Abstract: [Objective] To investigate the clinical consequences of 3D printing assisted arthroscopic fixation of anterior cruciate ligament (ACL) tibial avulsion fracture. [Methods] A retrospective study was performed on 58 patients who received arthroscopic fracture reduction and elastic fixation with high-strength suture pulled out through tibial tunnels for ACL tibial avulsion fracture in our hospital from October 2020 to December 2022. According to preoperative doctor-patient communication, 28 patients had simulated surgical operation performed on 3D printed model before the real surgery (the 3D group), while other 30 patients had routinely arthroscopic fixation conducted without preoperative simulation (the routine group). The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had arthroscopic fracture reduction and fixation performed smoothly. The 3D group proved significantly superior to the routine groups in terms of the operation time [(44.6±9.0) min vs (51.3±13.2) min, P=0.029], the postoperative drainage volume [(163.1±29.1) ml vs (180.3±33.4) ml, P=0.019], and the success rate of first establishment of bone tunnel [cases (%), 17 (60.7) vs 10 (33.3), P=0.037]. The follow-up period lasted for (12.7±6.9) months on an average, and the 3D group resumed full weight-bearing activities significantly earlier than that in the routine group [(21.7±5.4) days vs (25.9±6.1) days, P=0.033]. The Lysholm and IKDC scores, as well as anterior drawer test were significantly improved in both groups over time (P＜0.05). The 3D group was significantly better than the routine group regarding IKDC score 3 months after surgery [(78.6±6.6) vs (74.1±7.1), P=0.016]. With respect of imaging, the 3D group was also significantly better than the routine group in term of fracture reduction quality [excellent/good/poor, (15/12/1) vs (8/16/6), P=0.045]. The ACL angle was significantly increased (P＜0.05), while the anterior ACL crest height was significantly decreased postoperatively compared with those preoperatively in both groups (P＜0.05). The 3D group got significantly lower anterior ACL crest height than the routine group 3months postoperatively [(2.3±0.8) mm vs (2.9±0.8) mm, P=0.009]. [Conclusion] Arthroscopic reduction and fixation of ACL tibial avulsion fracture does achieve good clinical outcomes. The 3D printing assistance is helpful to shorten the operation time, improve the success rate of bone tunnel establishment and the quality of fracture reduction, and promote the early recovery of knee joint function.

Abstract:[Objective] To compare the clinical outcome of hip hemiarthroplasty (HA) through posterolateral approach with or without piriformis transection for femoral neck fractures in the elderly. [Methods] A retrospective study was conducted on 129 elderly patients who received HA for femoral neck fractures in our hospital from January 2018 to June 2023. According to the doctor-patient communication, 59 patients had HA performed with non piriformis transection (NPT), while other 70 patients had piriformis transection (PT). The perioperative, follow-up and imaging data of the two groups were compared. [Results] Although there were no significant differences in operation time, incision length, intraoperative blood loss and incision healing grade between the two groups (P＞0.05), the NPT group proved significantly superior to the PT group in terms of postoperative walking time [(4.0±1.1) days vs (5.1±1.3) days, P＜0.001] and hospital stay [(13.6±1.7) days vs (14.5±2.0) days, P=0.007]. As time elapsed in follow-up time period lasted for (8.9±2.0) months in a mean, the VAS score for pain decreased significantly (P＜0.05), while the Harris score and hip extension-flexion ROM increased significantly in both groups (P＜0.05). At 3 months after surgery and the latest follow-up, the NPT group was significantly better than the PT group regarding to VAS score [(3.7±0.7) vs (5.4±0.7), P＜0.001; (1.5±1.2) vs (2.5±1.1), P＜0.001], Harris score [(88.1±1.4) vs (87.3±1.7), P=0.004; (92.4±1.8) vs (90.1±1.5), P＜ 0.001], hip flexion-extension ROM [(101.3±8.0)° vs (90.4±6.0)°, P=0.004; (130.8±5.9)° vs (116.1±6.0)°, P＜0.001]. As for imaging, the leg length discrepancy (LLD) significantly reduced in both groups at the last follow-up compared with that preoperatively (P＜0.05), whereas the number of femoral stem deviation remained unchanged significantly in both groups at the last follow-up compared with that immediately postoperatively (P＞0.05). At any corresponding time points, there were no significant differences in LLD and femoral stem deviation between the two groups (P＞0.05). [Conclusion] Compared with traditional piriformis transection, the HA through posterior approach without piriformis transection has advantages of walking earlier and hospital stays shorter, which is conducive to accelerating the recovery of hip function in the treatment of femoral neck fractures in the elderly.

