Abstract:[Objective] To evaluate the clinical outcomes of high tibial osteotomy (HTO) combined with platelet-rich plasma (PRP) for medial knee osteoarthritis (MKOA) . [Methods] A retrospective study was conducted on 88 patients for MKOA in our hospital from Decem- ber 2016 to March 2020. According to doctor-patient communication results, patients were divided into 3 groups, 29 patients received HTO, 31 patients underwent PRP, while the remaining 28 patients were treated by HTO combined with PRP (the combined group) . The periopera- tive period, follow-up and imaging data were compared among the 3 groups. [Results] All the patients in the 3 groups had the corresponding procedures performed successfully without serious complications, and were followed up for more than 18 months. The combined group re- sumed full weight-bearing activity significantly earlier than the HTO group (P＜0.05) . The VAS scores decreased significantly (P＜0.05) , while the knee flexion and extension ROM and KOOS scores significantly increased in all the 3 groups over time (P＜0.05) . Although there was no significant difference in the above items among the three groups before operation (P＞0.05) , the combined group proved significantly superior to the other two groups at 6 months after operation (P＜0.05) . At latest follow-up, the HTO group and the combined group proved sig- nificantly superior to the PRP group in terms of abovementioned scores (P＜0.05) , while there were no significant differences in the scores be- tween the composite group and the HTO group (P＞0.05) . Regarding imaging, the femorotibial angle (FTA) and medial proximal tibial angle (MPTA) were significantly improved in the HTO group and the combined group both immediately after surgery and at the last follow-up (P＜ 0.05) , but there was no significant change in Kellgren-Lawrence grade in the medial compartment (P＞0.05) . At the corresponding time points, there was no significant difference in the above imaging indexes between the two groups (P＞0.05) . [Conclusion] This HTO com- bined with PRP does significantly improve knee function and relieve pain, which is superior to any single therapy.

Abstract:[Objective] To compare the clinical outcomes of internal fixation with volar locking plate (VLP) versus external fixator com- bined with percutaneous Kirshner wire for unstable distal radius fractures (UDRF) . [Methods] A retrospective study was performed on 73 patients who underwent surgical treatment for UDRF in our hospital from January 2018 to January 2020. According to the results of preoper- ative doctor-patient communication, 41 patients received VLP internal fixation (the IF group) , while the remaining 32 patients were treated with external fixator combined with percutaneous Kirshner wire (the EF group) . The perioperative, follow-up and imaging data were com- pared between the two groups. [Results] All the patients in both groups had operation performed smoothly. Although the IF group consumed significantly longer operation time than the EF group (P＜0.05) , the former proved significantly superior to the latter in terms of times of in- traoperative fluoroscopy and VAS scores in the early stage (P＜0.05) . The total incidence of postoperative complications was 7.3% in the IF group, whereas 25.0% in the EF group, which was statistically significant (P＜0.05) . All patients in both groups were followed up for (15.3± 2.1) months on an average, and the IF group returned to full weight-bearing activity significantly earlier than the EF group (P＜0.05) . In ad- dition, the IF group proved considerably superior to the EF group in terms of Cooney score, flexion-dorsiflexion range of motion (ROM) , ul- nar-radial deviation ROM, and forearm pronation/supination ROM postoperatively (P＜0.05) . Radiographically, the IF group proved signifi- cantly superior to the EF group in terms of palmar tilt (PT) , radial inclination (RI) , radial length (RL) , and joint congruence grade immedi- ately after surgery and at last follow-up (P＜0.05) , moreover, the former got fracture healing on images significantly earlier than the latter (P＜0.05) . [Conclusion] Compared with external fixator combined with Kirschner wire, the VLP internal fixation has fewer early adverse re- actions, better functional recovery, and is more conducive to fracture healing.

