Abstract:Spontaneous spinal epidural hematoma(SSEH)is a rare and rapidly progressive spinal disorder,usually caused by rupture of the intraspinal venous plexus.It presents with severe,unexplained back pain and acute neurological deficits that can quickly evolve into paraplegia.The thoracic spine is the most frequently involved segment,and the hematoma may span multiple vertebral levels.Early diagnosis and prompt surgical intervention are critical for improving prognosis;MRI is the imaging modality of choice.Differential diagnosis must exclude epidural tumors,spinal subdural hematoma,spinal infections,and other entities.Surgery is the first-line treatment,and its efficacy is closely related to the degree of neurological impairment and the timing of intervention.

Abstract:Objective To observe the mid-term efficacy of mobile-bearing unicompartmental knee arthroplasty.Methods A total of 200 patients who underwent cemented mobile-bearing unicompartmental knee arthroplasty from February 2022 to February 2023 were selected.The patients were followed up for 24 months.The posterior tibial slope angle,knee joint surface angle,and joint space height were observed before and after surgery.The knee joint function,lower limb alignment and postoperative complications were evaluated.The correlations between patient age,gender,body mass index(BMI),surgical side,and knee joint function at 24 months postoperatively were analyzed.Results At 1,6,12,and 24 months after surgery,the posterior tibial slope angle,knee joint surface angle,visual analogue scale(VAS)score,and tibiofemoral angle were lower than those before surgery,while the range of motion(ROM)of the knee joint,Hospital for Special Surgery knee score,Oxford Knee Score,and hip-knee-ankle angle were higher than those before surgery(P<0.05).There was no statistically significant difference in joint space height compared with that before surgery(P>0.05).The number of postoperative complications at 1,6,12 and 24 months of follow-up was 12 cases(6.00%),18 cases(9.00%),24 cases(12.00%),and 26 cases(13.00%),respectively.Pearson correlation analysis showed that patient age was significantly negatively correlated with ROM(r=-0.312,P=0.002),and no correlations were found between other indicators and knee joint function.Conclusion Mobile-bearing unicompartmental knee arthroplasty has good mid-term efficacy and safety,with a significant negative correlation between patient age and ROM.

Abstract:Objective To investigate the clinical efficacy of open reduction and internal fixation(ORIF)in the treatment of patients with clavicular fracture,and to analyze the key factors affecting the postoperative recovery of shoulder joint function,so as to provide evidences for optimizing clinical treatment and rehabilitation protocols.Methods A retrospective study was conducted to collect the clinical data of 80 patients with clavicular fracture who underwent ORIF in Zhengzhou People's Hospital from January 2022 to December 2024.The rehabilitation compliance,disabilities of the arm,shoulder and hand(DASH)score,and Constant-Murley shoulder function score of the patients were statistically analyzed.Univariate and multivariate Logistic regression analyses were performed to identify the effects of age,body mass index(BMI),fracture type,rehabilitation compliance,and other factors on postoperative functional recovery.Results Among the 80 patients,40 achieved good postoperative recovery and 40 had poor postoperative recovery.Univariate analysis showed that higher BMI(P=0.038),complex fracture type(P=0.018),and moderate/low postoperative rehabilitation compliance(P<0.001)were adverse factors for postoperative functional recovery.Multivariate Logistic regression analysis further confirmed that higher BMI(OR=1.25,P=0.030),complex fracture type(OR=2.10,P=0.030),and moderate/low postoperative rehabilitation compliance(OR=2.63,P=0.010)were independent risk factors for poor postoperative functional recovery.Conclusion BMI,fracture type,and rehabilitation compliance are independent influencing factors for the functional recovery of patients with clavicular fracture after ORIF.Clinical individualized interventions should be implemented for high-risk patients to improve the prognosis.