Abstract:[Objective] To compare the clinical efficacy of tenodesis of biceps long head tendon versus repair in situ for type II superiorlabrum anterior to posterior (SLAP) tear. [Methods] Clinical data of 31 patients with type II SLAP injury admitted to our hospital from Janu-ary 2018 to June 2021 were retrospectively analyzed. According to the results of doctor-patient communication, 16 patients were treatedwith tenodesis of biceps long head tendon (tenodesis group), while other 15 patients were treated with repair in situ by suture anchor (the re-pair group). The perioperative period and follow-up results of the two groups were compared. [Results] The operation was successfully com-pleted in both groups, with no significant differences in operation time, incision length, intraoperative blood loss, active activity time, inci-sion healing and hospital stay between the two groups (P＞0.05). All patients in both groups were followed for more than 1 year, and therewas no significant difference in the time to regain full weight-bearing activities between the two groups (P＞0.05). As time went by, the VAS,ASES, QuickDASH and Constant-Murley scores were significantly improved in both groups (P＜0.05). The tenodesis group proved signifi-cantly superior to the repair group regarding the VAS score 3 months after surgery [(2.5±0.5) vs (3.7±1.0), P＜0.001]. Moreover, the tenode-sis group was significantly better than the repair group in terms of ASES [(93.7±1.8) vs (90.3±3.3), P=0.002], QuickDASH [(8.9±1.9) vs(11.0±1.6), P=0.002] and Constant-Murley scores [(93.8±1.5) vs (91.1±3.1), P=0.006] at the last follow-up, although the difference in VASscores between the two groups became not statistically significant at that time (P＞0.05). [Conclusion] Both biceps long head tenodesis andrepair in situ by suture anchor do achieve satisfactory outcomes in the treatment of type II SLAP injury. In comparison, the biceps long headtenodesis is superior to the repair in situ in terms of experience and efficacy more than six months after surgery.

Abstract:[Objective] To compare the clinical efficacy of robot-assisted versus traditional freehand percutaneous cannulated screwfixation for femoral neck fracture. [Methods] A retrospective analysis was performed on 69 patients who received surgical treatment for Pau-wels type II-III femoral neck fractures in our hospital from April 2021 to April 2022. According to doctor-patient communication, 39 pa-tients were treated with robot-assisted fixation (the robot group), while other 30 patients underwent conventional free-hand percutaneouscannulated screw (the free hand group). The perioperative, follow-up and imaging data of the two groups were compared between the twogroups. [Results] The robot group proved significantly superior to the free hand group in terms of operation time [(61.9±13.5) min vs (87.0±14.4) min, P＜0.001], the total length of incision [(2.2±0.4) cm vs (5.2±0.4) cm, P＜0.001], intraoperative blood loss [(29.3±4.8) ml vs (33.0±7.8) ml, P=0.018], intraoperative fluoroscopy times [(6.7±1.2) times vs (9.8±1.1) times, P＜0.001] and guide pin adjustment times [(4.5±1.1)times vs (7.9±0.9) times, P＜0.001]. In addition, the robot group resumed full weight-loading activity time significantly earlier than the freehand group [(104.6±4.3) days vs (108.7±8.1) days, P＜0.001]. The VAS score, Harris score, hip extension-flexion ROM, and hip internal-ex-ternal rotation ROM significantly improved in both groups over time (P＜0.05). The robot groups was significantly better than the free handgroup in terms of Harris score [(85.3±3.4) vs (82.2±3.3), P＜0.001] a month postoperatively, [(87.0±2.6) vs (82.8±4.2), P＜0.001] 6 monthspostoperatively; hip flexion-extension ROM [(89.6±7.2)° vs (86.6±5.0)°, P=0.045] a month postoperatively, [(105.2±4.6)° vs (102.8±4.0)°,P=0.030] 6 months postoperatively; and hip internal-external rotation ROM [(58.0±2.7)° vs (54.7±2.5)°, P＜0.001] a month postoperatively.Regarding image, the robot group was also significantly better than the free hand group in term of Garden alignment index, cannulatedscrew dispersion and femoral neck shortening (P＜0.05), but there were no statistically significant differences in femoral neck-shaft angle and cannulated screw parallelism, fracture healing time and Ficat grade between the two groups (P＞0.05). [Conclusion] Compared withhands-free technique, the robot-assisted cannulated screw fixation of femoral neck fracture has the advantages of shorter operation time,better screw placement with greater dispersion, and better early hip function recovery.

