Objective To evaluate the clinical results of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP)lesions in patients with recurrent shoulder dislocations.Methods Between May 2011 and January 2015,we reviewed 15 cases with combined Bankart and SLAP lesions with recurrent shoulder dislocations who underwent arthroscopic repair.Their average age during surgery was 24.2 years (ranging from 16 to 38 years).During the operation,we began by repairing the unstable SLAP lesion with absorbable suture anchors before we repaired Bankart lesion from the inferior to superior.Fifteen patients in the control group had isolated Bankart lesions without SLAP lesions and underwent arthroscopic repair.Their mean age was 24.6 years (ranging from 18 to 35 years).The preoperative and postoperative results were analyzed by Visual Analogue Scale (VAS)for pain,the range of motion,American Shoulder and Elbow Surgeon (ASES)and Rowe Shoulder Scores Systems.We compared the results with the isolated Bankart lesion. Results For patients who underwent arthroscopic repair of combined Bankart and SLAP lesions,the mean postoperative follow-up period was 15 months (ranging from 13 to 28 months),vs 22 months (ranging from 21 to 34 months)in the control group.VAS for pain was decreased from preoperative 4.9 to postoperative 1.9 (P <0.05).Mean ASES and Rowe Shoulder Scores were improved from preoperative 56.4 and 33.7 to postoperative 91.8 and 94.1,respectively (P <0.05). Recurrent dislocation was not observed until the last follow-up and anterior instability in two groups was not noted during the physical examination.Compared with the isolated Bankart lesion group,no statistical significance was found in the ASES score,Rowe Shoulder Score,or VAS for pain (P >0.05 ).Anterior flexion,abduction,and internal rotation of the affected shoulder during the last follow-up were normal after surgery.Conclusion For recurrent dislocation of the shoulder with combined Bankart and SLAP lesion,arthroscopic repair using absorbable suture anchors can achieve favorable clinical results.It can effectively restore shoulder function.

Objective To observe the clinical effect of Expert A2FN treating the adult femoral shaft fractures and evaluate its clini-cal value. Methods From May 2010 to May 2014, there were 23 adults of femoral shaft fractures treated by Expert A2FN internal fixa-tion in our hospital, 15 men and 8 women, aged 19-58 years, mean 37. 27 ± 10. 34 years old. Patients were followed up 3-28 months, an average of 15 months. Results Totally 23 patients had been followed up, fracture healing normally, no incision and bone infection, no broken nails and nail back phenomenon, no limb vascular thrombosis, muscle atrophy and joint dysfunction, etc. Conclusion Expert A2FN is an ideal treatment for adult femoral shaft fractures. It has small surgical trauma, less bleeding, short period and high fracture healing rate significantly.

Objective To evaluate the clinical results of one-stage artiifcial humeral head replacement in the treatment of comminuted proximal humeral fractures in the elderly. Methods From December 2010 to October 2014, 19 patients with comminuted proximal humeral fractures were adopted and treated, whose mean age was 71.3 years old ( range:63-85 years ). There were 8 cases of Neer 3-part fractures and 11 cases of Neer 4-part fractures, accompanied by dislocation of the humeral head in 7 cases, brachial plexus injuries in 3 cases, ipsilateral distal radius fractures in 2 cases and ipsilateral femoral neck fracture in 1 case. Hypertension was noticed in 15 cases, type II diabetes in 13 cases and old and lacunar cerebral infarction in 6 cases. All the patients underwent humeral head replacement using the same prostheses of Bigliani/Flatow type produced by Zimmer company at 3-7 days after injuries. Early functional exercise was carried out after the surgery according to the Neer rehabilitation principles. The average follow-up time was 16.3 months. Pain severity and range of motion ( ROM ) of the joint were recorded, as well as the complications of dearticulation, prosthetic loosening and periprosthetic joint infections. The postoperative functions were evaluated according to the Constant-Murley scoring system. Results Fifteen patients had no pain and 4 patients had mild pain. No dearticulation, prosthetic loosening or periprosthetic joint infections were found. The mean postoperative functional score was 70.1, and the rate of subjective satisfaction was 78.9%. Conclusions Artiifcial humeral head replacement is a good choice in the treatment of comminuted proximal humeral fractures in the elderly, which can quickly relieve pain and restore joint function. There are many key factors that cannot be ignored, namely surgical indications, timing and techniques, functional exercise, etc.

Objective To investigate whether arthroscopic remplissage with Bankart repair is an effective treatment for patients with Hill-Sachs defects.Methods Between 2007 and 2009,20 patients underwent arthroscopic Bankart repair with remplissage for the treatment of recurrent anterior glenohumeral instability and large Hill-Sachs defects.Preoperative imaging in all patients demonstrated both a Bankart lesion and a significant Hill-Sachs defect.Patients were followed up postoperatively with the Western Ontario Shoulder Instability score(WOSI),the American Shoulder and Elbow Surgeons score(ASES),and the Penn Shoulder Score.Recurrent dislocation was documented.Results The mean length of follow-up in this study was 25 months(range,18 to 32 months).At final follow-up,3 patients reported recurrence of instability.The mean American Shoulder and Elbow Surgeons score was 92.5.The mean Penn score was 90.The mean total Western Ontario Shoulder Instability score was 572.5.There was no statistical difference in ASES,Penn and WOSI shoulder scores for patients with concomitant injury.Conclusion For the Bankart lesions with Hill-Sachs defects,arthroscopic remplissage technique with Bankart repair can achieve satisfactory clinical results and effectively restore shoulder function.