Abstract:[Objective] To compare the clinical outcomes of hip hemiarthroplasty versus internal fixation with proximal femoral nail an-ti-rotation (PFNA) for femoral intertrochanteric fractures in the elderly. [Methods] A retrospective study was conducted on 128 elderly pa-tients who received surgical treatment for femoral intertrochanteric fractures in our hospital from August 2015 to August 2020. According tothe preoperative doctor-patient communication, 66 patients received hip hemiarthroplasty (the hemiarthroplasty group), while other 62 pa-tients received PFNA fixation (the PFNA group). The documents regarding to perioperative period, follow-up and images were compared be-tween the two groups. [Results] Although the hemiarthroplasty group proved significantly greater than the PFNA group in terms of operativetime [(62.9±5.2) min vs (52.5±4.9) min, P＜0.001], total incision length [(15.1±0.8) cm vs (12.2±0.8) cm, P＜0.001], intraoperative blood loss[(301.8±40.9) ml vs (142.9±20.2) ml, P＜0.001], and length of hospital stay [(13.7±1.1) days vs (12.6±1.5) days, P＜0.001], the former wassignificantly better than the latter in intraoperative fluoroscopy times [(3.5±1.1) times vs (13.8±2.1) times, P＜0.001] and the ambulationtime [(3.4±1.3) days vs (18.0±4.6) days, P＜0.001]. In addition, the hemiarthroplasty group regained full weight bearing activity significantlyearlier than the PFNA group [(24.0±2.0) days vs (59.4±2.6) days, P＜0.001]. The VAS score and Harris score significantly improved in bothgroups over time (P＜0.05), and the hemiarthroplasty group was significantly superior to the PFNA group in terms of VAS score at all timepoint after surgery (P＜0.05), and Harris scores at 1 and 3 months after operation (P＜0.05). With respect of imaging, the leg length discrep-ancy in the hemiarthroplasty group significantly reduced at the last follow-up compared with that before surgery. On other hand, the femoralneck shaft angle (FNSA) significantly decreased (P＜0.05), whereas the tip-apex distance (TAD) significantly increased in the PFNA groupat the last follow-up compared with those immediately after operation (P＜0.05). [Conclusion] Both hemiarthroplasty and PFNA fixationachieve satisfactory consequences for femoral intertrochanteric fractures in the elderly. In comparison, hemiarthroplasty is more advanta-geous as long as the patient's own conditions permit before surgery.

Abstract:[Objective] To investigate the effectiveness of axial load-sharing ratio test in assessing the rigidity of callus of tibial frac-tures for the removal of unilateral external fixator. [Methods] A retrospective study was conducted on 49 patients who were admitted toTianjin Hospital for tibial fractures from January 2017 to July 2020. All patients received unilateral external fixator within 2 weeks after in-jury. According to random number table method, axial load sharing ratio was measured in 24 patients (the tested group), while not tested inother 25 patients (the routine group). The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patientsin both groups had the treatment completed successfully, without significant differences in operation time, total incision length, intraopera-tive blood loss, intraoperative fluoroscopy times, walking time, incision healing, hospital stay, and adjustment time of external fixator be-tween the two groups (P＞0.05). With time of follow-up period lasted for (10.5±2.4) months on an average, the VAS score, knee flexion-ex-tension rang of motion (ROM) and ankle plantar flexion-dorsal extension ROM significantly improved in both groups (P＜0.05), which werenot statistically significant between the two groups at any time points accordingly (P＞0.05). However, the time interval bearing the externalframe in the tested group was significantly less than that in the routine group [(198.8±36.4) days vs (315.7±51.8) days, P＜0.001], whereasthere were no significant differences in adverse events, such as incidence of pin infection and refracture between the two groups (P＞0.05).As for imaging, the tibial alignment significantly improved in both groups after frame adjustment compared with that immediately after oper-ation (P＜0.05), while the quality of callus formation in both groups gradually improved over time (P＜0.05). However, the routine group hadsignificantly better the quality of callus on images than the tested group at the time of frame removal [excellent/good/poor, (23/2/0) vs (13/11/0), P=0.002]. [Conclusion] Regular application of axial load sharing ratio test can safely and timely guide the removal of unilateral externalfixator for tibial fracture, and the effect is safe and reliable.