Abstract: [Objective] To compare the clinical efficacy of double-plate (DP) versus triple-plate (TP) internal fixation of hyperexten-sion tibial plateau fractures in the elderly. [Methods] A retrospective research was performed on 80 elderly patients who received open re-duction and internal fixation (ORIF) for hyperextension tibial plateau fractures in our hospital from April 2017 to April 2022. According todoctor-patient discussion before operation, 40 patients were treated by ORIF with DP, while other 40 patients were with TP. The periopera-tive, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had operation performed successful-ly. The DP cohort proved significantly less than the TP cohort in terms of operative time [(119.6±25.6) min vs (132.5±27.2) min, P=0.032]and intraoperative blood loss [(249.5±40.3) ml vs (273.3±47.9) ml, P=0.019], although the DP group resumed postoperative ambulation sig-nificantly later than the TP group [(69.5±9.7) days vs (63.7±7.9) days, P=0.019]. In addition, the DP group was marked significantly lessVAS than the TP group 1 day [(8.1±0.9) vs (8.5±0.7), P=0.013] and 3 days postoperatively [(4.8±1.1) vs (5.3±0.9), P=0.016], whereas whichbecame not significant between the two groups 12 days after surgery (P＞0.05). The average follow-up time lasted for (16.2±2.6) months, andthere was no significant difference in time to recover full weight-bearing activities between the two groups (P＞0.05). The knee pain VASscore, HSS score and knee extension-flexion ROM significantly improved over time in both groups (P＜0.05). The DP cohort was significant-ly inferior to the TP cohort in terms of VAS [(1.8±0.7) vs (1.5±0.5), P=0.025], HSS [(65.5±4.4) vs (67.7±4.5), P=0.026] and knee extensionflexionROM [(102.3±4.3)° vs (104.3±4.4)°, P=0.044] 6 months after surgery, while which turned to be not statistically significant betweenthe two groups 12 months postoperatively (P＞0.05). Regarding imaging, there were no significant differences in terms of reduction quality of the fractures and healing time, as well as posterior tibial slope (PTS), medial proximal tibial angle (MPTA) at matching time points between

Abstract:[Objective] To compare the clinical efficacy of elastic stable intramedullary nailing (ESIN) and locking intramedullary nail(LIN) for femoral shaft fractures in children and adolescents. [Methods] A retrospective study was conducted on 38 patients who receivedsurgical treatment for femoral shaft fractures from January 2017 to July 2023. According to preoperative doctor-patient communication, 29cases were treated with ESIN, while 9 cases were treated with LIN. The perioperative, follow-up and imaging results were compared be-tween the two groups. [Results] The ESIN proved significantly superior to the LIN in terms of operating time [(103.8±37.4) min vs (188.3±28.5) min, P＜0.001], total incision length [(3.0±0.6) cm vs (6.4±0.7) cm, P＜0.001], intraoperative blood loss [(33.6±26.7) ml vs (145.6±45.3) ml, P＜0.001], intraoperative fluoroscopy times [(6.5±1.2) times vs (12.9±1.3) times, P＜0.001] and hospital stay [(7.3±2.3) days vs(11.9±1.3) days, P＜0.001]. The follow-up time was ＞12 months, and the ESIN cohort resumed walking [(44.1±5.7) days vs (67.7±10.2)days, P＜0.001] and full weight-bearing activity time [(84.8±10.3) days vs (102.8±21.5) days, P=0.038] significantly earlier than the LIN co-hort. Compared with those 3 months after surgery, Harris score, hip extension-flexion ROM, HSS score and knee extension-flexion ROMwere significantly increased in both groups at the last follow-up (P＜0.05). The ESIN proved significantly better than the LIN regarding tohip extension-flexion ROM [(110.5±4.2)° vs (100.6±3.0)°, P＜0.001] 3 months postoperatively, as well as HSS score [(84.1±1.7) vs (74.4±4.2), P＜0.001; (94.4±0.9) vs (92.5±1.8), P=0.005], knee extension-flexion ROM [(114.4±3.9)° vs (71.4±4.6)°, P＜0.001; (125.0±3.5)° vs(106.2±3.4)°, P＜0.001] 3 months after operation and at the latest follow-up. As for images, the femoral alignment, femoral bilateral lengthdiscrepancy and femoral neck-shaft angle (NSA) significantly improved in both groups postoperatively (P＜0.05). However, the ESIN cohorthad greater NSA than the LIN cohort (P＜0.05). [Conclusion] ESIN used for relatively stable femoral fractures is simple, safe and has goodfunctional recovery. However, for relatively unstable fractures, LIN fixation may be considered.

Abstract:[Objective] To compare the clinical efficacy of modified Mason-Allen (MA) single row versus suture bridge techniques inarthroscopic repair of rotator cuff tear. [Methods] Clinical data of 65 patients with rotator cuff tear admitted from January 2020 to Decem-ber 2022 were retrospectively analyzed. According to the results of doctor-patient communication, 33 patients underwent modified Mason-Allen single row suture under arthroscopy (the MA group), while other 32 patients received the suture bridge (SB) (the SB group). The peri-operative period, follow-up and imaging indexes were compared between the two groups. [Results] There were no significant differences inoperation time, total incision length, intraoperative blood loss, active activity time and hospital stay between the two groups (P＞0.05). Withthe passage of time, the serum levels of IL-1β and IL-6 were significantly decreased (P＜0.05), while ghrelin was significantly increased (P＜0.05). At any corresponding time points, there was no statistical significance in the above indexes between the two groups (P＞0.05). Themean follow-up time was of (17.0±2.0) months. Compared with those preoperatively, both MA group and SB group had significant improve-ments at the last follow-up in terms of VAS score [(7.6±1.3), (0.8±0.3), P＜0.001; (8.0±1.0), (0.7±0.2), P＜0.001]. Compared with those 1month postoperatively, MA group and SB group had significantly improvements at the last follow-up in terms of UCLA score [(22.8±3.0),(32.0±1.7), P＜0.001; (21.4±2.8), (32.8±2.0), P＜0.001], Constant -Murley score [(62.2±5.8), (89.3±7.1), P＜0.001; (63.6±6.2), (91.0±6.8),P＜0.001] and ASES score [(50.0±3.5), (93.2±3.8), P＜0.001; (51.7±4.2), (95.0±3.5), P＜0.001], as well as forward flexion / lifting ROM (P＜0.05). However, there was no statistical significance in the above indexes between the two groups at any time points accordingly (P＞0.05).Regarding to imaging, the acromiohumeral distance (AHD), tendon integrity and fat infiltration in both groups were gradually improved over time (P＜0.05). At any corresponding time points, there were no significant differences in the above imaging indexes, the improvement de-gree of muscle atrophy and the incidence of re-fracture between the two groups (P＞0.05). [Conclusion] The modified Mason-Allen singlerow technique under arthroscopy can achieve similar clinical results as suture bridge technique in the treatment of rotator cuff tear.

