Abstract:[Objective] To compare the clinical outcome of ＞2.0 cm large incision versus 1.5 cm small incision for percutaneous locking plate fixation of distal radius fractures. [Methods] A retrospective study was done on 86 patients who had distal radius fractures fixed by percutaneous locking plate from January 2012 to February 2023. According to different time periods, 35 patients in the early stage used the ＞2 cm large incision, while 51 patients in the later stage used 1.5 cm small incision for fixation. The perioperative, follow-up and imaging data were compared between the two groups. [Results] The large group proved significantly greater than the small group in terms of incision length [(4.0±0.1) cm vs (1.7±0.1) cm, P＜0.001] and intraoperative blood loss [(49.7±7.5) mL vs (38.8±5.6) mL, P＜0.001], whereas the former consumed significantly less the intraoperative fluoroscopy times than the latter [(2.5±0.8) times vs (5.5±0.7) times, P＜0.001]. With the passage of time after surgery, swelling and VAS scores in both groups were significantly improved (P＜0.05). The proportion of grade I swelling in the large incision group was significantly lower than that in the small incision group one day postoperatively [I/II/III, (6/27/2) vs (24/24/3), P=0.014]. The mean follow-up period was of (13.6±2.1) months, and there were no significant differences in time to regain full weight-bearing activity, PRWE score and GWWE function score at the last followup between the two groups (P＞0.05). Compared with those 1 month after surgery, the wrist flexion-extension ROM, carpal ulnar-radial deviation ROM and pronation-supination ROM in both groups were significantly improved at the last follow-up (P＜0.05), and there was no statistical significance in the above indexes between the two groups at any corresponding time points (P＞0.05). Compared with those preoperatively, the articular congruency, palmar tilt, radial inclination angle and radial length of both groups were significantly improved at the last follow-up (P＜0.05), whereas which were no statistically significant differences between the two groups at any corresponding time points (P＞0.05). [Conclusion] Both large and small incisions for percutaneous locking plate fixation are safe and effective in the treatment of distal radius fractures, but the smaller incision is more mini-mally invasive. On the basis of skillfully carrying out the minimally invasive approach with large incision, the minimally invasive approach with small incision is changed, which is in line with the development direction.

Abstract:[Objective] To compare the clinical efficacy of external fixators verus non-surgical treatments for tibial shaft fractures in the senile elderly. [Methods] A retrospective study was conducted on 39 senile elderly patients who had tibial shaft fractures treated in the Department of Orthopedics of Beijing Rehabilitation Hospital Affiliated to Capital Medical University from May 2017 to April 2023. According to doctor-patient communication before treatment, the patients were divided into two groups. Of them, 26 patients received closed reduction and external fixation with Ilizarov external fixator (the EF group), while other 13 patients received non-surgical treatment (the NS group). The documents regarding treatment periods, follow-ups and imaging evaluations of the two groups were compared. [Results] The EF group proved significantly superior to the NS group in terms of ambulation time [(34.4±4.5) days vs (59.9±4.0) days, P＜0.001], hospital stay [(18.5± 7.8) days vs (35.6±14.3) days, P＜0.001], ICU admission rate (11.5% vs 38.5%, P=0.033), complication rate (32.8% vs 75.9%, P=0.005), and mortality rate (7.7% vs 30.8%, P=0.041). The follow-up period was lasted for (15.3±5.4) months in an average, and the EF group resumed full weight-bearing activity significantly earlier than the NS group [(115.7±13.9) days vs (128.7±19.9) days, P=0.038]. Compared with those 3 months after treatment, the VAS, HSS and AOFAS scores, as well as knee range of motion (ROM) and ankle ROM were significantly improved at the last follow-up in both groups (P＜0.05). The EF group was significantly better than the NS group in terms of HSS score [(72.6± 14.8) vs (60.6±11.2), P=0.012; (86.5±16.6) vs (76.2±13.3), P=0.018], AOFAS score [(70.2±10.8) vs (58.8±9.2), P=0.011; (85.8±13.7) vs (72.8±11.3), P=0.009], knee ROM [(104.3±8.9)° vs (88.4±6.8)°, P=0.003; (128.6±11.8)° vs (111.5±9.2)°, P=0.022] and ankle ROM [(42.4± 6.8)° vs (32.5±4.8)°, P=0.016; (58.3±8.2)° vs (40.2±6.5)°, P=0.008] 3 months after treatment and at the last follow-up. In addition, the EF group was also significantly better than the NS group regarding Johner-Wruhs grades at the last interview (P＜0.05). As for imaging, the EF group was further proved significantly better than the NS group regarding the tibial alignment, leg length discrepancy, the coronal displacement of the fractures, the coronal angulation of the fractures, and the fracture healing (P＜0.05). [Conclusion] The Ilizarov external fixator used in the treatment of tibial shaft fractures does achieve more satisfactory therapeutic outcome than non-surgical treatment, and is more conducive to the care and rehabilitation of the senile elderly.

