Abstract:[Objective] To compare the clinical efficacy of "stretching soft tissue and distracting bone” reduction combined with per-cutaneous pedicle screw fixation (PSF) versus PSF only for single-segment thoracolumbar fracture. [Methods] A retrospective study wasdone on 47 patients who received surgical treatment for type A single-segment thoracolumbar fracture without neurological symptoms inour hospital from January 2019 to June 2021. According to the preoperative doctor-patient discussion, 24 patients received "stretching softtissue and distracting bone” reduction combined with PSF (the reduction group), while other 23 patients had PSF performed only (the con-ventional group). The documents regarding perioperative period, follow-up and images were compared between the two groups. [Results] Al-though there were no significant differences in total incision length, intraoperative blood loss, success rate of one-time screw placement,postoperative walking time, grade of incision healing, hospital stay and incidence of early complications between the two groups (P＞0.05),the reduction group was significantly greater than the conventional group in terms of operation time [(74.0±4.6) min vs (58.8±7.4) min, P＜0.001] and intraoperative fluoroscopy times [(32.3±2.8) times vs (26.1±3.2) times, P＜0.001]. All the patients in both group were followed upfor a mean of (15.2±2.5) months. The VAS and ODI scores in both groups were significantly improved over time after surgery (P＜0.05), andthe reduction group proved significantly better than the conventional group in term of ODI scores at the last follow-up [(1.4±0.9) vs (3.1±1.6), P＜0.001]. Radiographically, the local kyphotic angle (LKA), vertebral wedge angle (VWA) and anterior vertebral height (AVH) weresignificantly improved in both group after surgery (P＜0.05). By comparison, the reduction group was significantly superior to the convention-al group in terms of LKA [(2.3±2.1) ° vs (6.2±3.6) °, P＜0.001], VWA [(2.8±0.7) ° vs (6.7±2.0) °, P＜0.001] and AVH [(94.1±2.5) % vs (85.7±4.9) %, P＜0.001] at the latest follow-up. [Conclusion] This "stretching soft tissue and distracting bone” reduction combined with percuta-neous pedicle screw fixation (PSF) does restore the height of the injured vertebra better to correct the wedge-shaped vertebral deformity,avoid the occurrence of kyphosis, and maintain the long-term clinical effect for single-segment thoracolumbar fracture.

Abstract:[Objective] To investigate the clinical outcomes of robot-assisted extrapedicular percutaneous kyphoplasty (PKP) for thetreatment of osteoporotic vertebral compression fracture (OVCF). [Methods] A retrospective study was conducted on 43 patients who re-ceived extrapedicular PKP for OVCF from March 2019 to March 2022. According to the preoperative doctor-patient communication, 18cases underwent robot-assisted puncture (robot group), while other 25 cases underwent traditional fluoroscopy guided puncture (fluoroscopygroup). The perioperative, follow-up and imaging data of the two groups were compared and analyzed. [Results] Although the robot groupconsumed significantly longer operative time than the fluoroscopy group [(43.5±5.2) min vs (26.2±4.9) min, P＜0.001], the former was signifi-cantly less than the latter in term of intraoperative fluoroscopy number [(3.3±0.8) times vs (8.8±3.3) times, P＜0.001]. There were no signifi-cant differences in first puncture success rate, bone cement leakage rate, walking time and hospitalization days between the two groups (P＞0.05). The mean follow-up time was (19.8±5.7) months, and there was no significant difference between the two groups in the time to returnto full weight-bearing activities (P＞0.05). The VAS and ODI scores were significantly decreased in both groups over time (P＜0.05), whichwere not significantly different between the two groups at any corresponding time points (P＞0.05). As for imaging, there was no significantdifference in the excellence rate of bone cement distribution between the two group (P＞0.05). The local kyphotic Cobb angle and the rela-tive anterior vertebral height significantly improved postoperatively compared with those preoperatively in both groups (P＜0.05), whereaswhich proved not statistically significant between the two groups at any time points accordingly (P＞0.05). [Conclusion] Robotic navigationcan reduce the number of fluoroscopy, but increase the operation time, and can be a useful supplement to current surgical methods.

