Abstract:[Objective] To summarize the clinical experience of reverse sural fasciocutaneous flap for tissue defect of distal end of the lower extremity in 435 limbs, and explore the risk factors of partial necrosis of the flap. [Methods] From April 2001 to December 2019, skin and soft tissue defects in distal ends of 435 legs were repaired with reverse sural fasciocutaneous flap in our hospital. Univariate com- parison and binary multiple logistic regression analysis were conducted to search the factors related to partial necrosis of the flap. [Results] Among 435 limbs, partial necrosis of the flap occurred in 39 limbs, accounted for 8.97%, while completely survival flap was seen in 396 limbs, accounted for 91.03%. In term of univariate comparison, there were no significant differences in gender composition, age and defect site of skin and soft tissue between the two groups (P＞0.05) . The partial necrosis group had greater length and width of fascia pedicle, as well as greater width of skin island and position of rotation point than the survival group, but which were not statistically significant (P＞ 0.05) . However, the partial necrosis group had significantly greater length of skin island, the total length of skin flap, the ratio of length to width of flap and extent of proximal location of the flap than the survival group (P＜0.05) . As results of logistic regression analysis, the lon- ger total length of the flap (OR=3.462, P=0.015) , and greater extent of proximal location of the flap were independent risk factors for partial necrosis of the flap. [Conclusion] The partial necrosis of reverse sural fasciocutaneous flap is mainly related to poor design of the flap, among which, the greater overall length and proximal position of the flap are the main risk factors related to partial necrosis.

Abstract:[Objective] To explore the factors related to survival and quality of life after decompression and internal fixation for spinaltumors. [Methods] From July 2014 to July 2017, 153 patients, including 80 males and 73 females aged from 17 to 87 years with an averageof (61.10±10.71) years, received spinal decompression alone or decompression combined with internal fixation in our hospital for spinal tu-mors complicated with spinal nerve damages. Postoperative follow-up was continued to patient death to observe the change and correlationof ECOG- PS scale and Frankel index of the surviving patients. Univariate comparisons and Cox regression analysis were conducted tosearch the factors to death. [Results] All the 153 patients in survival were followed up for 3~36 months. The ECOG-PS scores significantlyimproved in 78 patients (50.98%) one month after surgery, which was maintained for a mean of (9.74±0.87) months, while the Frankel indexfor neurological function significantly improved in 76 patients (49.67%) at 1 months postoperatively, of them 71 patients had the improve-ment maintained for (10.11±15.17) months after surgery on an average. The Spearman correlation analysis showed that ECOG-PS was sig-nificantly negatively correlated with Frankel index at all corresponding time points (P＜0.05) . Among 153 patients, 121 patients (79.08%)survived, while 32 patients (20.12%) died at 12 months after surgery. In term of univariate comparison between them, the survival grouphad significantly lower proportion of breast cancer, Tokuhashi modified score, the number of extramedullary bone metastases and the num-ber of spinal involved site lower than the death group (P＜0.05) , while the former had significantly better ECOG-PS and Frankel gradesthan the latter (P＜0.05) . As results of Cox analysis, the preoperative Tokuhashi modified score (HR=9.21, P＜0.05) , preoperative ECOGPS score (HR=10.63, P＜0.05) , extraspinal bone metastasis (HR=10.45, P＜0.05) , spinal involved number (HR=2.77, P＜0.05) were the inde-pendent risk factors for death. [Conclusion] Decompression and interna fixation does improve the quality of life of the patients with spinaltumors. The preoperative Tokuhashi modified score, ECOG-PS scale, number of extraspinal bone metastases, and number of spine involved are risk factors for death