Abstract:[Objective] To investigate the factors related to membrane angiogenesis induced by Masquelet technique. [Methods] A total of 36 patients who had bone defect treated by Masquelet technique were included in this study from August 2019 to October 2021. The formation and distribution blood vessels of induced membrane tissue were observed, and the factors related to induced membrane vascularization were analyzed by univariate comparison and multi-factor regression analysis. [Results] All the 36 patients had the first-stage operation performed successfully, and had histological assay of membrane angiogenesis at the second-stage surgery by biopsy of the membrane tissue. According to the median blood vessel count of the induced membrane tissue section, the patients were divided into two groups, the good group with blood vessel count above the median, whereas the poor group below the median, with 18 cases in each group. As results of univariate comparison, the good group had significantly greater than the poor group in terms of intramembranous bone formation [yes/no, (4/14) vs (0/18), P=0.021] and membrane blood vessel density [(53.4±12.7) vessel/mm² vs (21.4±7.1) vessel/mm² , P＜0.001], whereas the former had significantly lower ratio of wound closure with free skin flap than the latter [flap/non-flap, (2/16) vs (7/11), P=0.029]. However, there were no significant differences in the general information and comorbidities, the inflammatory response, foreign body rejection, fibrosis grade, site cause, length of bone defect, muscle coverage, debridement degree, filling of bone cement, healing grade of first-stage incision, interval between the two stages of surgical operation between the two groups (P＞0.05). Regarding the multiple regression analysis, the wound closure with free flap and intramembranous osteogenesis were the factors related to number of induced intramembranous vessels, with the standardized partial regression coefficients of -0.350 and 0.384, respectively. [Conclusion] Age, sex, BMI, smoking, drinking, diabetes and bone defects had no impact on inducing membrane vascularization, whereas wound closure with free skin flaps and intramembrane osteogenesis are the factors related to the number of blood vessels formation in the induced membrane.

Abstract:[Objective] To explore the risk factors of death within one year after surgical treatment for hip fractures in elderly. [Methods] A retrospective study was conducted on 225 elderly patients who underwent surgical treatments for hip fractures in The First Affiliated Hospital of Shihezi University from January 2021 to December 2022. The death within 1 year after operation was observed, and the risk factors of death were analyzed by univariate comparison and Cox regression. [Results] All the 225 were followed up completely, 44 patients of them died within 1 year after surgery with mortality of 19.6%, and the remaining 181 patients survived 1 year after surgery with survival rate 80.4%. As results of univariate comparison, the death group was proved significantly greater than the survival groupin terms of age at operation [(83.0±5.8) years vs (78.9±6.4) years, P＜0.001], coronary heart disease [yes/no, (19/25) vs (49/132), P=0.037], chronic obstructive pulmonary disease [yes/no, (13/31) vs (13/168), P＜0.001], cardiac insufficiency [yes/no, (13/31) vs (12/169), P＜0.001], Alzheimer's disease [yes/ no, (7/37) vs (7/174), P=0.003], the number of comorbidity [(3.2±1.1) vs (1.8±1.2), P＜0.001], ASA grade [I/II/III/IV, (0/12/31/1) vs (30/105/ 46/0), P＜0.001]. However, the death group was significantly less than the survival group in terms of preoperative Hb [(99.1±8.1) g/L vs (107.3±10.3) g/L, P＜0.001], postoperative Hb [(77.2±6.9) g/L vs (85.6±9.8) g/L, P＜0.001] and postoperative albumin [(30.6±2.1) g/L vs (33.7±2.2) g/L, P＜0.001]. There were no significant differences in gender, diabetes, hypertension, stroke, complicated Parkinson's disease, operation method, fracture site and anesthesia method between the two groups (P＞0.05). As for Cox survival regression, the ASA grade (HR=2.672, P＜0.001) and age (HR=1.106, P＜0.001) were the independent risk factors for death within 1 year after surgery, while postoperative albumin level (HR=0.627, P＜0.001) were the protective factors. [Conclusion] Advanced age and higher ASA grade are risk factors, whereas higher level of postoperative serum albumin is a protective factor for death within 1 year after surgeries for hip fractures in elderly.

Abstract: [Objective] To compare the clinical efficacy of arthroscopic double-locked Chinese knot (DLCK) versus traditional doublerow anchor (TDRA) for repairing rotator cuff tear. [Methods] From June 2021 to December 2022, 60 patients with rotator cuff injury were enrolled in this study and divided into two groups by random number table method. Among them, 30 patients underwent DLCK repair, while the other 30 patients underwent TDRA. Finally, 3 cases of them were deleted due to loss of follow-up, including 1 case in the DLCK group and 2 cases in the TDRA. The documents regarding perioperative period, follow-up and images were compared between the two groups. [Results] All patients in both groups had corresponding surgical procedures conducted successfully, with no vascular and nerve injuries, as well as other serious complications during the operation. The DLCK group proved significantly superior to the TDRA group in terms of intraoperative blood loss [(24.2±6.5) mL vs (30.5±7.3) mL, P＜0.001] and hospital stay [(2.0±0.6) days vs (3.5±1.0) days, P＜0.001]. With time of the follow-up period lasted for (10.5±2.4) months, the VAS, UCLA, Constant-Murley, ASES scores, forward elevation ROM, abduction elevation ROM were significantly improved in both groups (P＜0.05). The DLCK group was significantly better than the TDRA group in terms of VAS [(3.4±1.0) vs (4.0±0.7), P=0.012], UCLA [(21.3±2.6) vs (19.0±2.5), P＜0.001], Constant-Murley [(71.0±6.8) vs (66.5±7.0), P=0.017], ASES score [(60.2±5.7) vs (56.0±6.2), P=0.010], forward elevation ROM [(130.3±21.2)° vs (118.4±22.0)°, P=0.042], and abduction elevation ROM [(118.0± 22.5)° vs (105.3±3.0)°, P=0.040] a month postoperatively.With respect of imaging, the acromiohumeral distance (AHD), tendon integrity, fat infiltration and muscle atrophy were significantly improved in both groups over time (P＜0.05). The DLCK group was also significantly better than the TDRA group in AHD [(8.6±0.8) mm vs (8.1±0.7) mm, P=0.015] a month postoperatively. [Conclusion] The arthroscopic double-lock Chinese knot achieves better short-term consequence over the traditional double-row anchors for rotator cuff tear, which can effectively reduce the intraoperative blood loss and shorten the hospital stay.

Abstract:Nice knot is a self-locking sliding knot with double stranded suture, which is easy to operate and can exert certain pressure on the bound bone fragments. In trauma orthopedics, the use of plates for internal fixation treatment of fractures is the most commonly used fixation technique. For comminuted fractures, it is not possible sometimes to use plates and screws to fix all free bone fragments during surgery. Traditional surgical knots are prone to loosening when tying the bone fragments, and often require hemostatic forceps to assist in clamping and tying knots, which can lead to a decrease in suture strength. Therefore, Nice knots are becoming more and more widely used in trauma orthopedics due to their simple operation and reliable fixation characteristics. This article reviews relevant papers regarding to this knot at home and abroad in recent years, and proposes the current status and progress of the application of Nice knots in trauma orthopedics, in order to better guide clinical practice.

Abstract:Free flap transplantation remains the gold standard for reconstructing complex soft tissue defects in traumatic orthopedics. However, postoperative vascular compromise-induced perfusion disorders persist as the predominant complication leading to graft failure. Near-infrared spectroscopy (NIRS), a noninvasive monitoring modality, enables real-time assessment of tissue oxygen saturation by detecting differential light absorption characteristics of oxygenated and deoxygenated hemoglobin, thereby offering innovative solutions for microcirculatory surveillance of free flaps. Compared with conventional methods, NIRS demonstrates distinct advantages, including superior penetration depth, enhanced sensitivity, and capacity for continuous monitoring. Notably, this technology shows promise in early detection of subclinical vascular impairment, particularly in dynamically tracking intraoperative and postoperative hemodynamic fluctuations, as well as providing timely alerts for vascular thrombosis or spasm. In view of the relatively short clinical application time of NIRS in free flap monitoring, this article reviews the research progress of the principle of NIRS and the application of free flap monitoring, in order to provide reference for the related research of free flap monitoring.