Abstract:

[Objective] To compare the effects of three perioperative blood managements during total hip arthroplasty (THA) in the el- derly. [Methods] From August 2018 to October 2021, a total of 60 elderly patients who were undergoing unilateral total hip arthroplasty for corticosteroid-induced osteonecrosis of the femoral head were included in this study and were divided into three groups by random number table method. Of them, 20 patients in conventional group were treated with tranexamic acid, 20 patients in hydrogen-rich group were treated with tranexamic acid and hydrogen-rich water, while the renmaining 20 patients in the combined group had tranexamic, hydrogen-rich wa- ter and received additionally postoperative intravenous iron. The document regarding clinical presentations and laboratory test, as well as their correlation were analysized. [Results] All patients in the three groups had THA completed successfully. Although no significant differ- ences in the operation time and intraoperative blood loss were found among the 3 groups (P>0.05) , the combined group had significantly less postoperative drainage volume, total blood loss and invisible blood loss than the other two groups (P<0.05) . Some patients in the three groups had blood transfusion after operation, and the number of patients in the combined group was the least (P<0.05) . In addition, VAS score of the combined group was significantly lower than those of the other two groups (P<0.05) . The hip range of motion (ROM) and Harris score in- creased significantly over time in all the 3 groups (P<0.05) , which proved significantly better in the combined group than the other two groups at the corresponding time point (P<0.05) . Additionally, hemoglobin (Hb) and hematocrit (Hct) had the highest level in the combined group compared with the other two groups (P<0.05) , while IL-6 was the lowest in the combined group at corresponding time point (P<0.05) . In terms of CRP, the combined group was significantly lower than the other two groups from 3 to 7 days after operation (P<0.05) . What is more, it was found that there was a certain correlation between the clinical results and the laboratory indicators. [Conclusion] Tranexamic acid combined with hydrogen-rich water and iron does significantly alleviate the pain, promote the recovery of Hb and Hct, improve function- al recovery during perioperative period of THA for corticosteroid-induced femoral head necrosis in the elderly.

Abstract:[Objective] To compare the clinical outcomes of arthroscopic cystectomy (AC) , arthroscopic internal drainage (AID) and tra- ditional open cystectomy (TOC) for popliteal cyst. [Methods] A retrospective analysis was performed on 108 patients who underwent surgi- cal treatment for popliteal cyst in our department from March 2015 to March 2019. According to preoperative doctor-patient communication, 38 patients underwent AC, the other 35 patients underwent AID, while the remaining 35 received TOC. The perioperative, follow-up and im- aging data of the three groups were compared. [Results] All the 108 patients had the corresponding procedure performed successfully with- out neurovascular injury and other complications. The AC and AID groups were significantly superior to the TOC group in terms of incision length, operation time, blood loss, postoperative ambulation, incision healing and hospital stay (P＜0.05) . The AID group had significantly shorter operation time than the AC and TOC groups (P＜0.05) . As time went in follow-up period lasted for more than 12 months, the VAS score significantly decreased (P＜0.05) , while the Lysholm score significantly increased in all the 3 groups (P＜0.05) . At last follow-up, the AC and AID groups got significantly lower VAS scores than the TOC group (P＜0.05) , while the AC group was marked significantly higher Lysholm score than the AID and TOC groups (P＜0.05) . Radiographically, the AC and AID groups had significantly lower recurrence of popli- teal cyst than the TOC group (P＜0.05) . However, there were no significant differences in Kellgren-Lawrence grade of knee degeneration among the three groups at any corresponding time points (P＞0.05) . [Conclusion] The arthroscopic cystectomy and arthroscopic internal drainage have the advantage of low cyst recurrence over the traditional open cystectomy. Among them, arthroscopic cystectomy does achieve more satisfactory knee function recovery.

