Abstract:[Objective] To compare the clinical efficacy of tension band plate versus cannulated screw for fixation of posterior cruciate ligament (PCL) tibial avulsion fractures. [Methods] A retrospective study was conducted on 48 patients who had PCL tibial avulsion fractures treated by open reduction and internal fixation (ORIF) from January 2018 to June 2024. According to preoperative doctor-patient communication, 23 patients had fractures fixed with tension band plate (the plate group), while other 25 patients were fixed with cannulated screw (the screw group). The clinical and imaging data of the two groups were compared. [Results] Regarding preoperative general data, the plate group had significantly higher rate of comminuted fracture than the screw group [single/comminuted, (6/17) vs (16/9), P=0.008]. All patients in both groups had ORIF performed smoothly without serious complications, such as vascular and nerve injury. The plate group proved significantly greater than the screw group in terms of operative time [min, (63.4±7.6) vs (53.7±7.2), P=0.001], incision length [cm, (7.5±0.9) vs (6.4±1.0), P=0.001], intraoperative blood loss [mL, (63.7±8.7) vs (56.7±7.6), P=0.005] and postoperative drainage [mL, (76.5± 14.7) vs (55.4±10.5), P=0.001], respectively. However, the former used significantly less additional anchors than the latter (4.4% vs 32.0%, P=0.037). There was no significant difference in the incidence of postoperative complications between the two groups (P＞0.05). All patients in both groups were followed up for an average of (12.5±2.8) months, and during the follow-up period, no serious adverse events occurred in either group. At the latest follow-up, there were no significant differences between the two groups in the maximum active knee flexion angle, knee extension loss angle and Lysholm score (P＞0.05). As for imaging, there was no a statistically significant difference in the rate of excellent and good fracture reduction between the two groups (P＞0.05), and no statistically significant difference in the incidence of fracture re-displacement between the two groups (P＞0.05). At the last follow-up, all patients in both groups got fractures healed well, without loosening of the internal fixation, and obvious degenerative changes of the knee. [Conclusion] Both tension band plate and cannulated screw fixation do achieve good clinical consequence in the treatment of PCL tibial avulsion fractures. For the comminuted avulsion fractures, the use of tension plate fixation is more reasonable.

Abstract:[Objective] To compare the clinical efficacy of suprapatellar intramedullary nailing (IMN) versus percutaneous plate (PP) fixation for distal one third tibial fractures. [Methods] A retrospective study was conducted on 78 patients who underwent surgical treatment for distal 1/3 tibial fractures in our hospital from January 2019 to December 2022. According to the doctor-patient communication, 38 patients received IMN, while other 40 patients underwent PP. The perioperative, follow-up and imaging data of the two groups were compared. [Results] Although there were no statistically significant differences in the operation time, total incision length, intraoperative blood loss, fibular fixation and the number of intraoperative fluoroscopy between the two groups (P＞0.05), the IMN group proved significantly superior to the PP group in terms of ambulation time [days, (2.1±0.9) vs (3.4±1.0), P＜0.001], incision healing grade [A/B/C, (37/0/1) vs (32/5/ 3), P=0.020] and hospital stay [days, (8.9±1.4) vs (9.8±1.9), P=0.019]. All patients were followed up for more than 12 months, and the IMN group resumed full weight-bearing activity significantly earlier than the PP group [days, (72.2±11.8) vs (87.2±10.8), P＜0.001]. The pain VAS, Lysholm and AOFAS scores, as well as knee ROM and ankle ROM were significantly improved over time in both groups (P＜0.05). At the last follow-up, there was no statistically significant difference in the above items between the two groups (P＞0.05). As for imaging, there was no statistically significant difference in the leg length discrepency and the lateral distal tibial angle (LDTA) at the last follow-up between the two groups (P＞0.05). The IMN group had significantly smaller anterior distal tibial angle (ADTA) than the PP group [°, (79.3±2.7) vs (80.7±2.8), P=0.033], while the former got fracture healed significantly earlier than the PP group (P＜0.05). [Conclusion] Both suprapatel-lar intramedullary nailing and percutaneous plate do achieve good therapeutic effects for the distal 1/3 fracture of the tibia. By comparison, the percutaneous plates have no interference with the knee, while suprapatellar intramedullary nailing achieves earlier weight-bearing time, faster fracture healing, and a lower incidence of soft tissue complications. Clinically, the two internal fixation techniques should be selected based on specific conditions.

