Phosphonic acid (PA)-based interlayers used in metal-halide perovskite solar cells (PSCs) can suffer from instability at elevated temperatures. We report that the acidic protons of PAs weakly bound to indium tin oxide (ITO) can accelerate the oxidation of iodide, decomposition of formamidinium, and reduction of lead ions and that these reactions accelerate at high temperature and on exposure to ultraviolet light. Also, some common PA molecules weakly bonded to ITO can desorb and react with perovskites. We synthesized a bis(diarylamino)biphenyl-based PA that binds more strongly to ITO and show that its use in PSCs led to an operational lifetime of nearly 3000 hours with 10% efficiency loss (T-90) at 85 degrees C under a metal halide lamp (including ultraviolet light) with maximum power point tracking. Minimodules had power conversion efficiencies >22% with an aperture area of >20 square centimeters and exhibited a T-90 lifetime of similar to 2200 hours under similar testing conditions.

State-of-the-art encapsulation cannot prevent the permeation of oxygen into perovskite solar cells (PSCs). Here, we report the finding that p-i-n structured PSCs degrade quickly under oxygen exposure. Oxidation of C60, rather than perovskites, dominates the degradation. Chemical absorption of oxygen by C60 is identified, which impairs its electron transport property. We modify the electron transport layers to address the instability under oxygen exposure. The elongated fullerene C70 is found to react with oxygen orders of magnitude slower than C60. In combination with a compact SnO2 buffer fabricated by atomic layer deposition, which can slow down the oxygen diffusion, the resulting unencapsulated PSCs with C70 retained 90% of their initial efficiency after 1-sun illumination in pure oxygen for 1,200 h at 70°C, improving stability by hundreds of times. Testing of unencapsulated perovskite minimodules of different perovskite compositions with C70 gives extrapolated lifetimes of 17–41 years at 50°C.

Formamidinium-caesium lead iodide (FA(X)Cs(1-X)PbI(3), 0 < x < 1) perovskites are pivotal for commercialization of perovskite solar cells owing to their superior stability. However, their upper stability limits under combined thermal and light stressors remain poorly understood. Through Arrhenius analysis of hundreds of p-i-n devices, we reveal two distinct degradation regimes: below 106 degrees C, cation segregation dominates, whereas above 106 degrees C, FAI loss dominates perovskite decomposition. Incorporating a compact tin oxide (SnO2) layer effectively suppresses FAI loss, maintaining cation-segregation-dominated degradation beyond 106 degrees C. Moreover, introducing trace CsI3 in perovskite precursor enhances cation homogeneity in as-prepared films, dramatically extending the device T-90 (time to 90% of maximum efficiency) to similar to 2,700 h under continuous 1-sun illumination (1.0% UV) at 85 degrees C. The extrapolated T-90 at 45 degrees C exceeds 50 years by assuming a same degradation pathway. These findings elucidate the temperature-dependent degradation pathways in formamidinium-caesium perovskites and provide practical strategies to enhance their operational stability.

High-performance wide-bandgap (WBG) perovskite solar cells are expected to play a key role in next-generation multi-junction solar cells. However, several challenges remain to be overcome, such as large photovoltage loss, poor stability and scalable fabrication in ambient air, which hinder the commercialization of this technology. Here we incorporate a reductive methylhydrazinium cation into WBG perovskites, which not only reduces defect density but also suppresses iodide oxidation and halide demixing, enabling scalable fabrication of efficient and stable WBG solar cells and modules in ambient air. Remarkably, the champion WBG perovskite solar cells achieve a power conversion efficiency (PCE) of 23.3% with an open-circuit voltage of 1.28 V, corresponding to a record low voltage loss of 0.37 V. The WBG mini modules deliver a stabilized PCE of 19.8% with an aperture area of 25 cm2. The mini modules can keep 94% of the initial PCE after 700 hours of operation under continuous light soaking at 1-sun illumination at 55 +/- 5 degrees C. This work suggests a viable route to the sustainable harvesting of solar energy.