Abstract:[Objective] To compare the clinical efficacy of elastic stable intramedullary nail (ESIN) versus proximal femoral locking compression plate (PFLCP) for femoral subtrochanteric fracture in old children. [Methods] A retrospective study was conducted on 33 old children who received surgical treatment for femoral subtrochanteric fractures in our hospital from January 2013 to January 2018. Based on the fracture type and instrument indication, 18 patients underwent ESIN, while the other 15 patients had fractures fixed with PFLCP. The documents regarding to perioperative period, follow-up and radiographs were compared between the two groups. [Results] All the patients in both groups had operation performed smoothly. The ESIN group proved significantly superior to the PFLCP group in terms of operation time, intraoperative bleeding, incision length, and hospital days (P＜0.05) , although the former had significantly greater intraoperative fluo- roscopic frequency than the latter (P＜0.05) . The postoperative follow-up lasted for more than 18 months in the two groups. There were no significant differences in the time to return walking and the time to resume full-weight bearing activity between the two groups (P＞0.05) . Both the hip extension-flexion range of motion (ROM) and Harris score significantly increased over time postoperatively in both groups (P＜ 0.05) . The ESIN group was superior to the PFLCP group in terms of ROM and Harris score postoperatively, whereas which proved not sta- tistically significant at any matching time point (P＞0.05) . Regarding to radiographic assessment, the ESIN group was significantly inferior to the PFLCP group in term of fracture reduction quality based on Baumgaertner criteria (P＜0.05) , however, the ESIN group got fracture healing significantly earlier than the PFLCP group (P＜0.05) . [Conclusions] Both ESIN and PFLCP are effective for internal fixation of fem- oral subtrochanteric fractures in old children, which should be selected according to patient's concreate condition and the instrument indica- tions.

Abstract:[Objective] To compare the clinical efficacy of interlocking intramedullary nail (IIN) versus proximal humeral internal locked system plate (PHILOS) for internal fixation of Neer 3-part or 4-part proximal humeral fractures (PHF) . [Methods] A retrospective study was conducted on 40 patients who received open reduction and internal fixation for Neer 3-part or 4-part PHF from February 2018 to May 2020. According to the results of preoperative doctor-patient communication, 20 patients had the fractures fixed with IIN, while the re- maining 20 patients were with PHILOS. The documents regarding to perioperative period, follow-up and radiographs were compared be- tween the two groups. [Results] All the patients in both groups had operation finished successfully without serious complications. The IIN group proved significantly superior to the PHILOS in terms of operation time, intraoperative blood loss, incision length and postoperative drainage volume (P＜0.05) , and there were no significant differences in intraoperative fluoroscopy frequency, wound healing and hospital stay between the two groups (P＞0.05) . All patients in both groups were followed up for 12~18 months, with a mean of (14.48±3.16) months. There was a statistically significant difference in the time to return to active activity between the two groups (P＜0.05) , and no statistically significant difference in the time to full weight-bearing activity (P＞0.05) . Compared with those 3 months after surgery, VAS score signifi- cantly decreased, whereas the forward flexion range of motion (ROM) , Neer and ASES scores significantly increased in both groups at the latest follow-up (P＜0.05) . However, there were no statistically significant differences between the two groups in the VAS score, ROM, Neer and ASES scores between the two groups at any corresponding time point postoperatively (P＞0.05) . Radiographically, there was no a statis- tically significant difference between the two groups in fracture reduction quality revealed by radiographs within 3 days after surgery (P＞ 0.05) . The INN group got fracture healing earlier than PHILOS group, but the difference was not statistically significant (P＞0.05) . [Conclusion] Both the intramedullary nailing and the plate fixations do achieve satisfactory clinical results for treatment of Neer 3-part or 4-part proximal humeral fractures. By comparison, the intramedullary nail has less iatrogenic injury.