Abstract:[Objective] To compare the clinical outcomes of percutaneous transforaminal endoscopy (PTE) versus unilateral biportal en-doscopy (UBE) for degenerative lumbar spinal stenosis (DLSS) in the elderly. [Methods] A retrospective research was done on 72 patientswho received surgical decompression for single-segment DLSS from January 2020 to June 2022. Based on surgeon-patient discussion pre-operatively, 37 patients underwent PTE, while other 35 patients received UBE. The perioperative, follow-up and imaging data of the twogroups were compared. [Results] The PTE group proved significantly superior to the UBE group in terms of operating time [(63.2±11.0) minvs (81.2±10.3) min, P＜0.001], total length of incision [(1.0±0.2) cm vs (2.5±0.3) cm, P＜0.001], intraoperative blood loss [(39.2±10.9) ml vs(89.5±11.3) ml, P＜0.001], postoperative walk time [(1.4±0.5) days vs (2.2±0.4) days, P＜0.001], hospitalization time [(9.2±1.4) days vs (11.2±2.1) days, P＜0.001], and time to recover full weight-bearing activity [(62.2±9.5) days vs (71.1±10.2) days, P＜0.001]. The VASs for lowerback pain and leg pain, as well as ODI scores were significantly decreased in both groups over time (P＜0.05). The PTE group was signifi-cantly better than the UBE group a day postoperatively regarding to VAS score for back pain [(3.7±1.0) vs (4.3±1.1), P=0.018], VAS for legpain [(2.9±0.5) vs (3.2±0.4), P=0.007], and ODI score [(26.6±7.7) vs (30.3±5.4), P=0.022], despite of that the differences in abovesaidscores between the two groups became not statistically significant since then (P＞0.05). With respect of imaging, the canal area in bothgroups increased significantly postoperatively compared with those preoperatively (P＜0.05), but which in both groups decreased again overtime after surgery (P＜0.05). At the last follow-up, PTE group was significantly inferior to the UBE group in canal aera [(126.3±25.4) cm2 vs(163.7±28.6) cm2, P＜0.001]. There were no statistically significant differences in intervertebral space height and lumbar lordosis between the two groups at any time points accordingly (P＞0.05). [Conclusion] Both PTE and UBE can achieve good clinical efficacy in the treat-ment of DLSS. By comparison, PTE has benefits of less trauma, faster recovery, and less early postoperative low back pain and leg pain, butUBE get a wider range of decompression.

Abstract:[Objective] To explore the clinical efficacy of percutaneous endoscopic medial foraminal discectomy (PEMFD) with or with-out Kirschner wire positioning for the treatment of lumbar disc herniation (LDH). [Methods] A retrospective study was conducted on 93 pa-tients who underwent PEMFD using a visualizing trephine for LDH in our hospital from June 2019 to January 2022. Based on doctor-pa-tient discussion preoperatively, 48 patients received PEMFD with Kirschner wire anchoring positioning, while the remaining 45 patients un-derwent the conventional PEMFD. The perioperative, follow-up, and imaging data were compared between the two groups. [Results] All pa-tients in both groups had operation performed successfully with no serious complications . The positioning group proved significantly superi-or to the conventional group in terms of surgical operation time [(44.9±3.2) min vs (54.3±3.3) min, P＜0.001] and fluoroscopy frequency[(3.4±1.1) times vs (7.0±1.4) times, P＜0.001], whereas there were no statistically significant differences in incision length, intraoperativeblood loss, postoperative walking time, incision healing grade and hospital stay between the two groups (P＞0.05). All patients were followedup for 12~18 months, with an average of (14.4±5.0) months, and there was no statistically significant difference in the time to resume fullweight-bearing activity between the two groups (P＞0.05). The VAS and ODI scores significantly decreased in both cohorts over time (P＜0.05), and there was no statistically significant difference in VAS and ODI scores between the two groups at any time points accordingly (P＞0.05). According to the modified Macnab's criteria, there was no statistically significant difference in the excellent and good rate of clinicalresults between the two groups at the latest follow-up (89.6% vs 88.9%, P＞0.05). Regarding imaging, the spinal canal area significantly increased (P＜0.05), while the intervertebral space height and lumbar lordosis angle remained unchanged in both group at the latest follow-upcompared with those preoperatively (P＞0.05). At the corresponding time points, there was no statistically significant difference in the above-said imaging measurement indicators between the two groups of patients (P＞0.05). In addition, there was no significant change in the Pfir-rmann grade of involved discs in both groups at the last follow-up (P＞0.05), and no statistically significant difference in Pfirrmann grade be-tween the two groups at any corresponding time point (P＞0.05). [Conclusion] The Kirschner wire anchoring positioning in PEMFD for pos-terior endoscopic treatment of LDH can significantly improve surgical efficiency.

