中国修复重建外科杂志最新文献

{"title":"[Efficacy and safety of emergency administration of tranexamic acid in elderly patients with intertrochanteric femoral fractures].","authors":"Chen Rui, Guangchun Dai, Wenbin Fan, Shaoyang Zhou, Chuwei Tian, Liu Shi, Tian Xie, Cheng Zhang, Xiangxu Chen, Hui Chen, Yunfeng Rui","doi":"10.7507/1002-1892.202511095","DOIUrl":"10.7507/1002-1892.202511095","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of emergency administration of tranexamic acid (TXA) in reducing perioperative blood loss and blood transfusion rate in elderly patients with intertrochanteric femoral fractures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 102 elderly patients with intertrochanteric femoral fractures who were admitted between October 2023 and May 2025 and met the selection criteria. Patients were divided into two groups based on whether TXA was administered in the emergency department: the TXA group (patients received a single intravenous infusion of 1 g TXA immediately upon emergency admission, <i>n</i>=50) and the control group (no TXA was used in the emergency department, <i>n</i>=52). There was no significant difference in baseline data between the two groups ( <i>P</i>>0.05), including age, gender, body mass index, American Society of Anesthesiologists (ASA) classification, AO/Orthopaedic Trauma Association (AO/OTA) fracture classification, underlying comorbidities, prothrombin time, activated partial thromboplastin time, fibrin degradation products, D-dimer, bone mineral density T-score, time from injury to admission, time from admission to surgery, hemoglobin (HB), and hematocrit (HCT) levels at emergency admission. The following parameters were collected and analyzed statistically: changes in HB and HCT on the day before surgery (compared with values at emergency admission); hidden blood loss (HBL) on the day before surgery; total blood loss (TBL) on postoperative day 1, day 3, and during the entire perioperative period; in-hospital blood transfusion rate; and incidence of complications such as thrombosis.</p><p><strong>Results: </strong>There was no significant difference in operation time between the two groups ( <i>P</i>>0.05). All patients were followed up 3-12 months (mean, 6.6 months). On the day before surgery, the decreases in HB and HCT in the TXA group were significantly lower than those in the control group ( <i>P</i><0.05). The HBL on the day before surgery and perioperative TBL in the TXA group were significantly lower than those in the control group ( <i>P</i><0.05), whereas there was no significant difference in TBL on postoperative day 1 or day 3 between the two groups ( <i>P</i>>0.05). The in-hospital blood transfusion rate in the TXA group (34.0%) was significantly lower than that in the control group (55.8%, <i>P</i><0.05). During hospitalization and follow-up, no complication such as deep vein thrombosis of the lower extremities, pulmonary embolism, surgical site infection, or allergic reactions occurred in either group. Intermuscular venous thrombosis occurred in 4 patients (8.0%) in the TXA group and 5 patients (9.6%) in the control group, with no significant difference in incidence between the two groups ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Elderly patients with intertrochanteric femoral fractures ","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"526-532"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Morphological characteristics and clinical significance of os subfibulare in patients with chronic ankle instability].","authors":"Xinfang Duan, Junqiu Wang, Jianyao Chen, Zheheng Li, Yue Zhao, Xin Zhou, Lei Zhang","doi":"10.7507/1002-1892.202511013","DOIUrl":"10.7507/1002-1892.202511013","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the morphological characteristics of the os subfibulare (OSF) and evaluate its clinical association with chronic ankle instability (CAI).</p><p><strong>Methods: </strong>Imaging data of 130 patients with OSF between January 2015 and August 2025 were retrospectively analyzed, including 82 males and 48 females with a mean age of 30.6 years (range, 10-80 years). Patients were divided into CAI group ( <i>n</i>=74) and non-CAI group ( <i>n</i>=56). X-ray films were used for screening, while CT images were used to measure the parameters related to the shape and spatial location of the OSF, including the maximum diameter, maximum area, distance from the OSF center to the fibular tip, distance from OSF to the talus, and the angle between the OSF and the fibular long axis. OSFs were classified as regular or irregular. MRI categorized OSF location into three zones based on ligament attachment sites: zone Ⅰ [anterior talofibular ligament (ATFL)], zone Ⅱ (calcaneofibular ligament), and zone Ⅲ (posterior talofibular ligament). Bone interface fluid signal, bone marrow edema, and ATFL injury were recorded. The patients with CAI were stratified and analyzed to compare the differences in the location, shape and spatial localization of the OSF (the maximum diameter of OSF, the distance from the OSF center to the fibular tip, the angle between the OSF and the fibular long axis) and MRI signs between different genders and between different affected sides.