Abstract:[Objective] To compare the clinical outcomes of arthroscopic surgery versus open counterpart for glenohumeral dislocationcomplicated with avulsion fracture of the humeral greater tubercle. [Methods] A retrospective study was done on 80 patients who receivedsurgical treatment for glenohumeral dislocation combined with avulsion fracture of humeral greater tubercle from May 2021 to February2022. According to the doctor-patient communication, 42 patients underwent arthroscopic reduction and double-row anchor suture bridgefixation (the arthroscopic group), while other 37 patients received open reduction and fixation with proximal humeral locking plate (opengroup). The perioperative period, follow-up and imaging data of the two groups were compared. [Results] Although the arthroscopic groupconsumed significantly longer operative time than the open group [(75.2±9.4) min vs (62.5±9.3) min, P＜0.001], the former proved signifi-cantly superior to the latter in terms of intraoperative blood loss [(28.5±7.5) ml vs (85.1±8.5) ml, P＜0.001], total length of incision [(1.3±0.6)cm vs (5.0±2.2) cm, P＜0.001], active activity time [(3.1±0.9) weeks vs (3.9±0.9) weeks, P＜0.001] and hospital stay [(8.3±1.2) days vs (9.6±1.6) days, P＜0.001] and incidence of postoperative complications (0% vs 18.9%, P=0.010). As time went by after surgery, the VAS, ASESand Constant-Murley scores, as well as anterior flexion, abduction and external rotation ROMs were significantly improved in both groups(P＜0.05). At 3, 6 and 12 months after surgery, the arthroscopic group were significantly better than the open group in terms of abovemen-tioned items (P＜0.05). With respect of imaging, the arthroscopic group was also superior to the open group in fracture reduction quality [ex-cellent/good/fair/poor, (25/17/1/0) vs (18/12/5/2), P=0.036]. At 3 months and 12 months after surgery, the arthroscopic group had significant-ly less subacromial interval (SAI) than the open group (P＜0.05). [Conclusion] Minimally invasive shoulder arthroscopy achieves better clin-ical consequences than the traditional open surgery in the treatment of glenohumeral dislocation complicated with avulsion fracture of hu-meral greater tubercle.

Abstract:With the development of computer science and technology, artificial intelligence (AI) has shown remarkable applicationprospects in the field of medicine, especially orthopedics. This paper discusses in detail the current situation, challenges and future devel-opment trends of AI in orthopedics. From the intelligent analysis of medical images, to the application of AI in surgery, and then to the ex-ploration of AI in rehabilitation, AI is gradually penetrating and changing the diagnosis and treatment methods of orthopedics. AI has im-proved the accuracy of doctors' interpretation of image data, assisted precise operation and program optimization in surgery, monitored pa-tient progress in the rehabilitation stage, and formulated personalized rehabilitation plans. Although there are still some technical and ethi-cal challenges such as data security, technical standardization and verification issues, the further development and application of AI tech-nology will undoubtedly bring more innovation and progress to orthopedic medicine.

Abstract:As a highly vascularized tissue, the skeletal system can hardly perform its functions without the support from blood vesselsin bone, and angiogenesis is closely associated with osteogenesis spatially and temporally. Recent studies have identified a new type of mi-crovessels in bone marrow with distinct morphological, molecular, and functional characteristics, termed as type H vessels due to the highexpression of platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31) and endomucin (Emcn) in the endothelial cells. It was re-vealed that type H vessels were the key regulatory factors for the maintenance of angiogenesis-osteogenesis coupling, regulating physiologi-cal activities such as bone modeling and remodeling through interactions with osteoprogenitors, osteoblasts, and osteoclasts progenitors. Be-sides, type H vessels were also involved in the pathogenesis of various skeletal diseases, such as osteoporosis and osteoarthritis. This reviewaims to summarize the latest research progress on type H vessels and their role in bone disorders.