Abstract:[Objective] To evaluate the clinical efficiency of a novel traction table used in closed reduction and intramedullary nailingof femoral intertrochanteric fractures. [Methods] From December 2019 to April 2022, a total of 72 patients who admitted to our hospital forfemoral intertrochanteric fractures were randomly divided into two groups. Of them, 36 patients received operation under the novel tractiontable (the novel group), while other 36 patients were under the traditional fracture table (the traditional group). The perioperative, follow-upand imaging documents were compared between the two groups. [Results] The novel group proved significantly superior to the traditionalgroup in terms of positioning time [(5.9±1.5) min vs (13.6±3.3) min, P＜0.001] and anesthesia time [(101.5±13.2) min vs (137.3±18.7) min,P＜0.001], intraoperative fluoroscopy times [(34.1±4.1) times vs (38.2±5.5) times, P＜0.001], despite of no statistically significant differencesin closed reduction time, operation time, total incision length, intraoperative blood loss, incision healing grade, hospital stay, and time to re-gain full weight-bearing time between the two groups (P＞0.05). The VAS score, Harris score, hip extension-flexion range of motion (ROM),and hip internal-external rotation ROM were significantly improved in both groups at the latest follow-up compared with those 3 monthspostoperatively (P＜0.05), whereas which were not statistically significant between the two groups at any corresponding time points (P＞0.05).With respect to imaging, there were no statistically significant differences in fracture reduction quality and fracture healing time betweenthe two groups (P＞0.05). At last follow-up, femoral neck-shaft angle (FNSA) decreased significantly in both groups (P＜0.05), while tipapexdistance (TAD) remained unchanged (P＞0.05). There were no significant differences in FNSA and TAD between the two groups at anycorresponding time points (P＞0.05). [Conclusion] This new traction table can effectively reduce the time of position placement and times offluoroscopy, and does not increase the operation time and closed reduction time, reduce the anesthesia time, and improve the efficiency ofsurgery.

Abstract:[Objective] To investigate the clinical consequences of early continuous passive motion (CPM) on the repair of knee carti-lage injury after arthroscopic microfracture. [Methods] A retrospective study was conducted on 79 patients who received arthroscopic mi-crofracture for knee cartilage injury in our hospital from January 2017 to May 2021. According to the results of doctor-patient communica-tion, 40 patients received early CPM treatment, while other 39 cases received routine rehabilitation. The perioperative period, follow-upand imaging documents were compared between the two groups. [Results] There were no significant differences in cartilage injury site, ma-jor lesion area, operation time, incision healing, hospital stay, preoperative and postoperative VAS scores 1 day after surgery between thetwo groups (P＞0.05). However, the CPM group were significantly better than the conventional group in term of VAS scores 3 and 7 days af-ter surgery [(5.4±0.9) vs (5.9±0.8), P=0.007; (4.6±1.0) vs (5.2±1.2), P=0.010]. The VAS, OKS, WOMAC , AKS scores and knee ROM signifi-cantly improved in both groups over time (P＜0.05). The CPM group proved significantly superior to the routine group in terms of VAS score[(3.9±0.9) vs (4.4±0.6), P=0.004; (2.8±1.0) vs (3.4±0.9), P=0.003], OKS score [(33.8±4.2) vs (40.1±3.7), P＜0.001; (25.5±3.4) vs (30.3±3.8),P＜0.001], WOMAC score [(16.5±2.9) vs (20.1±3.1), P＜0.001; (13.7±3.0) vs (18.2±3.9), P＜0.001], AKS score [(96.3±10.5) vs (80.4±9.9), P＜0.001; (113.5±13.3) vs (103.8±10.4), P＜0.001], knee ROM [(107.1±9.3)° vs (99.0±7.8)°, P＜0.001; (111.9±9.0)° vs (105.0±9.1)°, P＜0.001]18 weeks postoperatively and the latest follow up. With respect of imaging, MRI grading of cartilage injury in the CPM group was signifi-cantly improved at the last follow-up compared with the preoperative period (P＜0.05), but there was no significant change in MRI grade of cartilage injury in routine group (P＞0.05). At the last follow-up, the MRI grade of cartilage injury in the CPM group was significantly betterthan that in the routine group [0/I/II/III/IV, (1/7/11/13/8) vs (0/2/8/15/14), P＜0.001] . [Conclusion] Early continuous passive motion afterarthroscopic microfracture for knee cartilage injury can greatly improve the clinical symptoms and knee function, with considerable carti-lage repair effect and fewer complications.