Abstract:[Objective] To compare the clinical results of open reduction and internal fixation (ORIF) of acetabular fractures involvingthe posterior wall by the direct posterior approach (DPA) versus Kocher Langenbeck (K-L) approaches. [Methods] A retrospective analysiswas conducted on 43 patients who underwent open reduction and internal fixation for acetabular fractures involving the posterior wall fromJanuary 2015 to June 2022. Of them, 19 patients underwent ORIF through DPA approach, while other 24 patients were through the K-L ap-proach. The documents of perioperative period, follow-up, and images were compared between the two groups. [Results] The DPA groupshowed significantly better than the K-L group in terms of surgical time [(83.9±13.9) min vs (102.0±20.9) min, P=0.002], incision length[(9.8±1.2) cm vs (16.0±1.5) cm, P＜0.001], intraoperative blood loss [(267.4±56.6) ml vs (326.7±84.1) ml, P=0.002], intraoperative fluorosco-py frequency [(2.4±0.6) times vs (3.4±0.7) times, P＜0.001], and postoperative walking time [(40.2±6.8) days vs (50.5±10.1) days, P＜0.001].The average follow-up time was of (15.4±1.3) months, and the DPA cohort resumed full weight-bearing activity significantly earlier thanthat in the K-L counterpart [(79.4±6.9) days vs (86.2±7.1) days, P=0.003]. The VAS scores significantly decreased (P＜0.05), while Harrisscore, Merle D'Aobign é-Postel score, hip flexion-extension ROM, and internal-external rotation ROM significantly increased in bothgroups over time (P＜0.05). The DPA group was significantly superior to the K-L group regarding VAS [(4.1±1.0) vs (5.4±1.2), P＜0.001;(1.7±1.0) vs (3.0±0.8), P＜0.001], Harris score [(74.2±5.0) vs (71.1±3.6), P=0.026; (87.0±3.1) vs (83.3±3.8), P=0.002], hip flexion-extensionROM [(75.5±8.5)° vs (69.5±7.0)°, P=0.014; (92.4±11.8)° vs (86.0±9.2)°, P=0.045] at 1 and 6 months postoperatively, and Merle D'Aobigné-Postel score [(13.0±1.3) vs (11.7±1.4), P=0.003] 1 month after surgery. As for imaging, there was no statistically significant difference inthe quality of fracture reduction, fracture healing time, Tonnis hip degeneration grade, ectopic ossification, and femoral head necrosis between the two groups (P＞0.05). [Conclusion] The DPA approach has advantages of fewer bleeding, shorter incisions, and fewer complica-tions for ORIF of acetabular fractures involving the posterior wall, and achieves more satisfactory short-term outcomes over the traditionalK-L approach.

Abstract:[Objective] To compare the clinical efficacy of arthroscopic knotless anchor versus cannulated screw for fixation of posteri-or cruciate ligament (PCL) tibial avulsion fractures. [Methods] A retrospective study was performed on 28 patients who received arthroscop-ic reduction and fixation of acute PCL tibial avulsion fractures in our hospital from October 2013 to October 2020. According to doctor-pa-tient communication, 14 patients had fractures fixed with knotless anchors, while the other 14 patients were with cannulated screws. Theperioperative, follow-up and imaging data were compared between the two groups. [Results] All patients were operated on smoothly withoutserious complications. There were no significant differences in operation time, incision length, blood loss, incision healing grade and hospi-tal stay between the two groups (P＞0.05). The anchor groups proved significantly superior to the screw group in terms of intraoperative fluo-roscopy [(0) times vs (2.1±0.4) times, P＜0.001] and postoperative analgesic use [(2.1±0.5) days vs (3.1±0.6) days, P＜0.001], despite of thefact that the former spent significantly higher medical cost than the latter [(29 677.3±2 406.3) yuan vs (18 605.2± 953.7) yuan, P＜0.001].There was no significant difference between the two groups in the time to regain full-weight bearing activity (P＞0.05). Compared with those3 months after surgery, the VAS, IKDC and Lysholm scores, as well as ROM significantly improved in both groups at the last follow-up (P＜0.05), which were not statistically significant between the two groups at any time points accordingly (P＞0.05). Regarding to imaging, therewere no statistically significant differences in fracture reduction quality and fracture healing time between the two groups (P＞0.05). At thelast follow-up, there was no significant imaging change of worsening knee degeneration in both groups. [Conclusion] Both knotless anchorand cannulated screw fixation do achieve good consequences for PCL tibial avulsion fractures. In contrast, the knotless anchor has higherpostoperative comfort but higher treatment costs.

Abstract:[Objective] To compare the clinical outcomes of anterior reduction and instrumented fusion versus posterior counterpart forlower cervical spine fractures and dislocations (LCSFD) with spinal cord injury (SCI). [Methods] A retrospective research was performed on80 patients received surgical treatment for LCSFD combined with SCI from September 2018 to August 2022. According to doctor-patientdiscussion, 40 patients had operation performed through the anterior approach (AA), while the other 40 patients were through the posteriorapproach (PA). The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups wereoperated on smoothly, and the AA group proved significantly superior to the PA group in terms of operation time [(95.0±10.4) min vs (123.5±13.6) min, P＜0.001], the total incision length [(3.5±0.6) cm vs (11.2±2.0) cm, P＜0.001], intraoperative fluoroscopy times [(3.6±1.2) times vs(6.5±1.5) times, P＜0.001], intraoperative blood loss [(96.2±14.6) ml vs (254.5±30.5) ml, P＜0.001], postoperative drainage [(40.2±8.7) ml vs(66.0±12.4) ml, P＜0.001], hospital stay [(8.2±2.6) days vs (12.5±3.8) days, P＜0.001] and the time to resume full weight-bearing activity[(74.2±12.0) days vs (83.5±14.6) days, P=0.003]. The VAS, NDI, JOA scores and ASIA grades in both groups were significantly improvedas time went on (P＜0.05). The AA group was significantly better than the PA group in terms of VAS score [(2.0±0.4) vs (2.4±0.5), P＜0.001],NDI [(26.1±5.3) vs (29.0±5.6), P=0.020] and the JOA score [(13.6±2.3) vs (12.3±2.1), P=0.010] 3 months postoperatively, as well as theVAS score at the last follow-up [(1.5±0.3) vs (1.7±0.4), P=0.013]. In term of imaging, the local kyphotic angle, injured vertebral slippage,relative height of intervertebral space and vertebral canal area of affected segment were significantly improved in both groups after surgerycompared with those preoperatively (P＜0.05). The AA group was significantly better than the PA group in terms of local kyphotic angle[(4.2±0.8)° vs (5.0±1.6)°, P=0.006], the injured vertebral slippage [(2.0±0.4) mm vs (2.4±0.6) mm, P＜0.001] 7 days postoperatively, as wellas injured vertebral slippage [(2.1±0.5) mm vs (2.5±0.9) mm, P=0.016] at the latest follow-up. [Conclusion] The anterior reduction and in-strumented fusion for LCSFD complicated with SCI has the characteristics of less trauma, faster postoperative recovery, and is more condu-cive to the restoration of spinal nerve function.

Abstract:[Objective] To compare the clinical efficacy of double-loop Endobutton plates and clavicular hook plate for acute acromio-clavicular dislocation. [Methods] A retrospective study was conducted on 44 patients who received surgical treatment for Rockwood typeIII or more severe type acute acromioclavicular dislocation in our hospital from January 2019 to June 2021. Based on surgeon-patient dis-cussion, 21 patients received double-loop button plates fixation (the DLB group), while other 23 patients underwent hook plate fixation (theHP group). Perioperative period, follow-up and imaging data of the two groups were compared. [Results] Although there were no significantdifferences in operation time, intraoperative blood loss and active activity time between the two groups (P＞0.05), the DLB group proved sig-nificantly superior to the HP group in terms of incision length [(5.3±0.6) cm vs (6.2±1.1) cm, P=0.002] and hospital stay [(8.1±1.6) days vs(9.6±2.8) days, P=0.042]. As time went on in the follow-up period lasted for (14.5±3.3) months on an average, the VAS and Constant-Mur-ley scores, as well as shoulder forward flexion-uplifting and abduction-uplifting range of motions (ROMs) significantly improved in bothgroups (P＜0.05). There was no statistical significance in the abovesaid items before operation (P＞0.05), but the DLB group was significantlybetter than the HP group 3 months postoperatively and at the last follow-up in terms of VAS score [(2.1±0.7) vs (3.4±0.7), P＜0.001; (1.0±0.7) vs (2.4±0.8), P＜0.001], Constant-Murley score [(80.8±3.3) vs (69.4±5.0), P＜0.001; (90.0±3.1) vs (80.4±5.8.), P＜0.001], forward flex-ion-uplifting ROM [(147.6±7.0)° vs (117.4±8.1)°, P＜0.001; (171.9±6.8)° vs (153.0±9.1)°, P＜0.001] and abduction-uplifting ROM [(140.0±7.7)° vs (99.1±6.7)°, P＜0.001; (165.7±5.1)° vs (140.4±8.2)°, P＜0.001]. With respect of imaging, the postoperative coracoclavicular distanceand acromioclavicular distance were significantly decreased in both groups compared with those preoperatively (P＜0.05), whereas whichwere not statistically significant between the two groups at any time points accordingly (P＞0.05). [Conclusion] The double-loop button plates have advantages of smaller surgical incision, better shoulder function recovery, less complication rate, and no need to remove the im-plant secondarily over the hook plat , therefore, the double-loop button plates maybe a better choice for the treatment of acute acromiocla-vicular dislocation.

Abstract:[Objective] To evaluate the clinical efficacy of the proximal femur bionic nail (PFBN) versus proximal femoral nail anti-ro-tation (PFNA) in the treatment of intertrochanteric fractures in elderly patients. [Methods] A comprehensive literature search was conduct-ed in databases including PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang, VIP and CBM. The search period wasfrom the inception of the databases to November 2023. Literature quality assessment and data extraction were performed independently bytwo researchers, and then RevMan 5.3 software was used for data analysis. [Results] Four studies involving a total of 236 patients, includ-ing 118 in the PFBN group and 118 in the PFNA group, were enrolled into this study. As results of the meta analysis, PFBN group had sig-nificant advantages over the PFNA group in terms of fracture healing time (MD=-0.43, 95%CI -0.71~-0.14, P=0.003), weight-bearingtime (MD=-6.16, 95%CI -9.14~-3.18, P＜0.001), final Harris score (MD=0.52, 95%CI 0.11~0.93, P=0.01), and complications (OR=0.21,95%CI 0.05~0.91, P=0.04). However, the PFBN group had a longer surgical time (MD=0.82, 95%CI 0.08~1.55, P=0.03) compared to thePFNA group. There were no statistically significant differences between the two groups in terms of intraoperative blood loss and hospitalstay. [Conclusion] The PFBN demonstrates advantages in terms of earlier weight-bearing activity, faster fracture healing, better hip func-tion recovery, and lower complications rate over the PFNA in the treatment of intertrochanteric fractures in elderly. However, PFBN re-quired longer surgical time compared to PFNA.

Abstract:Cartilage is an important structure of joint, and plays role in lubricating the joint and cushioning pressure within the jointcavity. Cartilage injury can lead to knee osteoarthritis (KOA), severely affecting patients' quality of life. Current clinical methods used totreat KOA cannot repair damaged cartilage. In recent years, synovial mesenchymal stem cells (SMSCs) have shown unique advantages in re-pairing cartilage injuries, making it a hot research field for cartilage repair. Therefore, this article provides a comprehensive review of themechanisms and research progress of SMSCs in repairing cartilage injuries, with the aim of promoting the clinical translation of SMSCs incartilage repair.

Abstract:At present, the number of patients with lower limb dysfunction is increasing, while the technology of lower limb rehabilita-tion robot is also improving. Lower limb dysfunction seriously affects the quality of life of patients, however, the rational use of lower limb re-habilitation robots can effectively improve the symptoms of patients, achieve accurate rehabilitation, and make rehabilitation strategiesmore optimized. In this paper, the key technology and equipment characteristics of different lower limb robots are described, combined withthe research status at home and abroad. The clinical effect of lower limb robot was analyzed in different joints and diseases. Finally, the fu-ture development of lower limb rehabilitation robot is summarized and prospected.

Abstract:[Objective] To verify the effect of "shoulder-to-shoulder" anatomical marker localization in restoring lower limb length dur-ing total hip arthroplasty (THA). [Methods] "Shoulder-to-shoulder" THA was performed in 4 cadavers based on insertion obturator exter-nus as the “shoulder” of the femur for osteotomy. The length of lower limb, tip-shoulder distance, osteotomy distance, longitudinal andhorizontal deviation of center of rotation (COR) of femoral head, acetabular abduction angle and acetabular anteversion angle were mea-sured, and verified with the artificial intelligence hip (AIHIP). [Results] All the 4 cadavers got equal length of bilateral lower limbs after op-eration. There were no statistically significant differences in tip-shoulder distance, osteotomy distance, longitudinal and horizontal devia-tions of femoral head COR between the postoperative imaging measurement and the preoperative AIHIP planning (P＞0.05). However, theacetabular abduction angle measured by postoperative image was significantly lower than that planned by AIHIP [(32.5±3.1)° vs (41.3±2.5)°, P=0.005], while the acetabular anteversion measured postoperatively were significantly greater than that planned by AIHIP [(25.3±9.4)° vs (18.8±2.5)°, P=0.030]. In addition, The tip-shoulder distance measured intraoperatively was significantly greater than that mea-sured by postoperative imaging [(26.3±2.6) mm vs (15.5±1.5) mm, P＜0.001], and preoperative AIHIP planning [(26.3±2.6) mm vs (17.0±2.2) mm, P＜0.001]. [Conclusion] The validation of AIHIP after cadaveric surgery shows that the "shoulder-to-shoulder" as anatomic mark-er for femoral stem placement does ensure the accurate placement and effectively restore the lower limb length, although some parametersmeasured at different time points are different.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of self-developed guide posterior-anteriorto reduce and fix posterior cruciate ligament (PCL) avulsion tibial fracture. [Methods] From June 2020 to June 2022, 16 patients receivedthe self-developed guide posterior-anterior to reduce and fix PCL avulsion tibial fracture. After arthroscopic examination and debridement,the posterior medial compartment was entered anterior-posterior between the PCL and the medial femoral condyle to establish the postero-medial portals. Then the self-developed guide was placed, with the tip located at the lateral margin of the tibial tubercle, while a sleeve in-serted through the posteromedial portal aiming below the PCL fracture fragment to create tibial tunnel from the back to the front. The suturehook was used to introduce high-strength suture bundles through the PCL parenchyma, and the suture bundles were led out by PDS suturethrough the bone tunnel. Pulling out the suture bundles to reduce fracture, and fasten the sutures over button plate by tying to finish the sus-pension fixation. [Results] All the 16 patients were operated successfully without vascular or nerve damage, and were followed up for (9.7±2.8) months. Compared with those preoperatively, the IKDC score [(51.3±5.6) vs (91.4±3.1), P＜0.001] and Lysholm score [(46.3±3.4) vs(89.7±3.3), P＜0.001] significantly improved at the last follow-up. All the patients got fractures healed well, with stable knee and good flex-ionextension range of motion. [Conclusion] This self-developed guide used for reduction and fixation of PCL tibial avulsion fracture fromthe back to the front has advantages of accurate tunnel establishment, convenient and simple operation manipulation, and high surgical safe-ty.

Abstract:[Objective] To describe the surgical technique and preliminary clinical outcomes of intelligent robot-assisted percutane-ous fixation of pelvic fractures. [Methods] A total of 15 patients underwent intelligent robot-assisted percutaneous fixation for pelvic frac-tures from June 2022 to January 2023. Preoperative CT data of the patient's pelvis were collected and the tracer was fixed. As intraoperativeCT data were matched with the preoperative CT images, the corresponding Schantz pins were placed on both sides of the pelvis. After plan-ning and designing the path of the pelvic reduction, the robotic arm was automatically operated to pull the affected pelvic side aiming thetarget position to achieve closed pelvic reduction. Finally, pelvic fixation was conducted by placement of cannulated screws, INFIX internalfixation or external frame depending on the concrete condition of pelvis. [Results] All patients had the surgery completed successfully, with-out postoperative complications such as neurovascular injury or incision infection, whereas with operation time of (339.9±116.2) min, intra-operative blood loss of (140.4±102.6) ml, and residual fracture displacement on images of (6.6±3.4) mm. According to the Matta criteria,the excellent and good rate of fracture reduction was of 86.7%. [Conclusion] This intelligent robotic-assisted reduction does achieve satis-factory closed reduction of displaced pelvic fracture in most cases, is a safe and efficient tool, which deserves to be studied furtherly indepth.

Abstract:[Objective] To present the medium-term clinical outcome of pedicled iliac flap combined with cannulated screw fixationfor displaced femoral neck fractures in middle-age adult. [Methods] A retrospective study was performed on 19 middle-aged patients whounderwent pedicled iliac flap combined with cannulated screw fixation for displaced femoral neck fractures from January 2014 to Septem-ber 2020. The clinical and imaging data were evaluated. [Results] All patients were successfully operated on, with operation time of (129.3±9.8) min, incision length of (16.7±1.7) cm, intraoperative blood loss of (50.5±6.7) ml, and the hospital stay of (10.1±1.0) days. All of themwere followed up for the average of (60.1±7.8) months, and regained full weight-bearing activity in a mean of (12.2±4.3) weeks. Comparedwith those 1 month after surgery, VAS scores [(3.1±1.8) vs (1.5±2.3), P=0.015], hip flexion-extension ROM [(113.3±7.3)° vs (129.2±8.3)°,P=0.018], hip internal-external rotation ROM [(76.3±3.2)° vs (89.5±2.7)°, P＜0.001], Harris score [(79.4±2.3) vs (90.6±4.6), P=0.024] sig-nificantly improved by the time of the latest follow-up. Radiologically, the mean fracture healing time was (4.5±6.7) months in an average.Compared with those 1 month after surgery, Garden index remained unchanged at the last follow-up (P＞0.05), whereas the Tonnis scale fordegeneration significantly deteriorated (P＜0.05), with femoral head necrosis in 2 cases (GardenⅣ type) more than 2 years after fracturehealing. [Conclusion] Pedicled iliac flap combined with cannulated screw fixation does achieve satisfactory clinical consequence for dis-placed femoral neck fractures in middle-age adult.

Abstract:[Objective] To investigate the clinical efficacy of 3D printing assisted planning Ortho-Bridging system for personalized fixa-tion of femoral intertrochanteric fractures. [Methods] A retrospective research was done on 46 patients who had intertrochanteric fracturefixed with bridging system planned individually by 3D printing from January 2017 to September 2021. The clinical and imaging documentswere evaluated. [Results] All patients were successfully operated, with the average operation time of (78.3±16.2) min, intraoperative bloodloss of (210.2±113.3) ml, and hospital stay of (13.1±5.0) d, and followed up for more than 12 months. Compared with those 3 months postop-eratively, the pain VAS score significantly declined [(2.1±0.9), (1.4±0.5), P＜0.001], whereas Harris score [(77.3±3.5), (87.5±3.2), P＜0.001]and hip flexion-extesion range of motion (ROM) [(89.9±6.4)°, (124.3±7.9)°, P＜0.001] increased significantly at the latest fullow-up. Imag-ing, compared with those preoperatively, the fracture alignment significantly improved [excellent/good/can/poor, (0/2/3/41), (15/24/6/1), (14/25/5/2), P＜0.001], shaft-neck angle increased significantly 3 months postoperatively and the latest follow-up [(93.7±3.9)°, (128.3±5.4)°,(126.2±5.2)°, P＜0.001]. All the patients got fracture healing at the latest follow-up. [Conclusion] This 3D printing assisted planning Ortho-Bridging system for fixation of femoral intertrochanteric fractures has satisfactory short-term consequence, which is conducive to personal-ized treatment.

Abstract:[Objective] To compare the clinical outcomes of endoscopic unilateral laminotomy and bilateral decompression (Endo-ULBD) with Endo-Surgi Plus endoscope versus open bilateral decompression for lumbar spinal stenosis in the elderly. [Methods] A retro-spective study was done on 51 patients who received surgical treatment for lumbar spinal stenosis in our hospital from December 2018 to De-cember 2020. According to the doctor-patient communication, 31 patients underwent the endoscopic decompression, while other 20 patientshad the conventional open decompression. The clinical and imaging data were compared between the two groups. [Results] All patients inboth groups had operation performed successfully. The endoscopic group was significantly superior to the open group in terms of operationtime [(73.2±21.0) min vs (178.4±22.9) min, P＜0.001], intraoperative blood loss [(7.1±3.6) ml vs (220.0±140.9) ml, P＜0.001], postoperativebed rest time [(1.5±0.4) days vs (6.4±1.8) days, P＜0.001], and hospital stay [(3.0±1.2) days vs (9.4±3.1) days, P＜0.001]. As time went by, theVAS scores of low back pain and leg pain, as well as ODI score in the two groups were significantly improved (P＜0.05), which were not statis-tically significant between the two groups at any corresponding time points (P＞0.05). At the last follow-up, there was no significant differ-ence in MacNab excellent and good rate between the two groups (P＞0.05). At the last follow-up, there was no significant change in vertebralspace height (P＞0.05), while the dural sac cross-sectional area was significantly increased in both groups compared with those before opera-tion (P＜0.05). At corresponding time points, there were no significant differences in the above image indicators between the two groups (P＞0.05). [Conclusion] The Endo-ULBD achieve good short-term clinical consequence comparable to the open surgery, while has the advan-tages of minimally invasive surgery and rapid recovery for lumbar spinal stenosis in the elderly.

Abstract:[Objective] To investigate the early outcomes of diversified rehabilitation and nursing care on pain, quality of life and func-tional recovery in open reduction and internal fixation (ORIF) of ankle fractures. [Methods] From February 2023 to February 2024, 66 pa-tients who were undergoing ORIF for ankle fractures in our hospital were included in this study, and were randomly divided into two groupsby numerical table method. Among them, 33 patients were treated with conventional perioperative rehabilitation and nursing, while other 33patients received diversified perioperative nursing and rehabilitation, mainly with increasing active functional exercise in the early stage,and the external application of traditional Chinese medicine in the late stage. The documents regarding to early clinical conditions werecompared between the two groups. [Results] All patients in both groups were successfully operated on without serious complications. The di-versified group proved significantly superior to the conventional group in terms of postoperative ambulation time [(2.1±0.6) days vs (3.7±1.1)days, P＜0.001], hospital stay [(8.0±1.6) days vs (12.0±3.0) days, P＜0.001] and pain VAS score at discharge [(3.1±0.7) vs (5.5±1.4), P＜0.001], as well as WHOQOL-Brief scores, including physical health [(70.5±3.1) vs (60.1±3.7), P＜0.001], mental health [(1.1±4.2) vs (58.9±3.1), P＜0.001], social relations [(72.1±4.4) vs (60.2±4.1), P＜0.001] and the surrounding environment [(72.6±4.2) vs (60.7±3.7), P＜0.001].In addition, the diversified group was also regained full weight-bearing activities significantly earlier than the conventional group [(61.0±4.4) days vs (76.1±7.1) days, P＜0.001]. [Conclusion] The implementation of multiple rehabilitation and nursing intervention in periopera-tive period of ORIF of ankle fractures not only significantly reduces pain, but also benefit the recovery of ankle joint function and improvethe quality of life of the patients.

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