Abstract:[Objective] To investigate the effects of traumatic brain injury (TBI) on unilateral femoral fracture healing in rats in termsof calcitonin gene-related peptide (CGRP), and osteoprotegerin (OPG) / receptor activator of nuclear factor-κB ligand (RANKL). [Meth-ods] A total of 80 11-week-old male rats were randomly divided into 4 groups with 20 rats in each group. A model was established accord-ing to neurological severity score (NSS) and the rats were divided into simple femoral fracture (non-injury group) and mild TBI combinedwith femoral fracture (mild group), moderate TBI with femur fracture (moderate group), and severe TBI with femur fracture (severe group).The data of fracture healing and serum assays were compared. [Results] The noninjury group, mild group, moderate and severe groupwere measured X-ray score [(1.0±0.7) vs (1.0±0.7) vs (1.8±0.5) vs (1.8±0.5), P＜0.001] and callus volume [(418.6±25.7) mm³ vs (414.3±29.6)mm3 vs (689.8±31.2) mm³ vs (681.4±31.8) mm³, P＜0.001] 6 weeks after operation, of which the moderate and severe groups were significant-ly higher than the non-injury and mild groups. Regarding to serum assay, the non-injury group, mild group, moderate group and severegroup at 6 weeks after surgery were assayed CGRP [(10.9±0.9) pg/ml vs (11.1±0.7) pg/ml vs (15.2±0.6) pg/ml vs (15.6±0.5) pg/ml, P＜0.001],OPG [(1 131.6±49.9) pg/ml vs (1 180.6±49.3) pg/ml vs (1 443.8±42.3) pg/ml vs (1 457.6±43.8) pg/ml, P＜0.001], RANKL [(66.1±6.8) pg/mlvs (68.3±5.4) pg/ml vs (49.5±5.8) pg/ml vs (50.2±6.0) pg/ml, P＜0.001], OPG/RANKL [(17.2±1.1) vs (17.3±0.7) vs (29.4±2.7) vs (29.3±2.6),P<0.001], with statistically significant differences between moderate and severe groups, and non-injury and mild groups. [Conclusion]

Abstract:[Objective] To introduce the surgical techniques and preliminary clinical results of the anterior "V"-shaped osteotomy,"Y"-shape decompression and fusion (ACVYF) for cervical spondylotic myelopathy. [Methods] As the affected segments were fully ex-posed and the upper and lower intervertebral spaces were treated, a "V"-shaped osteotomy was conducted with ultrasonic osteotome on thevertebral body at 30°~40° along the medial margin of the cervical longus muscle, to the depth of 1/2 of the sagittal diameter of the vertebrae,and the "V" -shaped bone blocks were completely removed and preserved. After grooving at the base of the osteotomy to reach the posteriorcortex, curette and laminar forceps were used to sneak to both sides of the vertebral body to expand the decompression area in a "Y" shape.The posterior longitudinal ligaments and compressors are removed from the intervertebral space up or down for complete decompression. The"V" -shaped bone block was re-implanted back into the "V" -shaped bone groove of the osteotomy in situ, and cage frames in appropriatesize was placed into the upper and lower intervertebral space. Finally, the segments were fixed with a locking plate. [Results] All patientshad operation performed successfully without serious complications during and after the operation. Postoperative CT and MRI of the cervicalspine showed that the compressors were removed completely, in other word, the nerve was decompressed completely. Compared with thosepreoperatively, JOA score [(8.3±1.4), (14.8±1.1), P＜0.001], C2~7 Cobb angle [(15.7±2.5), (19.9±1.9), P＜0.001) were significantly improved atthe latest follow-up lasted (16.4±3.1) months on an average. At the last interview, all patients had good bony fusion without bone graft dis-placement, implant loosening or fracture. [Conclusion] ACVYF is safe and feasible in the treatment of cervical spondylotic myelopathy, in-cluding ossification of posterior longitudinal ligament, osteophytic hyperplasia of posterior margin of vertebral body, severe disc calcification,and obvious stenosis of vertebral canal.

Abstract:[Objective] To analyze the clinical diagnosis and treatment of early joint infection secondary to anterior cruciate ligament re-construction (ACLR) with hamstring tendon autograft. [Methods] From December 2017 to December 2022, a total of 13 patients with joint in-fection after arthroscopic ACLR in our hospital underwent arthroscopic debridement as soon as knee joint aspiration for bacterial and fungalculture and routine cell examination. The clinical outcomes were evaluated. [Results] All the 13 patients had arthroscopic debridement con-ducted successfully with the average operation time of (67.5±14.3) min, and the average irrigation time of (9.1±1.8) days after operation. Allpatients were followed up, and with time from that preoperatively, 14 days after surgery and the last follow-up, the VAS score significantly re-duced [(7.6±1.2), (3.5±0.9), (1.1±0.3), P＜0.001], while the Lysholm score [(47.5±9.4), (58.7±12.3), (83.8±11.5), P＜0.001], knee extensionflexionrange of motion (ROM) [(65.9±13.6)°, (87.8±15.6)°, (121.4±11.7)°, P＜0.001] significanty increased. The graft was successfully re-tained in 12 patients, while graft removed in 1 patient who received revision reconstruction in the second stage. Regarding lab test, a total of11 strains of bacteria were cultured, Staphylococcus epidermidis was the most, with 5 strains, followed by Staphylococcus aureus, with 3strains. The WBC count, neutrophil ratio (N%), CRP and ESR were significantly decreased 14 days after surgery and at the last follow-up (P＜0.05). [Conclusion] Staphylococcus epidermidis is the main pathogen of joint infection secondary to ACLR with hamstring tendon autograft.Arthroscopic debridement combined with catheter irrigation and drainage and intravenous antibiotics do achieve good clinical efficacy.

Abstract:[Objective] To observe the therapeutic effect of pelvic correction combined with core muscle training on adolescent idiopath-ic scoliosis (AIS). [Methods] From January 2022 to May 2023, 86 children with AIS were randomly divided into two groups, with 43 cases ineach group, and were respectively given pelvic correction manipulation combined with core muscle training (composite group) or simple coretraining (training group) for 12 weeks. Clinical and imaging results were compared between the two groups. [Results] At 12 weeks after treat-ment, VAS score, ODI and trunk rotation angle significantly decreased (P＜0.05), while SAQ, SRS-22 score and back muscle strength weresignificantly increased (P＜0.05). There was no significant difference between the two groups before treatment (P＞0.05). At 12 weeks aftertreatment, the composite group proved significantly superior to the training group in terms of VAS , ODI, SAQ [(65.2±5.3) vs (61.4±5.8), P=0.002], the SRS-22 scores [(91.2±8.4) vs (84.8±9.3), P＜0.001], and back muscle strength [(440.5±18.3) N·m vs (410.8±17.4) N·m, P＜0.001]and trunk rotation angle [(5.2±1.0)° vs (6.5±1.1)°, P＜0.001]. In terms of imaging, 12 weeks after treatment, Cobb angle and apical translation(AT) of the main curve were significantly decreased in both groups (P＜0.05), and there was no statistical significance in the above imaging in-dicators between the two groups before treatment (P＞0.05). However, the composite group proved significantly better than the training groupin Cobb angle and AT of the main curve 12 weeks after treatment. [Conclusion] Compared with simple core muscle training, pelvic correc-tion manipulation combined with core muscle training for AIS can enhance back muscle strength, improve spinal function and quality of lifein the children.

Abstract:[Objective] To evaluated the surgical efficacy of minimally invasive expansive decompression combined with anteroposteri-or pedicle screw fixation for type A3 thoracolumbar fractures with neurological deficits. [Methods] A retrospective analysis was conductedon 16 patients who received abovementioned surgical treatment for thoracolumbar fractures with nerve injuries between August 2022 andAugust 2023. The clinical and imaging documents were evaluated. [Results] All patients underwent the surgery successfully without any se-vere complications, and followed up for (9.4±3.9) months in mean. Compared to those preoperatively, the VAS score [(7.4±0.6), (1.8±0.6),(0.7±0.7), P＜0.001] and ODI score [(81.8±8.7), (16.5±4.6), (9.4±4.1), P＜0.001] significantly decreased, while JOA scores significantly in-creased [(6.6±1.5), (22.5±1.5), (26.8±1.3), P＜0.001] 3 months postoperatively and at the final follow-up. In term of neurological function, 9patients recovered to ASIA grade E 1 week postoperatively, additionally, all the 16 patients returned to ASIA grade E at the latest followup.Regarding to imaging, the anterior vertebral height ratio (AVHR) increased significantly [(61.4±12.9)%, (94.3±3.6)%, (92.1±4.0)%, P＜0.001], while local kyphotic angle (LKA) decreased significantly [(9.2±5.4)°, (0.9±1.5)°, (1.0±1.5)°, P＜0.001] with time preoperatively, 3months postoperatively and latest follow-up. [Conclusion] The minimally invasive expansive decompression combined with pure anteropos-terior percutaneous pedicle screw fixation is effective in correcting deformity and improving neurological function for type A3 thoracolum-bar fractures with nerve injuries.

