4 to C_6/7 intervertebral space, and Von Mises stress on disc endplate or im- plant were measured under the flexion, extension, lateral bending, rotation loading. [Results] Both T₁S≤18 °and T₁S＞18° groups had signifi- cantly higher ROMs on each segment than the control group (P＜0.05) . Under flexion and extension loadings, the T₁S≤18 ° group had signif- icantly higher ROMs on each segment than T₁S＞18° group (P＜0.05) . However, there was no significant difference in the ROMs of each seg- ment between T₁S≤18 °and T1S＞18° groups under unilateral bending and unilateral rotation loadings (P＞0.05) . In addition, the Von Mises stresses on the adjacent intervertebral disc in T₁S≤18° and T₁S＞18° groups were significantly higher than that in control group (P＜0.05) . The Von Mises stresses of C_4/5, C_5/6 fusion cage and C_6/7 under flexion and extension loadings in the T₁S≤18° group were significantly higher than those in the T1S＞18° group (P＜0.05) , whereas they became not significant different between the two groups under lateral bending and rotating loadings (P＞0.05) . [Conclusion] The decrease of T₁S might be the main factors leading to the increase of adjacent segment disc mo- tion and cage stress after Zero-P fusion.

Abstract:[Objective] To compare biomechanical characteristics of a novel pedicle screw (NPS) with the traditional pedicle screw (TPS) , TPS combined with transvers link (TPS-T) and TPS enhanced by bone cement (TPS-C) by finite element method. [Methods] The lumbar CT scan data of volunteers were obtained, and the L4/5 vertebral body model was established by Mimics, UG and Abaqus software. On this basis, the NPS, TPS, TDS-T and TDS-C fixation models were established respectively. In 6 degrees of freedom, including flexion, extension, left and right lateral bending, left and right rotation, the segmental range of motion (ROM) , von Mises stress on the screw and bone around screw tract were compared among 4 groups. [Results] In terms of flexion, extension, left lateral bending and right bending, there were no significant differences in ROM, screw von Mises stress and bone von Mises stress between NPS group and the other three groups (P＞0.05) . In terms of left and right rotations, the NPS group had ROM, screw von Mises stress and bone von Mises stress significant- ly lower than the other three groups (P＜0.05) , whereas the TPS group had ROM, screw von Mises stress and bone von Mises stress signifi- cantly higher than the other three groups (P＜0.05) . There was no significant difference in ROM and screw von Mises stress between TPS-T group and TPS-C group (P＞0.05) , but the TPS-T group had bone von Mises stress significantly lower than that in TPS-C group (P＜0.05) . [Conclusion] The NPS has considerably lower ROM, screw von Mises stress and bone von Mises stress than the 3 types of TPS, which might be facilitated to reduce the screw loosening.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of open reduction and internal fixation (OR- IF) of double- column acetabular fractures through a single lateral rectus abdominis approach. [Methods] From September 2016 to July 2019, 32 patients with double-column acetabular fractures were treated by ORIF through a single lateral rectus abdominis approach, in- cluding 14 males and 18 females, aged ranged from 21 to 72 years, with an average of (36.42±4.73) years. The acetabulum was exposed through the lateral incision of the rectus abdominis. The first and second windows were separated by the external iliac artery and vein, while the third window was the lateral iliopsoas muscle. The anterior column, quadrilateral area and posterior column were exposed, reduced and fixed by the combination of the first window and second window, while the iliac margin was exposed, reduced and fixed by the third window. The acetabular reduction was evaluated by Matta's criteria, whereas postoperative hip function was evaluated by modified Merle D 'Aubig- ne and Postle criteria. [Results] All patients had operation completed smoothly without obvious complications, and followed up from 9 to 24 months with a mean of (14.73±2.34) months. Based on Matta's criteria, quality of fracture reduction was of excellent in 21 cases, good in 7 cases, fair in 4 cases, with excellent rate of 87.5%. By the time of the latest follow-up, the clinical outcome was marked as excellent in 19 cases, good in 8 cases, fair in 4 cases and poor in 1 case with an excellent and good rate of 84.3% according to Merle D 'Aubigne and Pos- tle's criteria. [Conclusion] The lateral rectus abdominis approach has the advantages of small incision, full exposure of quadrilateral area and anterior column, as well as fixation of posterior column with screw and iliac plate under direct vision, and fewer complications.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of double ring cross suture for repairing acute Stener injury of thumb. [Methods] From May 2012 to July 2019, a total of 12 patients received double ring cross suture for acute Sten- er injury of thumb with lateral collateral ligament insertion reconstruction. The thumb spica cast without involving interphalangeal joint line was used for external fixation for 4 weeks postoperatively, with active interphalangeal joint exercises. After the cast was removed, a brace was used for another 2 weeks without involving the wrist and interphalangeal joints, and progressing rehabilitation of the affected finger was conducted. [Results] All the 12 patients were followed up for 7~25 months. At the latest follow up, the metacarpophalangeal joint of thumb was stable and normal, with negative the ulnar stress test, normal pinching force, and normal sensation of the back of the hand and finger. According to Saetta's criteria, the outcome was graded as excellent in 10 cases, good in 1 case and fair in 1 case, with the excellent and good rate of 91.67%. [Conclusion] This double ring cross suture may be a better choice for the treatment of acute Stener injury of thumb.

Abstract:[Objective] To evaluate the clinical efficacy of ankle arthroscopic debridement combined with anatomical reconstruction of the lateral collateral ligament by autograft peroneus brevis tendon for chronic lateral ankle instability. [Methods] From October 2016 to Oc- tober 2018, a total of 18 patients received ankle arthroscopic debridement, followed by anatomical reconstruction of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) with ipsilateral part of peroneus breus tendon for chronic lateral ankle instability. The clinical outcomes were assessed by using AOFAS and VAS scores, as well as radiographic examination. [Results] All the 18 patients were successfully operated on without serious complications, while with operation time of (71.56 ± 6.06) min and intraoperative blood loss of (46.50±5.38) ml. Over time during follow up lasted for (19.89±1.68) months, the AOFAS score significantly increased (P＜0.05) , whereas the VAS score significantly decreased (P＜0.05) . As findings on postoperative X-rays, ankle alignment was normal with anchor and bone tunnel in proper position. In addition, the MRI revealed that the reconstructed ATFL and CFL were in normal shape with proper tension. [Conclusion] Ankle arthroscopic debridement combined with anatomical reconstruction of the lateral collateral ligament by using partial peroneus brevis tendon for chronic lateral ankle instability does achieve satisfactory clinical results, with the advantages of less trauma, sim- ple operation and fewer complications.

Abstract:[Objective] To investigate the effect of axial displacement on clinical outcomes of distal radius fractures fixed with tradition- al Chinese splints. [Methods] From January 2019 to October 2019, 45 patients received manual reduction and external fixation with tradi- tional Chinese splint for distal radial fractures. Based on the radial axial displacement at the latest follow up, 24 patients fall into the ＜ 2.5mm group, while 21 patients were in the ≥ 2.5 mm group. Wrist function was assessed by using Mayo score, additionally, the extent of ra- dius shortening displacement, palmar tilt and radial angle on radiographs were measured and compared between the two groups at the last follow-up. [Results] At the last follow-up of more than 3 months, there was no significant difference in the Mayo pain subscore between the two groups (P＞0.05) , but the ＜2.5 mm group was significantly superior to the ≥2.5 mm group in terms of function, grip strength, range of motion subscores and the total Mayo score, with statistical significances (P＜0.05) . At the last follow-up, the ＜2.5 mm group proved signifi- cantly superior to the ≥2.5 mm group in terms of axial displacement, palmar tilt and radial angle (P＜0.05) . [Conclusion] Axial displace- ment of the distal radius occurred after traditional splint fixation, however, the axial displacement ＜2.5 mm has little effect on wrist joint function.

Abstract:[Objective] To compare the clinical outcomes of minimally invasive repair and traditional open repair for acute Achilles ten- don injury. [Methods] From 2016 to 2020, a total of 59 patients underwent surgical treatment for acute Achilles tendon rupture. Among them, 30 patients were treated with minimally invasive repair (minimally invasive group), while the remaining 29 patients received tradition- al open repair (traditional group) . The data of perioperative period and follow-up period were compared between the two groups. [Results] All the patients in both groups had operation performed successfully. The minimally invasive group proved significantly superior to the tra- ditional group in terms of operative time, total incision length, intraoperative blood loss and hospital stay (P＜0.05) . However, there was no significant difference in the incidence of postoperative complications between the two groups (P＞0.05) . At the latest follow up, there was no significant difference in average AOFAS score and ankle range of motion between the two groups (P＞0.05) . [Conclusion] Both minimally invasive repair and traditional open repair are effective treatment for acute Achilles tendon rupture. By contrast, the minimally invasive technique has the advantages of short hospital stay and less trauma.

Abstract:[Objective] To compare three treatments for cervical spinal cord injury (CSCI) without major fracture or dislocation in pa- tients with pre exiting cervical spinal canal stenosis (CSCS) . [Methods] From March 2015 to March 2020, 144 patients with CSCI com- bined with CSCS were enrolled in this study. According to the results of preoperative doctor-patient communication, 51 patients underwent anterior decompression, 44 patients underwent posterior decompression, and 49 patients received conservative treatment. The clinical and imaging data of the three groups were compared. [Results] All the patients in the three groups successfully completed the treatment, without aggravation of neurological symptoms and death. The anterior group proved significantly superior to the posterior group in terms of operative time and intraoperative blood loss (P＜0.05) . The ASIA neurological function grades and JOA score improved significantly over time in all three groups (P＜0.05) . At 3 and 12 months later, ASIA and JOA score ranked from superior to inferior were as follows: anterior approach group, posterior approach group and conservative group, with statistically significant differences (P＜0.05) . Compared with those preopera- tively, the C2~7 Cobb angle and spinal canal area significantly increased in anterior and posterior approaches (P＜0.05) , whereas remained unchanged among different time points in the conservative group (P＞0.05) . [Conclusion] Anterior decompression achieve the best out- comes for CSCI combined with CSCS in this study .

Abstract:[Objective] To explore the significance of staged injury control and treatment for severe lower extremity damages in emer- gency. [Methods] A total of 116 patients with severe lower extremity injuries were divided into two groups according to treatment in emer- gency. Of them, 64 patients in the trial group received staged injury control and surgical treatment according to the theory of damage con- trol, while the remaining 52 patients in the control group underwent conventional emergent treatment. The rescue and lower limb function recovery were compared between the two groups. [Results] The trial group proved significantly higher rescue success rate, whereas signifi- cantly shorter emergency time, ICU days, and hospital stay than the control group (P＜0.05) . At one month after emergent surgical treat- ment, the trial group had significantly higher muscle strength and flexion and extension range of motion (ROM) , whereas significantly lower incidence of knee stiffness, local swelling, local blisters and complication in total than the control group (P＜0.05) . The trial group was marked significantly higher total satisfaction rate of family members than the control group (P＜0.05) . [Conclusion] The use of staged injury control and surgical treatments for severe lower extremity injuries does effectively shorten the time elapsed in emergency, increase the suc- cess rate of rescue, and promote the recovery of lower extremity functions.

Abstract:[Objective] To explore the initial outcomes of fast-track surgery (FTS) principles used in arthroscopic rotator cuff repair. [Methods] From July 2020 to July 2021, 112 patients with rotator cuff injury were randomly divided into two groups. All the patients re- ceived arthroscopic rotator cuff repair, of them, 57 patients were treated with FTS perioperative management, while the other 55 patients were treated with conventional treatment. The VAS score, infusion time, hospital stay, incidence of complications, patient's satisfaction were compared between the two groups. [Results] There was no significant difference in gender, age, cause of rotator cuff tear, comorbidity and operation time between the two groups (P＞0.05) . However, the FTS group proved significantly superior to the conventional group in terms of time of postoperative infusion, hospital stay and incidence of complications (P＜0.05) . In addition, the FTS group had significantly higher satisfaction score than the conventional group at discharge (P＜0.05) . Regarding to pain, the FTS group had significantly lower VAS score than the conventional group on the day of surgery and 3 days after operation (P＞0.05) , despite of the fact that no a statistically signifi- cant difference in VAS score between the two groups was noted before and 7 days after operation (P＞0.05) . [Conclusion] The application of fast-track surgery principles in arthroscopic rotator cuff repair does relieve pain, reduce complications and improve patient satisfaction.