Abstract:Objective To compare the clinical efficacy of percutaneous transforaminal endoscopic discectomy(PTED)in treating upper lumbar disc herniation(ULDH)and lower lumbar disc herniation(LLDH),and to validate the differences in effectiveness and safety of PTED for lumbar disc herniation(LDH)at different spinal levels.Methods Clinical data of 84 patients who underwent PTED between January 2020 and January 2024 were retrospectively analyzed.All patients were preoperatively diagnosed with ULDH(L1-2,L2-3)or LLDH(L4-5)via imaging.Of them,42 ULDH patients were involved into ULDH group,and then 42 patients in LLDH group were matched 1:1 by gender and age.Patients were followed up for 1 year postoperatively.Outcomes were evaluated using visual analogue scale(VAS),Oswestry disability index(ODI)and MacNab criteria.Results No statistical differences were found in operative time or postoperative hospital stay between two groups(P>0.05).Transient postoperative sensory abnormalities occurred in two patients in ULDH group and one patient in LLDH group,with no severe complications reported.There was no statistical difference of complication incidence between two groups(P>0.05).In both groups,there were significant improvements in VAS scores for low back pain and leg pain at 1 day and 1 year postoperatively,as well as in ODI at 1 year postoperatively,compared to the preoperative levels(all P<0.05).Furthermore,VAS scores for low back pain and leg pain at 1 year postoperatively showed significant improvement compared to those at 1 day postoperatively(all P<0.05).However,there were no statistical differences between the two groups in these three outcome indicators before and after the surgery(all P>0.05).The excellent-good rate was 88.10%in ULDH group and 92.86%in LLDH group,with no significant difference between the groups(P=0.713).Conclusion PTED has been demonstrated to obtain comparable short-term efficacy and safety in the treatment of ULDH and LLDH,with no significant differences in pain relief,functional recovery,or complication rates.

Abstract:Objective To investigate the efficacy of bone cement segmental perfusion during percutaneous vertebroplasty(PVP)for osteoporotic thoracolumbar burst fractures.Methods Clinical data of 56 patients with osteoporotic burst thoracolumbar spinal fractures who treated by PVP in PLA Navy Marine Corps Hospital from September 2022 to May 2024 were retrospectively analyzed.Patients were divided into two groups according to different bone cement perfusion methods.Segmental perfusion group was given bone cement segment perfusion(n=32),while conventional perfusion group was given conventional bone cement perfusion(n=24).Operative time,intraoperative blood loss and fluoroscopy times,as well as bone cement perfusion volume,bone cement dispersion type,bone cement leakage were compared between the two groups,and Changes of postoperative visual analogue scale(VAS)score,Oswestry disability index(ODI)and Cobb angle of injured vertebra were observed.Results All 56 patients successfully completed the surgery.The difference in classification of bone cement diffusion,intraoperative blood loss between the two groups were not statistically significant(P>0.05).Compared with the conventional perfusion group,the segmented perfusion group had longer operation times,more fluoroscopy sessions,and a lower incidence of bone cement leakage,but the segmented perfusion group had a larger volume of bone cement injected(all P<0.05).VAS socres,ODI and injured vertebra Cobb angles at 2 days after the surgery and at the latest follow-up in the two groups all showed significant improvement compared to preoperative ones,and VAS scores in segment perfusion group at 2 days postoperatively and at the latest follow-up were all lower than those in conventional perfusion group(P<0.05).Conclusion During the PVP procedure in the treatment of osteoporotic thoracolumbar burst fractures,the use of bone cement segmental perfusion,although takes longer and requires more fluoroscopy times when compared with conventional bone cement perfusion,could further reduce the incidence of bone cement leakage,and relieve postoperative pain symptoms.