Abstract:[Objective] To compare the clinical outcomes of suture loop with button plate (BP) versus post washer screw (PWS) outletfixations for posterior cruciate ligament (PCL) tibial avulsion fractures. [Methods] A retrospective study was performed on 43 patients whoreceived arthroscopic suture loop fixation of PCL tibial avulsion fractures in our hospital from September 2020 to March 2023. According tothe results of doctor-patient communication, 21 patients had the suture loop fixed by BP at the anterior outlet of the tibial tunnel, while theother 22 patients were fixed by PWS. The perioperative conditions, follow-up data and imaging data were compared between the twogroups. [Results] The BP group consumed significantly less operative time than the PWS group [(51.0±5.2) min vs (58.4±5.2) min, P＜0.001], however, there were no significant differences in the total incision length, intraoperative blood loss, postoperative walking time andhospital stay between the two groups (P＞0.05). All patients in both groups were followed up for more than 12 months, with an average of(20.2±4.6) months, and there was no significant difference in the time to resume full weight-bearing activities between the two groups (P＞0.05). With the passage of postoperative time, Lysholm score and IKDC score were significantly increased in both groups (P＜0.05), whilethe posterior drawer test grade was significantly declined (P＜0.05). There were no significant differences in Lysholm score, IKDC score andpost-drawer test between the two groups before surgery, 3 months after surgery and the last follow-up (P＞0.05). In terms of imaging, therewere no significant differences in fracture reduction quality and fracture healing time between the two groups (P＞0.05). [Conclusion] In ar-throscopic suture loop fixation of PCL tibial avulsion fractures, both BP and PWS fastenings at the anterior outlet do obtain good clinicalconsequences, but the former consumed operation time considerably less.

Abstract:Blood vessels in bone tissue play an important role in bone growth, development, remodeling and injury repair. Type H ves-sels are a subtype of bone vessels with high expression of CD31 and Emcn, which have significant anatomical characteristics and age-de-pendent decline characteristics, and are deeply involved in the coupling between angiogenesis and bone formation. Some cellular mole-cules, such as hypoxia inducible factor-1, vascular endothelial growth factor-A, platelet derived growth factor-BB, and slit guidance ligand3, are involved in regulating the formation of Type H vessels. Meanwhile, drugs therapy, physical therapy, and metastatic tumors can also af-fect Type H vessels. In this paper, the molecular mechanism and influencing factors of Type H vessels formation are reviewed based on theliteratures in recent years, to provide a new idea for the diagnosis and treatment of bone diseases such as fracture nonunion and abnormalbone metabolism.

Abstract:The fractures fixation has been evolved from rigid mechanical internal fixation (association for osteosynthesis, AO) to biolog-ical osteosynthesis (BO), and further to elastic osteosynthesis (EO). In history of internal fixation, the development and innovation at eachstage was based on the outcomes of previous period. The EO theory believes that the minimized stress-shielding might produce a controlla-ble stress in fractures area due to strain effect, which is beneficial to fractures healing. However, relative stability of fixation should be con-sidered except controlled stress in EO, and a balance between flexibility and stiffness of the EO is essential for successful fractures healing.The interfragmentary strain (IFS) is a simple mechanical parameter that could be used to describe the fractures stability, and leads to vari-ous bone healing outcomes. In this paper, a review involving a large number of literatures was presented on EO.

Abstract:Meniscus tear is a common knee injury, while arthroscopic surgery as an important treatment technique mainly divided intomeniscectomy and meniscus repair. Nowadays, with the rapid development of knee arthroscopic technology, as well as deepen understand-ing meniscus anatomy and biomechanics, the concept of clinical diagnosis and treatment has undergone great changes. In this paper, the an-atomical structure of meniscus, diagnosis of meniscus injury, common surgical methods of meniscus repair under arthroscopy at present,and repair of different types of meniscus tears are reviewed, aiming to improve clinicians' understanding of the treatment of meniscus injuryand select the best treatment means.

Abstract:Bone defects are often caused by high-energy injury, open injury combined with infection, primary and secondary bone tu-mors, surgical debridement of osteomyelitis, and congenital skeletal dysplasia. With the progress of human society and the continuous im-provement of people's living standards, the number of patients with complex open fracture of the lower leg is also increasing year by year.Due to the special anatomical position and characteristics of the tibia and fibula, traumatic and open comminuted fractures lead to bone de-fects of the tibia and fibula, which account for a large proportion of bone defects. However, the traditional treatment for complex open tibiaand fibula fractures is strict debridement and fracture reduction in the first stage, and bone grafting and internal or external fixation in thesecond stage. Due to heavy wound contamination and soft tissue defect, it is prone to be infectious bone defect in the later stage. At present,there are many treatment methods for infected tibiofibular bone defects, but each technique has advantages and disadvantages. This articleaims to review the current research status of treatment of infected tibiofibular bone defects at home and abroad, so as to provide a necessaryreference for clinicians to handle the infected tibiofibular bone defects in the proper ways, which is beneficial to the patients to the greatestextent and reduce the pain of patients.