Abstract:[Objective] To compare the clinical efficacy of the lateral deltoid-splitting approach (LDSA) versus deltopectoral approach (DPA) for open reduction and internal fixation (ORIF) of proximal humeral abduction impacted fractures. [Methods] A retrospective study was conducted on 61 patients who underwent ORIF for proximal humeral abduction impacted fractures in our hospital from January 2017 to December 2019. Based on the consequence of perioperative patient-surgeon communication, 34 patients had ORIF performed through the LDSA, while the remaining 27 patients were through the DPA. The perioperative, follow-up and imaging data were analyzed and compared between the two groups. [Results] The patients in both groups had surgical procedures conducted smoothly without serious complications. The LDSA group proved significantly superior to the DPA group in terms of operation time, intraoperative blood loss, total incision length (P＜0.05) , whereas no significant differences were noted between the two groups in intraoperative fluoroscopic frequency, the time to re- sume active motion of the affected limb, incision healing and hospital stay (P＞0.05) . The LDSA group resumed full-weight bearing activity of the involved extremity significantly earlier than the DPA group (P＜0.05) . The VAS score significantly decreased, whereas the forward flexion-backward extension range of motion (ROM) of the shoulder and Constant-Murley score significantly increased over time postopera- tively in both groups (P＜0.05) . The LDSA group proved significantly superior to the DPA group in abovementioned items postoperatively at 1 months and 3 months after operation(P＜0.05) , but there was no significant difference in VAS score, forward flexion-backward extension range of motion (ROM) of the shoulder and Constant-Murley score between the two groups one year after operation (P＞0.05) . With respect to radiographic assessment, the excellent and good rate of fracture reduction quality was 94.12% in the LDSA group, whereas 96.30% in DPA group，which was not statistically significant (P＞0.05) . Bony fracture healing achieved in all patients of both groups with no a statisti- cally significant difference in fracture healing time between the two groups (P＞0.05) . [Conclusion] The LDSA has advantages of less soft tissue damage, fewer complications and earlier functional recovery over the DPA for ORIF of proximal humeral abduction impacted frac- tures

Abstract:[Objective] To investigate the clinical outcomes of extracorporeal shock wave therapy (ESWT) for ARCO stage II non-trau- matic femoral head necrosis with different lesion areas. [Methods] A retrospective study was done on 69 patients (101 hips) who received ESWT for ARCO stage II non-traumatic femoral head necrosis from January 2017 to September 2018. The patients were divided into two groups according to the area of necrosis measured on MRI before treatment, including 35 patients (52 hips) in the ≤30% group and 34 pa- tients (49 hips) in the ＞30% group. The clinical and imaging data of the two groups were compared. [Results] There were no serious adverse reactions happened in anyone of them during the therapy. Patients in both groups were followed up for 12-24 months, with an average of (20.63±11.26) months. The VAS and Harris scores, as well as hip flexion-extension range of motion(ROM) and internal-external rotation ROM variated in curve manner in both groups over time. At 6 months after treatment, the ≤30% group proved significantly superior to the ＞ 30% group in terms of VAS and Harris scores and hip flexion-extension ROM (P＜0.05) , whereas there was no statistically significant dif- ference between the two groups in term of internal- external rotation ROM (P＞0.05). At 12 months after treatment, the ≤30% group was sig- nificantly superior to the ＞30% group in terms of VAS and Harris scores, as well as hip flexion-extension ROM and internal-external rota- tion ROM (P＜0.05) . However, the ≤30% group was only significantly better than the ＞30% group in VAS score (P＜0.05) , whereas the dif- ferences in Harris score, hip flexion-extension ROM and internal-external ROM between the two groups became not statistically significant at the latest follow up (P＞0.05) . Radiographically, the lesion area, the degree of femoral head collapse, and the Tonnis scales of hip degen- eration significantly worsened in both groups at the latest follow-up compared with before treatment (P＜0.05) . At the last follow-up, the le- sion area and femoral head collapse in the ≤30% group remained significantly smaller than that of the ＞30% group (P＜0.05) , but there was no significant difference in the extent of Tonnis degeneration grades between the two groups (P＞0.05) . [Conclusion] ESWT does consider-ably relieve pain and improve hip function within 12 months, especially for those with smaller lesion areas of ARCO stage II non-traumatic femoral head necrosis.