</p><p><strong>Results: </strong>CT measurements showed that, compared with the non-CAI group, the CAI group exhibited differences in spatial localization of the OSF. The distance from the OSF center to the fibular tip was significantly greater in the CAI group ( <i>P</i><0.05), whereas the distance from OSF to the talus, and the angle between the OSF and the fibular long axis showed no significant difference ( <i>P</i>>0.05). Regarding morphology and size, the maximum diameter of OSF was significantly larger in the CAI group ( <i>P</i><0.05), while no significant difference was found in maximum area of OSF or morphological type ( <i>P</i>>0.05). MRI findings showed that OSFs were predominantly located in zone Ⅰ in both groups, followed by zones Ⅱ and Ⅲ. There was no significant difference in distribution between groups ( <i>P</i>>0.05). The incidences of bone marrow edema, bone interface fluid signal, and ATFL injury were significantly higher in the CAI group than in the non-CAI group ( <i>P</i><0.05). Within the CAI group, no significant difference was observed between genders or affected sides in terms of OSF location, morphology, spatial parameters, or MRI findings ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Patients with CAI showed a larger maximum OSF diameter and a greater distance from the OSF center to the fibular tip, and were more frequently accompanied by MRI findings such as bone marrow edema, bone interface fluid signal, and ATFL injury. These imag","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"584-590"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparative observation of analgesic efficacy between liposomal bupivacaine and \"cocktail\" therapy following artificial intelligence-assisted direct anterior approach total hip arthroplasty: A prospective randomized controlled study].","authors":"Yuyang Zhai, Xun Cao, Shanbin Zheng, Zhiyuan Chen, Xinyi Hou, Tianchen Zhang, Chao Zhang, Tianwei Xia, Jirong Shen","doi":"10.7507/1002-1892.202511055","DOIUrl":"10.7507/1002-1892.202511055","url":null,"abstract":"<p><strong>Objective: </strong>To compare the analgesic efficacy and safety of liposomal bupivacaine (LB) versus ropivacaine for surgical incision local anesthesia after artificial intelligence (AI)-assisted direct anterior approach (DAA) total hip arthroplasty (THA).</p><p><strong>Methods: </strong>A prospective randomized controlled study was conducted. A total of 120 patients who underwent AI-assisted DAA-THA between March 2024 and January 2025 were enrolled and randomly assigned to the LB group ( <i>n</i>=60) or the \"cocktail\" group ( <i>n</i>=60). Patients in the LB group received an intraoperative injection of LB 266 mg (diluted to 100 mL) around the incision, whereas those in the \"cocktail\" group received a mixture of ropivacaine 200 mg, compound betamethasone 1 mL, and epinephrine 0.5 mg (diluted to 100 mL). Resting and active visual analogue scale (VAS) scores were recorded at 6, 12, 24, 36, 48, 60, and 72 hours and at 2 and 4 weeks postoperatively. Changes in Pain Catastrophizing Scale (PCS) score, Harris hip score, and hip flexion and abduction range of motion at 4 weeks postoperatively relative to preoperative values were assessed. In addition, operation time, incision length, total postoperative oral morphine consumption, time to first ambulation, length of hospital stay, and complications within 72 hours after surgery were recorded and compared between the two groups.