Abstract:Ramp lesion of meniscus is a special type of injury closely related to the tear of anterior cruciate ligament, involving thetransition area from the red-red zone of the posterior horn of the medial meniscus to the posteromedial joint capsule. With the deepening un-derstanding of its anatomy, injury mechanism and biomechanics, it is recognized that ramp lesion will have a serious impact on the stabilityof the knee joint. Untreated ramp lesion often leads to the failure of anterior cruciate ligament reconstruction. The diagnosis and classifica-tion of ramp injury can be determined by MRI and arthroscopy, and the corresponding surgical plan can be formulated. The subjective kneejoint score can be significantly improved, the stability of the knee joint can be improved and a higher healing rate can be guaranteed by sur-gical repair of the disease and following the appropriate rehabilitation program. This article reviews the recent research development oframp lesion in order to provide reference for clinical diagnosis and treatment.

Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of arthroscopic repair of wrist triangular fi-brocartilage complex (TFCC) by sutures through the double transosseous tunnels in Y shape. [Methods] From June 2021 to February 2022,6 patients underwent abovementioned surgical procedures for type IB TFCC tear. First all, arthroscopic debridement was performed withsynovium and fibrovascular granulation tissue removed, and TFCC clearly exposed. The "Y" shaped double transosseous tunnels was pre-pared by drilling Kirschner wires into the volar border of the ulna styloid ulnar about 3cm away from the cartilage surface. As double bundleof sutures were introduced through the bone tunnels, the deep and superficial, or the volar and dorsal portions of the TFCC were threadedunder the arthroscope, and fixed by fastening the sutures. [Results] All the 6 patients successfully completed the operation without seriouscomplications, and followed up for (10.2±3.5) months on an average. Compared with those preoperatively, VAS scores [(3.3±1.2), (1.3±0.8),P＜0.001], Mayo score [(43.0 ±6.1), (92.7±3.4), P＜0.001], wrist extension-flexion range of motion (ROM) [(100.7±8.6)°, (152.3±5.5)°, P＜0.001], ulnar radial deviation ROM [(17.8±5.0)°, (36.2±2.1)°, P＜0.001], forearm rotation ROM [(114.5±10.3)°, (158.8±2.2)°, P＜0.001] weresignificantly improved at the latest follow-up. Furthermore, the radioulnar space under stress X-ray was of (2.3±0.6) mm, with well integri-ty of TFCC revealed by MRI at the latest interview. [Conclusion] This wrist arthroscopy assisted suture of type IB TFCC tear with doubletransosseous tunnels in Y shape is safe and reliable, and can significantly improve the wrist joint function of the patients.

Abstract:[Objective] To introduce the design and preliminary application results of multi-purpose shield in total knee arthroplasty(TKA). [Methods] The multi-purpose shield was comprised with shield plate connected with each other, a handle and a negative pressuregetter. The shield plate was provided with a circular transparent window, a circular transparent window channel and a rectangular transpar-ent window. The rectangular transparent window was arranged in the middle of the top edge of the baffle, while the circular transparent win-dow was arranged on one side of the geometric center of the shield. The handle was connected with the lower part of the shield, where a nega-tive pressure getter connected with the opening in the middle part of the shield plate to form an suction port. The rear end opening was con-nected to an external negative pressure suction pipe to suck out the blood and debris near the shield plate or attached to the surface of theplate. [Results] The multi-purpose shield was applied in TKA in 86 patients, which effectively shielded the spattered blood and bone frag-ments, greatly reduced the surgical infection rate, and effectively protected medical staff to prevent blood-borne occupational exposure. All86 patients had the operation performed successfully, with surgical incision healed well. All of them got knee function recovered well, withno serious complications such as infection occurred during follow-up. [Conclusion] This multi-purpose shield blocks and absorbs the pollut-ants such as blood and bone fragments spattered during TKA, reduces the infection rate, and reduces the pollution and injury to medical staff.

