This study sought to compare the clinical outcomes of left total knee arthroplasty performed under robotic assistance by right-handed surgeons of differing experience levels, and to assess how such technology may improve operative precision and mitigate experience-related variations in results. A retrospective review was performed for 120 patients suffering from left knee osteoarthritis, all of whom received total knee arthroplasty from December 2020 to June 2025. Patients were divided into Group A (senior surgeons, > 10 years of experience) and Group B (junior surgeons, < 2 years of experience), each comprising 60 patients. Each group was further subdivided into robot-assisted total knee arthroplasty (RTKA) and conventional total knee arthroplasty (CTKA) subgroups, with 30 patients in each. Recorded parameters included operative time, incision length, intraoperative blood loss, postoperative hip-knee-ankle (HKA) angle, sagittal and coronal tibial and femoral component angles (LTC, FTC, LFC, FFC), as well as Knee Society Score (KSS), visual analogue scale (VAS) for pain, range of motion (ROM), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores on postoperative days 3 and 90. Complication rates were also compared. The results showed that while senior surgeons had shorter operative times and better early radiographic outcomes in conventional TKA, robotic assistance significantly improved component alignment and early clinical scores for junior surgeons, resulting in no statistically significant inter-group differences. in both radiographic and clinical outcomes. Notably, in the RTKA subgroups, there were no statistically significant disparities noted in operative outcomes when comparing procedures performed by senior and junior surgeons in any intraoperative, radiographic, or clinical parameters. Additionally, junior surgeons performing conventional left TKA had a higher incidence of femoral anterior cortical notching (NOTCH). In conclusion, robot-assisted left total knee arthroplasty enhances procedural consistency and reduces the performance gap between surgeons of different experience levels, particularly aiding junior right-handed surgeons in overcoming technical challenges associated with non-dominant side surgery, thereby showing potential to promote greater consistency in surgical outcomes and patient safety.

Total hip arthroplasty (THA) requires precise acetabular cup placement to ensure long-term success. Despite the widely accepted “safe zone,” manual THA outcomes can be influenced by surgeon handedness, leading to side-dependent disparities in cup positioning, especially among right-handed surgeons. This study aimed to compare the consistency of acetabular cup placement between left and right sides in robotic-assisted (RA-THA) versus manual THA (M-THA) performed by right-handed surgeons. A retrospective cohort of 220 patients who underwent primary unilateral THA via posterolateral approach was included. Patients were divided into RA-THA (n = 110) and M-THA (n = 110) groups, each further stratified by operative side (left/right). Radiographic parameters (inclination, anteversion, limb length discrepancy, femoral/acetabular offset), safe zone achievement, perioperative outcomes, and early clinical results were assessed. Results showed that in the M-THA group, left-side procedures exhibited significantly greater anteversion (25.5°±6.2° vs. 22.9°±3.8°, p = 0.009), larger limb length discrepancy (0.7 ± 0.3 mm vs. 0.5 ± 0.2 mm, p < 0.001), and greater offset deviations compared to right-side procedures. In contrast, the RA-THA group demonstrated no significant side-to-side differences in any radiographic parameters, with consistently higher safe zone placement rates (92.7–94.5

Deep vein thrombosis (DVT) is a common postoperative complication in patients with tibial plateau fractures. The aim of this study is to determine the incidence and risk factors of postoperative DVT in patients with tibial plateau fractures. We conducted a retrospective study from January 1, 2023, to December 31, 2025. The primary endpoints of this study were the prone site and risk factors of DVT. Univariate analysis and multivariate Logistic regression analysis were used to analyze the related factors, and the receiver operating characteristic (ROC) curve was drawn to evaluate its predictive value. Among 890 patients, 207 (23.25

The differential impact of robotic assistance on surgeons with varying levels of experience in total hip arthroplasty (THA) remains underexplored. This retrospective study investigated whether robotic-assisted THA (RA-THA) differentially affects the surgical performance and early clinical outcomes of senior versus junior surgeons compared to manual THA (M-THA). A total of 211 patients who underwent primary THA were divided into four groups based on surgeon seniority (senior, with > 10 years of experience vs. junior, with < 2 years of experience) and surgical technique (RA-THA vs. M-THA). All six participating surgeons (three senior, three junior) completed standardized robotic training before performing RA-THA. Perioperative parameters, radiographic outcomes, and one-month clinical follow-up data were analyzed. The results demonstrated a significant effect with use of robotic assistance, which differed slightly based on seniority level. For junior surgeons, RA-THA dramatically elevated their performance to the level of senior experts. While junior surgeons in the M-THA group exhibited significant variability, with a lower rate of acetabular cups placed within the Lewinnek safe zone (79.2