</p><p><strong>Results: </strong>There was no significant difference between the two groups in incision length, time to first ambulation, length of hospital stay, or total postoperative oral morphine consumption ( <i>P</i>>0.05). Operation time was significantly longer in the LB group than in the \"cocktail\" group ( <i>P</i><0.05). All patients were followed up for 6 months postoperatively. Both resting and active VAS scores decreased over time in the two groups ( <i>P</i><0.05). Intergroup comparison showed that resting and active VAS scores at 60 and 72 hours postoperatively were significantly lower in the LB group than in the \"cocktail\" group ( <i>P</i><0.05), whereas no significant difference was observed at other time points ( <i>P</i>>0.05). There was no significant difference between the two groups in the changes in PCS score, Harris Hip Score, or hip range of motion at 4 weeks postoperatively ( <i>P</i>>0.05). In the LB group, nausea and vomiting occurred in 3 cases, significant blood glucose fluctuations in 2 cases, superficial incision infection in 1 case, and local hematoma in 1 case; the corresponding numbers in the \"cocktail\" group were 5, 4, 0, and 1 case, respectively. No significant difference was observed between the two groups in the incidence of these complications ( <i>P</i>>0.05). No local allergic reactions, deep vein thrombosis, significant blood pressure fluctuations, deep incision infection, skin necrosis, or pulmonary embolism occurred in either group. At last follow-up, satisfaction rates for analgesic efficacy and hip function both exceeded 90","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"540-547"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Short-term effecetiveness of endoscopic lumbar discectomy combined with annular suturing in treatment of lumbar disc herniation].","authors":"Senyan Zhang, Feng Yao, Zilong Liao, Tingyao Wang, Mao Shen","doi":"10.7507/1002-1892.202512054","DOIUrl":"10.7507/1002-1892.202512054","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the short-term effectiveness of endoscopic lumbar discectomy combined with annular suturing in treatment of lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>A retrospective analysis was performed on the clinical data of 79 patients diagnosed with single-level LDH and admitted between February 2024 and December 2024, who met the selection criteria. Of these patients, 39 underwent a combined endoscopic discectomy with annular suturing (combined group), while 40 received endoscopic discectomy alone (control group). No significant difference was found between groups ( <i>P</i>>0.05) in terms of gender, age, disease duration, surgical level, or baseline measurements, including preoperative visual analogue scale (VAS) scores for back and leg pain, Oswestry disability index (ODI), and intervertebral disc height. The study evaluated and compared several parameters between groups, including operation time, intraoperative blood loss, postoperative complications, VAS scores for back and leg pain, ODI, intervertebral disc height at 1, 3, 6, and 12 months postoperatively, and recurrence during follow-up.</p><p><strong>Results: </strong>The combined group experienced longer operation time compared to the control group ( <i>P</i><0.05). However, there was no significant difference in intraoperative blood loss between groups ( <i>P</i>>0.05). Postoperative complications, such as intervertebral space infection, nerve root injury, cerebrospinal fluid leakage, or deep vein thrombosis of the lower limbs, were absent in both groups. All patients were followed up for 12 months. After operation, the ODI and VAS scores for back and leg pain showed gradual improvement in both groups ( <i>P</i><0.05), yet no significant difference was observed between groups at different time points ( <i>P</i>>0.05). Imaging follow-up indicated a reduction in intervertebral disc height postoperatively in both groups relative to preoperative measurements ( <i>P</i><0.05). No significant difference in disc height between groups was noted at 1 and 3 months ( <i>P</i>>0.05). At 6 and 12 months, the combined group demonstrated significantly greater disc height compared to the control group ( <i>P</i><0.05). During follow-up, recurrence was observed in 1 case (2.56%) of combined group and in 3 cases (7.50%) of control group, showing no significant difference in the incidence of recurrence between groups ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>In comparison to simple lumbar discectomy, endoscopic lumbar discectomy with annular suturing for LDH not only yields comparable short-term effectiveness but also significantly mitigates the postoperative intervertebral disc height collapse, preserves spinal stability, and decelerates the progression of disc degeneration.