Abstract:[Objective] To explore the value of bone standardized uptake value (SUV) of SPECT/CT for spinal metastases. [Methods] The 99mTc-MDP SPECT/CT bone imaging data of 54 patients who were diagnosed of bone metastasis in our hospital from July 2020 to Decem- ber 2021 were retrospectively analyzed. The SUV were compared between the two genders in normal vertebrae, while the correlation between normal vertebral SUV and body parameters was analyzed. In addition, the SUVs were compared between the normal bone and lesions, among different primary tumor lesions, and between lesions with clear and unclear edges. Furthermore, receiver operator characteristic curve analy- sis was conducted to search the value of SUV_max and SUV_mean for differentiate lesion and normal bone. [Results] There were no significant dif- ferences in SUV_max and SUV_mean of normal vertebrae between two genders (P＞0.05) . However, the SUVmean of normal vertebrae was negatively correlated with age (P＜0.05) , while the SUVmax and SUVmean were positively correlated with BMI (P＜0.05) . The SUVmax and SUVmean in the vertebral metastases lesion were significantly higher than those in the normal vertebral bodies (P＜0.05) , nevertheless, there were no signifi- cant differences in SUVmax and SUVmean among different primary tumors (P＞0.05) . There were no significant differences in SUV_max and SU- V_mean between the lesion with clear edge and that with unclear edge (P＞0.05) . As results of ROC analysis, the SUV_max and SUV_mean had area under cure (AUC) of 0.983 (95%CI: 0.966~1.000) and 0.965 (95%CI: 0.928~1.000) , sensitivity of 92.6% and 96.3%, and specificity of 96.3%和 88.9% , respectively. The optimal diagnostic thresholds of SUV_max and SUV_mean were 11.5 and 5.7, respectively. [Conclusion] There is a significant positive correlation between normal vertebral bone SUV and BMI. SPECT/CT quantitative bone SUV analysis has cer- tain clinical value in the diagnosis of spinal bone metastases.

Abstract:[Objective] To explore the factors related to kinesiophobia after total knee arthroplasty. [Methods] A total of 205 patients who underwent total knee arthroplasty in our hospital from January 2020 to December 2021 were enrolled in this study. The motion status was evaluated by the Tampa Scale of Kinesiophobia (TSK) score, and TSK＞37 was identified as kinesiophobia. The patients were divided in- to two groups based on whether kinesiophobia happened for univariate comparison. In addition, Pearson or Spearman correlation analysis and multiple stepwise regression analysis were performed between TSK score and clinical parameters. [Results] Among 205 patients, 36 pa- tients were diagnosed of kinesiophobia, with an incidence of 17.6% . As consequence of univariate comparison, the kinesiophobia group proved significantly greater than the non- kinesiophobia group in terms of duration of preoperative pain, preoperative VAS score, the propor- tion of revision surgery and the proportion of one-stage bilateral replacement (P＜0.05) . However, the former proved significantly lower than the latter in terms of education level, preoperative HSS score, preoperative KSS clinical score and functional score, K-SES score and social support score (P＜0.05) . Regarding Pearson or Spearman correlation analysis, the education level, preoperative HSS score, KSS clinical score, K-SES score and social support score were negatively correlated with TSK score (P＜0.05) , whereas the preoperative VAS score and pain duration were positively correlated with TSK score (P＜0.05) . In term of multiple stepwise regression analysis, the longer preoperative pain duration and lower social support score were the main factors related to the occurrence of kinesiophobia. [Conclusion] Long duration of preoperative pain is the main risk factor for the occurrence of kinesiophobia after total knee arthroplasty, while high social support score is a protective factor for reducing the occurrence of kinesiophobia.

Abstract:[Objective] To evaluate the clinical outcomes of posterior column osteotomy (PCO) combined with local multi-level transfo- raminal lumbar interbody fusion (TLIF) in the treatment of degenerative scoliokyphosis. [Methods] A retrospective study was performed on 71 patients who received surgical treatment for degenerative spine deformity in our hospital from January 2018 to June 2021. Based on preop- erative doctor-patient communication, 40 patients received PCO combined with local mutipl-level TLIF (PCO-MF group) , while the re- maining 31 patients received grade ≥3 osteotomy and fixation (OF group) . The documents regarding perioperative conditions, follow-up and radiographs were compared between the two groups. [Results] The incidence of early complications was of 7.5% (3/40) in the PCO- MF group, whereas 25.8% (8/31) in the OF group, which was statistically significant (P=0.034) . The PCO-MF group proved significantly superi- or to the OF group in terms of operative time, intraoperative blood loss, postoperative walking time and full weight-bearing activity time (P＜ 0.05) , although there were no significant differences in the total incision length, intraoperative fluoroscopy times, incision healing and hospi- tal stay between the two groups (P＞0.05) . With time of follow-up for more than 12 months, the VAS and ODI scores significantly decreased (P＜0.05) , while JOA score significantly increased in both groups (P＜0.05) , which in the PCO-MF group was significantly better than those in the OF group at discharge (P＜0.05) . Radiographically, the main curved coronal Cobb angle, sagittal Cobb angle, coronal balance and sag- ittal balance significantly improved in both groups immediately after surgery and at the latest follow-up compared with those preoperatively (P＜0.05) , nevertheless no significant differences in the above image parameters were noted between the two groups at any time point accord- ingly (P＞0.05) . At the latest follow-up, non-patient in both groups had adverse imaging manifestations such as loosening and fracture of the implants. [Conclusion] PCO combined with local multi-level TLIF is an effective treatment for degenerative spinal deformity, and does re- duce surgical trauma, reduce surgical risk, accelerate postoperative rehabilitation, and reduce complications.