Abstract:Objective To investigate the application value of bone scintigraphy target/nontarget ratio(T/NT ratio,the radioactive uptake ratio of metastatic lesions to normal bone tissue)and diffusion-weighted imaging(DWI)apparent diffusion coefficients(ADC)in the diagnosis of solitary spinal bone metastases.Methods A total of 123 patients diagnosed with malignant tumors and solitary bone lesions between January 2021 and December 2024 at Zhengzhou Orthopedic Hospital were selected,and their clinica data were analyzed retrospectively.Based on the pathological examination results and comprehensive imaging findings,46 patients with confirmed spinal bone metastasis were included in the bone metastasis group,while the remaining 77 cases diagnosed by benign lesions were included in the benign lesion group.All patients underwent MRI and bone scintigraphy,signal characteristics of patients in two groups were recorded,and changes in ADC values and T/NT ratios were analyzed to assess their diagnostic performance for spinal bone metastases.Results There were no significant differences between the two groups in clinical symptoms(low back pain,skeletal pain,neurological symptoms,pathological fractures,spinal deformities)and lesion locations(cervical,thoracic,lumbar-sacral spine)(P>0.05).In T1WI sequence,the proportion of equal or low signal and high signal in both groups did not differ significantly(P>0.05).In T2WI sequence,the high-signal proportion in the bone metastasis group was significantly higher than that in the benign lesion group(P<0.05).In DWI sequence,the high-signal proportion in the bone metastasis group was also higher than that in the benign lesion group(P<0.05).ADC value and T/NT ratio of the affected vertebrae in the bone metastasis group were significantly higher than those in the benign lesion group(P<0.05),while there was no significant difference in the ADC value of the adjacent normal vertebrae between the two groups(P>0.05).According to receiver operating characteristic curve analysis,ADC value and T/NT ratio of the affected vertebrae were demonstrated high diagnostic efficiency for bone metastasis,with area under curve of 0.847 and 0.834,respectively.The combined diagnostic AUC values of both parameters was 0.900,which was higher than the AUC avalue of separate detection.Conclusion The high-signal proportion in T2WI and DWI sequence of the bone metastasis group are higher than those of the benign lesion group.Additionally,ADC value and T/NT ratio of the affected vertebrae in the bone metastasis group are higher than those of the benign lesion group,and the combination of ADC value and T/NT ratio provides higher diagnostic value.

Abstract:Objective To investigate the technical feasibility,safety,and short-term clinical efficacy of a novel arthroscopic bone-grafting instrument for the treatment of scaphoid fracture nonunion.Methods A retrospective analysis was conducted on 18 patients with scaphoid fracture nonunion who were treated in Zhongshan Hospital of Traditional Chinese Medicine using the novel arthroscopic bone-grafting instrument between July 2022 and June 2024.All patients underwent arthroscopic debridement,bone grafting,and percutaneous internal fixation.The operative time,bone-grafting time,and bone-grafting error rate were recorded.Wrist range of motion(ROM),grip strength,visual analog scale(VAS)for pain,patient-rated wrist evaluation(PRWE)score,and Mayo wrist score(MWS)were assessed preoperatively and at 6 months postoperatively.Results The operative time was(111.06±24.16)minutes,the bone-grafting time was(18.83±6.46)minutes,and the bone-grafting error rate was(5.14±2.01)%.All patients achieved radiographic bone union,with an average healing time of(14.78±3.89)weeks.At 6 months postoperatively,patients showed improvement in wrist flexion and extension ROM,radial-ulnar deviation,grip strength,PRWE score,MWS score,and VAS score compared to preoperation(Z=-3.730,Z=-3.732,Z=-3.748,t=21.300,t=-14.080,Z=-3.944,all P<0.001).No surgical complications or instrument-related adverse events occurred during the perioperative period and the follow-up period.Conclusion For the treatment of scaphoid fracture nonunion,the novel arthroscopic bone-grafting instrument is user-friendly,and has the advantages of short operative time,precise and efficient bone grafting,good safety and remarkable short-term efficacy.

Abstract:Objective To evaluate the effects of narrative nursing education on the training of humanistic care competence of orthopedic nursing interns.Methods Twenty-nine orthopedic nursing interns in a tertiary Grade A hospital were recruited.Participants received standard nursing education supplemented with a two-month narrative nursing education intervention when they entered into the department.The medical narrative competence scale and the humanistic care competence scale were used to investigate their medical narrative competence and humanistic care competence before and after the intervention.Results Post-intervention scores for both medical narrative competence and humanistic care competence were higher than those pre-interventaion scores,which showing statistical differences(P<0.05).Conclusion Narrative nursing education effectively enhances medical narrative competence and humanistic care competence of orthopedic nursing interns.