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"623-629"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Differential analysis of gut microbiome in patients with periprosthetic joint infection, aseptic failure, and osteoarthritis].","authors":"Kari Muzhabaier, Yicheng Li, Fei Wang, Xiaobin Guo, Quan Chen, Xiaogang Zhang, Li Cao","doi":"10.7507/1002-1892.202601002","DOIUrl":"10.7507/1002-1892.202601002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the differences in gut microbiota diversity and structural characteristics among patients with periprosthetic joint infection (PJI), aseptic failure (AF), and osteoarthritis (OA), and to analyze the association between gut microbiota dysbiosis and the occurrence of PJI, thereby providing a new theoretical basis for elucidating the pathogenesis and treatment strategies of PJI in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study enrolled patients with PJI and AF admitted between February 2024 and December 2024, as well as OA patients admitted in February 2024. A total of 52 PJI patients, 19 AF patients, and 29 OA patients who met the selection criteria were included in the analysis. Significant differences were observed among the three groups in terms of gender, age, surgical site, preoperative C-reactive protein levels, and erythrocyte sedimentation rate ( &lt;i&gt;P&lt;/i&gt;&lt;0.05), while no significant difference was found in American Society of Anesthesiologists (ASA) classification and body mass index ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). Among the PJI patients, infection staging was as follows: 9 cases in the acute phase, 28 cases in the delayed phase, and 15 cases in the chronic phase; 23 cases were accompanied by sinus tract formation. Fecal samples were collected at different time points: for the PJI group, samples were obtained preoperatively and on postoperative days (7±1) and (14±1); for the AF group, preoperatively and on postoperative day (7±1); and for the OA group, preoperatively only. Metagenomics next-generation sequencing were employed to analyze gut microbiota α-diversity indices (ACE index, Chao1 index, Shannon index, Simpson index, and observed_species index) and differential bacterial genera (screened using the LEfSe algorithm).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Analysis of gut microbiota diversity showed that the preoperative α-diversity indices (ACE index, Chao1 index, Shannon index, Simpson index, and observed_species index) in the PJI group were significantly lower than those in AF group and OA group ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Compared with the AF group on postoperative day (7±1), the α-diversity indices in the PJI group on postoperative day (7±1) were lower, but the difference was not significant ( &lt;i&gt;P&lt;/i&gt;&gt;0.05); by postoperative day (14±1), these indices further decreased, and the difference was significant ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). In the PJI group, no significant difference was observed in any of the indices across different time points postoperatively ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). Analysis of gut microbiota structural characteristics revealed that the PJI group exhibited characteristic dysbiosis both before and after operation. Preoperatively, the PJI group was characterized by enrichment of &lt;i&gt;Pseudomonadota&lt;/i&gt; (relative abundance 13.19%), &lt;i&gt;Enterobacteriaceae&lt;/i&gt; ( &lt;i&gt;Escherichia&lt;/i&gt; 3.26%, &lt;i&gt;Klebsiella&lt;/i&gt; 1.90%), and opportunistic pathogens such as &lt;i&gt;Enterococcus faecium&lt;/i&gt; (0.43%), while the relative abundances of &lt;","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"548-556"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical application research of three-dimensional printed patient-specific cutting guides in Cole midfoot osteotomy].","authors":"Zhiyuan Zhang, Boquan Qin, Jia Li, Shijiu Yin, Yi Ren, Yu Chen, Xi Liu, Hui Zhang","doi":"10.7507/1002-1892.202510006","DOIUrl":"10.7507/1002-1892.202510006","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate effectiveness of three-dimensional (3D) printed patient-specific cutting guides (PSCGs) in Cole midfoot osteotomy for treatment of rigid pes cavus deformity associated with Charcot-Marie-Tooth (CMT) disease, and to analyze learning curve for PSCGs-assisted surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted of 20 patients (40 feet) with rigid pes cavus deformity associated with CMT who were admitted between March 2021 and July 2023 and met the inclusion criteria. The cohort comprised 13 men and 7 women, with ages ranging from 17 to 62 years (mean, 37.3 years). All patients underwent whole-genome sequencing, which identified 17 patients with CMT type 1 and 3 patients with CMT type 2. Preoperatively, 3D models of bilateral feet were reconstructed based on CT data, and PSCGs were designed and fabricated accordingly. All patients underwent a Cole midfoot osteotomy assisted by the guides. Operation time, number of intraoperative fluoroscopic exposures, and intraoperative complications were recorded. Pre- and post-operative outcomes were compared using the visual analogue scale (VAS) score for pain, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and domain scores of the 36-Item Short Form Health Survey (SF-36), as well as radiographic parameters including the Meary's angle, Pitch angle, talo-first metatarsal angle (T1MT), talocalcaneal angle (TCA), and Djian-Annonier angle, to assess the corrective effect of the osteotomy. A modified cumulative sum analysis was performed to evaluate the learning curve for PSCGs-assisted surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All procedures in the 20 patients (40 feet) were completed successfully, with no cases of massive hemorrhage or injury to critical neurovascular or tendinous structures. The operation time ranged from 63 to 129 minutes (mean, 82.9 minutes), and fluoroscopy was performed 2-11 times (mean, 4.7 times). Postoperatively, 1 patient (1 foot) developed a mild superficial surgical-site infection, which resolved with symptomatic treatment; no deep infections occurred. All patients were followed up 8-43 months (mean, 17 months). At last follow-up, the AOFAS ankle-hindfoot score and all domain scores of the SF-36 were significantly higher than preoperative values, and the VAS score, the Meary's angle, T1MT, TCA, and Djian-Annonier angle significantly decreased, Pitch angle significantly increased ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). The imaging confirmed osteotomy union in all feet, and no fixation-related complications was observed. Learning-curve analysis indicated that both operation time and fluoroscopy usage plateaued after the 13th case, suggesting stabilization of surgical performance from that point onward.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The use of PSCGs during Cole midfoot osteotomy enables precise and efficient correction of complex midfoot deformities while significantly reducing intraoperative fluoroscopic exposu","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"571-577"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of risk factors for postoperative loss of reduction in unstable distal radius fractures and development of a nomogram prediction model].","authors":"Yongliang Liu, Qingzhu Kong, Xiong Zhang","doi":"10.7507/1002-1892.202511063","DOIUrl":"10.7507/1002-1892.202511063","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors for postoperative loss of reduction in unstable distal radius fractures and to develop a predictive model, providing clinicians with a more precise risk assessment tool to support the formulation of individualized treatment plans.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 209 patients with unstable distal radius fractures who met the selection criteria between January 2018 and December 2023. There were 97 males and 112 females, aged 44-81 years with a mean age of 57.1 years. Univariate analysis was performed to identify factors associated with postoperative loss of reduction. Multivariate logistic regression analysis was then used to screen risk factors and construct a nomogram prediction model. The Hosmer-Lemeshow test was applied to assess model fit, while the area under the receiver operating characteristic (ROC) curve (AUC) was calculated to evaluate the predictive performance. Additionally, decision curve analysis was employed to assess the clinical utility of the model.</p><p><strong>Results: </strong>At 6 months after operation, radiographic evaluation showed loss of reduction in 68 cases. Univariate analysis identified the following as influencing factors for postoperative loss of reduction ( <i>P</i><0.05): age, fracture displacement, fracture classification, dorsal metaphyseal comminuted fracture, osteoporosis, operation time, and preoperative serum calcium level. Multivariate analysis confirmed the following as risk factors for postoperative loss of reduction ( <i>P</i><0.05): older age, more severe fracture type (higher AO/OTA classification), presence of fracture displacement, dorsal metaphyseal comminuted fracture, low preoperative serum calcium level, osteoporosis, and prolonged operation time. The nomogram prediction model constructed based on these factors demonstrated high accuracy in assessing the risk of loss of reduction, with an AUC of 0.946 (95% <i>CI</i>: 0.917, 0.975). The calibration curve showed good agreement between predicted and observed probabilities ( <i>χ</i> ²=4.735, <i>P</i>=0.785). Decision curve analysis indicated that when the predicted risk of postoperative loss of reduction exceeds 0.1, timely intervention can yield substantial net clinical benefit.</p><p><strong>Conclusion: </strong>Older age, AO/OTA type C fractures, fracture displacement, dorsal metaphyseal comminuted fracture, prolonged operation time, low preoperative serum calcium level, and comorbid osteoporosis are the main risk factors for postoperative loss of reduction in patients with unstable distal radius fractures. The established predictive nomogram model enables clinicians to more accurately assess the risk of postoperative loss of reduction and provides valuable support for personalized treatment decisions.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"591-596"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress of robot-assisted total knee arthroplasty for valgus knee from perspective of precision medicine].","authors":"Chengji Qin, Hai You, Rui Zhang","doi":"10.7507/1002-1892.202512014","DOIUrl":"10.7507/1002-1892.202512014","url":null,"abstract":"<p><strong>Objective: </strong>To systematically summarize the application and research progress of robot-assisted total knee arthroplasty (TKA) in the treatment of valgus knee from the perspective of precision medicine in recent years, so as to provide a reference for the clinical treatment of valgus knee.</p><p><strong>Methods: </strong>Relevant domestic and foreign literature, including clinical studies and evidence-based evaluations regarding robot-assisted TKA versus conventional TKA for valgus knee, was reviewed. A systematic analysis was performed focusing on technical advantages, efficacy differences and existing controversies.</p><p><strong>Results: </strong>Conventional TKA is limited by surgeons' experiences, leading to insufficient accuracy in alignment correction, great challenges in soft tissue balance, and postoperative residual deformity. Robot-assisted TKA is significantly superior to conventional approaches in terms of alignment correction accuracy, joint function improvement, and reduction of postoperative complication rates, with confirmed short-term effectiveness. Nevertheless, controversies remain concerning the limitations of robot applicability, prolonged operation time and uncertain long-term effectiveness.</p><p><strong>Conclusion: </strong>Robot-assisted TKA provides a precision-oriented therapeutic option for valgus knee with remarkable short-term effectiveness. Further large-sample studies with long-term follow-up are still required to verify its efficacy and facilitate its clinical popularization.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"675-680"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Protective effect and mechanism of TSPAN9-mediated mitocytosis in interleukin-1β-induced rat chondrocyte senescence].","authors":"Quan Chen, Wacili Da, Naijia Luo, Bin Shen","doi":"10.7507/1002-1892.202602016","DOIUrl":"10.7507/1002-1892.202602016","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the regulatory role and molecular mechanisms of TSPAN9-mediated mitocytosis in an interleukin-1β (IL-1β)-induced rat chondrocyte senescence model, and to identify novel therapeutic targets for osteoarthritis (OA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Primary knee articular chondrocytes were isolated from the cartilage of knee joints harvested from 1-week-old male Sprague-Dawley rats and maintained in culture. Cell viability was assessed using the cell counting kit 8 (CCK-8) assay, and cell-cycle distribution was analyzed by flow cytometry to determine the optimal concentration and exposure time of IL-1β for model induction, thereby establishing an &lt;i&gt;in vitro&lt;/i&gt; chondrocyte senescence model [early-OA (E-OA), middle-OA (M-OA), late-OA (L-OA)] and grouped. Cellular senescence was evaluated by senescence-associated β-galactosidase (SA-β-gal) staining. Real-time quantitative PCR (qRT-PCR) was used to quantify the mRNA expression levels of senescence markers [cyclin-dependent kinase inhibitor 2A (Cdkn2a) and Cdkn1a], extracellular matrix (ECM) catabolic-anabolic genes [collagen type Ⅱ alpha 1 chain (Col2a1), Aggrecan (Acan), matrix metalloproteinase 13 (MMP-13), and a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS5)], and key mitocytosis-related genes [kinesin family member 5B (KIF5B), TSPAN9, and TSPAN4]. Mitochondrial ultrastructure and mitocytosis-related morphological features were examined by transmission electron microscopy, and changes in mitochondrial membrane potential were assessed using the JC-1 fluorescent probe. To activate TSPAN9 expression, chondrocytes were transduced with a TSPAN9-overexpressing lentivirus (LV-TSPAN9). The