Abstract:[Objective] To compare the clinical outcomes of total hip arthroplasty (THA) through minimal incision posterolateral ap- proach versus conventional posterolateral approach. [Methods] All randomized or non- randomized controlled trials about THA through minimal incision versus conventional posterolateral approaches were searched from PubMed, Cochrane Library, EMbase, Web of Science, CNKI and Wanfang database from January 2003 to July 2021. After screening and data extraction were conducted according to inclusion and exclusion criteria, a meta-analysis was performed using RevMan 5.3 software. [Results] A total of 14 literatures were included, involv- ing 2 randomized controlled trials and 12 cohort studies. As results of the meta-analysis, the minimal incision group proved significantly su- perior to the conventional group in terms of incision length (SMD=- 3.78, 95% CI:-4.97~- 2.58, P＜0.001) , intraoperative blood loss (SMD=-2.27, 95% CI: -3.13~-1.40, P＜0.001) , postoperative drainage (SMD=- 6.90, 95% CI: -7.57~-6.23, P＜0.001) , complications (OR=0.34, 95% CI: 0.21~0.56, P＜0.001) , abducent angles (SMD=-0.24, 95%CI: -0.41~ -0.06, P=0.007) , hospital stay (SMD= -1.93, 95% CI: -2.33~-1.52, P＜0.001) and Harris hip score at 6 months after surgery (SMD=0.87, 95% CI: 0.34~1.40, P=0.001) . However, there were no significant differences between the two groups in terms of operation time (SMD=0.50, 95% CI: -0.20~1.19, P=0.16) and VAS score (SMD=-0.51, 95% CI: -1.31~0.29, P=0.21) . [Conclusion] This study shows that the clinical outcome of THA through minimal incision posterolateral approach is considerably better than that of conventional posterolateral approach.

Abstract:[Objective] To evaluate the factors related to proximal femoral nail anti-rotation (PFNA) failure for internal fixation of inter- trochanteric fractures by meta-analysis. [Methods] Relevant literatures were retrieved from CNKI, Wanfang, Pubmed and other databases, and the data were extracted. Review Manager 5.3 software was used for meta-analysis. [Results] A total of 14 literatures were included, in- cluding 11 papers in Chinese and 3 in English, which all were retrospective case-control studies. All patients (2 477 cases) in the litera- tures were treated with PFNA, and followed up for 6 months at least, and 333 patients of them proved of internal fixation failed. The factors related to postoperative failure of PFNA were as follows: fracture stability (OR=20.94, 95% CI: 13.45~32.61, P＜0.001) , fracture reduction quality (OR=9.68, 95%CI: 4.85~19.3, P＜0.001) , tip-apex distance (OR=3.98, 95%CI: 2.71~5.84, P＜0.001) , osteoporosis (OR=2.88, 95% CI: 2.01~4.15, P＜0.001) , lateral wall integrity (OR=5.40, 95% CI: 3.36~8.70, P＜0.001) , complicated with medical diseases (OR=3.10, 95%CI: 1.75~5.49, P＜0.001) , the zoledronate used (OR=0.47, 95% CI: 0.26~0.85, P=0.01) . [Conclusion] Fracture stability, fracture re- duction quality, tip-apex distance, osteoporosis, lateral wall integrity and associated medical diseases are the risk factors for PFNA failure, whereas using zoledronate is a protective factor.

Abstract:Incision complications secondary to surgical treatment for calcaneal fractures have been a hot research topic in the field of traumatic orthopedics for foot and ankle. The complications mainly include incision skin necrosis, infection, dehiscence, hematoma forma- tion, plate exposure and so on, which pose a great threat to the postoperative rehabilitation of patients. However, the knowledge regarding to the postoperative incisional complications and its management mostly remain in the "fragmented" state without comprehensive understand- ing in junior clinicians and medical worker in the primary hospitals. This article gives a literature review of risk factors and prevention strat- egies for postoperative incisional complications of calcaneal fracture with the aim to provide a comprehensive overview.

Abstract:Tibial plateau fracture is a common injury of the knee, which generally needs surgical treatment. Compared to the open re- duction surgery, arthroscopy reduction and internal fixation in the treatment of tibial plateau fracture has many advantages, including direct vision of intra-articular cartilage injury, accurate reduction of fracture, optimization of diagnosis and treatment of intra-articular concomi- tant injury, reduction of surgical invasiveness and rapid rehabilitation, which is more in line with the concept of minimally invasive treat- ment. Although there is a consensus on the general principles of arthroscopic surgery, there is particularity in the selection of indications, the management of soft tissue injuries, the evaluation of therapeutic effects and surgical procedures. This article reviews the related prob- lems of arthroscopic reduction and internal fixation for tibial plateau fractures in order to provide a reference for clinicians.

Abstract:Spinal epidural lipomatosis (SEL) is an occupying lesion caused by excessive accumulation of extra-epidural fat in the ver- tebral canal, which mainly involving the thoracic lumbar canals. Clinically, it is rare condition, might present no obvious symptoms, or neu- rological symptoms in some extent, such as back pain, numbness, weakness of the lower extremities or abnormal reflexes. We have treated a SEL patient recently, now we report it and review the relevant literatures to introduce the pathogenesis, diagnosis, and treatment of SEL.

Abstract:[Objective] To explore the effect on mechanism of irisin combined with extracorporeal shock wave (ESW) on fracture heal- ing in the ovariectomized rats. [Methods] A total of 80 SD rats were randomly divided into 5 groups with 16 rats in each group, including sham operation group, model group, model +ESW group, model + irisin group, model +ESW+ irisin group. Except the animals in sham oper- ation group that received surgical incision only, all rates received bilateral ovariectomy, and then left femoral fracture and internal fixation successively, subsequently, corresponding postoperative treatments were given respectively, including ESW treatment once a week, and lo- cal injection of irisin group in fracture site. At 4 weeks after treatment, the animals were sacrificed for bone mineral density, osteoclast in- dex, microCT, Western blot and RT-QPCR assays. [Results] Bone mineral density and osteoclast index were ranked superior-inferiorly in orders of sham operation group ＞ model + ESW + irisin group ＞ model + ESW group or model + irisin group ＞ model group (P＞0.05) . Mi- croCT detection items, including BS/BV, Tb.N, Tb.Th and Tb also ranked superior-inferiorly in sequence of model + ESW+ irisin group ＞ model +ESW group or model + irisin group ＞ model group (P＜0.05) . In term of Western blot detection, the relative protein expression of BMP2, VEGF, Nrf2F and OH-1 arranged up-down in order of sham operation group ＞ model + ESW+ irisin group ＞ model +ESW group or model + irisin group ＞ model group (P＜0.05) . In term of RT-QPCR assay, the relative mRNA expression of Nrf2 and OH-1 from high to low were: sham operation group ＞ model +ESW+ irisin group ＞ model + irisin group or model +ESW group ＞ model group (P＜0.05) . [Conclusion] Irisin combined with ESW might activate Nrf2/OH-1 pathway to promote the expression of VEGF and BMP2 proteins, and pro- mote fracture healing in the ovariectomized rats