Abstract: [Objective] To evaluate the clinical consequence of arthroscopic repair of subscapularis through modified portals, including the distal anterior portal and distal lateral portal by comparison with the conventional portals. [Methods] A retrospective study was performed on 120 patients who underwent arthroscopic repair of subscapularis tear complicated with or without other rotator cuff injuries from January 2022 to January 2023. According to doctor-patient communication, 60 patients received repair through the modified portals, including the distal anterior portal and distal lateral portal on the basis of conventional technique, while the other 60 patients had the tendon repaired through the conventional portals. The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients in both groups had corresponding arthroscopic procedures conducted smoothly. The modified group consumed significantly less operation time than the conventional group [min, (49.0±8.3) vs (66.5±11.7), P＜0.001], despite of no significant differences in intraoperative blood loss, incision healing, active time and hospital stay between the two groups (P＞0.05). All patients were followed up for an average of (15.6± 2.8) months, and there was no significant difference in time to resume the full weight-bearing activity between the two groups (P＞0.05). Compared with those preoperatively, the VAS, UCLA and ASES scores, as well as forward flexion-elevation, abduction-elevation and internal-external rotation range of motions (ROM) were significantly improved in both groups 3 months after surgery and at the latest follow-up (P＜0.05). The modified group proved significantly superior to the conventional group in terms of VAS [points, (2.4±1.3) vs (3.8±1.1), P＜ 0.001; (1.7±1.1) vs (2.6±1.6), P=0.002], UCLA score [points, (26.8±3.4) vs (20.0±2.0), P＜0.001; (31.6±3.5) vs (26.2±2.1), P＜0.001], ASES score [points, (79.9±7.5) vs (69.6±7.9), P＜0.001; (89.3±8.8) vs (80.6±9.6), P＜0.001] internal-external rotation ROM [°, (68.1±6.7) vs (60.8±7.1), P＜0.001; (74.8±8.0) vs (69.6±8.4), P=0.002] 3 months postoperatively and at the latest follow-up. With respect of imaging, the tendon integrity was significantly improved (P＜0.05), while fat infiltration and muscle atrophy remained unchanged in both groups at the last follow-up compared with those preoperatively (P＞0.05). At any corresponding time points postoperatively, there were no significant differences in the abovesaid imaging indicators, and the incidence of re-rupture between the two groups (P＞0.05). [Conclusion] The modified distal anterior portal and the distal lateral portal used in arthroscopic repair do shorten operation time, reduce pain and improve joint function, and provide a new option for clinicians to treat subscapularis tears.

Abstract:[Objective] To evaluate the clinical outcome of modified high-strength suture elastic fixation of anterior cruciate ligament (ACL) tibial avulsion fractures under arthroscopy. [Methods] A retrospective study was performed on 36 patients who had ACL tibial eminence avulsion fracture treated surgically from July 2020 to December 2022. According to the preoperative doctor-patient communication, 18 patients were fixed by suture, while the other 18 cases were fixed by screw. The perioperative, follow-up and imaging data of the two groups were compared. [Results] The suture group proved significantly superior to the screw group in terms of operating time [min, (51.2± 4.6) vs (73.5±4.9), P＜0.001], total incision length [cm, (8.3±1.2) vs (10.2±1.5), P＜0.001], intraoperative blood loss [mL, (80.4±20.1) vs (97.3±18.9), P＜0.001], postoperative drainage [mL, (204.3±61.2) vs (320.1±74.3), P＜0.001] and ambulation time [days, (36.4±4.3) vs (43.2± 5.3), P＜0.001] and incision healing grade [A/B/C, (14/4/0) vs (10/7/1), P=0.028]. All the patients were followed up for (23.4±8.1) months in a mean, and the suture group regained full weight-bearing activity significantly earlier than the screw group [days, (78.3±9.5) vs (88.4± 10.0), P=0.004]. The Lysholm score, IKDC score and anterior drawer test in both groups were significantly improved over time (P＜0.05). The suture group was significantly better than the screw group in terms of Lysholm score [points, (87.5±2.3) vs (75.4±2.1), P＜0.001] 1 month postoperatively, and IKDC score [points, (62.4±0.3) vs (52.3±0.7), P＜0.001; (86.6±0.5) vs (81.6±1.7), P＜0.001] 1 and 6 months after surgery. As for imaging, the suture group was significantly better than the screw group in fracture reduction quality [excellent/good/poor, (10/ 8/0) vs (5/10/3), P＜0.001]. In addition, the suture group proved significantly superior to the screw group regarding ACL angle [°, (50.6±4.1) vs (46.2±3.8), P＜0.001], the ACL eminence height [mm, (18.2±1.5) vs (12.9±4.3), P=0.004] 3 months postoperatively, whereas which were not significantly different between them before surgery (P＞0.05). [Conclusion] The modified high-strength suture under arthroscopy not only promote the functional recovery of the knee, but also has many advantages, such as less postoperative pain and shortened operation time over the screw fixation for ACL tibial avulsion fractures.

Abstract:[Objective] To investigate the clinical consequence and safety of Mako robot-assisted total hip arthroplasty (THA) through the modified Harding approach. [Methods] A retrospective study was conducted on 48 patients who underwent THA in our hospital from April 2021 to May 2023. According to the preoperative doctor-patient communication, 24 patients underwent Mako robot assisted THA (the robot group), while another 24 patients underwent conventional manual THA through the modified Harding approach (the manual group). The perioperative, followup, and imaging assessment data of the two groups were compared. [Results] All patients in both groups had THA through the modified Harding approach performed successfully. The robot group consumed significantly longer operation time [min, (102.6±15.7) vs (83.7±16.8), P＜0.001], associated with significantly greater intraoperative blood loss [mL, (279.7±35.1) vs (212.5±29.6), P＜ 0.001] than the manual group, although there were no statistically significant differences in postoperative drainage volume and hospital stay between the two groups (P＞0.05). With time went on during the follow-up period lasted for (20.8±8.5) months in a mean, the VAS and Harris scores, as well as the maximum range of motion (ROM) in extension, flexion, adduction and abduction of the hip significantly improved in both groups (P＜0.05). The robot group proved significantly superior to the manual group in terms of VAS [points, M (P25, P75), 2.0 (2.0, 4.0) vs 3.5 (3.0, 5.0), P＜0.001], maximum flexion [°, (74.5±9.0) vs (66.5±10.4), P=0.006] and maximum adduction [°, (18.5±6.2) vs (7.0± 1.6), P＜0.001] 1 week postoperatively, additionally, the Harris scores [points, (75.1±4.9) vs (68.3±5.1), P＜0.001; (84.8±4.9) vs (78.3±4.5),P＜0.001], maximum extension [°, (20.5±5.3) vs (12.5±5.6), P＜0.001; (31.0±3.6) vs (24.1±4.5), P＜0.001], and maximum abduction [°, (26.2± 3.3) vs (21.5±4.8), P＜0.001; (33.4±3.8) vs (27.8±4.3), P＜0.001] 1 week and 3 months after operation. However, by the latest follow-up, the differences in these indicators between the two groups were no longer statistically significant (P＞0.05). As for imaging, the robot group was significantly less than the manual group in terms of the postoperative leg length discrepancy (LLD) [mm, (4.9±1.0) vs (8.1±1.4), P＜0.001] and the absolute value of the combined offset (CO) difference (?CO) [mm, (1.5±0.5) vs (3.5±0.6), P＜0.001], the abduction of the acetabular component [°, (40.3±1.7) vs (45.3±4.1), P＜0.001] and the anteversion [°, (15.9±1.2) vs (18.8±3.6), P＜0.001]. [Conclusion] The Mako robotassisted THA takes advantages of more accurate prosthesis placement and better early outcome over the conventional manual THA through the modified Harding approach, despite of more operation time and intraoperative blood loss consumed in the robot assisted technique.

Abstract:Ankle sprains are one of the most common sports injuries, while the untreated or improperly managed injuries may lead to chronic lateral ankle instability (CLAI). Chronic rotational ankle instability (RAI) may occur when both the medial ligament complex (MLC) and the lateral ligamentous complex (LLC) are injured. Due to the lack of specific clinical tests for diagnosing chronic RAI, it is very difficult to assess clinically, and therefore the incidence may be underestimated. This article reviews the latest research results on the anatomy and biomechanics, pathological mechanisms, clinical diagnosis, and treatment concepts of chronic RAI in recent years, in order to improve the understanding of chronic RAI and guide treatment decisions.

Abstract:Reverse total shoulder arthroplasty (RTSA) is currently an important method for treating end-stage shoulder diseases. However, glenoid bone loss (GBL) poses challenges to the surgery and impacts the stability of implants and clinical outcomes. This article elaborates on the common causes and classification of glenoid defects, introduces preoperative assessment methods, and details treatment techniques such as eccentric reaming, bone grafting, using enhanced bases, and patient-specific techniques, aiming to provide reference for clinical practice and research.

Abstract:The military training induced acute and chronic injuries of the musculoskeletal system seriously affect the combat effectiveness of our army. It is very important to explore more scientific and advanced treatment methods to ensure that the injured soldiers can recover their health quickly and effectively and return to their training and combat posts as soon as possible. The platelet-rich plasma (PRP) can induce regenerative responses and has a positive effect on improving metabolism and tissue repair, is increasingly being used in the treatment of diseases related to military training injuries, especially in the repair of acute and chronic bone and soft tissue injuries. The purpose of this article is to review the application of PRP in the treatment of military training injury related diseases.

Abstract:[Objective] To systematically review the existing orthopaedics- related patents of a national medical center, analyzes the key factors hindering the transformation of these patents, aiming to accelerate the revitalization and utilization of these orthopaedics-related patent technologies and resources, and providing a basis and reference for establishing an application-oriented patent transformation management system. [Method] The National Patent Navigation Comprehensive Service Platform was used to retrieve all orthopaedics- related patents of the national medical center from January 1, 2011 to May 31, 2025, and extract the parameters, such as patent type, transformation status, technical maturity, and transformation intention. [Results] There were 253 orthopaedics-related existing patents in this national medical center, with 83% of them in valid legal status with the average maintenance period of 3.9 years. A total of 20 patents were transformed, mainly concentrated in the fields of medical, surgical, and veterinary equipment manufacturing. Compared with untransformed patents, the transformed patents had higher technical maturity and self-assessed value classification, with 90% of the transformed patents reaching the trial production or application development stage. In addition, 58.1% of the patent holders had clear transformation intentions, among which 62.6% intended to transform through transfer, and 26.5% through licensing. The distribution of patent intention transformation amounts was uneven, with 24.5% concentrated below 200 000 yuan; the transformation intentions were highly concentrated in first-tier cities, such as Shanghai, Beijing, and Shenzhen. [Conclusion] Currently, orthopaedics-related patents have problems, mainly involving low technical maturity, emphasizing clinical application while neglecting market assessment, and a lack of path support and guidance in the transformation process. It is recommended to focus on frontier technology fields, specifically enhancing their technical maturity and market potential, and strengthening enterprises' transformation intentions; promote the establishment of medical innovation consortia with biopharmaceutical enterprises to jointly cultivate high-value patents and explore key technology market potential; at the same time, through measures such as conducting intellectual property courses, enriching the transformation assistance team, and conducting full-cycle tracking services, mobilize the enthusiasm of patent holders for transformation, and reduce non-research-related burdens in the transformation process.

Abstract:[Objective] To compare the anatomical matching extent of the distal humerus between the deformity side and the healthy side after inverted V-shaped osteotomy, Dome osteotomy, Cora osteotomy, and lateral wedge osteotomy by digital simulation using 3D modeling software for correcting elbow varus deformity in children. [Methods] The imaging data taken from the affected side and the healthy side of 19 children who visited our hospital for traumatic elbow varus deformity from January 2015 to March 2024 were modeled using Mimics 21.0 and 3-Matic 12.0 software. The inverted V-shaped osteotomy, Dome osteotomy, Cora osteotomy, and lateral wedge osteotomy were simulated on the affected side, with each image model simulated and measured for 6 times. The postoperative model on the affected side was registered with the mirror image of the healthy side using N-Points Registration, and the maximum deviation value, minimum deviation, average deviation, standard deviation (SD), root mean square error (RMSE), and surface point overlap ratio within 3mm offset were measured. Furthermore, the distal metaphysis of the humerus after osteotomy was divided into 7 anatomical regions, and the measurements were compared. [Results] As results of overall measurement, the maximum deviation between the affected side after osteotomy and the health side ranked down-up as inverted V-shaped osteotomy ＜ Dome osteotomy ＜ Cora osteotomy ＜ wedge osteotomy [mm, (5.13±0.11) vs (6.44±0.34) vs (10.61±0.54) vs (12.99±1.91), P=0.001]. In addition, the inverted V-shaped osteotomy was significantly less than the other three osteotomy methods in terms of average deviation, SD, and RMSE (P＜0.05). However, the inverted V-shaped osteotomy proved significantly greater than the other three osteotomy methods regarding the surface point overlap ratio within 3mm offset [% , (91.13 ± 0.05) vs(87.82±0.04) vs (81.11±0.01) vs (74.25±0.03), P=0.001]. As for regional measurement, the inverted V-shaped osteotomy had significantly better average deviation SD, and RMSE in regions R1-R6, surface point overlap ratio within 3 mm offset in regions R1, R2, R4-R7 than the other surgical methods (P＜0.05). [Conclusion] The inverted V-shaped osteotomy leads the most similar distal humerus morphology of affected side to the normal anatomical structure, with the highest correcting accuracy. It should be the preferred surgical method for the correction elbow varus deformity in children.

Abstract:[Objective] To introduce the surgical technique and the preliminary clinical outcome of ultrasound-guided percutaneous reduction and cannulated screw fixation of posterior cruciate ligament (PCL) tibial avulsion fracture. [Methods] A total of 21 patients received this surgical procedure for Meyers type Ⅱ PCL tibial avulsion fracture. After anesthesia, the patient was placed in prone position with knee flexion from 5° to 10°. Under fluoroscopy, the PCL tibial avulsion fracture position was marked on the popliteal fossa surface, and then a 1cm transverse incision was made on the mark. As the popliteal blood vessels and nerves were located by ultrasound, a guiding cannula was placed through the incision, and then advanced along the medial side of the blood vessels and nerves to the posterior edge of the avulsed PCL bone fragment. The guide cannula was pressed to reduce the bone fragment, and two Kirschner wires were placed over the guide cannula, one used for temporary fixation and another used as guide pin, respectively. After the guide cannula removed, drill a hole with cannulated drill bit, and then fix the bone fragment with a cannulated screw. After ultrasound confirmed the blood vessels and nerves intact, the incision was sutured. [Results] All patients had operation performed successfully without popliteal neurovascular injury and other complications. The patients regained full weight-bearing activity in a mean of (61.6±2.8) days, with Lysholm score significantly increased from (30.1±7.6) preoperatively to (92.1±3.4) at the last follow-up (P＜0.001). All of them had stable knee, with negative posterior drawer test, and normal extension-flexion range of motion at the latest follow-up. [Conclusion] This ultrasound-guided percutaneous reduction and cannulated screw fixation of posterior cruciate ligament (PCL) tibial avulsion fracture is feasible in technique, with advantages of high safety and less trauma, and achieves satisfactory preliminary clinical consequece.

Abstract: [Objective] To introduce the surgical technique and preliminary clinical results of arthroscopic continuous locking and tension-reducing suture for subscapular tendon tears. [Method] From January 2019 to August 2023, arthroscopic continuous interlocking tension- reducing suture were used for repairing degenerative subscapular tendon tears in 55 patients. During the operation, endoscopy was placed through the posterior portal for observation, an anchors with double sutures was inserted through the anterior portals to fix and suture the torn subscapular tendon. Among them, one set of anchor sutures was continuously interlocked and sutured with 2 to 4 stitches from the upper 1/3 edge of the subscapular tendon, while the other set of sutures passed through the ventral junction of the upper and middle 1/3 of the subscapular tendon at both ends respectively, forming a tension-reducing thread loop. After tightening and knotting the tension-reducing thread loop, the continuous locking suture loops were knotted, and finally repositioning and fixing the torn and retracted subscapular tendon to the lesser tubercle of the humerus. [Results] All patients successfully completed the surgery and were followed up for 12 to 18 months. The Constant score significantly increased from (47.3±9.3) before the operation to (80.4±7.6) one year after the operation (P＜ 0.001), and the ASES score significantly increased from (30.0±8.5) before the operation to (79.7±7.3) one year after the operation (P＜ 0.001). However, the VAS score decreased significantly from (7.1±0.8) before the operation to (2.0±0.9) one year after the operation (P＜ 0.001). [Conclusion] This single anchor with continuous locking tension-reducing suture technique for the treatment of subscapular tendon tear under arthroscopy is feasible, simple and fast and achieves satisfactory clinical efficacy. It can increase the suture holding force and axial tensile force on the tendon at the broken end.

Abstract:[Objective] To introduce the surgical technique and preliminary outcome of arthroscopic partial meniscectomy under selfdeveloped limited open sheathing. [Methods] From August 2022 to August 2023, 26 patients had medial meniscus tear treated with the abovesaid surgery. Under the moderate valgus stress at 30° of knee flexion, the limited open sheath tube was introduced under arthroscope. Subsequently, the distal end of the limited open sheath tube was dilated with the rod to expand the posteromedial space of the knee in proper tension without damage to cartilage to create a operation space for punches and other instruments. Identifying the injured meniscus and completing the partial meniscectomy were conducted under direct vision. [Results] All patients were operated on successfully without complications, such as injuries to nerves, blood vessels, anterior and posterior cruciate ligament, articular cartilage and medial collateral ligament. The 26 patients were followed up with pain visual analogue scale (VAS) significantly reduced from (3.7±0.3) before the operation to (0.3±0.5) at the last follow-up, while the Lysholm score significantly increased from (53.5±7.4) before the operation to (97.2±2.8) at the last follow-up. [Conclusion] This limited opening sheath tube used in knee arthroscopy can improve the intraoperative operating space, facilitate partial meniscectomy, and avoid severe injuries to ligaments and cartilage.

Abstract:[Objective] To explore the role of navigated total knee arthroplasty (N-TKA) combined with multiple intravenous uses of tranexamic acid (TXA) on perioperative blood loss. [Methods] A retrospective study was conducted on 200 patients who underwent N-TKA or traditional total knee arthroplasty (TKA) for knee osteoarthritis in our department from January 2019 to December 2024. According to preoperative doctor-patient communication, the patients were divided into 4 groups with 50 cases in each group. In the N-TKA + TXA group, the N-TKA was performed with TXA intravenously injected multiple times; in the N-TKA group, N-TKA was performed without TXA given; in the TKA+TXA group, traditional TKA was performed with TXA intravenously injected multiple times; and in the TKA group, traditional TKA was adopted without TXA given. The total blood loss and hidden blood loss of each group 1 day and 3 days after the operation were compared among the 4 groups. [Results] There were statistically significant differences among the N-TKA+TXA group, N-TKA group, TKA + TXA group and TKA group in terms of the total blood loss 1 day postoperatively [mL, (451.4±106.1) vs (523.7±134.4) vs (544.3±125.7) vs (606.2±114.8), P＜0.001] and the hidden blood loss 1 day after surgery [mL, (229.1±82.3) vs (276.1±88.9) vs (289.5± 101.2) vs (358.9±93.3), P＜0.001], as well as the total blood loss 3 days after the operation [mL, (574.2±128.6) vs (663.3±182.9) vs (733.9± 178.6) vs (842.9±181.0), P＜0.001] and latent blood loss 3 days after the operation [mL, (307.9±81.4) vs (374.3±136.2) vs (455.1±129.3) vs (533.3±160.3), P＜0.001]. As results of repeated measures ANOVA, the main effect of N-TKA was significant (P＜0.001), and the main effect of TXA was significant (P＜0.05), but the interaction effects between N-TKA and TXA were not significant (P＞0.05). Regarding color Doppler ultrasound, no deep vein thrombosis in the lower extremities was found in any patients of the four groups after the operation. [Conclusion] Navigation combined with multiple intravenous TXA before and after surgery does reduce the total blood loss and latent blood loss during the perioperative period of total knee arthroplasty, without increasing the risk of thrombosis.

Abstract: [Objective] To evaluate the clinical consequence of arthroscopic tendon fixation for massive rotator cuff tear (MRCT) complicated with proximal long head biceps tendon (LHBT) rupture. [Methods] From February 2019 to July 2023, 100 patients with an average age of (43.8±7.4) years received arthroscopic tendon fixation with suture bridge formed between the two rows of anchors to fasten torn end of the rotator cuff and the stump of the LHBT on the humeral head for MRCT complicated with LHBT rupture in our hospital. The clinical and imaging documents were evaluated. [Results] All the 100 patients had the surgical procedures performed successfully, with operation time of (93.2±14.3) min, incision length of (4.0±0.4) cm, intraoperative blood loss of (32.7±4.9) mL, and the intraoperative fluoroscopy of (4.3± 0.6) times. The patients were followed up for more than 1 year with a mean of (14.7±2.2) months, and regained full weight-bearing activity in a mean of (23.7±3.8) weeks. With time preoperatively, 3 months postoperatively and the last follow-up, the VAS score [points, (6.5±1.3), (2.7±0.6), (1.6±0.3), P＜0.001] decreased significantly, while the UCLA score [points, (12.4±2.7), (27.2±3.2), (30.6±2.8), P＜0.001] and ASES score [points, (34.8±8.2), (76.8±7.3), (84.6±6.5), P＜0.001] increased significantly. As for imaging, the acromiohumeral distance (AHD) increased significantly over time [mm, (6.6±1.4), (8.7±1.5), (9.6±1.2), P＜0.001]. [Conclusion] Arthroscopic tendon fixation for treatment of MRCT complicated with LHBT proximal rupture has a good short-term consequence with good postoperative functional recovery.

Abstract:[Objective] To evaluate the clinical outcome of the arthroscopic internal brace-enhanced Brostrom procedure (AIBBP) for chronic ankle instability. [Methods] A retrospective study was conducted on 19 patients who underwent AIBBP at our institution from January 2020 to December 2022. The clinical and imaging data were analyzed. [Results] All patients had AIBBP performed successfully, and were followed up for 12 months. With time elapsed preoperatively, 3 months after surgery and the last follow-up, the VAS score was decreased significantly [points, (3.1±1.0), (0.7±0.6), (0.5±0.6), P＜0.001], whereas the AOFAS score [points, (59.7±6.9), (80.5±2.5), (88.5± 3.9), P＜0.001], ankle dorsal-plantar flexion range of motion (ROM) [°, (41.6±6.3), (59.7±3.5), (66.1±3.8), P＜0.001], inversion-eversion ROM [°, (57.6±5.3), (41.0±5.2), (43.9±2.7), P＜0.001], anterior drawer test [0/1+/2+/3+, (0/0/6/13), (10/9/0/0), (13/6/0/0), P＜0.001] and inversion test [0/1+/2+/3+, (0/1/8/10), (0/12/7/0), (11/6/2/0), P＜0.001] were significantly improved. As for imaging, both talus anterior displacement [mm, (7.3±1.6), (2.2±0.7), (1.3±0.5), P＜0.001] and talus inversion angle under stress [°, (11.5±2.8), (2.6±1.4), (0.8±0.7), P＜ 0.001] were significantly reduced, whereas the Takakura classification remained unchanged significantly (P＞0.05) over time preoperatively, 3 months postoperatively and the latest follow-up. [Conclusion] This arthroscopic internal brace enhanced Brostrom procedure does effectively improve ankle function and stability, and provide a safe and effective surgical technique for the treatment of chronic ankle instability.

Abstract:[Objective] To compare the clinical outcomes of robot-assisted minimally invasive reduction and fixation versus traditional open reduction and internal fixation with L-shaped incision for calcaneal fractures. [Methods] A retrospective analysis was conducted on 40 patients who had calcaneal fractures treated surgically at Gaomi People's Hospital from January 2021 to January 2023. Based on doctorpatient communication, 20 patients underwent robot-assisted minimally invasive surgery, while the other 20 patients received conventional open reduction and internal fixation with plates. Perioperative, follow-up, and imaging data of the two groups were compared. [Results] All patients in both groups underwent successful surgeries without severe complications. The robot group showed significant advantages over the conventional group in terms of incision length [cm, (4.1±0.7) vs (13.5±1.6), P＜0.001], intraoperative fluoroscopy [times, (3.8±0.7) vs (7.7±1.0), P＜0.001], intraoperative blood loss [mL, (44.2±4.1) vs (134.2±15.0), P＜0.001], and hospital stay [days, (7.3±0.7) vs (15.1±1.5), P＜0.001]. Both groups were followed up for more than 6 months. At the last follow-up, the clinical consequence was marked as excellent in 15 cases and good in 5 cases in the robot group, whereas excellent in 14 cases and good in 6 cases in the conventional group according to the AOFAS ankle-hindfoot score, which was not statistically significant between the two groups (P＞0.05). As for imaging, the B?hler angle, Gissane angle, and calcaneal width in both groups were significantly improved at the last follow-up compared with preoperative conditions (P＜0.05). At any corresponding time points, there was no statistically significant difference in the above imaging indicators between the two groups (P＞0.05). [Conclusion] The robot-assisted minimally invasive calcaneal fracture reduction and fixation takes the advantages of smaller surgical incisions, less intraoperative bleeding, and fewer intraoperative fluoroscopies, and might enable patients to achieve better functional recovery earlier.

Abstract: [Objective] To explore the feasibility and clinical efficacy of sagittal oblique osteotomy of the ulna in the treatment of Bado type I old Monteggia fractures in children. [Methods] A retrospective research was conducted on 23 children who had Bado typeⅠold Mon-teggia's fractures treated surgically by sagittal oblique osteotomy of the ulna in our department from October 2017 to October 2023. The clinical and imaging documents were evaluated. [Results] All patients underwent surgery successfully, with no perioperative complications including vascular or nerve injuries. The mean follow-up duration was (11.2±2.2) months. Compared with those before the operation, the elbow maximal flexion range of motion (ROM) [°, (111.7±7.6), (134.3±3.1), P＜0.001] and HSS score of the elbow [points, (85.1±5.5), (92.4± 3.7), P＜0.001] significantly increased at the last follow-up. However, the maximal forearm pronation ROM significantly reduced [°, (70.7± 5.5), (67.4.±4.2), P＜0.001], and the maximal forearm supination ROM remained unchanged significantly [°, (83.4±6.6), (85.3±2.4), P= 0.058]. During the follow-up period, none of the patients experienced recurrence of radial head dislocation, nor did they develop late complications such as elbow stiffness, traumatic arthritis, or elbow deformity. In terms of imaging, the midline of the radial neck passed through the center of the humeral capitellum, and the osteotomy healed well at the latest follow-up. [Conclusion] This ulna oblique osteotomy in the sagittal plane is feasible in the treatment of Bado type I old Monteggia fractures in children, and achieves satisfactory clinical consequence.

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