experiments included four groups: control group, M-OA group, lentivirus negative control group, and LV-TSPAN9 group. After confirming overexpression efficiency, differences in cellular senescence, mitochondrial homeostasis, and key ECM metabolic indices were compared among the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Using CCK-8 assays and cell-cycle analysis, the staged rat chondrocyte senescence model induced by IL-1β (5 ng/mL), and defined 12, 24, and 48 hours as the E-OA, M-OA, and L-OA senescence phenotypes were successfully established, respectively. Model validation demonstrated that, with prolonged induction, the proportion of SA-β-gal-positive cells increased markedly, mitochondrial membrane potential progressively declined ( &lt;i&gt;P&lt;/i&gt;&lt;0.05), and mitochondrial ultrastructural damage became increasingly severe. qRT-PCR showed progressive upregulation of the senescence markers Cdkn2a and Cdkn1a, as well as the ECM catabolic genes MMP-13 and ADAMTS5 ( &lt;i&gt;P&lt;/i&gt;&lt;0.05), together with sustained downregulation of the ECM anabolic genes Col2a1 and Acan ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Notably, the key mitocytosis-related genes KIF5B, TSPAN4, and TSPAN9 displayed a biphasic pattern, with early compensatory upregulation followed by decompensatory decline at the middle-t","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"643-655"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of lamina formation range on lumbar biomechanics in unilateral biportal endoscopic spine surgery: a finite element analysis for surgical optimization].","authors":"Shuo Ji, Bingxu Ma, Yang Zou, Menglong Zhang, Mingyu Ren, Huanyu Li, Keyou Duan, Chen Xu, Changchun Zhang, Yuchen Ye, Pinghui Zhou","doi":"10.7507/1002-1892.202511054","DOIUrl":"10.7507/1002-1892.202511054","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of different lamina formation ranges on the biomechanical stability of L ₅, S ₁ in spine surgery with unilateral biportal endoscopy (UBE), providing a theoretical basis for optimizing clinical surgical plans.</p><p><strong>Methods: </strong>A complete lumbar finite element model (M0) was constructed based on CT data of L ₃-S ₁ from a healthy male volunteer. Four different UBE surgical models with varying lamina formation ranges (M1-M4) were simulated. M1 model involved initial laminectomy with essentially intact facets; M2 model involved minor facet resection (5-10 mm from the inferior facet joint surface); M3 model involved greater facet resection with partial laminectomy depth >10 mm; M4 model involved complete facet resection to simulate extreme decompression. Finite element analysis was performed to assess the range of motion (ROM), maximum displacement, and maximum von Mises stress of the vertebrae under different physiological activities (flexion, extension, left/right bending, and left/right rotation), as well as the maximum displacement and maximum von Mises stress of the intervertebral disc, and the maximum von Mises stress of right facet joints under left rotation and right bending.</p><p><strong>Results: </strong>With increasing forming range, the ROM of the vertebrae in flexion showed a slight increase (0.32° higher in M4 model than in M0 model), and the maximum displacement generally increased in all motion states. For the intervertebral disc, the maximum von Mises stress and displacement increased mildly in flexion and left rotation, which were approximately 17% and 12% higher in M3 and M4 models than in M0 model, respectively. And the biomechanical parameters changed little among different models under extension, right rotation, and left bending. The von Mises stress of the right facet joint increased stepwise with forming range during left rotation (about 57% higher in M3 model than in M0 model) and was higher in all surgical models than in M0 model during right bending.</p><p><strong>Conclusion: </strong>Expanding the lamina formation range in UBE spine surgery can lead to reduced stability in flexion and left rotation activities at L ₅, S ₁, increasing the mechanical load on the intervertebral disc and facet joints. Clinically, under the premise of achieving adequate decompression, prioritizing a forming range corresponding to the lower transverse width partition (25%-50%) may better balance decompression efficacy with biomechanical stability of the L ₅, S ₁ segment, thereby reducing the potential risk of long-term degeneration caused by excessive bony resection.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"40 4","pages":"616-622"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}