Abstract:[Objective] To introduce the surgical technique and preliminary results of membrane induction (Masquelet technique) com- bined with double-plate internal fixation for large segmental bone defect of tibial shaft. [Methods] From January 2016 to January 2019, 18 patients with tibial diaphysis defect were treated with induction membrane technique combined with double-plate internal fixation. The de- formity was evaluated before surgery, and the defect of tibia bone was thoroughly debrided. After infection control, bone cement was filled and the wound was covered at the same time, skin flap was used if necessary. After the membrane induced was formed properly, the bone ce- ment was removed and bone grafting was performed at the defect site, simultaneously, internal fixation with lateral and medial plates in the same incision was conducted. [Results] All the 18 patients were successfully operated on without serious complications. Except 2 patients who had postoperative superficial wound infection, which healed after dressing change and using anti-infective drugs, all the patients got sound wound healing after the second-stage operation. All the patients were followed up for more than 12 months, and got clinical bone healing in (4.44±0.98) months. At 12 months postoperatively the VAS score, Lowa knee function score and Lowa ankle function score signif- icantly improved compared with those preoperatively (P＜0.05) . [Conclusion] This membrane induction technique combined with doubleplate for internal fixation does effectively treat the large-segment bone defect of tibial shaft with good clinical outcomes, and has the advan- tages of simple operation, high acceptance by patients, and few complications.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of the lateral four-cut osteotomy for cor- rection of malunion of calcaneus fractures. [Methods] From January 2016 to October 2019, 19 patients received the lateral four-cut osteoto- my for correction of malunion secondary to calcaneus fractures. The patients were placed on the healthy side, and a transvers incision was made under the tip of lateral malleolus to expose the calcaneus. According to the preoperative plan, four-cut osteotomy on calcaneus was conducted, including the first cut on the lateral wall of calcaneus, the second cut on the periarticular bone, the third cut outside to sustentac- ulum tali and the fourth cut on posterior tuberosity vertically or in curvature. After that, the articular surface was restored with correction of deformity and bone autografting for bone defect. Finally, plate fixation was performed, whereas Achilles tendon lengthening was added if necessary. [Results] All the 19 patients had operation completed successfully without serious complications. The follow-up period was last- ed for 9~30 months. Compared with those preoperatively, the VAS and AFOAS scores, as well as the height, width, Bohler angle and the Gissane angle measured on radiographs significantly improved at the latest follow up (P＜0.05) . [Conclusion] This lateral four-cut osteoto- my does effectively restore the height, width, length, the Bohler and Gissane angles of the calcaneus to resume the biomechanical alignment of the foot for malunion of calcaneus fractures.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcomes of "Chinese knot" for arthroscopic repair of supraspinatus tear in muscle-tendon junction. [Methods] Form February 2020 to January 2021, 14 patients underwent arthroscopic re- pair of supraspinatus tear in muscle-tendon junction with this Chinese knot technique. The Ethibond sutures were placed in the proximal end of the torn rotator cuff in a reverse triangle shape, like a "Chinese knot" in appearance, and then an anchor was inserted on the outside row, tied under the appropriate tension to repair the rupture. The side-side sutures were added to strengthen the rotator cuff repair if neces- sary. [Results] All the 14 patients were successfully operated on without serious complications, with operation time of (92.23±15.34) min. and were followed up for (7.22±1.85) months on average. The UCLA score, Constant score and range of motion of shoulder significantly in- creased (P＜0.05) , while VAS score significantly decreased over time (P＜0.05) . The MRI checks in regular revealed rotator cuff tissue heal- ing about 9 months after operation. [Conclusion] This “Chinese knot" technique for arthroscopic repair of supraspinatus tear in muscletendon junction is feasible, and achieves reliable clinical outcomes.

Abstract:[Objective] To explore the clinical outcomes of anatomic reconstruction of ankle lateral collateral ligament with partial pero- neal longus tendon autograft for chronic lateral ankle instability. [Methods] A retrospective study was performed on 19 patients who under- went anatomical reconstruction of ankle lateral collateral ligament with partial autograft of peroneus longus tendon for chronic lateral ankle instability from January 2019 to April 2021. The perioperative, follow- up and imaging data were summarized. [Results] All the patients were successfully operated on with operative time of (100.42±18.15) min, intraoperative blood loss of (47.63±13.88) ml, and excellent inci- sion healing. At the latest interview lasted for (20.79±5.90) months the VAS score significantly decreased (P＜0.05) , whereas the AOFAS ankle-hindfoot score significantly increased compared with those preoperatively (P＜0.05) . Although there was no significant change in dor- siflexion plantarflexion range of motion (ROM) (P＞0.05) , the ROM of eversion-inversion significantly decreased at the latest follow- up compared with those preoperatively (P＜0.05) . In term of patients' satisfaction, 10 cases (52.63%) were very satisfied, 7 cases (36.84%) were satisfied, 2 cases (10.53%) of the fair. Radiographically, the talus title (TT) and anterior talar translation (ATT) on radiographs under stress at the latest follow-up significantly reduced compared with those before operation (P＜0.05) . The MRI or musculoskeletal ultrasound showed good continuity of graft tendon and no abnormal edema signal in 16 patients of them at the last follow-up. [Conclusion] Anatomical reconstruction of the ankle lateral collateral ligament with partial peroneus longus tendon autograft is a safe, effective and feasible method for the treatment of chronic lateral ankle instability.