Abstract:Objective To explore the application value of neuroelectrophysiological monitoring in unilateral bioportal endoscopic(UBE)decompression for patients with lumbar degenerative diseases.Methods A prospective single-blind randomized clinical trial was conducted on 103 patients with lumbar degenerative diseases who underwent UBE decompression surgery at Puyang People's Hospital from June 2022 to June 2024.Among them,52 cases were included in the monitoring group(with neuroelectrophysiological monitoring during the operation),and 51 cases were included in the control group(without neuroelectrophysiological monitoring during the operation).The surgical indicators of the two groups of patients were observed.Low back and leg pain,neurological function,spinal cord function and pain mediators in two groups were compared before and after the surgery.Results There was no statistical differences in surgical indicators(operation time,intraoperative fluoroscopy frequency,blood loss,postoperative drainage volume and total hospital stay),preoperative visual analogue scale(VAS)score for low back and leg pain and Oswestry disability index(ODI),as well as preoperative levels of serum nitric oxide(NO),substance P(SP),β-endorphin(β-EP),and prostaglandin E2(PGE2)between the two groups(all P>0.05).At 1,3,6 and 12 months after the operation,the VAS scores and ODI of the two groups of patients were significantly improved compared with those before the operation,and the VAS scores and ODI of the monitoring group at different time points after the operation were lower than those of the control group(all P<0.05).Three days after the operation,the levels of serum NO,SP,β-EP and PGE2 in both groups decreased,and the levels of the above pain mediator indicators in the monitoring group were all lower than those in the control group(all P<0.05).During the follow-up period,1 case of incision infection and 1 case of pulmonary infection occurred in the monitoring group,while 2 cases of nerve root injury,1 case of intervertebral space infection,1 case of incision infection and 2 cases of pulmonary infection occurred in the control group.There was no statistical difference in the incidence of complications between the two groups(3.85%vs 11.76%,P>0.05).Conclusion For patients with lumbar degenerative diseases who undergo UBE decompression surgery,the application of neuroelectrophysiological monitoring during the operation can reduce the risk of nerve root injury,improve surgical safety,and provide favorable conditions for improving the levels of pain mediators,alleviating low back and leg pain,and promoting the recovery of nerve function after the operation.

Abstract:Objective To observe the surgery-related complications of Inter-Tan fixation in elderly patients with intertrochanteric fractures,and to propose surgical keypoints and corresponding strategy.Methods A retrospective analysis was carried out on 429 elderly patients with intertrochanteric fractures in Xingyi People's Hospital from March 2015 to March 2024.All patients were treated with closed manual reduction and minimally invasive insertion of Inter-tan fixation.Results Fifteen patients were suffered from internal fixation-related complications with the incidence of 2.27%,including 1 case of crossed head-neck screws and coupling failure,3 cases of head-neck screws cutting into the joint cavity,7 cases of difficult positioning of distal locking screws,and 4 cases of distal locking screws sinking into the bone.Conclusion During the surgical procedure of Inter-Tan nailing for intertrochanteric fractures in elderly patients,factors such as osteoporosis,complex fracture patterns,and different surgical techniques,may lead to complications,such as head-neck screws intercrossing,cutting into the joint cavity,or difficult positioning or sinking into the bone of distal locking screws,which requiring special attention in clinical practice.

Abstract:Objective To evaluate the clinical efficacy and safety of ultrasonic bone curette assisted spinous process and lamina replantation combined with pedicle screw fixation for the reconstruction of posterior column during intraspinal tumor resection.Methods A total of 16 patients with intraspinal tumor who underwent the operation from January 2021 to August 2024 were included.In this single-center retrospective study,the operation time,intraoperative blood loss,length of hospital stay and complications were recorded,clinical efficacy was evaluated at 1 week,3 months and the last follow-up.The primary outcomes related indicators included visual analogue scale(VAS)score,Japanese Orthopaedic Association(JOA)score,and Oswestry disability index(ODI),and the secondary outcomes included serum interleukin-6(IL-6),and calcitonin gene-related peptide(CGRP)levels.Results All operations were completed successfully.Imaging data showed that the tumor was completely removed and the posterior column was reconstructed stably.The main outcome indicators at each follow-up point were significantly improved when compared with those before the operation,and the differences were statistically significant(P<0.05).The levels of IL-6 and CGRP decreased after operation and tended to be stable.No serious adverse events such as spinal cord/nerve injury or internal fixation failure were observed.During the follow-up period,MRI showed no tumor recurrence.Conclusion Ultrasonic bone curette assisted spinous process and lamina replantation combined with pedicle screw fixation can achieve anatomical reconstruction of the posterior column in the context of ensuring tumor resection,with the advanatages of less trauma,quick recovery,good stability and fewer complications.

Abstract:Objective To observe the application effect of subpackage and zoning optimization combined with plug structure surgical nail box in the counting of foreign instruments for orthopedic internal fixation surgery.Methods A total of 120 patients undergoing orthopedic internal fixation surgery at General Hospital of Southern Theater Command from January to December 2022 were selected as the study subjects.Among them,60 patients who underwent the traditional foreign instrument counting method from January to June 2022 were assigned to the control group,while 60 patients who adopted the counting method of subpackage and zoning optimization combined with plug structure surgical nail box from July to December 2022 were assigned to the study group.The time and accuracy of counting foreign instruments,and surgeons'satisfaction with the cooperation of surgical nurses were compared between the two groups.Results After implementing the subpackage and zoning optimization combined with plug structure surgical nail box method,the median counting time for foreign instruments in spinal fusion internal fixation surgery and long bone fracture internal fixation surgery decreased from 187 s,192 s to 90 s,60 s,respectively.The error repetition rate of foreign instrument counting dropped from 7.89％and 12.28％to 0,with both counting time and error repetition rate significantly lower than those in the control group(P<0.05).Surgeons'satisfaction with the cooperation of surgical nurses increased from 78.33％to 96.67％.Conclusion During orthopedic internal fixation surgery,the subpackage and zoning optimization combined with plug structure surgical nail box method enables rapid and accurate counting of foreign instruments,improves work efficiency,and enhances surgeons'satisfaction with the cooperation of surgical nurses,making it worthy of clinical promotion and application.

Abstract:Objective To explore the clinical efficacy of elastic intramedullary nailing fixation combined with platelet-rich plasma(PRP)injection in the treatment of midshaft clavicle fractures,and to provide references for optimizing the treatment plan of such fractures.Methods A total of 80 patients with midshaft clavicle fractures admitted to Zhoukou Orthopedic Hospital from January 2023 to May 2024 were involved and divided into the experimental group and the control group by random number table method,with 40 cases in each group.The control group was treated with simple elastic intramedullary nailing fixation,while the experimental group was treated with additional PRP injection.The Constant-Murley shoulder score(CMS)and visual analogue scale(VAS)score for pain were compared between the two groups after surgery.Meanwhile,the fracture healing-related indicators(fracture healing time,postoperative callus score,bone mineral density)and the total incidence of complications were compared between the two groups.Results CMS of both groups gradually increased at 1,3,and 6 months after the operation,and CMS of the experimental group at each time point were significantly higher than those of the control group at the same period(P<0.05).The VAS scores gradually decreased over time(P<0.05);There was no significant difference in the VAS score between the two groups before the operation and 6 hours after the operation(P>0.05),while VAS scores of the experimental group at 1 day,3 days,1 week,and 2 weeks after the operation were significantly lower than those of the control group at the same period(P<0.05).The fracture healing time of the experimental group was significantly shorter than that of the control group,and the postoperative callus score and bone mineral density of the experimental group were significantly higher than those of the control group.The total incidence of complications in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion Elastic intramedullary nailing fixation combined with PRP injection in the treatment of midshaft clavicle fractures can effectively reduce the degree of postoperative pain in patients,accelerate the process of fracture healing,improve the recovery of shoulder joint function,and reduce the risk of postoperative complications.

Abstract:Objective To explore the feeling and symptom experience of neuropathic pain(NP)in patients with peripheral nerve injury(PNI),and to clarify the needs of pain management,so as to provide a basis for medical staff to fully grasp the symptoms of pain,improve symptom management and promote the rehabilitation of patients.Methods The descriptive qualitative research method in qualitative research was used to conduct semi-structured in-depth interviews.By purposive sampling method,12 patients who suffered from PNI with NP and treated in the First Affiliated Hospital of Sun Yat-sen University between February and September 2023 were involved,and face-to-face interviews were conducted encompassing three core domains,the experience of pain-related illness trajectories,symptoms and signs of NP and its impact,coping strategies and expectations for pain management.Data were analyzed and then the subjects were extracted by Colaizzi's 7-step analysis method.Results A total of 3 core themes and 6 sub-themes were extracted,including symptom perception(uncertain symptom experience,complex and diverse changes in pain),symptom distress(sleep disorders and complex pain emotions),symptom self-management(self pain response and proactive seeking of support information).Conclusions Patients with PNI are facing various difficulties and burdens in terms of pain experience with a variety of NP symptoms.The lack of systematic support and guidance in self-managing pain symptoms is also a significant challenge.All these indicates medical staff need to pay attention to pain perception and symptom experience,and strengthen pain symptom management,so as to improve quality of life of patients with PNI accompanied with NP.

Abstract:Objective To observe the application of staged rehabilitation training in the postoperative recovery of patients with rotator cuff tears after arthroscopic rotator cuff repair.Methods A total of 118 patients with rotator cuff laceration who underwent arthroscopic rotator cuff repair at Zhengzhou Orthopedic Hospital from January 2023 to October 2024 were enrolled.There were randomly divided into two groups by the envelope method.The conventional group was given conventional training intervention after the operation,while the staged group adopted staged rehabilitation training intervention after the operation.The range of motion(ROM)of the shoulder joints,the levels of flexor peak moment(FPT),and extensor peak torque(EPT)of the shoulder joints in were detected the two groups.The Constant-Murley score(CMS),visual analog scale(VAS)score,University of California at Los Angeles(UCLA)score of the shoulder joint,and satisfaction score were evaluated.Results After 12 weeks'treatment,ROM of shoulder flexion,abduction,and external rotation in the neutral position,as well as the FPT and EPT of the shoulder joint in both groups were higher than those before treatment,and the staged group were higher than the conventional group(all P<0.05).The total CMS score and the scores of pain,daily life,shoulder joint ROM and muscle strength,as well as VAS score,UCLA score in both groups at 12 weeks after treatment all improved when compared with those before treatment,and the above indicators in the staged group were better than those in the conventional group after treatment(all P<0.05).The scores of training program design,pain management,functional recovery and effect,therapist guidance and communication,time and convenience,overall experience and satisfaction in the staged group were higher than those in the conventional group(all P<0.05).Conclusion Staged rehabilitation training applied after arthroscopic surgery for rotator cuff laceration can promote shoulder joint ROM and the recovery of shoulder joint function,relieve pain,improve the muscle strength of forward flexion and backward extension of the shoulder joint,and increase patient satisfaction.

Abstract:Objective To investigate the efficacy and safety of three types of electric pneumatic tourniquet pads,gypsum cotton pads,elastic tubular bandages,and gauze bandages,in limb fracture surgeries.Methods The study included 102 patients who underwent limb fracture surgery at Xingtan Hospital Affiliated to Southern Medical University Shunde Hospital between January 2024 and January 2025.Patients were randomly assigned using a random number table to one of three groups:plaster cotton paper group,elastic tubular bandage group,and gauze bandage group,with 34 patients in each group.The study compared indicators including surgical duration,intraoperative blood loss,tourniquet application time,and hemostatic efficacy among the 3 groups.Patients'skin condition,satisfaction of surgeon,and tourniquet-induced shock incidence in 3 groups were observed.Results Comparing the three groups for operative time,intraoperative blood loss and tourniquet application duration,elastic tubular bandage group<plaster cotton paper group<gauze bandage group(P<0.05);When compared hemostatic efficacy and the excellent and good rates of skin condition among 3 groups,elastic tubular bandage group>plaster cotton paper group>gauze bandage group(P<0.05);Satisfaction of surgeon was higher in elastic tubular bandage group than that in plaster cotton paper group and gauze bandage group(P<0.05).There was no statistical difference in tourniquet-induced shock incidence within 3 days after surgery among the three groups(P>0.05).Conclusion Compared to plaster cotton paper pads and gauze bandage pads,the use of elastic tubular bandage pneumatic tourniquet pads for patients with limb fractures could significantly reduce surgical duration and tourniquet application time,decrease intraoperative blood loss,lower the risk of skin damage,enhance hemostatic efficacy,and improve satisfaction of surgeon,making it worthy of clinical promotion.

Abstract:Objective To explore the efficacy of arthroscopic surgery for senile discoid meniscus injury,and to analyze the infuence factors and postoperative inflammatory levels.Methods A total of 80 elderly patients with discoid meniscus injury who underwent arthroscopic surgery at Puyang Hospital of Traditional Chinese Medicine from March 2021 to March 2024 were selected.The therapeutic efficacy at 12 months postoperatively and its influencing factors were observed,and the differences in serum levels of nuclear factor-κ B(NF-κ B),human cartilage glycoprotein-39(HCgp-39,also known as YKL40),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were analyzed before and after surgery.Results At 12 months postoperatively,according to the Hospital for Special Surgery knee score,the efficacy was excellent in 20 cases,good in 43,fair in 13,and poor in 4 cases,with an excellent and good rate of 78.75％(63/80).Logistic regression analysis showed that age(OR=0.443),course of disease(OR=0.415),and surgical type(OR=3.401)were influencing factors of therapeutic efficacy(P<0.05).At one month after surgery,the serum levels of NF-κB、YKL-40、IL-6 and TNF-α were improved when compared with preoperative ones,and the above levels in patients undergoing meniscoplasty were significantly lower than those in patients undergoing other surgical types,with statistical differences(P<0.05).Conclusion The efficacy of arthroscopic surgery for senile discoid meniscus injury is affected by age,course of disease,and surgical type,and there are differences in postoperative inflammatory levels among patients with different surgical types.

Abstract:Objective To observe the repair effect of adjacent finger digital artery island flap in replantation of severed finger with skin defect.Methods Clinical data of 82 patients with severed fingers of skin defect treated in the First People's Hospital of Pingdingshan City between May 2022 and January 2024 were retrospectively analyzed.According to different treatment methods,they were divided into traditional group(n=38,traditional replantation)and flap repair group(n=44,repair of adjacent finger digital artery island flap).The repair effect,clinical indexes,repair satisfaction and postoperative complications were compared between the two groups.Results The excellent and good rate of repair in flap repair group was higher than that in traditional group[88.64％(39/44)vs 71.05％(27/38),P<0.05].Flap repair group exhibited reductions in hospital stay and two-point discrimination,while the operation duration,as well as the range of motion of the proximal and distal phalanx joints,were higher than those in traditional group(all P<0.05).The total satisfaction rate of repair in flap repair group was higher than that in traditional group[95.45％(42/44)vs 76.32％(29/38),P<0.05],and the incidence of postoperative complications of repair in flap reair group was lower than that in traditional group(4.55％vs 21.05％,P<0.05).Conclusion The repair effect of adjacent finger digital artery island flap is good in replantation of severed finger with skin defect,which can effectively shorten treatment time,better recover postoperative function,improve patients'satisfaction and reduce postoperative complications.