PURPOSE:To test the mechanical properties of novel design hook plates for fixation of the patellar fracture by finite element analysis. METHODS:Finite element analysis was used to construct a model of transverse patellar fracture and inferior pole fracture of the patella (IPFP) based on the CT data of the knee joint of a healthy young male volunteer. For the transverse fracture, stress distribution within the winged hook plate fixation and displacement of the fracture was compared to that of tension-band wiring (TBW) fixation. For the IPFP, the stress distribution within the wingless plate and displacement of the fracture were calculated under the four different application methods. All the models were created by assuming the knee flexion in 45° during non-weight-bearing, and applying the quadriceps tension on the superior pole of the patella. RESULTS:In the model of transverse patellar fracture: The displacement and stress incurred in the fixation of patellar fractures with winged hook plates are much less than with TBW fixation (0.05 mm vs 0.3 mm; 121 MPa vs 268 MPa). In the model of IPFP: The wingless hook plate-cable wire-screw construction resulted in the least amount of displacement, followed by the wingless hook plate-cable wire (0.18 mm vs 0.297 mm). Displacement of the inferior pole of the patella would be more obvious in the two constructions that did not combine cable wires, especially the construction with neither cable wires nor screws. CONCLUSION:In consideration of improvement of mechanical rigidity, winged hook plate was superior to TBW technique when being used for fixation of transverse patellar fracture, while combination of cable wire should be recommended when wingless hook plate being used for fixation of IPFP.

Perovskite/silicon tandem solar cells can exceed Shockley-Queisser limit, but achieving complete coverage of 2-4 μm pyramids on industrial fully-textured silicon with solution-processed perovskite film remains challenging. We address this issue by spray-coating alumina particles onto fully-textured silicon, creating a super-hydrophilic rough surface that both enhances wet film coverage and provides guided nucleation sites. Although super-hydrophilic effect enhances wetting, it alone is insufficient to achieve complete coverage of pyramids by perovskite film. Beyond enhanced wetting, alumina particles promote uniform nucleation at particle-decorated sites across pyramids by lowering nucleation barrier and suppressing valley-preferred nucleation, which enables near-conformal deposition of perovskite film on pyramids. Additionally, alumina particles reduce nonradiative recombination and extend carrier lifetimes. Using this approach, we achieve a efficiency of 32.74% for perovskite/silicon tandem solar cells with one-step solution-processed perovskite on fully-textured silicon. This strategy offers a pathway for seamless integration of perovskite and silicon photovoltaics into high-performance tandem devices.

The light-emitting diodes (LEDs) used in indoor testing of perovskite solar cells do not expose them to the levels of ultraviolet (UV) radiation that they would receive in actual outdoor use. We report degradation mechanisms of p-i-n–structured perovskite solar cells under unfiltered sunlight and with LEDs. Weak chemical bonding between perovskites and polymer hole-transporting materials (HTMs) and transparent conducting oxides (TCOs) dominate the accelerated A-site cation migration, rather than direct degradation of HTMs. An aromatic phosphonic acid, [2-(9-ethyl-9H-carbazol-3-yl)ethyl]phosphonic acid (EtCz3EPA), enhanced bonding at the perovskite/HTM/TCO region with a phosphonic acid group bonded to TCOs and a nitrogen group interacting with lead in perovskites. A hybrid HTM of EtCz3EPA with strong hole-extraction polymers retained high efficiency and improved the UV stability of perovskite devices, and a champion perovskite minimodule—independently measured by the Perovskite PV Accelerator for Commercializing Technologies (PACT) center—retained operational efficiency of >16% after 29 weeks of outdoor testing.

Flexible perovskite solar cells have attracted substantial attention owing to their promises for soft and high power–weight compatibility. However, the inferior quality of the buried perovskite–substrate interface due to low interfacial adhesion and large deformation of flexible substrates have greatly limited the performance of flexible perovskite solar cells. Here we add the organic molecule entinostat into the hole extraction material poly(bis(4-phenyl)(2,4,6-trimethylphenyl)amine) to enhance adhesion at the perovskite–substrate interface using the interaction of entinostat with perovskites, poly(bis(4-phenyl)(2,4,6-trimethylphenyl)amine) and indium tin oxide through its multiple functional groups. In addition, entinostat reduces the density of voids at the bottom of the perovskite film owing to its capability to tune the crystallization of perovskites. We demonstrate inverted small-area flexible perovskite solar cells with a power conversion efficiency of 23.4%. Flexible perovskite minimodules with an area of 9 cm 2 achieve a certified aperture efficiency of ~19.0%. The optimized unencapsulated flexible minimodule retains 84% of its initial efficiency after 5,000 bending cycles and 90% of the initial power conversion efficiency after light soaking for >750 h.

Stability of perovskite solar cells (PSCs) under light, heat, humidity and their combinations have been notably improved recently. However, PSCs have poor reverse-bias stability that limits their real-world application. Here we report a systematic study on the degradation mechanisms of p-i-n structure PSCs under reverse bias. The oxidation of iodide by injected holes at the cathode side initialize the reverse-bias-induced degradation, then the generated neutral iodine oxidizes metal electrode such as copper, followed by drift of Cu+ into perovskites and its reduction by injected electrons, resulting in localized metallic filaments and thus device breakdown. A reinforced barrier with combined lithium fluoride, tin oxide and indium tin oxide at the cathode side reduces device dark current and avoids the corrosion of Cu-0. It dramatically increases breakdown voltage to above -20 V and improved the T-90 lifetime of PSCs to similar to 1,000 h under -1.6 V. The modified minimodule also maintained over 90% of its initial performance after 720 h of shadow tests.

Interstitial iodides are the most critical type of defects in perovskite solar cells that limits efficiency and stability. They can be generated during solution, film, and device processing, further accelerating degradation. Herein, we find that introducing a small amount of a zinc salt- zinc trifluoromethane sulfonate (Zn(OOSCF 3 ) 2 ) in the perovskite solution can control the iodide defects in resultant perovskites ink and films. CF 3 SOO ̶ vigorously suppresses molecular iodine formation in the perovskites by reducing it to iodide. At the same time, zinc cations can precipitate excess iodide by forming a Zn-Amine complex so that the iodide interstitials in the resultant perovskite films can be suppressed. The perovskite films using these additives show improved photoluminescence quantum efficiency and reduce deep trap density, despite zinc cations reducing the perovskite grain size and iodide interstitials. The zinc additives facilitate the formation of more uniform perovskite films on large-area substrates (78-108 cm 2 ) in the blade-coating process. Fabricated minimodules show power conversion efficiencies of 19.60% and 19.21% with aperture areas of 84 and 108 cm 2 , respectively, as certified by National Renewable Energy Laboratory (NREL), the highest efficiency certified for minimodules of these sizes.

To the Editor: Osteosynthesis is considered as a standard management for the non-displaced femoral neck fracture in elderly patients,[1] but some of the patients would be suffered from avascular necrosis or non-union after osteosynthesis. It has been demonstrated that the outcome of the salvage procedure after primary avascular necrosis is not reliable.[2] Therefore, the preoperative detection of the risk factors should be of great significance. The Garden classification system has been the most commonly used to distinguish the severity of femoral neck fracture, but it is mainly focused on the displacement in the coronal plane. Since the integrity of posterior cortex has been demonstrated as an important role in the outcomes of displaced femoral neck fractures,[3] it is reasonable to investigate the effect of posterior cortex on the non-displaced pattern. Recently, we compared the outcome after osteosynthesis for non-displaced femoral neck fractures with and without posterior cortex complete fracture. This study was approved by the Ethics Committee of Beijing Jishuitan Hospital (No. 202203-100). Written informed consent was obtained from all the subjects. Patients data including age, sex, affected side, body mass index (BMI), American Society of Anesthesiologists classification (ASA), Harris score, Pain Intensity-Numerical Rating Scale (PI-NRS), 3- Level Europe Quality of life Five Dimensions Questionnaire, and Visual Analogue Score (EQ-5D-3L and EQ-5D-VAS), 1-year mortality, local and systemic complication, and avascular necrosis, were collected. The inclusion and exclusion criteria, statistical analysis were shown in Supplementary Materials, https://links.lww.com/CM9/B710. A total of 157 consecutive patients aged ≥65 years old with non-displaced femoral neck who were admitted to our department between January 1, 2015 and October 1, 2019, were included in the present study. About 15 patients were lost to follow-up and 16 were excluded based on the exclusion criteria. Among ten patients who died by the last follow-up, two died of fatal pulmonary embolism and hepatic carcinoma within one year, respectively. The 1-year fatality was 1.59% (2/126). One hundred and sixteen patients with complete data were enrolled for the analysis [Supplementary Figure 1, https://links.lww.com/CM9/B710]. The average age of these 116 patients was 72.5 ± 6.3 years (range: 65.0–92.0). Ninety-eight (94/116, 84.5%) patients were female. Sixty-two (62/116, 53.4%) cases were left side. All of the patients suffered from low-energy injuries. The mean follow-up period was 4.6 ± 1.4 years (range: 2.0–6.7). Assessment of the integrity of the posterior cortex was based on the oblique axial views of computerized tomography (CT) scans, which were available for all patients. If there was no displacement or only angulation at the fracture site and both ends of posterior cortices at the fracture site were still shaped in a smooth curve, it was categorized as the incomplete fracture of the posterior cortex. Correspondingly, if there was an overlap or gap at the posterior cortex so that both ends of posterior cortices could not form a smooth curve at the fracture site, it was categorized as a complete fracture of posterior cortex. For the assessment of the integrity of the posterior cortex, the interclass agreement of Hangyu Gu (HG) and Minghui Yang (MY) showed substantial agreement with κ = 0.65 (95% confidence interval [CI]: 0.40–0.90); the intraclass agreement of HG and MY showed substantial agreement with κ = 0.72 (95% CI: 0.49–0.95) and κ = 0.75 (95% CI: 0.52–0.98), respectively. Based on the integrity of the posterior cortex, the patients were divided into group I (incomplete fracture of posterior cortex) and group II (complete fracture of posterior cortex). A significant difference was found in the incidence of avascular necrosis between the two groups (4.5% [4/88] in group I vs. 32.1% [9/28] in group II, odds ratio [OR]: 9.95, 95% CI [2.77–35.73], P <0.001). This result indicated that the complete fracture of the posterior cortex was a risk factor for avascular necrosis in patients with the non-displaced femoral neck fractures. Also, the scores of Harris and EQ-5D-3L questionnaires were significantly lower in group II due to the higher rate of avascular necrosis (91.00 [87.00, 97.00] vs. 84.00 [72.75, 91.00], Z =–3.068, P = 0.002; 1.00 [0.85, 1.00] vs. 0.85 [0.72, 1.00], Z =–2.263, P = 0.024, respectively). Other sets of data, such as average age, sex ratio, BMI, follow-up time, EQ-5D-VAS, and the ratio of ASA III-IV, did not significantly differ between groups I and II [Supplementary Table 1, https://links.lww.com/CM9/B710]. In conclusion, the complete fracture of posterior cortex was a risk factor for avascular necrosis in non-displaced femoral neck fractures. Given that avascular necrosis of the femoral head would lead to poor hip function and quality of life in elderly patients, a CT scan should be performed to help orthopedic surgeons evaluate the non-displaced femoral neck fractures in elderly patients. Funding This work was funded by grants from the National Natural Science Foundation of China (No. 82072445) and National Natural Science Foundation Cultivation Programme of Beijing Jishuitan Hospital (No. ZR-202309). Conflicts of interest None.

Perovskite-silicon tandem cells have shown much higher efficiencies than single-junction cells, which promises further reduction of energy cost from photovoltaics. Due to the protection by perovskites, silicon subcells in perovskite-silicon tandem cells may last much longer than those in single-junction devices. Herein, we report recycling silicon bottom cells from end-of-life perovskite-silicon tandem solar cells, which further reduces their cost and enhances the sustainability. We demonstrate that silicon bottom cells can be recycled from end-of-life tandem cells by thermal delamination and chemical cleaning processes. The optoelectronic properties of silicon bottom cells were shown to be largely unchanged in the end-of-life tandem cells. The efficiencies of tandem cells refurbished from recycled silicon bottom cells are comparable to those fabricated from fresh cells.

Bifacial solar modules can produce 5% to over 30% more energy than monofacial ones, which can further reduce the levelized cost of electricity from photovoltaic devices. The market share of bifacial silicon modules is rising. To compete with silicon photovoltaics, perovskite solar cells also need to go bifacial structure for an increased energy yield. In addition, the bifacial perovskite modules are essentially semitransparent modules which are needed to realize efficient perovskite-silicon 4-terminal tandem modules. However, the efficiency of bifacial perovskite modules was far below that of monofacial ones. Here I will report bifacial perovskite minimodules with a high certified efficiency by addressing several unique challenges in bifacial module design and fabrication. The front efficiency without albedo light already reached that of best opaque monofacial minimodules, which is the highest efficiency a bifacial module can reach, while these bifacial modules gain additional power from albedo light. The additional of hydrophobic additive in hole transport layer surprisingly protects the perovskite films from moisture damage during atomic layer deposition. Integrating silica nanoparticles with proper size and spacing in perovskite films recovers the absorption loss induced by the absence of reflective metal electrodes while maintains the charge collection properties of perovskites. The small area single junction bifacial cells have an equivalent stabilized efficiency of 26.4% at an albedo of 0.2, which is already higher than any reported single junction perovskite solar cells. The bifacial solar minimodules show front and rear aperture efficiencies of 19.2% and 14.1%, respectively, certified by National Renewable Energy Laboratory, which yield an equivalent aperture efficiency of 22% at albedo of 0.2. We also show that the bifacial minimodules are extremely stable, with 97% of its initial efficiency retained after light soaking under one simulated sun for over 6000 hours at 60±5 °C, representing the most stable perovskite module reported so far. We believe these efficiency and stability of the perovskite modules represent a significant advance, while most other reported work still focus on small area devices.

The defective bottom interfaces of perovskites and hole-transport layers (HTLs) limit the performance of p-i-n structure perovskite solar cells. We report that the addition of lead chelation molecules into HTLs can strongly interact with lead(II) ion (Pb2+), resulting in a reduced amorphous region in perovskites near HTLs and a passivated perovskite bottom surface. The minimodule with an aperture area of 26.9 square centimeters has a power conversion efficiency (PCE) of 21.8% (stabilized at 21.1%) that is certified by the National Renewable Energy Laboratory (NREL), which corresponds to a minimal small-cell efficiency of 24.6% (stabilized 24.1%) throughout the module area. Small-area cells and large-area minimodules with lead chelation molecules in HTLs had a light soaking stability of 3010 and 2130 hours, respectively, at an efficiency loss of 10% from the initial value under 1-sun illumination and open-circuit voltage conditions.

The efficiency and stability of bifacial perovskite solar modules are still relatively low. Here we report bifacial minimodules with front efficiency comparable to opaque monofacial counterparts, while gaining additional energy from albedo light. We add a hydrophobic additive to the hole transport layer to protect the perovskite films from moisture. We integrate silica nanoparticles with proper size and spacing in perovskite films to recover the absorption loss induced by the absence of reflective metal electrodes. The small-area single-junction bifacial perovskite cells have a power-generation density of 26.4 mW cm −2 under 1 sun illumination and an albedo of 0.2. The bifacial minimodules show front efficiency of over 20% and bifaciality of 74.3% and thus a power-generation density of over 23 mW cm −2 at an albedo of 0.2. The bifacial minimodule retains 97% of its initial efficiency after light soaking under 1 sun for over 6,000 hours at 60 ± 5 °C.

Objective:To explore the short-term efficacy of fixation with a 3D printed individualized custom-made plate in the treatment of elderly patients with periprosthetic femoral fracture.Methods:Retrospectively analyzed were the 5 elderly patients with periprosthetic femoral fracture who had been treated by fixation with a 3D printed individualized custom-made plate from January 2022 to July 2022 at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital. There were 3 males and 2 females, aged 81, 86, 77, 91 and 87 years, respectively. One left and 4 right limbs were affected. Vancouver classification: type B1 ( n=3), type B2 ( n=1), and type C ( n=1). The time from operation to injury was 5, 6, 10, 5 and 7 days, respectively. Preoperatively, the femur affected, prosthesis and individualized plate with a greater trochanteric hook, loop cable channel and bone-like trabecular microporous structure were custom-made by 3D printing according to 1:1 models. Virtual operations were simulated to formulate surgical protocols. The operation time, length of surgical incision, intraoperative blood loss and transfusion, hospital stay, hip function and complications at the last follow-up were recorded. Results:The 5 patients were followed up for 12, 7, 10, 3 and 6 months, respectively. There were no events of superficial incision or deep prosthesis infection. Respectively, the operation time was 1.8, 1.7, 2.3, 2.0 and 3.3 h; the length of surgical incision 31, 30, 38, 27 and 30 cm; the intraoperative bleeding volume 400, 300, 300, 500 and 600 mL; the length of hospital stay 8, 9, 15, 14 and 11 d. Four patients received intraoperative blood transfusion of 300, 900, 150 and 1, 050 mL, respectively. One patient died of a heart attack 3 months after discharge; another patient developed dyskinesia at the contralateral limb 3 months after discharge due to cerebral infarction and died of recurrent cerebral infarction 7 months after discharge. At the last follow-up, the Harris hip scores of 3 patients were 86, 77 and 69 points, respectively. None of the patients had complications like breakage or loosening of implants.Conclusion:In the treatment of elderly patients with periprosthetic femoral fracture, fixation with a 3D printed individualized custom-made plate may lead to fine limb function and good short-term curative efficacy.

目的 探讨采用对损伤结构进行直接加强和修复代替下胫腓螺钉固定治疗三角韧带断裂、后踝骨折伴下胫腓联合分离的开放踝关节骨折脱位的临床效果.方法 对2018年1月至2019年6月北京积水潭医院创伤骨科急诊行三角韧带缝合锚加强与后踝空心螺钉固定治疗的三角韧带损伤、后踝骨折伴下胫腓联合分离的开放踝关节骨折患者6例的临床资料进行回顾性分析.其中男4例,女2例;年龄(44.8±10.8)(25～57)岁;Gustillo开放骨折分型为Ⅰ型3例,Ⅱ型3例;踝关节骨折Laugh-Hansen分型为旋前外旋3例,旋前外展1例,另2例为经下胫腓联合骨折脱位的特殊形态骨折;踝关节骨折Weber分型为C型6例.受伤至就诊时间为(3.7±1.5)(2～6)h.采用术后影像学表现、疼痛视觉模拟评分(VAS)、美国足踝外科学会(AOFAS)后足功能评分、患侧与健侧踝关节活动范围差异、骨折愈合情况和感染率等指标对临床效果进行评价.结果 随访时间为(2.8±0.7)(2.0～3.5)年.手术时间为(152±12)(135～167)min.骨折愈合时间为(4.2±1.8)(3～7)个月.术后未见固定失效发生.VAS评分为0分4例、1分2例.踝关节最大背伸较健侧差为(10.0° ±4.5°)(5° ～15°).AOFAS评分为(94±6)(86～100)分,优良(AOFAS评分≥80分)率为100％.未见急、慢性感染及创伤性关节炎发生.结论 采用三角韧带加强和后踝固定代替下胫腓螺钉固定治疗三角韧带断裂及伴后踝骨折和下胫腓联合分离的开放踝关节骨折,可获得良好的治疗效果.

Understanding carrier recombination processes in metal halide perovskites is fundamentally important to further improving the efficiency of perovskite solar cells, yet the accurate recombination velocity at grain boundaries (GBs) has not been determined. Here, we report the determination of carrier recombination velocities at GBs (SGB) of polycrystalline perovskites by mapping the transient photoluminescence pattern change induced by the nonradiative recombination of carriers at GBs. Charge recombination at GBs is revealed to be even stronger than at surfaces of unpassivated films, with average SGB reaching 2200 to 3300 cm/s. Regular surface treatments do not passivate GBs because of the absence of contact at GBs. We find a surface treatment using tributyl(methyl)phosphonium dimethyl phosphate that can penetrate into GBs by partially dissolving GBs and converting it into one-dimensional perovskites. It reduces the average SGB by four times, with the lowest SGB of 410 cm/s, which is comparable to surface recombination velocities after passivation.

Objectives To present a new method consisting of cable cerclage and hook plate for fixating the comminuted inferior patellar pole fracture and evaluate the outcomes. Methods A total of 16 consecutive patients who were treated with the construct of a cable cerclage in combination with a hook plate between January 2018 and September 2020 were included in the study. Mechanism of injury, duration, and technical details of the operation were reviewed. Plain radiographs and computerized tomography (CT) scans were routinely taken to evaluate the fracture pattern. The primary outcome measures included bony healing time, pain intensity‐numerical rating scale (PI‐NRS), range of motion (ROM), and the Bostman score at the final follow‐up. Results Eight males and eight females with an average age of 55.6 ± 12.0 years (range, 41 to 73 years) were included. Bony union was achieved in all the patients, with an average healing time of 10.8 ± 2.4 weeks (range, 8–16 weeks). With the average follow‐up of 20.1 ± 5.3 months, 12 patients (75%) had no pain (PI‐NRS score of 0), and the remaining four patients (25%) reported mild pain (three with a PI‐NRS score of 1 and one with a score of 2). The final Bostman score was 27.8 ± 3.0 (range, 20–30) on average, and all the patients showed excellent or good results. The average range of motion was 127.5° ± 13.9° (range, 90°–140°). No implant failure or hardware irritation was found during the follow‐up. Conclusion The fixation of cable cerclage combined with hook plate resulted as a reliable method for managing the inferior patellar pole fractures, allowing immediate rehabilitation and weight‐bearing.

Objective:To evaluate the effectiveness of perioperative fasting abbreviation in traumatic patients with orthopaedic trauma and diabetes mellitus undergoing selective surgery.Methods:The patients were selected for this prospective nonrandomized controlled study who had undergone selective surgery from June 2019 to June 2021 at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital. They were divided into an intervention group and a control group according to the wards where they stayed. The intervention group was fasted for solids from 0 o'clock on the surgery day and received oral solution with 6.25% maltodextrin which had been prepared by the nutritional department 3 hours prior to surgery. The control group was fasted for either liquids or solids from the midnight before surgery. All patients were evaluated according to the wake-up score and defensive reflex score after surgery. Once they were awakened, they were allowed slag-free drinks. Normal food was allowed if there was no discomfort after 2 hours. The 2 groups were compared in terms of basic information, actual preoperative fasting time, total amount of preoperative drinking, and postoperative time for initial drinking and eating. The perioperative subjective feelings (anxiety, thirst, hunger, nausea, fatigue, dizziness, sweating, stomach discomfort, etc.), grip strength and blood glucose were observed and compared between the 2 groups. Adverse reactions in the 2 groups were also observed.Results:A total of 135 patients were included, including 52 in the intervention group and 83 in the control group. The intervention group consisted of 22 males and 30 females aged from 30 to 84 years; the control group consisted of 39 males and 44 females aged from 29 to 81 years. There was no significant difference in the basic information between the 2 groups, showing comparability ( P>0.05). The intervention group had significantly shorter preoperative fasting time [3.5 (2.5, 6.3) h versus 12.0 (9.0, 16.0) h], significantly higher water intake before surgery [300 (200, 300) mL versus 100 (100, 200) mL], significantly shorter postoperative fasting time [0.08 (0, 1.25) h versus 2.00(0, 6.00) h], and significantly reduced time to return to normal diet [2.0 (2.0, 2.3) h versus 3.0(2.0, 6.0) h] than the control group (all P<0.05). The symptoms of anxiety, fatigue, sweating, and stomach discomfort in the intervention group were significantly fewer than those in the control group throughout the evaluation period. The thirst in the intervention group was significantly alleviated than that in the control group immediately after returning to the ward after surgery, and the dizziness and hunger were significantly alleviated than those in the control group when the patients left the ward to the operation room before surgery and immediately after returning to the ward. The symptom of nausea after returning to normal diet in the intervention group was significantly relieved compared with the control group. All the comparisons above showed statistically significant differences ( P<0.05). The blood glucose in the intervention group 2 hours after taking slag-free drinks was significantly higher than that in the control group ( Z=-2.108, P=0.035). There was no significant difference in the blood glucose between the 2 groups during other measurement periods ( P>0.05). There were no serious adverse reactions in either of the 2 groups. Conclusion:The protocol of perioperative fasting abbreviation may be safe and feasible for the patients with orthopaedic trauma and diabetes mellitus undergoing selective surgery, because it shows benefits of improving the patients' subjective feelings and stabilizing the blood glucose perioperatively.