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are serious postoperative complications in patients with tibial plateau fractures. The aim of this study was to investigate the risk factors for postoperative DVT complicated with PE in patients with tibial plateau fractures, establish a risk prediction model and verify its predictive efficacy. We conducted a retrospective study from January 1, 2023, to December 31, 2025. The primary endpoint of this study was the risk factors for DVT complicated with PE after tibial plateau fracture. Univariate analysis and multifactor logistic regression analysis were performed to analyze the relevant risk factors, and nomogram models were established to verify the predictive efficacy of the model via receiver operating characteristic (ROC) curves, calibration curves, and clinical decision curve analysis (DCA) curves. Among the 224 patients, 36 (16.07

The impact of a surgeon’s routine operative experience on outcomes in robot-assisted total knee arthroplasty (RATKA) remains unclear. This retrospective study investigated whether the volume of a surgeon’s primary conventional TKA experience influences the clinical efficacy of subsequent RATKA procedures. Based on the primary surgeon’s level of experience, a total of 167 patients undergoing RATKA were enrolled and allocated into two cohorts: Group A (surgeons with fewer than 100 prior cases, n = 64) and Group B (surgeons with more than 500 prior cases, n = 103). Perioperative data, radiographic outcomes, and clinical functional scores were compared. The results showed that while surgeons in Group B had significantly shorter intraoperative registration, osteotomy, and total operative times (P < 0.001), Incision length, blood loss, and postoperative complication rates did not differ significantly between Group A and Group B. Crucially, at both 3 and 180 days post-surgery, functional outcomes as measured by VAS, KSS, ROM, and WOMAC scores were comparable between the two groups (P > 0.05), as was the accuracy of postoperative lower limb alignment and component positioning (P > 0.05). Our findings suggest that although a surgeon’s extensive routine experience enhances procedural efficiency in RATKA, the robotic system’s precision and standardization effectively mitigate the impact of experience variability, enabling surgeons with differing backgrounds to achieve equivalent and excellent short-term clinical and radiographic outcomes. This supports the role of robotic assistance in promoting outcome homogeneity in knee arthroplasty.

Objective The objective of this trial was to evaluate the efficacy and safety of topical administration of tranexamic acid (TXA) combined with diluted-epinephrine (DEP) on perioperative blood loss and transfusion in young and middle-aged patients with femoral neck fracture who did not undergo drainage. Methods Sixty patients were enrolled in this trial. In the target group(TXA/DEP group: n=30;18 men and 22 women, mean age 41.36±12.17 years), the surgical sites were injected with 50 mL normal saline mixed with 1 g of TXA with 0.25 mg of DEP at a 1:200,000 dilution (TXA/DEP).In the control group, (TXA group: n=30; 11 men and 19 women; mean age: 43.70±14.63 years), the surgical site was injected with 50 mL normal saline containing 1 g of TXA alone. The main outcome measures were total blood loss(TBL),dominant blood loss(DBL),hidden blood loss(HBL), postoperative hemoglobin (Hb) levels, hematocrit(HCT) and activated partial thromboplastin time(APTT), the secondary measures included transfusion requirements, Harris hip score, satisfactory degree and perioperative complications. Results The results showed that topical combined administration significantly reduced the decrease of hemoglobin among patients in the TXA/DEP group, measured on postoperative day 1 at 123.43±6.84 g/L vs. 118.33±6.30 g/L (TXA/DEP group vs. TXA group) , day 3 as 104.36±8.01 g/L vs. 96.83±7.56g/L, and day 5 as 115.96±6.49 g/L vs. 110.03±7.85 g/L, respectively (p<0.05). The mean HCT levels among patients in the TXA/DEP group were significantly higher than among those in the TXA group, measured on postoperative day 1 at 34.83±1.96% vs. 33.03±2.78% , day 3 as 32.40±2.83% vs. 30.83±2.65%, and day 5 as 38.63±1.56% vs. 37.06±1.99%, respectively (p<0.05). TBL, DBL, and HBL were also significantly reduced in the TXA/DEP group vs. the TXA group, measured at 333.40±42.19 ml vs. 396.30±53.54 ml, 72.33±16.28 ml vs. 91.86±20.10 ml, and 261.06±36.76 ml vs. 304.43±48.68 ml. 2 patients (6.66%) from the TXA/DEP group and 9 (30.00%) from the TXA group received blood transfusions, respectively (p<0.05).The Harris scores and satisfactory degrees among patients in the TXA/DEP group were significantly higher than among those in the TXA group, measured on postoperative day 21, respectively (p<0.05),which did not significantly differ from one another on postoperative3 months, respectively(P＞0.05).Furthermore, four cases in the TXA/DEP group and seven in the TXA group were diagnosed with subcutaneous ecchymosis, five cases in the TXA/DEP group and nine in the TXA group were diagnosed with deep vein thrombosis, and one case in the TXA/DEP group was diagnosed with adverse medicine reaction, those differences did not reach statistical significance (p>0.05). Conclusion Topical administration of TXA with DEP was safer and more effective in reducing blood loss and transfusion than the administration of TXA alone in treating young and middle-aged patients with femoral neck fracture, without increasing the risk of perioperative complications.

背景:股内侧肌下入路是全膝关节置换最微创的一种手术方式,患者术后膝关节功能恢复快,但长期疗效不清楚.目的:观察股内侧肌下入路全膝关节置换治疗膝外翻畸形中长期的假体位置和膝关节功能情况.方法:回顾性分析2009年1月至2018年1月福建省立医院骨科收治的膝外翻畸形患者50例共55膝,采用股内侧肌下入路、股骨外翻3°-5°截骨、常规置换髌骨.统计手术时间、显性出血量、切口长度、起始下地时间、起始上下楼梯时间和住院天数等一般资料;采用目测类比评分、膝关节协会功能评分、纽约特种外科医院评分、膝关节屈伸活动度、胫股角、髋-膝-踝角、髁-髋角、平台-踝角等指标评价术后疗效和假体在位情况.结果 与结论:①随访时间为4.7-11.1年;②手术时间(67.2±6.2)min,显性出血量(317.3±109.6)mL,切口长度(11.5±1.2)cm,起始下地时间(1.1±0.5)d,起始上下楼梯时间(2.3±0.9)d,住院天数(4.9±1.2)d;③与术前相比,末次随访时患者目测类比评分显著降低、膝关节活动度、膝关节协会功能评分、纽约特种外科医院评分均显著增加,胫股角/髋-膝-踝角显著降低,髁-髋角/平台-踝角显著降低,差异均有显著性意义(P<0.001);④术后均未发生腓总神经麻痹、感染、深静脉栓塞等并发症,随访期间假体位置良好,无翻修病例;⑤提示股内侧肌下入路全膝关节置换治疗膝外翻畸形,中长期假体位置、下肢力线良好,功能恢复满意.

The incidence of open femoral fractures is relatively low, primarily caused by high-energy trauma and often associated with multiple injuries. The management of open femoral fractures is considered one of the most challenging lower limb injuries due to their serious nature, multiple traumas, high disability rate, high infection rate, and high amputation rate. Most scholars currently recommend that open grade I and grade II fractures of the femur be treated with thorough debridement and open reduction, and internal fixation at the initial stage when the patients are in good condition. However, for open grade III femur fractures, many studies still show that staged treatment strategies are preferred, but the fixation method at the initial stage is still controversial. For patients with severe open femoral fractures, the medical team should create an individualized treatment plan, taking into account the patient's and family's preferences, the medical team's experience, and available resources, rather than simply relying on the salvage or amputation scoring system to make the final decision. This review discusses the epidemiology, classification, surgical management options, and strategies for limb salvage and amputation in the treatment of open femur fractures, providing practical guidance for healthcare professionals who manage these patients.

目的 探讨增强现实(augmented reality,AR)技术在骨科临床教学中的应用效果,改革教学模式,提升教学质量.方法 选取 2021 年 6-12 月于攀枝花市中心医院骨科参与临床实习的60名本科学员,随机分为两组,对照组 30 名采用传统教学法,试验组 30 名在此基础上采用AR技术构建虚拟模型辅助教学,完成授课后,对所有学员进行客观的考核测试,主观的自我评价及问卷调查,对比判断教学效果的差异.结果 采用AR技术辅助教学后,试验组学员的理论知识、病例分析、体格检查成绩均高于对照组,差异有统计学意义(P＜0.05);试验组学员的学习能力自评总分为(81.96±4.83)分,高于对照组的(73.83±5.69)分,差异有统计学意义(P＜0.05);试验组学员的教学问卷调查自评总分(83.46±4.64)分较对照组的(75.56±5.93)分明显提高,差异有统计学意义(P＜0.05).结论 AR技术辅助骨科临床教学可加深学员对解剖结构的认识,提高理论和技能考核成绩,提高学习兴趣和思维能力,获得更高的教学满意度,极大提升了教学质量.

目的 研究补阳还五汤(BHD)对失神经大鼠骨骼肌纤维化及转化生长因子(TGF)-β1/Smad3信号通路的影响,探讨其延缓肌萎缩的作用机制.方法 32只SD大鼠随机分为假手术组、模型组、弥可保组、BHD组,每组8只.采用坐骨神经截断的方法建立失神经肌萎缩模型.各组采用相应干预连续21 d.完整取下双侧腓肠肌计算肌湿重比值,苏木素-伊红(HE)染色观察肌萎缩和纤维化情况并测定肌纤维横截面积,逆转录聚合酶链反应(RT-PCR)检测腓肠肌组织中TGF-β1、Smad3、MyoD1、Pax7 mRNA含量,生物信息学分析TGF-β1、Smad3、MyoD1、Pax7蛋白之间的相互关系,Western印迹检测腓肠肌组织中TGF-β1、p-Smad3蛋白表达.结果 与模型组相比,BHD组肌湿重比和横截面积明显升高(P<0.05);光镜下见模型组肌细胞明显萎缩、皱缩,细胞间隙大量结缔组织增生,纤维化明显,肌纤维束排列结构紊乱,BHD组肌细胞虽有萎缩,但肌纤维束排列结构有序,未见明显紊乱,肌细胞萎缩程度和纤维化程度均明显低于模型组;与模型组相比,BHD组TGF-β1、Smad3 mRNA表达水平和TGF-β1、p-Smad3蛋白表达水平明显降低,而MyoD1、Pax7 mRNA表达水平明显升高(均P<0.05);生物信息学分析结果显示,TGF-β1、Smad3、MyoD1、Pax7蛋白之间的关系基本呈流水线式的一一对应关系,TGF-β1首先作用于Smad3,再依次对MyoD1和Pax7进行调控.结论 BHD可通过抑制TGF-β1/Smad3信号通路转导途径,降低骨骼肌纤维化程度,进而延缓失神经肌萎缩的进程.

股骨干骨折是创伤骨科中常见的一种损伤,以高能暴力损伤为主,临床应用带锁髓内钉对股骨骨折进行治疗收到较好效果.但股骨干骨折髓内钉术后骨折不愈合的病例也屡见不鲜.本研究从疾病概述、常见分类及手术治疗方法的选择等方面进行综述,以期为股骨干骨折髓内钉术后骨折不愈合寻求更加安全有效的治疗方式提供参考依据.

背景:失神经骨骼肌萎缩尚缺乏较有效的治疗方法,预后差,microRNA在体内的表达谱不清楚.目的:采用高通量测序技术分析失神经支配骨骼肌萎缩大鼠microRNA表达谱及转化生长因子β1/Smad3信号通路的变化,探讨microRNA在骨骼肌萎缩中的作用及其机制.方法:12只SD大鼠随机分为2组,实验组采用坐骨神经截断的方法建立失神经肌萎缩模型,对照组仅暴露坐骨神经后缝合伤口.完整取下大鼠双侧腓肠肌计算肌湿质量比,苏木精-伊红染色观察肌萎缩和纤维化情况并测定肌纤维横截面积;应用Illumina HiSeq 2500测序技术筛查骨骼肌组织中的microRNA表达谱;结合火山图、层次聚类图、基因本体论、京都基因与基因组百科全书通路分析差异表达基因参与骨骼肌代谢的生物过程;采用实时荧光定量PCR验证候选基因在肌肉组织中的差异表达;Western blot检测转化生长因子β1、p-Smad3蛋白表达.结果 与结论:①与对照组相比,实验组腓肠肌湿质量比和横截面积明显降低(P<0.001),造模结果符合预期;②两组共筛查到1249个差异表达的microRNA(P<0.05;|log2 Fold Change|>0.0),筛选出显著差异表达的microRNA共14个,其中2个表达上调,12个表达下调;③生物学功能和通路分析结果提示,miR-1247-3p、miR-132-5p、miR-21-3p、miR-363-3p、miR-451-5p等具有显著差异表达的microRNAs显著富集于细胞增殖、分化、凋亡等生物过程及转化生长因子β信号通路;④实时荧光定量PCR结果显示,miR-21-3p在实验组腓肠肌组织中呈显著低表达(P<0.001),与测序结果趋势一致;⑤Western blot结果显示,转化生长因子β1、p-Smad3蛋白表达水平较对照组明显升高(P<0.05);⑥提示microRNA在骨骼肌萎缩生理病理过程中扮演关键角色,miR-21-3p可能通过激活转化生长因子β1/Smad3信号通路的生物活性,进而在骨骼肌细胞代谢中发挥作用.

Abstract Background Both of Minimally Anterolateral Approach (MIS-ALA) and Direct Anterior Approach (DAA) have been reported to be advantageous in Total Hip Arthroplasty (THA), reducing postoperative pain and permit quicker rehabilitation by preserving muscle insertions. There is little literature concern the difference of them. Therefore, we conducted a prospective study to assess the difference of early clinical outcomes, radiological, and patient-reported outcomes between the two minimally invasive approaches of MIS-ALA and DAA. Methods The subjects were 98 patients, with 50 in the MIS-ALA group and 48 in the DAA group. Patients with complete data were evaluated preoperatively and postoperatively at 2, 6 and 12 weeks. Clinical measurements including the ability to climb stairs and walk, a 6 minutes walk test (6MWT) distances, the Forgotten Joint Scale (FJS-12), Japanese Orthopaedic Association (JOA) Hip scores, radiological evaluation, and complications data were collected. Results There were no significant differences in clinical outcomes and implant alignments between MIS-ALA and DAA groups. In regards to patient-reported outcomes, the FJS-12 was significantly higher in the MIS-ALA group than in the group DAA at 2 and 6 weeks postoperatively. However, there was no significant difference in the FJS-12 between the two groups at 12 weeks after surgery. The differences also included shorter operative times, less blood loss, lower Hb drop, and fewer blood transfusions in the MIS-ALA group. The incidence of lateral femoral cutaneous nerve (LFCN) neuropraxia after surgery was 7 (14.6%) in the DAA group, zero occurred in the MIS-ALA group. One fracture was identified with each group and managed conservatively. Conclusion Both MIS-ALA and DAA approaches yielded excellent and similar early clinical outcomes. However, better patient-reported outcomes could be achieved by MIS-ALA THA. The MIS-ALA was a safer approach for shorter operative times, less blood loss, lower Hb drop, fewer blood transfusions and LFCN neuropraxia compared with DAA. A longer follow-up is needed to examine differences between these procedures.

To review the outcome of high-risk geriatrics with unstable pertrochanteric fractures treated with external fixator. Eighteen consecutive patients with pertrochanteric fractures were operated with external fixator by using closed reduction technique. AO type, accompanying diseases, operating time, transfused blood units, duration of hospitalization, complications, healing time and mortality were recorded. Patients were followed clinically and radiologically for two years at least. The Harris Hip Score was used to document hip function at each regular follow-up. Fifteen patients with average age of 71.5 years were available for final evaluation. The mean operating time was 41.1 min and union was achieved in all cases with an average time of 16 weeks. The mean Harris Hip Score at one, three, six, twelve and twenty-four months post-operatively was 42.07 ± 8.55; 55.07 ± 11.62; 70.07 ± 10.32; 86.27 ± 9.06 and 89.27 ± 8.81 respectively. Complications included all the patients undergoing loss of some motion in the knee and four of them had to experience revision surgery because of knee stiffness, ten cases of pin-tract infections, seven cases of deep venous thrombosis, two cases of migration of the screws and two cases limb shortening. The use of external fixator in high-risk geriatric provided a satisfactory long-term efficacy, but the short-term functional results were quite unsatisfactory owing to high complication rate. Therefore, the advantages and disadvantages should be fully weighed when using external fixators, which was especially suitable for those patients who could not tolerate prolonged operative time and open surgery. Therapeutic study, level 4.

Background Minimally anterolateral approach (MAA) and direct anterior approach (DAA) have been reported as beneficial for total hip arthroplasty (THA) due to their ability to reduce postoperative pain and lead to quicker rehabilitation by preserving muscle insertions. As there is an ongoing debate on the effect of these two approaches on early postoperative outcomes, this prospective study aimed to assess the difference in early clinical, radiological, and patient-reported outcomes between the two minimally invasive approaches. Methods A total of 98 patients, 50 in the MAA group and 48 in the DAA group, were included in the study. Patients with complete data were evaluated preoperatively and postoperatively at 2, 6, and 12 weeks. Clinical measurements, including the ability to climb stairs and walk, 6-min walk test (6MWT), the Forgotten Joint Scale (FJS-12), Japanese Orthopedic Association (JOA) Hip scores, radiological evaluation, and complications were analyzed. Results There were no significant differences in clinical outcomes and implant alignments between MAA and DAA groups. In regards to patient-reported outcomes, the FJS-12 was significantly higher in the MAA group compared to group DAA at 2 and 6 weeks postoperatively. However, there was no significant difference in the FJS-12 between the two groups 12 weeks after surgery. The differences also included shorter operative times (62.4 ± 9.05 min vs. 71 ± 8.01 min), less blood loss (132.6 ± 43.31 ml vs. 159.23 ± 37.25 ml), lower Hb drop (29.56 ± 8.02 g/L vs. 36.4 ± 7.12 g/L), and fewer blood transfusions in the MAA group (4.0% vs. 18.8%). The incidence of the lateral femoral cutaneous nerve (LFCN) neuropraxia after surgery was 7 (14.6%) in the DAA group and 0 in the MAA group. One fracture was found in each group and managed conservatively. Conclusion MAA and DAA approach yielded excellent and similar early clinical outcomes. However, better patient-reported outcomes could be achieved by MAA THA. The MAA resulted in a safer approach associated with shorter operative times, less blood loss, lower Hb drop, fewer blood transfusions, and LFCN neuropraxia than DAA. A longer follow-up is needed to further examine differences between these procedures.

目的 探究多模式镇痛在交锁髓内钉治疗胫骨骨折围术期的应用价值.方法 选取2020年1月—2021年4月本院收治的接受交锁髓内钉治疗的胫骨骨折患者74例,随机分为两组,观察组38例采用多模式镇痛,对照组36例采用传统镇痛,比较两组患者术后静息、运动状态下的VAS评分,膝关节活动度,主被动屈曲膝关节达90°所需时间及不良反应发生率.结果 术后第1、3、7天在静息及活动状态下VAS评分,多模式镇痛组低于传统镇痛组(P<0.05).术后第1、3、7天膝关节活动度,多模式镇痛组优于传统镇痛组(P<0.05).多模式镇痛组患者膝关节主、被动屈曲至90°所需时间均早于传统镇痛组(P<0.05).两组患者不良反应发生率差异无统计学意义(P>0.05).结论 在交锁髓内钉治疗胫骨骨折的围术期应用多模式镇痛理念,可有效减轻膝关节疼痛,增加膝关节活动度,临床应用效果满意.

目的 探讨微型静脉皮瓣与微型邻指皮瓣治疗伴有皮肤软组织缺损的手指末节离断再植的疗效及安全性.方法 选取我院105例(105指)伴有皮肤软组织缺损的手指末节离断患者,采用随机数字表法分为观察组(n=53)和对照组(n=52),对照组采用微型邻指皮瓣治疗,观察组采用微型静脉皮瓣治疗.比较两组伤指运动功能、伤指恢复情况、伤指血液循环情况、并发症发生情况.结果 观察组伤指运动功能优良率及血液循环优良率高于对照组;两点辨别觉小于对照组,远侧指间关节活动度、指甲长度高于对照组;并发症发生率低于对照组(P＜0.05).结论 微型静脉皮瓣治疗对皮肤软组织缺损手指末节离断再植患者的疗效优于微型邻指皮瓣治疗,能有效改善伤指运动功能及血液循环情况,促进伤指术后恢复,减少并发症,具有较高的安全性.

目的:分析复杂踝关节骨折复位不良的原因及预防策略.方法:回顾性分析自2016年1月至2019年1月行切开复位内固定的复杂踝关节骨折患者61例,男29例,女32例;年龄28～68岁,平均46.7岁,所有骨折均属于三柱损伤.结果:12例复杂踝关节骨折复位不良,失败率为19.67％,其中:外踝短缩畸形2例,外踝旋转畸形4例,下胫腓联合损伤漏诊6例.结论:复杂踝关节骨折损伤重,手术复杂,腓骨长度的恢复和旋转畸形的纠正对下胫腓联合损伤的修复十分关键,而下胫腓联合损伤的诊断及精确治疗对维持踝关节的长期稳定和降低踝关节远期创伤性关节炎十分重要.