Abstract:[Objective] To investigate the clinical outcomes of arthroscopic Endo-button fixation of posterior cruciate ligament tibial avulsion fracture. [Methods] From February 2016 to February 2020, a total of 17 patients underwent arthroscopic reduction and Endo-but- ton fixation of posterior cruciate ligament tibial avulsion fractures with a assisted posterior medial small incision. The clinical and imaging results were summarized. [Results] All patients had operations completed successfully, with no serious complications such as nerve and blood vessel injury, whereas with operation time of (87.09±19.41) min, intraoperative blood loss of (57.09±10.76) ml, and excellent incision healing in (12.09 ±2.73) days. All patients were followed up for 29.73±7.29 months, and resumed partial weight-bearing walking in (42.12± 5.98) days, protective brace removed in (56.32±9.98) days, and full weight-bearing walking in (12.07±1.23) weeks. The IKDC, Lysholm and Tegner scores, as well as knee range of motion at the latest follow-up significantly increased compared with those preoperatively (P＜ 0.05) , whereas the tibial displacement measured by KT-1000 significantly reduced compared with preoperatively (P＜0.05) , with negative posterior drawer tests in all of them. Radiographically, the fracture was reduced well postoperatively and healed about 12 weeks. [Conclusion] This arthroscopic Endo-button fixation of posterior cruciate ligament tibial avulsion fracture has minimizing trauma and get good sta- bility recovery of the knee.

Abstract:[Objective] To explore the outcomes of clinical nursing for senile femoral neck fracture without surgical treatment. [Methods] From March 2016 to March 2021, a total of 70 patients who were hospitalized in our hospital for femoral neck fractures and received nonoperative treatment due to heart disease or intolerance to surgery were randomly divided into two groups by the lottery method. Of them, 35 patients were given primary care (the routine group) , while the remaining 35 patients received family care, nutritional support, pain con- trol, cardiac function nursing and monitoring, as well as rehabilitation training on basis of primary care (the comprehensive group) . The in- cidence of complications, pain, quality of life and nursing satisfaction were compared between the two groups. [Results] The complication rate was of 20.00% (7/35) in the routine group, whereas 5.71% (2/35) in the comprehensive group, which proved statistically significant (P＜ 0.05) . No death occurred in anyone of them in both groups until discharge. Compared with those at admission, VAS score significantly de- creased (P＜0.05) , while WHOQOL-BREF score significantly increased at discharge (P＜0.05) . The comprehensive group was significantly superior to the routine group in terms of VAS and WHOQOL-BREF scores at the end of interventions (P＜0.05) . At discharge, the satisfac- tion rate of patients and relatives in the comprehensive group was significantly better than that in the conventional group (P＜0.05) . [Conclusion] Comprehensive nursing intervention for senile femoral neck fracture with non-surgical treatment does reduce complications and improve the quality of life of patients.

Abstract:[Objective] To compare clinical outcomes of percutaneous vertebroplasty (PKP) with low- viscosity bone cement in wetsand phase (WSP) versus wire- drawing phase (WDP) for osteoporotic vertebral compressive fracture (OVCF) . [Methods] From January 2018 to June 2020, a total of 146 patients with OVCF were enrolled in this study. According to the doctor-patient communication, 80 pa- tients had PKP performed with low- viscosity bone cement in WSP, whereas 66 patients received PKP with low-viscosity bone cement in WDP. The perioperative period and follow-up consequences were compared between the two groups. [Results] All the patients had opera- tion done successfully in both groups without neurovascular injury and other serious complications. There were no significant differences in operation time, intraoperative fluoroscopy times, amount of bone cement and hospitalization cost between 2 groups (P＜0.05) . However, WSP group had significantly higher excellent and good ratio of bone cement distribution than the WDP group (P＜0.05) , additionally, the former had significantly less occurrence of bone cement leakage than the latter (P＜0.05) . As time went during the follow up period lasted for (23.23±7.94) months, the VAS score in both groups decreased significantly (P＜0.05) . At 7 d, 30 d and the latest follow-up, the WSP group had significantly lower VAS score than the WDP group (P＜0.05) . [Conclusion] The PKP with low viscosity bone cement in wet-sand phase does achieve better therapeutic effect on OVCF than that in the wire-drawing phase.