Abstract:Ideberg type III glenoid fracture is the fracture of the upper part of glenoid, usually complicated with the superior shoulder suspensory complex involved. Improper treatment may lead to serious complications, such as glenohumeral instability, long-term pain, functional limitations and traumatic arthritis. Many scholars have boldly explored different treatment methods, but there is no consensus on the best therapeutic regimen yet. This article reviews the research progress in the treatment of Ideberg type III glenoid fractures, including injury mechanisms, surgical and non-surgical indications, surgical procedures, and prognosis of different treatment methods. It also specifically introduces arthroscopic reduction and fixation techniques. We hope to provide a useful reference for clinicians in treatment.

Abstract:Bone metabolism is the continuous material and energy self-renewal process of osteocytes, osteoblasts, osteoclasts and extracellular matrix in bone tissue, which rebuilds and reshapes bone mainly through the dynamic balance of bone formation and bone resorption. Abnormal bone metabolism caused by various reasons impairs the function of bone, and then exerts a significant impact on the body. Calcium (Ca) and phosphorus (P) are the two most important elements for bone formation, which maintain bone growth and development. Calciumphosphorus ratio (Ca/P ratio) regulates osteocytes, osteoblasts, osteoclasts and extracellular matrix, and influences bone formation and bone resorption through a series of cascade reactions. In this paper, the role of Ca/P ratio on osteogenesis, osteoclysis, bone differentiation and bone microenvironment were reviewed, and the relationship between Ca/P ratio and bone metabolism was discussed to provide new ideas for the research of osteoporosis and bone repair materials.

Abstract: [Objective] Introduce the surgical technique and clinical results of lateral plate combined with iliac bone autograft and BMP-2 with intramedullary nail retention for nonunion of the femoral shaft fractures secondary to intramedullary nail fixation. [Methods] After anesthesia, the patient was put in supine position, iliac bone autografts were harvest ipsilaterally. Based on preoperative images, a longitudinal incision centered on the fracture site was made on lateral side of the affected thigh to expose the nonunion. The fracture ends were debrided with previous intramedullary nail retension, involving removing dead bone and hardened bone until fresh bleeding on the bone surface. A reconstructive plate or locking plate in suitable length was placed on the outer side of the femoral fracture ends, with drilling, depth measure, and screw fixation conducted in sequence. According to the defect situation after debridement, the iliac bone autograft was trimmed into a suitable size, mixed with BMP-2, and fully filled in gap between the fracture ends. As the drainage tube was placed, the wound was closed in layers and bandaged in proper pressure. [Results] All patients successfully completed the surgery and were followed up from 12 to 24 months with a mean of (15.8±3.8) months. At the last follow-up, all patients had the fractures nonunion healed well, with a healing time of (7.5±1.7) months in a mean, ranged from 5 to 10 months. The knee extension-flexion range of motion (ROM) was (120.5±5.9)° 9 months postoperatively, while the HSS score for knee function at the last follow-up were of (87.9±2.4) in a mean. The clinical outcome was marked as excellent in 12 cases and good in one case, with excellent and good rate of 100% at the latest follow-up. [Conclusion] The lateral plate combined with autologous iliac bone and BMP-2 grafting with nail retention for nonunion of femoral shaft fractures secondary to intramedullary nail fixation achieves satisfactory clinical outcome, with advantages of high healing rate and good recovery of limb function.

Abstract:[Objective] To investigate the clinical outcome of asymmetric T-shaped locking plate used for internal fixation of posterior bi-column tibial plateau fractures through the posteromedial inverted L approach. [Methods] From January 2017 to January 2021, 21 patients received asymmetric T-shaped locking plate for internal fixation of posterior bi-column tibial plateau fractures through the postero medial inverted L approach. The clinical and imaging documents were evaluated. [Results] All patients had operation performed successfully without vascular and nerve injury, and were followed up for (17.6±3.9) months on an average. With time preoperatively, 3 months after surgery and the last follow-up, the VAS score decreased significantly [(8.1±0.7), (2.5±0.5), (1.1±0.8), P＜0.001], while the HSS score [(34.1± 3.1), (78.3±2.2), (90.3±2.1), P＜0.001], knee extension-flexion ROM [(10.1±2.6)°, (92.4±6.2)°, (115.7±6.9)°, P＜0.001] increased significantly. As for image, the Rasmussen image score [(8.3±1.3), (15.9±0.9), (15.8±0.9), P＜0.001] increased significantly, whereas the posterior tibial slope (PTS) [(19.0±1.2)°, (9.3±1.7)°, (9.4±1.8)°, P＜0.001], tibial plateau varus angle (TPVA) [(93.1±1.5)°, (87.1±1.7)°, (87.2±1.8)°, P＜0.001] were significantly decreased over time. [Conclusion] The asymmetric Tshaped locking plate through posterior inverted L approach for internal fixation of posterior bi-column tibial plateau fractures does achieve good consequences in terms of fracture reduction and internal fixation stability, and the knee function recovery.

Abstract: [Objective] To investigate the clinical outcome of open reduction and internal fixation (ORIF) of three-part and four-part injuries of superior shoulder suspensory complex (SSSC). [Methods] A retrospective study was conducted on 11 patients who received OR-IF for three-part and four-part SSSC injuries in our hospital from August 2016 to December 2021. The clinical and imaging data were evaluated. [Results] All patients had ORIF performed successfully without neurological or vascular injury, and were followed up for an average of (28.9±3.9) months. With time 1 month, 3 months postoperatively and the last follow-up, the VAS score [(7.0±1.5), (3.8±1.5), (1.8±1.0), P＜0.001]. Constant Murley score [(26.6±3.2), (40.9±2.9), (54.4±2.9), P＜0.001], forward flexion and elevation range of motion (ROM) [(94.3± 9.6)°, (127.0±6.4)°, (145.8±6.7)°, P＜0.001], abduction and elevation ROM [(75.7±6.5)°, (92.8±5.3)°, (115.2±5.9)°, P＜0.001] and internalexternal rotation ROM [(14.2±2.3)°, (32.4±3.1)°, (59.5±7.1)°, P＜0.001] were significantly improved, and no complications such as infection and bone nonunion occurred. Regarding imaging, there was no significant change in postoperative AHD (P＞0.05), and all fractures were bony union. [Conclusion] For the three-part and four-part injuries of SSSC, open reduction and internal fixation do restore the bone structure and stability of SSSC, and regain shoulder function well, so it is recommended to be the first choice of treatment.

Abstract:[Objective] To investigate the clinical efficacy of double-incision double-plate internal fixation (DIDPIF) in the treatment of Schatzker type VI tibial plateau fracture (TPF). [Methods] A retrospective study was conducted on 54 patients who received DIDPIF for Schatzker type VI TPF in our hospital from June 2021 to June 2023. The clinical and imaging data were evaluated. [Results] All the 54 patients were successfully operated on, with an average operation time of (100.0±11.6) min, an average intraoperative blood loss of (270.5± 40.3) mL, an average walking time of (9.4±2.5) days, and an average hospital stay of (10.2±2.0) days. No complications, such as neurovascular injury and incision infection occurred in anyone during perioperative period. They were followed up for a mean of (15.0±2.0) months. The VAS score significantly decreased at the last follow-up compared with that 3 months after surgery [(1.0±0.3) vs (2.3±0.6), P＜0.001], whereas the HSS score [(90.0±8.5) vs (63.2±7.4), P＜0.001] and knee extension-flexion ROM [(119.4±4.6)° vs (90.3±3.7)°, P＜0.001] significantly increased. Compared with those immediately after surgery, the MPTA and PTS remained unchanged remarkably at the latest follow-up (P＞ 0.05), and there was no a significant variation in K-L scale between the time points 3 months after surgery and latest follow-up (P＞0.05). [Conclusion] DIDPIF for Schatzker type VI TPF has advantages of good anatomic reduction quality and strong stability, which is conducive to the improvement of knee function and motion.

Abstract: [Objective] To evaluate the clinical consequence of a single Kocher-Langenbeck (K-L) approach for open reduction and internal fixation (ORIF) of acetabular transverse fracture with or without posterior wall fracture. [Methods] A retrospective study was conducted on 23 patients who received ORIF through a single K-L approach for acetabular transverse fracture with or without posterior wall fracture in the Department of Traumatic Orthopaedics of our hospital from 2018 to 2023, including 15 males and 8 females, aged 22-71 years with an average age of (35.6±9.6) years. The clinical and imaging data were evaluated. [Results] All the patients were operated on successfully with no serious complications such as death and massive hemorrhage, whereas with operative time of (184.7±21.1) min, intraoperative blood loss of (413.9±87.9) mL, and intraoperative fluoroscopy times of (26.6±4.1) times. One patient experienced foot numbness and weakened dorsal extensor strength after surgery, received neurotrophic drugs to treat the symptoms, and got the symptoms significantly relieved 3 months after surgery. None of the patients had wound infection, symptomatic thrombosis and other complications. All patients were followed up for 6-63 months, with an average of (31±9.4) months. The time to return to full weight-bearing activity ranged from 1.2 months to 2.6 months after operation, with an average of (1.7±0.3) months. At the last followup, of the 23 patients, 19 patients recovered pre-injury sports capacity, whereas 4 patients did not regained pre-injury level. One patient had ectopic ossification, which had a partial effect on hip function. As for imaging, according to the Mata criteria, the fracture reduction quality of 23 patients was rated as excellent in 7 cases, good in 12 cases, and poor in 4 cases. At the last follow-up, X-ray showed fracture healed in all patients, with healing time ranged from 8 weeks to 14 weeks. No implant loosening or fracture was found in anyone of them. [Conclusion] For transverse acetabular fracture with or without posterior wall fracture, a single K-L approach does meet the need of ORIF to obtain satisfactory clinical consequence.

Abstract:[Objective] To evaluate the clinical consequence of 3D printing assisted reduction and fixation of femoral condylar osteochondral fractures in adolescents. [Methods] A retrospective study was conducted on 30 adolescent patients who had femoral condylar osteochondral fractures treated surgically from March 2018 to March 2023. According to the doctor-patient communication, 15 patients received by 3D printing assisted and small-incision reduction and fixation (3D group), while other 15 patients were treated by open reduction and internal fixation (conventional group). Clinical and imaging documents were compared between the two groups. [Results] All patients in both groups had operation performed successfully. The 3D group proved significantly superior to the conventional group in terms of operation time [(64.5±6.1) min vs (75.4±10.0) min, P＜0.001] and incision length [(2.7±0.3) cm vs (3.4±0.4) cm, P＜0.001]. Compared with those preoperatively, the VAS and Kujala scores, as well as knee extension-flexion ROM were significantly improved in both groups at the latest follow-up lasted for more than 1 year (P＜0.05). At the last follow-up, the 3D group was significantly better than the conventional group regarding to the VAS score [(1.1±0.8) vs (1.8±0.8), P=0.031], Kujala scale [(78.5±2.7) vs (75.7±3.0), P=0.012], knee ROM [(124.6±4.7)° vs (120.4 + 4.5)°, P=0.019]. As for imaging, the 3D group was also significantly superior to the conventional group in terms of osteochondral fragment reduction quality [excellent/good/poor, (15/0/0) vs (11/4/0), P=0.032] and healing condition [union/edema/absorption, (14/1/0) vs (9/6/0), P=0.031]. [Conclusion] The 3D printing assisted reduction and fixation of femoral osteochondral fracture do significantly improve knee function, with less surgical trauma and complications.

Abstract:[Objective] To compare the clinical efficacy of proximal femoral nail anti-rotation (PFNA) with or without cerclage wire for femoral intertrochanteric fractures in the elderly. [Methods] From November 2021 to December 2023, 20 elderly patients who were undergoing PFNA for type 31A2.3 femoral intertrochanteric fractures in our hospital were enrolled into this study. According to the admission time, the single-day patients were classified as cerclage group, while the double-day patients fell into the non-cerclage group and received corresponding surgical treatment. The clinical and imaging data were compared between the two groups. [Results] All patients in both groups had PFNA performed successfully. The cerclage group proved significantly greater than the non-cerclage group in terms of operative time [(114.6±15.9) min vs (88.0±31.7) min, P=0.034] and the intraoperative blood loss [(220.1±91.9) mL vs (120.2±103.1) mL, P=0.035]. The VAS and Harris scores, as well as hip extension-flexion ROM and internal-external rotation ROM in both groups were significantly improved over time (P＜0.05). The cerclage group proved significantly superior to the non-cerclage group in terms of VAS scores [(2.2±0.7) vs (5.1±0.9), P＜0.001; (1.1± 0.8) vs (2.6±0.7), P＜0.001] one weeks and one month after surgery, hip extension-flexion ROM [(51.1±11.7)° vs (39.8±5.8)°, P=0.023] 1 week postoperatively and Harris score [(88.7±3.3) vs (81.3±7.9), P=0.021] at the latest follow-up. [Conclusion] The PFNA combined with cerclage wire takes advantage of reducing postoperative pain, shortening fracture healing time and promoting hip functional recovery for femoral intertrochanteric fractures in the elderly.

Abstract:[Objective] To evaluate the clinical outcome of MatrixRIB used as internal fixation implant for rib fractures complicated with hemopneumothorax. [Methods] A retrospective analysis was performed on 60 patients who underwent surgical treatment for rib fracture complicated with hemopneumothorax in our hospital from 2018 to 2023. According to the preoperative doctor-patient communication, 30 patients had the fractures fixed with MatrixRIB implants, while the other 30 patients were with traditional claw plate. The early-stage clinical and imaging data of the two groups were compared. [Results] The MatrixRIB group proved significantly superior to the traditional group in terms of operation time [(85.2±10.6) min vs (110.4±15.2) min, P=0.035], incision length [(10.5±1.8) cm vs (13.6±2.1) cm, P=0.042], intraoperative blood loss [(121.5±21.3) mL vs (182.6±37.6) mL, P=0.041], hospital stay [(10.2±2.1) days vs (13.5±2.9) days, P=0.045] and the overall complication rate (10.0% vs 30.0%, P=0.032). The MatrixRIB group returned to full weight-bearing activity significantly earlier than the traditional group [(6.4±1.3) weeks vs (8.8±1.9) weeks, P=0.039]. The pain VAS score was significantly decreased over time postoperatively in both groups (P＜0.05), which in the MatixRIB group were significantly lower than those in traditional group at 1, 3, 7 days and 3 months after surgery (P＜0.05). As for imaging 3 months postoperatively, the MatixRIB group was also significantly better than the traditional group in terms of fracture healing rate (93.3% vs 83.3% , P=0.041) and the complete absorption rate of hemopneumothorax (90.0% vs 73.3% , P= 0.036). [Conclusion] The MatrixRIB has significant advantages in the treatment of rib fracture complicated with hemopneumothorax, can shorten operation time, reduce intraoperative blood loss, alleviate postoperative pain, promote fracture healing and hemopneumothorax absorption, and reduce the incidence of complications.

Abstract: [Objective] To compare the clinical outcomes of pedicle screw fixation of osteoporotic vertebral compression fracture (OVCF) complicated with deep venous thrombosis (DVT) with or without inferior vena cava filter (IVCF) placement. [Methods] A retrospective study was conducted on 61 patients received pedicle screw fixation for OVCF complicated with DVT in our hospital from March 2021 to November 2023. The patients were divided into two groups according to doctor-patient communication. Among them, 31 patients received IVCF treatment, while other 30 patients received conventional anticoagulant treatment. The clinical and laboratory data of the two groups were compared. [Results] All patients were successfully operated on without serious complications or death. Although there was no significant difference in operation time, intraoperative mean arterial pressure (MAP) and incision length between the two groups (P＞0.05), the IVCF group proved significantly superior to the conventional group in terms of intraoperative blood loss [(132.3±25.7) mL vs (185.4±30.8) mL, P＜ 0.001], postoperative drainage [(60.5±12.3) mL vs (88.4±25.6) mL, P＜0.001] and hospital stay [(6.1±3.2) d vs (10.3±2.5) d, P＜0.001]. The VAS, ODI and JOA scores were improved significantly over time in both groups. There were no statistically significant differences in VAS, ODI and JOA scores between the two groups before surgery (P＞0.05), however, the IVCF group was significantly better than the conventional group regarding VAS scores 3 months after surgery (P＜0.05), ODI scores and JOA scores 1 month and 3 months after surgery (P＜0.05). As for blood test, there were no significant differences in YKL-40, ischemia modified albumin (IMA) and D-dimer (DD) between the two groups preoperatively (P＞0.05). However, the IVCF group had significantly lower YKL-40, IMA and DD than the conventional group 24 and 48 hours after surgery (P＜0.05). [Conclusion] IVCF achieves considerably better treatment consequence than conventional anticoagulation in the perioperative period of pedicle screw fixation for OVCF complicated with DVT.

Abstract: