Zhongguo gu shang = China journal of orthopaedics and traumatology最新文献

{"title":"[A cohort study on treatment of intermission period of gout with <i>Quzhuo Tongbi</i> formula ()combined with febuxostat].","authors":"Mei-Fei Li, Jing-Ya Zhang, Wei-Man Shi, Yi Zhang, Zhi-Jun Xie, Ji-Yong Huang, Cheng-Ping Wen, Dong-Hai Zhou, Qiao Wang","doi":"10.12200/j.issn.1003-0034.20250554","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250554","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore efficacy and safety of &lt;i&gt;Quzhuo Tongbi&lt;/i&gt; formula ()combined with febustat in treating interlude period of gout (spleen deficiency and dampness obstruction type).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From July 2024 to April 2025, 102 patients with gout during intermission period were selected for a cohort study and divided into Western medicine group and Chinese and Western group. There were 51 male patients in Western medicine group, aged with an age of (43.59±12.18) years old and the average courses of disease was (91.04±82.26) months. There were 51 patients in Chinese and Western group, including 49 males and 2 females with an average age of (47.67±11.75) years old, and the average course of disease was (92.41±85.92) months. The Western medicine group was took febuxotropic orally, while Chinese and Western medicine group was took &lt;i&gt;Quzhuo Tongbi&lt;/i&gt; formula() combined with febuxotropic orally, 12 weeks constituted as 1 course of treatment, and both groups were treated for 1 course in totally. The changes of serum uric acid (SUA), total cholesterol (TC), and triglycerides (TG), low-density lipoprotein (LDL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (Scr), and blood urea nitrogen (BUN) between two groups before and after treatment were detected and compared; numeric rating scale (NRS), patient global assessment (PGA), and TCM syndrome scores before and after treatment were compared;the number of gout attacks within 12 weeks and adverse reactions during treatment process were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Totally 99 patients were finally observed clinically, including 50 patients in Western group and 49 patients in Chinese and Western groups. After 12 weeks of treatment, the indicators such as SUA, Scr and BUN in Western medicine group were decreased compared with those of before treatment(&lt;i&gt;P&lt;/i&gt;&lt;0.01), and the indicators such as SUA, TC, TG, LDL, ALT, AST, Scr and BUN in Chinese and Western medicine group were decreased significantly compared with those of before treatment (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Moreover, the improvement of indicators such as SUA, LDL, ALT, AST, and Scr in Chinese and Western medicine group were better than those of in Western medicine group(&lt;i&gt;P&lt;/i&gt;&lt;0.05). During the treatment period, the frequency of gout attacks in Chinese and Western medicine group was lower than that in Western medicine group(&lt;i&gt;P&lt;/i&gt;&lt;0.01). The NRS, PGA scores and TCM syndrome scores of both groups were decreased compared with those of before treatment (&lt;i&gt;P&lt;/i&gt;&lt;0.01), and the improvement of NRS and PGA scores in Chinese and Western medicine group were better than those of in Western medicine group (&lt;i&gt;P&lt;/i&gt;&lt;0.01). One patient developed liver function damage due to taking medicine in Western medicine group, while there were no adverse reactions in Chinese and Western medicine group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;&lt;i&gt;Quzhuo Tongbi&lt;/i&gt; formula() combined with febuxo","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1194-200"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ilizarov technique combined with segmented removal of bone cement for the treatment of composite defects of tibia and soft tissues of skin].","authors":"Yun-Peng Zhang, Jiang-Hua Chen, Wei Qu, Xiu-Min Pi, Hong-Yu Hu, Tong Zhou, Shun-Hong Gao","doi":"10.12200/j.issn.1003-0034.20241027","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20241027","url":null,"abstract":"<p><strong>Objective: </strong>To explore clinical efficacy of Ilizarov technique combined with the segmented removal of bone cement in treating tibial and skin-soft tissue composite defects.