Abstract:Non-specific low back pain is a common clinical condition. Although there are many evaluation scales in clinical studies on this condition, mainly involving low back pain scales, functional impairment scales, emotional disturbance scales, and quality of life scales, there are cases of lack of accuracy in their use. Therefore, in this paper, the content and characteristics of the above-mentioned scales are evaluated and the advantages and disadvantages of each scale are summarized in order to objectively and accurately evaluate the efficacy of clinical treatment of nonspecific low back pain

Abstract:Brucellosis usually leads bone and joint damage, the most common of which is Brucellosis spondylitis. Once Brucella infec- tion occurs, the Brucella is mainly swallowed by human macrophages and parasitized in host macrophages, causing macrophages to release related inflammatory factors in polarization, such as tumor necrosis factor -α (TNF-α) , interleukin factor family (IL) and chemokines family. Many researches have showed that these inflammatory factors play an important role in inflammation and bone destruction of brucellosis spondylitis. At the same time, the transformation of macrophages with different polarization types can regulate the occurrence and develop- ment direction of inflammation and bone destruction. This article reviewed the possible mechanism of macrophage polarization-related in- flammatory factors in the pathogenesis of brucellosis spondylitis.

Abstract:Intertrochanteric fracture is one of the common fractures, which was continuously explored by many scholars for improving treatment for it. As the anatomy and biomechanics of the proximal femur have been better understood, the role of lateral and medial walls of the proximal femur are gradually recognized and paid more and more attention. The integrity of the lateral and medial walls of the femur is important for maintaining the stability of the fracture and for the choice of surgical approach. This article reviews the emergence and devel- opment of the knowledge about lateral and medial walls of intertrochanteric femoral fractures with the aim of increasing the awareness and attention of orthopaedic surgeons to the proximal femoral walls.

Abstract:[Objective] To compare the biomechanical characteristics of internal fixation of Dubberley type IIA humeral capitulum frac- ture with Kirschner wire (KW) , Herbert screw (HS) , mini plate (Mini plate) , mini plate plus Kirschner wire (MP-KW) , mini plate plus Her- bert screw (MP-HS) by finite element method. [Methods] After the CT image data of the right elbow in neutral position were collected from a volunteer, the Mimics and 3-matic software were used to establish a Dubberley type IIA humerus fracture model. On this basis, KW, HS, MP, MP-KW and MP-HS fixation models were established, respectively. As loads were added in ANSYS software, the displacement of frac- ture ends and the stress distributed on the implant of internal fixation were analyzed. [Results] The displacement of fracture ends was ranked up-down as KW＞HS＞MP-KW＞MP-HS [(2.7±0.1) mm, (0.7±0.0) mm, (0.4±0.0) mm, (0.2±0.0) mm, P＜0.05] under straight extension load- ing, while KW＞HS＞MP-KW＞MP-HS [(2.0±0.0) mm, (0.6±0.0) mm, (0.3±0.0) mm, (0.2±0.0) mm, P＜0.05] under flexion loading, and KW＞ MP-KW＞HS＞MP-HS [(2.0±0.0) mm, (1.1±0.0) mm, (0.8±0.0) mm, (0.6±0.0) mm, P＜0.05] under torsion loading. In addition, the Von-Mis- es stress on the implant at fracture line was ranked up-down as KW＞HS＞MP-KW＞MP-HS [(8 478.5±30.1) MPa, (1 790.3±33.8) MPa, (1 173.4±32.7) MPa, (645.3±3.5) MPa, P＜0.05] under straight extension loading, whereas KW＞HS＞MP-KW＞MP-HS [(4 540.2±60.0) MPa, (1 331.9±6.5) MPa, (824.8±4.9) MPa, (450.9±2.7) MPa, P＜0.05] under flexion loading, and KW＞MP-KW＞HS＞MP-HS [(6 260.38±39.6) MPa, (2 786.6±4.0) MPa, (1 141.0±35.7) MPa, (1 050.9±26.6) MPa, P＜0.05] under torsion loading. [Conclusion] For Dubberley type IIA humeral capitulum fracture, mini plates plus Herbert screws provide better biomechanical stability, which might give a better healing envi- ronment for the fracture.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of total hip arthroplasty (THA) without femo- ral shortening osteotomy for end-stage arthrosis complicated with femoral head and neck shortening deformity. [Methods] A total of 19 pa- tients received THA for end-stage hip arthrosis complicated with femoral head and neck constriction deformity. A posterolateral approach was used to expose the hip complicated with severe deformity. Identifying the location of the true acetabulum, the poorly developed acetabu- lum was reconstructed with autologous femoral head, reamed and then implanted with the acetabular components in proper position. After contracted soft tissues around the joint were released successively, the proximal femur was prepared and inserted with femoral stem in proper size. After trial, the femoral head component in suitable length was installed, and the joint was reduced with proper stability and motion. [Results] All the 19 patients had THA performed successfully with good initial stability of acetabulum and femoral components without serious complications, and followed up for 6 to 36 months. Six months after the operation, the Harris score was of (94.5±4.7) , while the clinical out- come was graded as excellent in 15 cases and good in 4 cases, with an excellent and good rate of 100%. In term of imaging, all the patients maintained the hip center of rotation in anatomic position, and had prosthesis in proper position, got obvious bone ingrowth of the prosthesis 3 months after surgery, without dislocation, stem displacement or fracture during follow- up. [Conclusion] Total hip arthroplasty without femoral shortening osteotomy is feasible technique for treatment of end-stage arthrosis complicated with femoral head and neck shortening deformity, does achieve satisfactory short-term clinical outcome.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical outcome of cement-augmented short-segment pedi- cle screw fixation for the stage III Kümmell disease. [Methods] From January 2018 to January 2021, 20 patients received abovesaid surgical treatment for the stage III Kümmell disease. As the affected vertebrae were located by fluoroscopy, the markers was made on the body surface. Two pairs of cannulated cemented pedicles screws were placed percutaneously into the vertebrae above and below the affected vertebra re- spectively, whereas only one cannulated pedicle screw was placed on one side of the affected vertebra. Bone cement was injected into the above and below adjacent vertebrae firstly. After the bone cement cured, bilateral connecting rods were inserted percutaneously to reduce the kyphotic deformity of affected vertebrae by distraction, and then retain the non-screw side rod of the affected vertebra to maintain the reduc- tion. A puncture needle was inserted on the side of the affected vertebra where the pedicle screw was not inserted, and bone cement was inject- ed into the affected vertebra through the cannulated pedicle screw and the puncture needle to form a completely integrated bone cement block in the affected vertebral body. After the cement solidified in the affected vertebra, the puncture needle was withdrawn, and the screw side was inserted the rod again percutaneously, and lock the tail plug. Finally, the 5 small incisions were closed by suture. [Results] All the 20 patients had the surgical procedures performed successfully without serious complications, and followed up for 12~36 months. The VAS and ODI scores significantly reduced (P＜ 0.05) , while the Frankel grade of neurological function significantly improved at the last follow-up compared with those preoperatively. In terms of imaging, the anterior height of the injured vertebra increased significantly, whereas the kyphotic Cobb angle of the surgical segments and the wedge angle of the injured vertebra decreased significantly postoperatively (P＜0.05) . [Conclusion] This cement-enhanced short-segment pedicle screw fixation for the stage III Kümmell’s disease does effectively restore the height of the in- jured vertebral body, correct kyphosis, prevent the re-collapse of the affected vertebral body, achieve satisfactory clinical outcomes.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of 3D printed guider assisted pelvic tumor resection and reconstruction. [Methods] From January 2017 to October 2018, 18 patients underwent 3D printed guider assisted pelvic tumor resection and reconstruction in our hospital. Before operation, the margin of abnormal signals on the preoperative images were identified, and the tumor size and extent of tumor invasion were determined. After 1:1 real pelvis model was made by 3D printing, a surgical simulation was conducted to create the resection and reconstruction plan, and design the corresponding guider. In the actual operation, tumor resection and pelvic reconstruction were performed according to the preoperative plan and guided by the 3D printed guider. [Results] All 18 patients had operation completed successfully, and were followed up for 18~24 months. During the follow-up period, all 18 patients were alive without deaths due to the tumors. The Musculoskeletal Tumor Society (MSTS) score significantly increased from (12.6±2.0) preoperatively, to (18.6± 1.2) at discharge, and (21.3±1.1) at the latest follow-up, which was statistically significant (P＜0.05) . Compared with those preoperatively, the bilateral differences between the affected side and healthy side in term of the distance of rotation center to midline, acetabular antever- sion and acetabular abduction angle reduced significantly (P＜0.05) . During the follow-up period, no internal fixation loosening or breaking, and local recurrence were found in anyone of them. [Conclusion] The application of 3D printed acetabular guider in pelvic tumor resection and reconstruction has benefits of shortening operation time, improving postoperative recovery, and prognosis.

Abstract:[Objective] To evaluate the efficacy of antibiotic-loaded bone cement (ABC) combined with low-dose dexamethasone palmi- tate (DXP) for diabetic foot ulcer (DFU) . [Methods] From November 2020 to May 2022, 36 patients with DFU were randomly divided into the DXP group and the saline group. After debridement and ABC application, the DXP group was injected low-dose DXP locally at 3, 6 and 9 days, while the saline group received normal saline injection locally. The clinical data were compared between the two groups. [Results] The DXP group proved significantly superior to the saline group in terms of hospital stay, wound healing time and wound healing rate (P＜ 0.05) . The VAS for pain significantly decreased over time in both groups (P＜0.05) , which in the DXP group was significantly better than the saline group at 9 and 15 days after treatment (P＜0.05) . With regard to laboratory test, the positive rate of wound bacterial culture decreased significantly in both groups over time (P＜0.05) , without a significant difference in the positive rate between the two groups at any correspond- ing time points (P＞0.05) . Compared with those before treatment, the TNF-α and IL-6 significantly decreased in both groups 15 days after treatment (P＜0.05) , which in the DXP group proved significantly lower than the saline group at 15 days after treatment (P＜0.05) . [Conclusion] ABC combined with low-dose DXP does effectively promote wound healing for diabetic foot ulcer.

Abstract:[Objective] To explore the clinical outcomes of one-stage total hip arthroplasty (THA) for high-displacement dislocation of the hip in adults. [Methods] From May 2017 to March 2021, 13 patients (17 hips) underwent THA in our department for high-displacement dislocation of the hip due to congenital dislocation of the hip in 7 cases (11 hips) , previous pyogenic hip osteoarthropathy in 2 cases, and un- reduced traumatic posterior dislocation of the hip in 4 cases. [Results] All patients had THA performed successfully with well incision heal- ing without infection and deep vein thrombosis, despite of the fact that temporary femoral nerve palsy in 1 case and re-dislocation in 2 cases were found, which were treated correspondingly without serious consequences. At the latest follow up lasted for (33.1±15.6) month the VAS score for pain significantly decreased (P＜0.05) , while the hip flexion-extension range of motion (ROM) , external-internal rotation ROM and Harris score significantly increased compared with those preoperatively (P＜0.05) . In term of radiographic evaluation, the leg length discrep- ancy and position of rotate centers significantly improved at the latest follow up compared with those preoperatively (P＜0.05) , with osteoto- my healed from 4 to 8 months postoperatively. [Conclusion] The one-stage THA used for high-displacement dislocation of the hip does achieve satisfactory mid-term clinical outcomes.

Abstract:[Objective] To evaluate the clinical outcomes of pararectus approach for open reduction and internal fixation (ORIF) with internal iliosciatic plate for complex acetabular fractures involving the posterior column. [Methods] From January 2017 to December 2018, 16 patients received ORIF with internal iliosciatic plate for complex acetabular fractures involving the posterior column through the pararec- tus approach. The clinical and imaging results were evaluated. [Results] All the 16 patients had ORIF performed successfully without inju- ries to the abdominal organ, blood vessel or nerve, while with the operation time of (195.3±43.7) min and the blood loss of (710.4±232.8) ml. All the patients were followed up for (16.9±3.9) months on average. Compared with those at 3 months after operation, the Merle d 'Au- bigne score, Harris score, internal-external rotation range of motion (ROM) and flexion-extension ROM significantly increased at the last follow-up (P＜0.05) . Compared with that 3 months after surgery, the Tonnis grade for hip degeneration deteriorated at the latest follow-up, whereas which was not statistically significant (P＞0.05) . All the patients got fractures healed well at last follow-up. [Conclusion] This para- rectus approach for open reduction and internal fixation with internal iliosciatic plate does achieve satisfactory clinical consequences for complex acetabular fractures involving the posterior column.

Abstract:[Objective] To evaluate the preliminary outcome of manipulative correction combined with 3D printing customized insoles for flat feet in children. [Methods] From December 2020 to June 2022, 56 children with flat feet were treated with manipulative correction. After that, 31 children (62 feet) received 3D printing customized insole, while the remaining 25 children (50 feet) not used the insole accord- ing to the consequence of doctor-patient communication. The visual analogue scales (VAS) for comfort, stability and satisfaction, and AO- FAS score, as well as the Clarke angle (CA) , Staheli arch index (AI) , Chippaux-Smirak index (CSI) , arch area index were compared be- tween the two groups. [Results] The insole group proved significantly superior to the non-insole group in terms of VAS scores for comfort, sta- bility and satisfaction 12 and 18 weeks after treatment, and the AOFAS score 18 weeks after treatment (P＜0.05) . Compared with those be- fore manual therapy, the CA, AI, CSI and arch area index significantly improved in both groups after therapy (P＜0.05) , whereas which signif- icantly lost 18 weeks after treatment (P＜0.05) . At 18 weeks after treatment, the insole group was significantly better than the non-insole group in term of arch area index (P＜0.05) , but there were no significant differences in CA, AI and CSI between the two groups (P＞0.05) . [Conclusion] The manipulative correction combined with 3D printing customized insoles might improve quality of lives in children who suf- fer from severe flat feet

Abstract:[Objective] To explore the clinical efficacy of extracorporeal shock wave therapy (ESWT) for chronic Achilles tendinitis. [Methods] A retrospective study was conducted on 187 patients who received ESWT for chronic Achilles tendinitis in the outpatient depart- ment from June 2017 to October 2021. All patients received five ESWTs 1 week apart, each with 2 000 pulses (0.45 mJ/mm2 , 10Hz) . The clini- cal results were evaluated by pain VAS and AOFAS ankle and hindfoot scores. [Results] All patients had no serious adverse reactions during treatment, and were followed up for more than 12 months. The patients who were able to resume physical activity proved of 20.9% at 3 months, 69.0% at 6 months, and 86.1% at 12 months after treatment. Of them, 135 patients had pain completely relieved, accounting for 72.2%; 26 pa- tients had no pain in low intensity exercise, while pain in high-intensity exercise, accounting for 5.3%; 10 patients had no pain in daily life, while pain only in exercise, accounting for 5.3%; 16 patients continued to complain of pain, accounting for 8.6% at the latest follow-up. The VAS score for pain decreased significantly [(7.3±0.9) , (2.8±0.7) , (2.4±0.5) , (2.0±0.7) , P＜0.05] , while AOFAS score significantly increased [(72.1±4.7) , (83.2±4.7) , (87.4±3.7) , (90.0±5.0) , P＜0.05] over time (befor treatment, 3, 6 and 12 months after treatment) . [Conclusion] The extracorporeal shockwave therapy for chronic Achilles tendinitis is simple, safe and effective, with good patient’s compliance.