Abstract:[Objective] To compare three postoperative drainage methods for total hip arthroplasty (THA). [Methods] From January2018 to March 2022, 150 patients who were undergoing primary unilateral THA were divided into three groups according to random num-ber table method, 50 patients had negative pressure drainage, 50 patients underwent normal pressure drainage, and 50 patients receivedpositive pressure drainage. The early clinical and blood test documents of the three groups were compared. [Results] All patients in the 3groups had THA performed successfully, with no significant differences in operation time, total incision length and intraoperative blood lossamong the three groups (P＞0.05). The postoperative total drainage volume [(335.9±38.1) ml vs (269.7±39.6) ml vs (187.0±34.8) ml, P＜0.001], total blood loss [(801.7±57.2) ml vs (720.9±58.6) ml vs (618.1±53.4) ml, P＜0.001] and latent blood loss [(284.1±40.9) ml vs (263.7±37.8) ml vs (246.6±36.0) ml, P＜0.001] were all ranked up-down as the negative pressure group ＞ the normal pressure group ＞ the positivepressure group. There were no significant differences in incision pain VAS score and hip circumference among the three groups at any corre-sponding time points (P＞0.05). In terms of blood test, Hb, Hct and RBC levels were significantly decreased in all the three groups 2 days af-ter surgery compared with those before surgery (P＜0.05). Two days postoperatively the Hb [(90.6±10.3) g/L vs (94.3±9.2) g/L vs (98.1±8.9 g/L, P＜0.001], Hct [(27.0±0.0)% vs (30.0±0.0)% vs (33.8±0.1)%, P＜0.001], RBC [(3.3±0.3)×1012/L vs (3.5±0.3)×1012/L vs (3.7 ±0.3)×1012/L,P＜0.001] were all ranked down-up as the negative pressure group ＜ the normal pressure group ＜ the positive pressure group. However,there were no significant differences in postoperative blood transfusion rate and incision healing grade among the three groups (P＞0.05).[Conclusion] The combination of early clamping for 4 hours and positive pressure drainage after THA can effectively reduce the postopera-tive blood loss without increasing the incision pain and hip swelling, which is a simple and effective drainage method for clinical selection.

Abstract:[Objective] To investigate the clinical consequence of 3D printing design for reconstruction plate combined with posteriorcolumn lag screw in the treatment of acetabular quadrilateral plate fractures. [Methods] A retrospective study was done on 25 patients whohad acetabular quadrangular plate fractures fixed with reconstruction plate combined with posterior column lag screw based on 3D printingdesign in our hospital from January 2019 to January 2022. The documents regarding to clinical and imaging conditions were evaluated. [Re-sults] All the 25 patients had operation performed smoothly with the average operation time of (156.8±26.3) min and the average intraopera-tive blood loss of (791.1±163.4) ml, were followed up for an average of (21.1±6.9) months. As time went from the point 1 month after opera-tion, 3 months postoperatively to the last follow-up, the Merled Aubign-Postel score [(10.6±1.9), (13.1±1.9), (17.0±1.6), P＜0.001], hip flex-ion-extension range of motion (ROM) [(84.8±13.1)°, (105.5±13.5)°, (127.0±12.1)°, P＜0.001], hip internal-external rotation ROM [(23.6±2.9)°, (39.6±3.1)°, (51.9±2.7)°, P＜0.001] were significantly increased. As for imaging, there was no significant change in Matta grade at thelast follow-up compared with that immediately after operation (P＞0.05). All patients had fractures healed, with healing time of (13.7±1.4)weeks on an average. [Conclusion] The 3D printed reconstruction plate combined with posterior column lag screw does achieve satisfactoryclinical outcomes for acetabular quadrilateral plate fractures.

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