</p><p><strong>Methods: </strong>From July 2018 to December 2021, 9 patients with composite defects of tibia and skin and soft tissue of the lower leg were treated by Ilizarov technique combined with segmented removal of bone cement, including 7 males and 2 females, aged from 38 to 52 years old, 4 patients on the left side and 5 patients on the right side;the length of bone defect ranged from 8.0 to 12.0 cm;the wound area ranged from 4.0 cm×5.0 cm to 6.0 cm×10.0 cm. After the infection lesion in the lower leg has been cleared and the infection has been controlled by bone cement filling for 6 to 8 weeks, the bone cement was removed after tibial osteotomy. Then, new bone cement was made and divided into several small sections to fill the bone defect area, leaving a sliding gap. Bone slippage began at 10 days after operation (1 mm/d, performed in 6 sessions). As the slippage progressed, the bone cement segments were removed successively until the connection points were successfully connected and the wound healed. The locking was completed, the mineralization of the sliding gap and bone healing at the docking point were evaluated based on X-ray films from 3 to 6(monthly), 9 and 12 months. The clinical efficacy was evaluated by Paley criteria at 2 years after operation.</p><p><strong>Results: </strong>All 9 patients were followed up for 17 to 30 months. There were no soft tissue collapse or entrapment, and no complications such as infection recurrence occurred on the wound surface during bone segment sliding process. Eight patients achieved successful bony union at the junction, 1 patient achieved bony union after bone grafting at the junction, 6 patients had successful wound healing, and 3 patients underwent surgical adjustment due to indentations of skin margin at the junction, which affected the appearance. All the wounds achieved primary healing after operation. Two years after operation, the therapeutic effect was evaluated according to Paley standard, 7 patients got excellent results and 2 good.</p><p><strong>Conclusion: </strong>Ilizarov technique combined with segmented removal of bone cement could simultaneously address composite defects of tibia and skin soft tissue of the lower leg, reducing flap surgery and avoiding complications such as soft tissue collapse and entrapation during bone segment sliding.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1276-81"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of efficacy of high-frequency ultrasound and magnetic resonance imaging of shoulder joint in the diagnosis of rotator cuff tears].","authors":"Li-Qi Liu, Yuan Li, Cong-Cong Liu, Wen Lu, Qing-Jing Ma","doi":"10.12200/j.issn.1003-0034.20240285","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20240285","url":null,"abstract":"<p><strong>Objective: </strong>To compare efficacy of high-frequency ultrasound(US) and MRI in detecting rotator cuff tears.</p><p><strong>Methods: </strong>From June 2023 to January 2024, 104 patients with unilateral shoulder pain or dysfunction were selected, including 40 males and 64 females, aged from 29 to 87 years old with an average of (59.8±11.9) years old. Methods 7 patients caused by trauma and 97 patients caused by non-trauma. All patients were underwent US and MRI examinations, and taking results of arthroscopic surgery as gold standard; the accuracy rate, positive coincidence rate, negative coincidence rate and total coincidence rate of US and MRI in diagnosis of rotator cuff tears were compared, and the diagnostic efficacy between two methods were analyzed.</p><p><strong>Results: </strong>Eighty-two patients was diagnosed as rotator cuff tears by arthroscopy(67 patients with partial tears and 15 patients with full-thickness tears), positive rate was 78.8%, accuracy rate of US in diagnosing rotator cuff tear was 29.3% (24/82), and that of MRI was 47.6%(39/82). Moreover, the diagnostic efficacy of MRI was significantly higher than that of US(<i>χ</i>²=5.799, <i>P</i>=0.061). According to analysis of tear depth, the accuracy rate of US in diagnosing full-thickness tears was 46.7% (7/15), and that of MRI was 53.3%(8/15), with no statistically significant difference (<i>P</i>=0.715). The accuracy rate of US in diagnosing partial tear was 25.3% (17/67), significantly lower than 46.2% (31/67) of MRI, and the difference was statistically significant (<i>χ</i>²=6.362, <i>P</i>=0.012). The total coincidence rates of US, MRI and the combined diagnosis of US+MRI for rotator cuff tear were 51.0%, 62.5% and 66.3% respectively.</p><p><strong>Conclusion: </strong>MRI is superior to US in diagnosing rotator cuff tears, especially partial tears, and comparable in diagnosing full-thickness tears. When combined diagnosis of US and MRI could further improve diagnostic efficiency, it is recommended to apply it in combination in clinical practice.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1231-5"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Calculation of personalized safety zone of hip joint prosthesis in patients with ankylosing spondylitis and analysis of influencing factors].","authors":"Yin-Xi Chen, Geng Liu, Peng-Ge Fu, Qi-Zhong Wang, Yu-Xin Wang, Hui Li","doi":"10.12200/j.issn.1003-0034.20240374","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20240374","url":null,"abstract":"<p><strong>Objective: </strong>To explore safe zones for acetabular prosthesis implantation in patients with ankylosing spondylitis (AS) at different anterior pelvic plane tilts (APPt), and to determine the optimal implantation angle of the prosthesis through the safe zones with different ranges of motion. To explore the influencing factors of size and scope of the safe zone.</p><p><strong>Methods: </strong>CT data of pelvis before total hip arthroplasty (THA) in a 54-year-old male patient with Tonnis stage Ⅳ left hip arthritis, and virtual THA simulated by computer prosthesis with a femoral head diameter of 32 mm, a head-to-neck ratio of 2.67, and a cervical-shaft angle of 132° was selected and assembled by tilting forward by 15°. After defining the target range of motion of hip joint that could meet functions such as standing, sitting, and squatting, acetabular prosthesis implantation safety zones corresponding to bony impact and prosthesis impact when the anterior pelvic plane inclination angles are -10°, -5°, 0°, 5°, 10°, 15°, 20° and 25° respectively were calculated. A model to change the parameters of the femoral prosthesis was select and calculated the safety zone when different prostheses were implanted.</p><p><strong>Results: </strong>When the range of motion of spine and pelvis disappeared, the safe zone for implant placement could meet the requirements of standing, sitting and squatting was extremely small. When the pelvis was tilted forward by 10° to backward by 25°, the abduction angle of acetabular implant could meet the daily range of motion decreased from 55.7° to 45.8°, and the forward inclination angle decreased from 29.9° to 7.4°. The diameter of femoral head was positively correlated with the size of safe zone. Within the range of 24 to 32 mm, for every 0.17 mm increased in the diameter of femoral head, the safe range of acetabular anterior inclination angle and abduction angle increased for 4° to 6°. For the ball head of the same diameter, the safety zone showed a trend of first increasing and then decreased with the increase of cervical shaft angle or anterior inclination angle of femur.</p><p><strong>Conclusion: </strong>When AS patients undergo THA, precise implantation techniques are required to obtain a safe range of motion that could meet the requirements of standing, sitting and squatting. For patients with obvious anterior or posterior pelvic tilt, personalized prosthesis implantation should be carried out to reduce prosthesis suspension and impact on the iliopsoas muscle. Large-diameter femoral head prostheses are more sensitive to changes in the cervical shaft angle and anterior inclination angle, and the area of the implanted combined safety zone is larger.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1249-55"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evidence evaluation of electroacupuncture treatment for gouty arthritis based on GRADE and integrated evidence chain-based efficacy evaluation of traditional Chinese medicine].","authors":"Ke Zhu, Guang-Cheng Wei, Xin-Wen Zhang, Rui Ma, Ye Luo, Xie-Yu Zhang, Jin-Jie Shi, Yue Yang, Xiao-Xu Li, Hong-Yu Yang, Jia-He Zhao, Jie-Yang Du, Yu-Long Ya, Jiu-Cheng Peng, Wei Cao","doi":"10.12200/j.issn.1003-0034.20250654","DOIUrl":"10.12200/j.issn.1003-0034.20250654","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate quality of evidence for electroacupuncture in treating gouty arthritis (GA) by grading of recommendations assessment, development and evaluation (GRADE) method and integrated evidence chain-based efficacy evaluation of traditional Chinese medicine (iEC-Eff).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Literatures published on PubMed, Web of Science, Cochrane Library, Embase, China national knowledge infrastructure(CNKI), Chinese science and technology journal database (VIP), and Wanfang medical journal database databases and Chinese biomedical (CBM) literature database were included by computer, the retrieval period was from establishment of database to April 2025, including randomized controlled trials (RCTS), experimental studies and clinical experience literature on electroacupuncture treatment of GA. The quality of RCTS was evaluated using Cochrane risk of bias tool andstandards for reporting interventions in clinical trials of acupuncture (STRICTA). Meta-analysis was conducted by Stata 18 software. The quality of evidence for outcome measures was rated by GRADE tool. Multi-dimensional evidence was integrated through iEC-Eff.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the GRADE evaluation, the evidence for indicators such as blood uric acid and visual analogur scale (VAS) for pain of single electroacupuncture intervention was grade C(low-quality evidence). The combination of acupuncture and medication reduced blood uric acid and improved the inflammatory indicators C-reactive protein (CRP) and erythrocyte sedimentation reaction (ESR) was grade B (moderate-quality evidence). The evidence for indicators such as cytokines was Grade C (low-quality evidence). In iEC-Eff evaluation, clinical empirical evidence was rated as grade B, experimental research evidence was rated as grade A, clinical trial evidence was rated as Grade B, and comprehensive assessment was BAB (intermediate evidence). The differences between GRADE and iEC-Eff evaluation systems stem from the fact that the former has a high requirement for the rigor of research design, while the latter conforms to the overall model of traditional Chinese medicine. Electroacupuncture combined with Western medicine has advantages in reducing uric acid and anti-inflammation, but high-quality RCT verification is required.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Electroacupuncture treatment for gouty arthritis could improve symptoms such as redness, swelling, heat and pain in the joints, lower blood uric acid levels, and alleviate joint inflammatory responses (such as ESR, CRP and other indicators). The evidence quality is relatively high and it has a good clinical application prospect. GRADE and Eff-iEC each have their own advantages in the evidence evaluation of electroacupuncture treatment for gouty arthritis. In the future, it is necessary to combine the two to optimize the evaluation system of the efficacy of traditional Chinese medicine and promote the accumulation of evidenc","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1260-70"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus on clinical application of absorbable polymer screw on foot and ankle surgery].","authors":"Ya-Min Li, Guo-Hua Mei, Tian-Yi Wu, Ting Li, Hui Du, Qin-Wei Guo, Xu Wang, Yun-Feng Yang, Hai-Lin Xu, Jin-Song Hong, Hui Zhang, Ming-Zhu Zhang, Shi-Jun Wei, Yong-Zhan Zhu, Yu Zhang, Ying Guo, Hong-Mou Zhao, Lu Bai, Can-Jun Zeng, Jian-Yi Yang, Xiu Xu, Lei Wang, Ming-Jie Tang, Zhong-Min Shi, Xin Ma","doi":"10.12200/j.issn.1003-0034.20250472","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250472","url":null,"abstract":"<p><p>Expert consensus on clinical application of absorbable polymer screw in foot and ankle surgery was developed by Foot and Ankle Committee of Orthopedic Branch of Chinese Medical Doctor Association, Foot and Ankle Committee of Sports Medicine Physician Branch of Chinese Medical Doctor Association, Foot and Ankle Group of Orthopedic Branch of Shanghai Medical Associationand, and Foot and Ankle Alliance of National Orthopedic Medical Center of Shanghai Sixth People's Hospital. Based on evidence-based medicine and expert clinical experience, this consensus provides academic guidance for foot and ankle surgeons regarding the clinical use of absorbable polymer screw. The key topics include clinical indications, practical applications, and relevant considerations for absorbable nail rod systems in foot and ankle surgery.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1215-23"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Predictive value of urate deposition volume for refractory gout development in gout patients].","authors":"Cun-Xiang Xie, Jian Mei, Xiao-Ying Hou, Jin-Ying Fang, Yi-di Huang, Jian Huang, Guan-Cheng Ye, Hao Wang, Hai-Long Wang","doi":"10.12200/j.issn.1003-0034.20250812","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250812","url":null,"abstract":"<p><strong>Objective: </strong>To analyze deposition of sodium urate in patients with gout, and to explore predictive value of sodium urate deposition for the occurrence of refractory gout (RG) by dual-energy CT imaging technique.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on basic data of 176 gout patients admitted from March 2023 to June 2025, including 171 males and 5 females, aged from 22 to 71 years old with an average of(43.16±10.82) years old. According to diagnostic criteria, the patients were divided into RG group and non-RG group. There were 92 patients in RG group, including 90 males and 2 females, aged from 24 to 66 years old with an average of (44.62±11.12) years old;there were 84 patients in non-RG group, including 81 males and 3 females, aged from 22 to 71 years old with an average of (41.46±10.31) years old. The courses of hyperuricemia, uric acid and deposition amounts of monosodium urate(MSU) between two groups were compared. Multivariate Logistic regression was used to analyze influencing factors of RG, receiver operating curve (ROC) was plotted, and area under the curve(AUC) was calculated, in order to evaluate predictive value of MSU deposition for RG.</p><p><strong>Results: </strong>The courses of hypertension and hyperuricemia and deposition amount of MSU between two groups were statistically significant (<i>P</i><0.05). Logistic analysis reault showed intra-articular MSU deposition[<i>OR</i>=5.402, 95%<i>CI</i>(2.095, 13.933), <i>P</i><0.01], hypertension[<i>OR</i>=2.724, 95%<i>CI</i>(1.209, 6.134), <i>P</i><0.05], courses of hyperuricemia [<i>OR</i>=1.122, 95%<i>CI</i>(1.032, 1.219), <i>P</i><0.01] were independent risk factors for RG. AUC of MSU deposition for predicting RG was 0.824[95%<i>CI</i>(0.763, 0.885), <i>P</i><0.01], and sensitivity was 63%, specificity was 92.9%, and the optimal cut-off value was 0.410 cm³.</p><p><strong>Conclusion: </strong>MSU deposition could increase risk of RG, and the amount of MSU deposition in joint cavity could provide a reference for early identification of patients with RG.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1210-4"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical research and application of intraoperative reduction quality assessment for unstable ankle fractures in surgical treatment].","authors":"Zi-Lai Yang, Ling-Ling Wang, Xin-Bo Han, Mei-Ling Sun, Xiu-Jun Teng","doi":"10.12200/j.issn.1003-0034.20240624","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20240624","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore methods for improving reduction quality of unstable ankle fractures through surgical treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From January 2020 to January 2022, preoperative X-ray films of healthy ankle acupoints of patients were taken. Talocrural angle (TCA) of healthy ankle joint, Shenton line, medial clear space (MCS) of ankle joint, and superior clear space (SCS)of tibial joint, tibiofibular overlap (TFO), and lateral malleolus morphology (referred to as the hexaenet) were measured and observed, and compared with above indicators of C-arm X-ray fluoroscopy after intraoperative reduction and temporary fixation, compare whether there were changes in hexagram and adjust reduction treatment in a timely manner for 31 patients with unstable ankle fractures, included 18 males and 13 females; aged from 22 to 70 years old with an average of (45.1±7.2) years old;17 patients on the left side, 14 patients on the right side; 6 patients caused by sprains, 13 caused by traffic injuries, and 12 caused by injuries from being hit by heavy objects; the time from injury to operation ranged from 1 to 11 days with an average of (4.5±1.6) days. There were 11 patients with severe comminuted fractures of lateral malleolus, 12 patients with bilateral malleolus fractures, and 8 patients with triple malleolus fractures. Among them, 10 patients were combined with separation of inferior tibiofibular syndesmosis, and 3 patients were combined with injury of medial collateral ligament. The intraoperative reduction, fracture healing, complications were observed, and functional evaluation was conducted by American Orthopaedic Foot and Ankle Society (AOFAS) score at 12 months after operation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 31 patients were followed up and the duration ranged from 12 to 20 months with an average of (14.5±1.2) months. C-arm X-ray fluoroscopy after intraoperative reduction and temporary fixation showed compared with healthy side, there were 9 patients of abnormal TCA, 8 patients of abnormal Shenton line, 11 patients of abnormal MCS, 12 patients of abnormal SCS, 3 patients of abnormal TFO, 5 patients of abnormal lateral malleolus morphology, and 21 patients of abnormal combined judgment of the six signs. There were statistically significant difference between combined judgment of the six signs and the judgment of a single indicator (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Twenty-six patients with normal bone healing, 4 patients with delayed bone healing, and 1 patient with bone nonunion caused by bone resorption. There were no complications such as infection and skin necrosis. Postoperative AOFAS score at 12 months was (89.08±5.23) points, 18 patients got excellent result, 9 patients good, 3 patients moderate and 1 patient poor.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Surgical treatment for unstable ankle fractures involves taking preoperative X-ray films of the healthy ankle points of patient, measuring and observing the hexagram to obtain pers","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1236-40"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical efficacy of external locking plate combined with platelet-rich plasma injection in the treatment of open tibiofibular fractures].","authors":"Yin-Chu Shao, Wen-Bo Xu, Hao Li, Xiang Peng, Di Yang, De-En Wan, Ji-Chun Liu, Li-Ling Liu, Feng Shuang","doi":"10.12200/j.issn.1003-0034.20240895","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20240895","url":null,"abstract":"<p><strong>Objective: </strong>To explore clinical efficacy of external locking plate combined with platelet-rich palasma (PRP) in treating open fractures of tibia and fibula.</p><p><strong>Methods: </strong>From November 2019 to May 2022, 13 patients with open fractures of tibia and fibula were admitted, including 11 males and 2 females, aged from 20 to 56 years old;6 patients with Gustilo typeⅡand 7 patients with type Ⅲ;all patients were treated with external tibial plate fixation for tibiofibular fractures in emergency department, combined with PRP injection at the fracture ends and wounds. The fracture healing time and complications were observed. The fracture healing was evaluated based on Lane-Sandhu X-ray score, ankle joint function was evaluated by Kofoed score at 3 months after operation and at the latest follow-up, respectively.</p><p><strong>Results: </strong>All patients were followed up for 6 to 24 months. Thirteen patients met requirements of bony union, and healing time ranged from 8 to 16 weeks. There were no complications such as infection, dislocation or loose fixation after operation. Lane-Sandhu X-ray score increased from 1 to 7 points at 3 months after operation to 10 points at the latest follow-up. Kofoed ankle joint function score increased from 21 to 48 points at 1 month after operation to 63 to 90 points at 3 months after operation, and then increased to 79 to 98 points at the latest follow-up. There were 11 patients got excellent result and 2 good.</p><p><strong>Conclusion: </strong>External locking plate combined with PRP for the treatment of open tibiofibular fractures could achieve good fracture healing and ankle joint function, and the clinical effect is satisfactory.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 12","pages":"1271-5"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of efficacy between unilateral biportal endoscopic technique and percutaneous interlaminar approach spinal endoscopic technique in the treatment of highly migrated lumbar disc herniation].","authors":"Long Wang, Er Wang, Hai-Dong Li, Ji-Kang Min","doi":"10.12200/j.issn.1003-0034.20240963","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20240963","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical efficacy of unilateral biportal endoscopic discectomy(UBE) and percutaneous interlaminar endoscopic discectomy(PIED) in the treatment of highly migrated lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 43 patients with highly migrated LDH who underwent spinal endoscopic surgery between January 2022 and December 2023. In the UBE group 22 patients included 8 males and 14 females, aged 49 to 59 years old with a mean of (54.13±2.07) years old. In the PIED group 21 patients included 11 males and 10 females, aged 49 to 59 years old with a mean of (55.04±2.80) years old. Perioperative parameters including intraoperative blood loss, operative time, and fluoroscopic exposures were compared between groups. Clinical outcomes were assessed using the visual analogue scale (VAS) for pain, Oswestry disability index (ODI), and modified MacNab criteria. Complications during the perioperative period and follow-up were recorded.</p><p><strong>Results: </strong>In the PIED group, there were 3 cases of nerve injury, 1 case of residual nucleus pulposus, and 1 case of dural injury. In the UBE group, there was 1 case of nerve injury and 1 case of cerebrospinal fluid leakage. No infections or major bleeding occurred in either group. All patients completed surgery and were followed up for at least 12 months. The UBE group had significantly more intraoperative blood loss (39.09±6.10) ml and more fluoroscopic exposures (6.45±0.26) than the PIED group (34.05±5.62) ml and (3.24±0.28) with significant difference (<i>P</i><0.05). Preoperative VAS and ODI showed no significant differences between two groups (<i>P</i>>0.05). Both groups demonstrated significant improvements in VAS and ODI postoperatively (<i>P</i><0.001). At the 3rd days postoperatively, the UBE group had a significantly lower leg pain VAS (2.27±0.20) than the PIED gruop(2.95±0.24) with significant difference (<i>P</i><0.05), but no significant differences were observed at the first or 12th months (<i>P</i>>0.05). No significant differences in ODI were found between two groups during follow-up (<i>P</i>>0.05). At the 1st month postoperatively, according to modified MacNab criteria, 15 patients got excellent results, 4 good, and 2 fair in PIED group;and 18 patients got excellent results, 2 good, and 2 fair in UBE group, with no significant difference between two groups(<i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Both PIED and UBE are effective surgical methods for treating highly migrated LDH. Compared with PIED, UBE involves slightly longer operative time, more blood loss, and more fluoroscopic exposures, but carries a lower risk of nerve injury.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"38 11","pages":"1093-9"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}