Abstract:[Objective] To introduce the surgical technique and clinical outcomes of F3 mini locking plate for ankle fractures com-bined with posteromedial fragment. [Methods] From February 2019 to February 2021, 12 patients underwent surgical treatment for anklefractures complicated with posteromedial fragment in our hospital with time interval from injury to surgery from 1 to 10 days. Surgical expo-sure was adopted among anterior and posterior window between tibialis posterior and neurovascular bundle through posteromedial ap-proach. Following reduction, fixation of fractures was conducted, including screw or tension band fixation of the anterior collicular fragment,posteromedial and posterior collicular fragment, and F3 mini locking plate for overall fixation. [Results] There was no intraoperative neuro-vascular injury, no incision infection and flap necrosis in anyone of them. No posterior tibialis tendon irritation and implant failure, loss offracture reduction as well as joint incongruity were observed in anyone at the last follow-up. The AOFAS ankle-hind foot score was from 86to 96 at the latest follow-up. [Conclusion] The fixation of posteromedial fragment with F3 mini-locking plate can achieve effective stabili-ty, reduce implant-related complications, and facilitate the recovery of ankle function, which is a feasible surgical scheme.

Abstract:[Objective] To compare the clinical effect of multi-ligament reconstruction and repair with or without tourniquet for KD-Ⅲ-M knee dislocation. [Methods] A total of 27 patients with knee joint dislocation combined with multiple-ligament injuries admittedfrom January 2017 to January 2022 were randomly divided into two groups using a random number table. In the tourniquet group, 13 pa-tients received multi-ligament reconstruction and repair underwent tourniquet, while in the non-tourniquet group, 14 cases were operatedon without tourniquet. The perioperative data and follow-up results were compared between the two groups. [Results] All patients in bothgroups were operated successfully without significant differences in terms of operation time, intraoperative blood loss, ambulation time aftersurgery, postoperative hospitalization days between the two groups (P＜0.05). However, the non-tourniquet group had significantly lowerpostoperative drainage volume than the tourniquet group [(35.6±2.7) ml vs (72.2±3.3) ml, P＜0001]. The VAS scores significantly decrease,whereas the Lysholm and IKDC scores significantly increased in both groups over time postoperatively (P＜0.05). The non-tourniquet groupproved significantly superior to the tourniquet group in VAS score 1week after surgery [(4.4±0.8) vs (5.6±0.9), P=0.021], despite of the factthat it became not significant between the two groups latterly (P＞0.05). There were no statistically significant differences in Lysholm and IK-DC scores between the two groups at any corresponding time points (P＞0.05). [Conclusion] The multi-ligament reconstruction and repairfor KD-Ⅲ-M dislocation of the knee achieve satisfactory clinical consequences, while the non-tourniquet operation has the advantages ofless drainage and less early pain.

Abstract:[Objective] To evaluate the clinical efficacy of closed reduction and fixation with external fixator combined with Kirschnerwire for unstable distal radius fractures. [Methods] From March 2019 to September 2021, a total of 30 patients received closed reductionand fixation with external fixator combined with Kirschner wire for unstable distal radius fractures, and the clinical and imaging data of thepatients were evaluated. [Results] All the patients were operated smoothly without serious complications, with operation time of (73.8±6.9)minutes, perioperative blood loss of (46.4±9.6) ml, and frame removal time of (7.8±0.9) weeks. With time from the point preoperatively, im-mediately postoperatively to that at the last follow-up, VAS score significantly reduced [(8.1±0.6), (6.1±0.9), (3.3±0.3), P＜0.001]. At the lastfollow-up, the Cooney score, palmar flexion-dorsal extension, radio-ulnar deviation, and pronation-supination ROMs were significantly im-proved (P＜0.05). In term of imaging, compared with those preoperatively, the volar tilt (VT) [(4.7±1.9)°, (13.2±0.7)°, (12.8±0.5)°, P＜0.001],radial inclination (RI) [(7.0±1.0)°, (22.8±0.8)°, (21.8±0.6)°, P＜0.001] and radial styloid height (RH) [(5.8±1.0) mm, (11.4±0.6) mm, (9.2±0.5) mm, P＜0.001] were significantly increased immediately postoperatively and at the latest follow up. However, the RH was significantlylost at the last follow-up compared with immediately after surgery (P＜0.05). [Conclusion] For unstable distal radius fractures, closed reduc-tion and internal fixation with external fixator combined with Kirschner wire can obtain satisfactory clinical consequences, despite of loss ofradius styloid height in some extent latterly, which can be used as one of the surgical methods chosen by clinicians.

Abstract: