Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Osteoporotic fractures secondary to osteoporosis increase very rapidly in incidence, and have become a major cause of disability and mortality in the elderly population. Currently, there have no standard guidelines for perioperative management, surgery and postoperative rehabilitation, causing multiple complications and poor therapeutic outcome. The authors previously proposed bone repair strategies including active anti-osteoporosis, adequate bone grafting and bone healing acceleration, namely "three-in-one" bone repair strategy. The care steps in osteoporotic fracture surgery inluded perioperative management, operative precaution, and postoperative prevention of secondary fractures. With this in mind, the authors further discussed the detailed application of "three-in-one" bone repair strategy including perioperative active anti-osteoporosis treatment, early rehabilitation training, standardized internal fixation selection, standard bone grafting methods and prevention of secondary complications, so as to promote the standardized treatment of osteoporotic fractures and improve the prognosis.

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

The osteoporotic fracture is characterized by a high disability rate，poor internal fixation strength，delayed bone healing，etc.，which greatly affects elderly health，so accelerating fracture healing is the key point of therapeutic strategies. Current researches mainly concentrate in bone formation acceleration and resorption inhibition，but the outcomes turn out to be unsatisfactory under the coupling of osteoblasts and osteoclasts. The accumulation of yellow adipose tissue in the medullary cavity is often arisen in patients with osteoporotic fractures，but its role and mechanism in bone metabolism remain unclear. Bone marrow adipocytes are differentiated from mesenchymal stromal cells and possess unique metabolic and secretory functions involving in energy metabolism，maintenance of hematopoietic microenvironment and regulation of bone metabolism balance. However，the role of bone marrow adipose tissue（BMAT）in osteoporotic fracture healing requires more elucidation. In this study，the authors discuss the key role and molecular mechanism of BMAT in the regulation of bone metabolism and homeostasis，aiming to provid new ideas and targets for the promotion of osteoporotic fracture healing.

Osteoporotic fractures have become major social problems threatening the health of the elderly population in China. Compared with conventional fractures, low bone mass, bone defect and retarded healing issues of osteoporotic fractures contribute to the difficulty in treatment and rehabilitation. Addressing major concerns in clinical settings, the "three in one" bone repair strategy focuses on anti-osteoporosis therapies, appropriate bone graft and fracture healing promotion. The authors summarize misunderstandings in diagnosis and treatment of osteoporotic fractures and repair strategies, expecting to improve prognosis and clinically standardize the treatments for osteoporotic fractures, to further improve therapeutic effect and living quality of the patients.

股骨转子间骨折是老年人常见的髋部骨折类型之一,约占全身所有骨折类型的3%～4%[1]。股骨转子间骨折患者多伴有不同程度的骨质疏松,保守治疗手段带来快速骨丢失、肺炎、褥疮和血栓等不良事件发生,目前实际应用相对较少[2]。对于老年股骨转子间骨折患者,早期手术治疗已经成为广泛认知,手术有助于缓解疼痛与早期功能锻炼,减少卧床相关并发症的风险[3]。

With aim to reasonably cope with the elderly patients with hip fracture during epidemic of corona virus disease 2019 (COVID-19), Professor Su Jiacan and Academician Zhang Yingze organized the "expert consensus on elderly patients with hip fractures under epidemic of novel coronavirus pneumonia" that for the first time formulated the management strategies for the elderly patients with hip fracture including selection of surgical methods and protective measures for medical staff from perspective of orthopedic surgeons. The authors interpret the clinical guiding value and key points of diagnosis and treatment of the consensus to help clinicians better understand the consensus and strengthen its practical application. Key words: Coronavirus infections; Pneumonia; Aged; Hip fractures; Interpretation of consensus

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

股骨颈骨折是老年人最常见的低能量骨折之一,目前的治疗方法主要有保守治疗和手术治疗两类,其中人工双极股骨头置换术是临床较为常用的方法.由于存在外展肌群张力低、髋臼形态不良和全身其他系统疾病等患者自身因素以及手术入路和假体选择不当、软组织平衡不佳等医源性因素,人工双极股骨头置换术后脱位仍然偶有发生.该文就人工双极股骨头置换术后脱位危险因素作一综述.