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08 July 2017, Volume 21 Issue 19 Previous Issue    Next Issue

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Postoperative quality of life of internal fixation versus hemiarthroplasty for femoral neck fractures in the elderly   Hu Jun, Zhang De-qiang, Tang Xin 2017, 21 (19):  2953-2960.  doi: 10.3969/j.issn.2095-4344.2017.19.001 Abstract ( 389 )   PDF (1043KB) ( 278 )   Save BACKGROUND: The treatment strategy for femoral neck fractures has not been confirmed, and choosing internal fixation or arthroplasty remains controversial. After internal fixation, the occurrence of bone nonunion and osteonecrosis of femoral head makes its long-term treatment outcomes far from satisfactory. Can we improve the functional recovery through high-quality reduction, accurate fixation and active postoperative exercise? If so, it may be favorable for the elderly with femoral neck fractures, especially for those combined with other serious diseases. OBJECTIVE: To compare the quality of life in the elderly with femoral neck fractures after internal fixation and hemiarthroplasty. METHODS: 148 patients with femoral neck fractures aged more than 60 years old in the First Affiliated Hospital of Dalian Medical University from January 2010 to December 2013 were analyzed retrospectively. The operation time, intraoperative blood loss, hospitalization time, mortality rate, reoperation rate and postoperative quality of life were compared between internal fixation and hemiarthroplasty in the patients with undisplaced femoral neck fractures (Garden type I or II) displaced femoral neck fractures (Garden type III or IV), respectively. RESULTS AND CONCLUSION: (1) Among 148 patients, 137 cases completed follow-up, and the follow-up rate was 92.6%. (2) The operation time, intraoperative blood loss and hospitalization time in the internal fixation group were significantly superior to those in the hemiarthroplasty group in patients with displaced or undisplaced femoral neck fractures (P < 0.05). (3) There was no significant difference in the mortality rate between two groups, and the reoperation rate in the internal fixation groups was slightly higher than that in the hemiarthroplasty group. (4) The Harris and SF-36 scores in both groups were increased with time, and the difference between two groups was decreased with time, which became equal at 2.5 years postoperatively (P > 0.05). Besides, the time of the patients with undisplaced femoral neck fractures in the internal fixation group achieving the same quality of life with the hemiarthroplasty group was earlier than that of displaced ones. (5) These results suggest that internal fixation holds short operation time, simple operation skills and less trauma in the treatment of femoral neck fractures, and with the development of technology, it can achieve the early functional recovery. Thereafter, it is an effective method for senile femoral neck fractures. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Time of lower extremity deep venous thrombosis after hip arthroplasty in senile patients with osteoporotic femoral neck fractures   Sun Hao, Wei Jun-qiang, Liu Li-rui, Yan Shi, Jin Yu, Feng Zhen 2017, 21 (19):  2961-2965.  doi: 10.3969/j.issn.2095-4344.2017.19.002 Abstract ( 365 )   PDF (774KB) ( 212 )   Save BACKGROUND: Lower extremity deep venous thrombosis is commonly seen after hip arthroplasty. The time of thrombosis after arthroplasty in senile patients with osteoporotic femoral neck fractures is little reported. OBJECTIVE: To investigate the time of perioperative lower extremity deep venous thrombosis in senile patients with osteoporotic femoral neck fractures undergoing hip arthroplasty. METHODS: The data of 178 patients with femoral neck fractures undergoing hip arthroplasty were analyzed, and were then allocated to anticoagulant and non-anticoagulant groups according to the preoperative use of low-molecular-weight heparins or not. Doppler ultrasonography of both lower extremity arteries was conducted at 1, 3, 5 and 5-7 days after injury, and 2, 5, 7 and 14 days postoperatively to monitor the lower extremity deep venous thrombosis, and the number and incidence of thrombosis in the two groups were recorded at different time points. The time of thrombosis occurred frequently after injury and surgery was determined through drawing the frequency distribution table and line chart. RESULTS AND CONCLUSION: (1) The incidence of thrombosis showed significant difference between anticoagulant (n=6, 8%) and non-anticoagulant (n=22, 21%)) groups (P < 0.05). (2) Thrombosis frequently occurred at 3 days after injury and 1 day postoperatively. (3) These results suggest that the thrombosis in patients with femoral neck fractures frequently occurs at 1-3 days after injury and 1 day after replacement. Additionally, active prevention measures after injury can significantly reduce the incidence of lower extremity venous thrombosis.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Analgesic effect of femoral and sciatic nerve block under multimodal analgesia in total knee arthroplasty     Gao Wei-lu, Li Hong, Liu Bi-quan, Hu Yong, Liu Jing-jun, Yin Li, Liu Hu, Mei Bin, Yin Zong-sheng 2017, 21 (19):  2966-2972.  doi: 10.3969/j.issn.2095-4344.2017.19.003 Abstract ( 380 )   PDF (827KB) ( 401 )   Save BACKGROUND: The effectiveness of femoral nerve block in perioperative analgesia for total knee arthroplasty has been widely recognized, but the need for combined sciatic nerve block remains controversial. OBJECTIVE: To investigate the analgesic effect and rehabilitation training of femoral and sciatic nerve block in the perioperative period of total knee arthroplasty. METHODS: 150 patients undergoing total knee arthroplasty were randomly divided into three groups: general anesthesia, femoral nerve block and femoral and sciatic nerve block groups. The visual analogue scale scores at rest and in activity, range of motion of the knee, postoperative hospitalization time, adverse effects and the Hospital for Special Surgery scores were recorded and compared among groups. RESULTS AND CONCLUSION: (1) The order of visual analogue scale scores at rest and in activity at each time point postoperatively was as follows: general anesthesia group > femoral nerve block group > femoral and sciatic nerve block group (P < 0.05). (2) The range of motion of the knee at different time points postoperatively was largest in the femoral nerve block group, followed by the femoral nerve block group, and smallest in the general anesthesia group (P < 0.05). (3) The postoperative hospitalization time in the femoral nerve block and femoral and sciatic nerve block groups was significantly less than that in the general anesthesia group, and the time in the femoral and sciatic nerve block group was significantly less than that in the femoral nerve block group (P < 0.05). (4) The Hospital for Special Surgery scores at 1 month postoperatively in the femoral nerve block and femoral and sciatic nerve block groups were significantly higher than those in the general anesthesia group, and the scores in the femoral and sciatic nerve block group were significantly higher than those in the femoral nerve block group (P < 0.05). But the Hospital for Special Surgery knee scores at 3 and 6 months postoperatively did not differ significantly among groups (P > 0.05). (5) These results indicate that the femoral and sciatic nerve block has better postoperative analgesia effect compared with general anesthesia and femoral nerve block under multimodal analgesia in total knee arthroplasty, which is favorable for early rehabilitative training.     中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Unilateral pedicle screw fixation combined with translaminar facet screw fixation versus bilateral pedicle screw fixation for lower lumbar degenerative diseases: a 2-year follow-up   Jiang Wei, Yuan Feng 2017, 21 (19):  2973-2979.  doi: 10.3969/j.issn.2095-4344.2017.19.004 Abstract ( 398 )   PDF (1249KB) ( 253 )   Save BACKGROUND: Bilateral pedicle screw fixation combined with intervertebral decompression and fusion is a classic surgical approach in treatment of lumbar degenerative diseases, but it can cause ligament and other soft tissue damage of lumbar spine and degeneration of the adjacent segments. While translaminar facet screw fixation has its unique advantages. OBJECTIVE: To compare the clinical efficacy of unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation for lower lumbar degenerative diseases. METHODS: Forty-six patients with single-level lower lumbar degenerative disease were enrolled, and were then treated with bilateral pedicle screw fixation combined with intervertebral fusion (group A, n=24) or unilateral pedicle screw along with translaminar facet screw fixation and intervertebral fusion (group B, n=22). Afterwards, the clinical indexes and efficacy were compared between two groups. RESULTS AND CONCLUSION: (1) All operations were performed successfully. The length of incision, operation time, intraoperative blood loss, postoperative drainage volume and cost of hospitalization in the group B were significantly superior to those in the group A (P < 0.05). (2) There was no significant difference in the rate of fusion between two groups (P > 0.05). (3) The visual analogue scale and Japanese Orthopaedic Association scores in both groups at 1 week, 3, 6, 12 and 24 months postoperatively were significantly improved compared with baseline (P < 0.05), but the scores had no significant differences between two groups (P > 0.05). (4) To conclude, unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation both exhibit satisfactory treatment outcomes, while the former holds little trauma, good stability, high fusion rate and less cost, which is a better choice for lower lumbar degenerative diseases. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Efficacy and safety of K-rod dynamic stabilization system in the repair of lumbar degenerative diseases: study protocol for a prospective, self-controlled, clinical trial Wang Jing-xu, Gong Shu-yi, Wu Bo 2017, 21 (19):  2980-2985.  doi: 10.3969/j.issn.2095-4344.2017.19.005 Abstract ( 473 )   PDF (799KB) ( 288 )   Save BACKGROUND: Posterior internal fixation and fusion system is a main method for chronic back pain caused by intervertebral disc degeneration, but more postoperative adverse reactions occur. Dynamic stabilization system can reduce adjacent-segment degeneration, and theoretically, repair intervertebral disc degeneration. OBJECTIVE: To investigate the efficacy and safety of K-rod dynamic stabilization system in the repair of lumbar degenerative diseases. METHODS/DESIGN: We conducted a prospective, single-center, self-controlled, clinical trial at the Orthopedic Hospital of Shenyang, China. Sixty-seven patients with lumbar degenerative diseases were enrolled, and treated with K-rod dynamic stabilization system. All patients were followed for 2 years. The primary outcome was the changes in the Oswestry dysfunction index scores at baseline, 3, 6, 12 and 24 months postoperatively. The secondary outcomes were the ratio of height vertebral space to body and lumbar lordotic angle at baseline, 3, 12 and 24 hours postoperatively; the visual analogue scale scores for back pain and morphological changes in the lumbar vertebrae on x-ray preoperatively and 3, 6, 12 and 24 months after surgery; the incidence of adverse reactions at 3, 6, 12 and 24 months postoperatively. This trial has been registered at ClinicalTrials.gov (identifier: NCT03214042). The study protocol has been approved by the Ethics Committee of Orthopedic Hospital of Shenyang. All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki. Written informed consent was provided by each patient after they indicated that they fully understood the treatment plan. DISCUSSION: This trial was designed to investigate the efficacy and safety of K-rod dynamic stabilization system for lumbar degenerative diseases, thus providing reference for its clinical application. Partial results demonstrated that the Oswestry Dysfunction Index and Visual Analogue Scale scores at 24 months postoperatively were significantly improved (P < 0.01), but the ratio of height vertebral space to body and lumbar lordotic angle did not differ significantly at different time points (P > 0.01). These results suggest that K-rod dynamic stabilization system can alleviate pain and improve lumbar function in the patients with lumbar degenerative diseases. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement for single-level thoracolumbar fracture  Zhan Fang-biao, Wang Shi-jun, Cheng Jun, Feng Shi-long, Xie Li-zhong, Li Bo, Zhang You 2017, 21 (19):  2986-2992.  doi: 10.3969/j.issn.2095-4344.2017.19.006 Abstract ( 316 )   PDF (1102KB) ( 314 )   Save  BACKGROUND: Thoracolumbar fracture is most common seen in spinal fractures. The paraspinal muscle is subjected to extensive detachment and traction in traditional posterior approach, so the muscular ischemia and denervation lead to muscle atrophy further inducing intractable low back pain. Thereafter, minimally invasive spinal surgery becomes more and more popular. OBJECTIVE: To investigate the clinical efficacy of pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement for single-level thoracolumbar fracture. METHODS: Clinical data of 52 patients with single-level thoracolumbar fracture without nerve injury were analyzed retrospectively, and were then assigned to observation (n=28) and control groups (n=24) according to the treatment method. The patients in the observation group were treated with pedicle screw fixation through Wiltse approach plus implanted with injectable calcium sulfate bone cement, and those in the control group were subjected to pedicle screw fixation through posterior approach plus implanted with injectable calcium sulfate bone cement. The operation time, blood loss and hospitalization time were compared between two groups. The low back pain was observed at baseline, 1 week and 3 months postoperatively, and the percentage of anterior vertebral height revealed on X-ray was observed at baseline, before ambulation, and during last follow-up. Moreover, the complications, loosening and rupture of the screws were recorded.  RESULTS AND CONCLUSION: (1) All patients were followed up, and the follow-up time was 16-24 months. (2) The operation time, blood loss and hospitalization time in the observation group were significantly less than those in the control group (P < 0.05). (3) The postoperative visual analogue scale scores in the two groups were significantly lower than those before surgery, and the scores showed significant differences between two groups (P < 0.05). (4) The percentage of anterior vertebral height before ambulation and during last follow-up in the two groups was significantly improved, and the percentage showed significant difference between two groups at each time point (P < 0.05). (5) These findings suggest that based on strict indications, the pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement is safe for single-level thoracolumbar fracture, which restores the anterior vertebral height rapidly, alleviates pain and exhibits satisfactory long-term efficacy. Furthermore, it holds shorter operation time and less blood loss than the traditional approach. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Risk factors for ligamentum flavum hypertrophy in lumbar spinal stenosis patients from the Xinjiang Uygur Autonomous Region, China: protocol for a retrospective, single-center study   Zhou Gang, Zhang Yu-kun, Huang Wei-min 2017, 21 (19):  2993-2998.  doi: 10.3969/j.issn.2095-4344.2017.19.007 Abstract ( 426 )   PDF (983KB) ( 211 )   Save BACKGROUND: Ligamentum flavum hypertrophy is one important cause of spinal stenosis. Ligamentum flavum thickness of more than 4 mm measured on computed tomography (CT) and magnetic resonance imaging is considered hypertrophy, but causes of hypertrophy and distribution characteristics remain poorly understood. Previous studies showed that the ligamentum flavum thickness at the segments L2/3, L3/4, L4/5 and L5/S1 was positively correlated with age. It remains unclear whether ligamentum flavum thickness is associated with nationality, sex and obesity. OBJECTIVE: To retrospectively analyze the risk factors for ligamentum flavum hypertrophy in lumbar spinal stenosis patients from the Xinjiang Uygur Autonomous Region, China. METHODS: We conducted a retrospective, single-center, case analysis at the Sixth Affiliated Hospital, Xinjiang Medical University, China. We collected lumbar CT imaging data of 104 patients diagnosed with lumbar spinal stenosis in the Sixth Affiliated Hospital, Xinjiang Medical University from May 2012 to May 2016. The primary outcome was the ligamentum flavum thickness of patients with different nationalities, sexes, heights, ages, and weights. The secondary outcomes were the morphology of lumbar vertebrae in patients with different nationalities, sexes, heights, ages, and weights; the correlation of nationality, sex, height, age, and weight with ligamentum flavum thickness; results of multiple linear regression analysis of relevant factors for ligamentum flavum hypertrophy. This trial has been registered at clinical Trials.gov (indentifier: NCT03057353). This protocol has been approved by the Medical Ethics Committee of Xinjiang Medical University and will be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment will be obtained from each participant. DISCUSSION: This study will determine the variations in the ligamentum flavum thickness of lumbar spinal stenosis patients of different nationalities, sexes, heights, ages, and weights in the Xinjiang Uygur Autonomous Region by measuring the ligamentum flavum thickness using CT, and analyzing risk factors for ligamentum flavum hypertrophy; the findings will provide quantitative reference data for preventing lumbar spinal stenosis induced by ligamentum flavum hypertrophy in the Xinjiang Uygur Autonomous Region. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Femoral neck fractures fixed with intramedullary cannulated screws: factors for postoperative functional recovery Wang Xiu-ping, Sun Rui-bo, Liu You-wen, Zhang Ying, Jia Yu-dong, Yang Yu-xia, Wang Hui-chao 2017, 21 (19):  2999-3004.  doi: 10.3969/j.issn.2095-4344.2017.19.008 Abstract ( 423 )   PDF (1001KB) ( 281 )   Save BACKGROUND: Hip arthroplasty and internal fixation with intramedullary cannulated screws are mainly used for senile femoral neck fractures. However, osteoporosis can usually lead to failure in internal fixation. OBJECTIVE: To analyze the joint function after fixed with intramedullary cannulated screws in elderly patients with femoral neck fractures, and to explore the factors related to functional recovery. METHODS: Clinical data of 89 patients with femoral neck fractures undergoing internal fixation with intramedullary cannulated screws after 2-year follow-up were analyzed retrospectively. The sex, age, Garden type, bone mineral density, body mass index, screw distribution, reduction index, operation time, bearing time and Harris hip scores were analyzed. Rank related analysis and accumulative Logistic regression analysis were performed on SPSS18.0 software. RESULTS AND CONCLUSION: (1) Normal Q-Q plot and normality test results indicated that the Horris scores in all patients after 2-year follow-up presented with skewed distribution (P=0.000). (2) Rank related analysis showed that age, Garden type, bone mineral density, and reduction index were related with Harris score (P < 0.05 or P < 0.01). (3) Accumulative Logistic regression analysis showed that the independent variables including age, Garden type, bone mineral density, and reduction index made significant effect on Harris hip scores. (4) To conclude, age, Garden type, bone mineral density, and reduction index are important factors for functional recovery of the hip after fixed with intramedullary cannulated screws. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Double-row suture anchors under arthroscopy for avulsion-type greater tuberosity fractures (Mutch type I)   Liu Gang, Zhang Lei, Wang Guo-you, Zhou Xin, Zhang Tao, Guan Tai-yuan, Guo Xiao-guang, Fu Shi-jie 2017, 21 (19):  3005-3010.  doi: 10.3969/j.issn.2095-4344.2017.19.009 Abstract ( 466 )   PDF (906KB) ( 305 )   Save BACKGROUND: Greater tuberosity of humerus, as the attachment point of rotator cuff, plays a vital role in shoulder. Neer and AO classification for proximal humeral fractures have been accepted extensively. However, the classification for single greater tuberosity fractures of the proximal humerus is little reported, and its fixation method remains controversial. OBJECTIVE: To explore the curative efficacy of the double-row suture anchors under arthroscopy for avulsion-type greater tuberosity fractures (Mutch type I) METHODS: Clinical data of 24 patients with avulsion-type greater tuberosity fractures (Mutch type I) undergoing double-row suture anchors under arthroscopy were analyzed retrospectively. The displacement distance of the greater tuberosity of humerus was measured on CT before and after fixation. The shoulder joint was evaluated by Constant-Murley Score and the University of California, Los Angeles score at baseline, 1, 3, 6 and 12 months postoperatively. Besides, the visual analogue scale scores were detected at baseline and 12 months postoperatively. RESULTS AND CONCLUSION: (1) Double-row suture anchors effectively improved the displacement of greater tuberosity and rotator cuff injury. (2) The patients accompanied by rotator cuff injury accounted for 79.16%. (3) The Constant-Murley Score and the University of California, Los Angeles scores were significantly improved at each time point (P < 0.05). The visual analogue scale scores after fixation were significantly superior to those before fixation (P < 0.05). (4) These results suggest that the double-row suture anchors under arthroscopy can effectively improve the displacement of greater tuberosity and alleviate the pain. Moreover, it is conductive for early recovery of the shoulder function with little trauma, so it is a good choice for avulsion-type greater tuberosity fractures (Mutch type I). 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Stability of ankle joint in the repair of deltoid ligament with suture anchors Gao Yi-jia, Huang Feng, Lao Yong-sheng, Zeng Zhan-peng, Xu Xian-feng, Luo Wei-dong, Sun Shi-dong, Chen Bo-hang 2017, 21 (19):  3011-3016.  doi: 10.3969/j.issn.2095-4344.2017.19.010 Abstract ( 409 )   PDF (902KB) ( 284 )   Save BACKGROUND: Ankle fracture combined with deltoid ligament rupture and distal tibiofibular syndesmosis injury occurs occasionally. Its treatment with distal tibiofibular syndesmosis screw fixation or deltoid ligament repair remains controversial. The former appears with poor reduction, broken nails, secondary surgery and other problems. OBJECTIVE: To observe the clinical effectiveness of suture anchor repair for ankle fracture combined with deltoid ligament injury. METHODS: Twelve patients with ankle fracture combined with deltoid ligament injury were selected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2013 and December 2015. All patients were treated with open reduction, internal fixation, and anchor repair, but without distal tibiofibular syndesmosis screw fixation. The curative efficacy and joint stability were observed. RESULTS AND CONCLUSION: (1) All patients were followed-up for more than 12 months. (2) The modified Baird-Jackson scoring system showed excellent in nine cases, good in two cases, average in one case, poor in none case, and the excellent and good rate was 92%. (3) At 1 year after internal fixation, the X-ray examination showed the malleolus gap and talus slope angle of the affect side were (3.47±0.12) mm and (0.45±0.18)°, and the malleolus gap and talus slope angle of the healthy side were (3.44±0.05) mm and (0.43±0.14)°, and there was no significant difference between two sides (P > 0.05). (4) These results indicate that the suture anchor can repair the anatomy and biomechanics of deltoid ligament with stable ankle joint, and secondary surgery is unnecessary.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Effect of the simultaneous correction of pectus excavatum and scoliosis on the thoracic deformity   Lu Guang-pu, Ye Jin-duo, Feng Jing-jing, Geng Li-yang, Liu Ji-fu, Zhong Wei-hong, Dong Li-min 2017, 21 (19):  3017-3022.  doi: 10.3969/j.issn.2095-4344.2017.19.011 Abstract ( 339 )   PDF (1056KB) ( 204 )   Save BACKGROUND: Studies on the biomechanical properties in NUSS procedure have obtained some achievements, but the effect of scoliosis surgical correction of scoliosis on thoracic deformity remains unclear. OBJECTIVE: To explore the effect of simultaneous correction of pectus excavatum and scoliosis on thoracic deformity so as to provide reference for designing a rational orthopedic scheme. METHODS: The three-dimensional reconstruction model of the chest was established based on the CT data of the patients with pectus excavatum and scoliosis. The surgical correction of pectus excavatum and scoliosis was simulated by numerical simulation method. RESULTS AND CONCLUSION: (1) Results after correction showed that the bilateral spinous processes at T3-5 segments displaced to the left (X direction) about 1 mm, suggesting that the simultaneous correction is favorable for the correction of scoliosis. (2) Compared with the single NUSS procedure, the displacement at Y direction was increased by 13.358 mm in the simultaneous correction; meanwhile, there was significant difference in the shortest displacement between two methods. (3) In views of Von Mises stress distribution, the stress in the simultaneous correction was decreased by 24.6 MPa compared with the single Nuss procedure, indicating that the simultaneous correction can significantly reduce the Von Mises stress on the chest, which contributes to alleviate the postoperative pain. (4) Our results show that the simultaneous correction cannot only improve scoliosis, but also improve the symptoms of pectus excavatum. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Navigational template applied in the orthopaedic field in China: a bibliometric analysis   Bai Zhao-hui, Zhang Ying, Yin Qing-shui, Xia Hong, Wang Jian-hua, Xu Jun-jie 2017, 21 (19):  3023-3030.  doi: 10.3969/j.issn.2095-4344.2017.19.012 Abstract ( 376 )   PDF (1089KB) ( 581 )   Save BACKGROUND: With the rapid development of digital orthopaedics, navigational template has been widely used in the field of orthopaedics, but the research status of the technique in China based on bibliometric analysis is never reported.  OBJECTIVE: To investigate the application status of navigational template in the orthopaedic field and to explore its tendency and hot spot based on bibliometric analysis, thereby providing reference for the development of digital orthopaedics in China. METHODS: A computer-based retrieval of CBMdisc, CNKI, CSPD, CMCI databases was conducted for articles published before December 1, 2016 using the keywords of “navigational template” and subject heading “orthopaedics” and the core orthopaedic journals published in 2016 were searched by manual. The articles were screened according to inclusion and exclusion criteria, and finally were analyzed by bibilometric study. RESULTS AND CONCLUSION: (1) In China, the first paper reporting navigational template was issued in 2008. A total of 199 articles were published in the past 9 years, with more than 10 papers yearly from 2009 to 2014, while there was a rapid increase tendency during 2015 and 2016. (2) The articles were mainly published in the orthopaedic journals and some professional journals closely related to digital orthopaedics, such as biomedical engineering, basic medicine and digital medicine. About 86.9% papers belong to Chinese core journals, including Chinese Journal of Orthopaedic Trauma, Chinese Journal of Orthopaedics, and Chinese Journal of Tissue Engineering Research. (3) There is a 99.5% cooperation rate and 6.15 degree of cooperation. Zhang Yuan-zhi, Ding Huan-wen, Lu Sheng, Chen Yu-bing, Hu Yong, Huang Xuan and Zheng Peng-fei are most productive authors, and core authors contribute to 53.8%, indicating that the group of core authors is being formed. First authors are all from hospitals and universities, mostly from Kunming General Hospital of Chengdu Military Command of PLA, General Hospital of Guangzhou Military Command of PLA, the Affiliated Hospital of Inner Mongolia Medical University and South China University of Technology. The cooperation rate of more than two institutes occupies 54.8%, indicating that the study holds a promising future with the strong support of research institutes in universities. About 59.3% articles are sponsored by funding, the national and provincial foundations accounting for 64.0% in 239 projects, and 57.6% articles were supported by more than two foundations, revealing the high research levels and academic values of this technique. (4) The articles are cited by 763 times; Lu Sheng,  Chen Yu-bing, and Zhang Yuan-zhi are the highly cited authors; Kunming General Hospital of Chengdu Military Command of PLA, General Hospital of Guangzhou Military Command of PLA and Nanfang Hospital of Southern Medical University are the highly cited institutes, and Chinese Journal of Orthopaedic Trauma is the highly cited journal. (5) To conclude, based on product design, manufacture and cadaver studies of the navigational template, it has been extensively applied in the spine surgery (especially cervical surgery), orthopaedic traumatology, bone and joint surgery, bone tumor and pediatric orthopaedics, and has obtained satisfactory clinical outcomes in assisting screw placement, osteotomy and precise resection and functional reconstruction. However, there is still a lack of a large-sample, multicenter, and long-term randomized trial.     中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Biomechanical properties of a novel automatic anti-rotation posterior atlantoaxial internal fixation system: a finite element analysis   Yang Min, Ma Xiang-yang, Yang Jin-cheng, Chen Shu-jin, Zou Xiao-bao 2017, 21 (19):  3031-3037.  doi: 10.3969/j.issn.2095-4344.2017.19.013 Abstract ( 312 )   PDF (1073KB) ( 183 )   Save BACKGROUND: Atlantoaxial posterior approach is currently the main surgical treatment for atlantoaxial instability and/or dislocation, but the shape of rod in normal screw-rod device system is cylindrical. To obtain satisfactory reduction of atlantoaxis, the rod will be pre-bent obviously before fixation; however, the cylindrical rod will be rotated when tighten the nuts. Extra devices will be required to adjust and maintain the direction of the rod, thereafter, the surgical field will be blocked by the device, and spinal injury will occur once the devices are not held tightly. While the novel automatic anti-rotation rod has the function of anti-rotation during nut-tightening process, and also holds all the advantages of normal rod. Further research should be performed for the differences in biomechanical characteristics between two methods. OBJECTIVE: To investigate the biomechanical properties of the novel automatic anti-rotation rod for internal fixation system of atlantoaxial posterior approach based on three-dimensional finite-analysis model of upper cervical spine. METHODS: The three-dimensional finite element model of upper cervical spine with internal rod fixation system was developed. The biomechanical characteristics of the internal fixation system were analyzed. RESULTS AND CONCLUSION: The traditional and novel three-dimensional finite element model with realistic and geometric similarity contained 198 330 elements, 964 747 nodes and 246 788 elements, 996 069 nodes, correspondingly. There was no obvious stress concentration in both two systems, stress was concentrated mainly in the screw-bone and screw-rod interfaces. The stress values of the novel system were higher than those of the traditional system, but the maximum Von Misses Stress of two systems was lower than the yield (795-827 MPa ) and ultimate (860-896 MPa) strength of titanium alloys. These results show that the design of the novel automatic anti-rotation rod-screw fixation system has matched the biomechanical requirements for new internal fixation instruments, and is one safe, effective and practical device for atlantoaxial posterior procedure showing promising application prospect. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Finite element analysis of kyphosis in ankylosing spondylitis treated by different osteotomy methods   Ma Yong, Sikandaer•Siyiti, Ou Yong, Aikeremujiang•Muheremu, Ma Yuan 2017, 21 (19):  3038-3043.  doi: 10.3969/j.issn.2095-4344.2017.19.014 Abstract ( 338 )   PDF (922KB) ( 294 )   Save BACKGROUND: Kyphosis in ankylosing spondylitis is sagittal or coronal imbalance, but there is a lack of study on its orthopedic biomechanics, and biomechanics is of great significance for the reconstruction of spinal stability after orthopedic surgery. OBJECTIVE: To establish a three-dimensional (3D) finite element model of kyphosis in ankylosing spondylitis treated by osteotomy on software, and to analyze its biomechanical properties, thus providing theoretical basis for clinical practice. METHODS: A 3D finite element model of kyphosis in ankylosing spondylitis was established based on CT data, and the predetermined angle of the osteotomy at L2 was measured. Afterwards, vertebral column decancellation and vertebral column resection were stimulated, and then the biomechanical parameters were analyzed. RESULTS AND CONCLUSION: (1) The 3D finite element models of kyphosis in ankylosing spondylitis treated by vertebral column decancellation or vertebral column resection at L3 were established successfully. (2) The stress on the screw and contact at each segment in the vertebral column decancellation group was significantly higher than that in the vertebral column resection group except for S1. (3) To conclude, both two methods can reconstruct the sagittal balance, but vertebral column decancellation exhibits significantly higher stress on the screw. Indeed, the incidence of internal fixation failure and complications in vertebral column decancellation is higher than that in vertebral column resection at the same segment and angle.   中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Age-related changes in condyle evaluated by cone-beam CT reconstruction Li Xin, Tang Jing, Li Ze-kui, Li Hong-fa, Liang Meng, Zhang Juan 2017, 21 (19):  3044-3055.  doi: 10.3969/j.issn.2095-4344.2017.19.015 Abstract ( 525 )   PDF (1053KB) ( 233 )   Save BACKGROUND: Cone-beam CT (CBCT) can show abnormal structures and shape of condyle, including thickened cortical bone and abnormal bone mineral density (BMD), which are closely associated with temporomandibular osteoarthrosis. How to identify the imaging changes of osteoarthrosis is a foundation to make correct diagnosis and treatment. However, there is still a lack of study on physiological changes of condyle in people with different ages and sexes. OBJECTIVE: To investigate the age-related changes of condyle using CBCT in poplulations with different ages and sexes. METHODS: CBCT data of 883 patients without temporomandibular osteoarthrosis were collected, and then divided into 22 groups by age (7-8, 9-10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26-27, 28-29, 30-35, 36-40, 41-45), and the BMD of each point at the surface of condyle was measured using examvision software and analyzed statistically. RESULTS AND CONCLUSION: As age increases, the BMD of the anterior point and apex was increased and reached a peak, then kept on a stable stage, while showed a decreased tendency after 40 years old. The BMD of the posterior point was increased until a peak and then decreased, and became stable after 30 years old. The BMD of the anterior point and apex both was higher than that of the posterior point in male and female patients. The BMD of each point in females all was higher than that in males. Our results suggest that there are age-related changes in condyle BMD. The BMD on the functional surface is higher than that on the nonfunctional surface. Besides, the condyle development of in males is later than that in females, and all above findings provide reference for the diagnosis of temporomandibular osteoarthrosis. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Relationship between the lumbar quantitative computed tomography values and contrast agent dispersion in osteoporotic thoracolumbar fractures Song Quan-sheng, Tang Fu-bo, Wang Xiao-hu, Zhang Jia-li, Li Zhi-fei, Rao Yuan-sen, Wu Liang, Tai Zhi-hong, Qin Hai-biao, Xu Jian-wen 2017, 21 (19):  3051-3056.  doi: 10.3969/j.issn.2095-4344.2017.19.016 Abstract ( 417 )   PDF (978KB) ( 218 )   Save BACKGROUND: Percutaneous vertebroplasty (PVP) is usually used for osteoporotic thoracolumbar fractures, which has various advantages such as easy to operate, short operation time, less trauma, rapid recovery, analgesic effect and so on. But its application is restricted due to nerve compression symptoms and pulmonary embolism caused by bone cement leakage. Thereafter, how to reduce the leakage of bone cement is an issue of concern. OBJECTIVE: To investigate the relationship between the lumbar quantitative computed tomography (QCT) values and contrast agent dispersion in osteoporotic thoracolumbar fractures. METHODS: Sixty cases of osteoporotic thoracolumbar fractures undergoing PVP were enrolled, and received QCT examination before surgery, and contrast agent was injected intraoperatively. X-ray examination was conducted to detect the bone mineral density, contrast agent dispersion and leakage of bone cement, and the relationship between the lumbar QCT values and contrast agent dispersion as well as leakage of bone cement. RESULTS AND CONCLUSION: (1) There were 110 vertebral fractures, and 74 vertebrae with contrast agent diffusing more than vertebral midline, accounting for 67.3%. There was significant difference in the contrast agent dispersion among groups (P < 0.05). (2) The bone cement leakage showed no significant difference among groups after injected with bone cement by unilateral or bilateral approach (P > 0.05). (3) These results suggest that contrast agent dispersion in osteoporotic thoracolumbar fractures has a certain relationship with the lumbar QCT values, and lumbar QCT values with more contrast agent dispersion, but the lumbar QCT values have no correlation with bone cement leakage. Therefore, choosing a appropriate approach based on the QCT values and contrast agent dispersion can reduce leakage and improve the safety of PVP. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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CT scanning applied in the preoperative planning of lumbar spine surgeries Wang Shuang, Li Hong-wei, Wang Hai-zhou, Yu Zhuo-li, Shui Yan, Wang Shuai, Ji Nan 2017, 21 (19):  3057-3062.  doi: 10.3969/j.issn.2095-4344.2017.19.017 Abstract ( 382 )   PDF (826KB) ( 230 )   Save BACKGROUND: Pedicle screws are widely used in spinal internal fixation, while complications related to screw mistaken placement can be found occasionally. Conventional imaging examination cannot provide the accurate situation of the nail, and the nail path can be directly revealed on CT. OBJECTIVE: To discuss the application of CT scanning in the preoperative planning of lumbar spine surgery using digital technology. METHODS: 136 patients were enrolled, and digital technology was used to determine the best nailing track on planar CT images. Then the length of the pedicle screws, width of the pedicle, angle between pedicle screws and standard sagittal plane, and angle between pedicle screw and spinous process as well as sagittal plane were measured. The difference in measured values on each side was compared. Also, the difference in angle between pedicle screw and sagittal plane and spinous process was compared. RESULTS AND CONCLUSION: (1) There was no significant difference in the length of pedicle screw in both sides (P > 0.05). (2) There was significant difference in the width of pedicle screw at L1 and L4 of two sides (P < 0.05). (3) The angle between pedicle screw and standard sagittal plane at each level bilaterally did not differ significantly (P > 0.05). (4) The angle between pedicle screw and spinous process at each level bilaterally did not differ significantly (P > 0.05). (5) To conclude, pedicle CT scanning can accurately reflect patients’ pedicle anatomic situation, which can help surgeons to design an appropriate scheme. Moreover, the anatomical variations of lumbar spine are remarkable, so pedicle screw insertion should be planned individuality. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Research progress and challenge of the stem cell therapy for intervertebral disc regeneration   Liang Hang, Deng Xiang-yu, Shao Zeng-wu 2017, 21 (19):  3063-3071.  doi: 10.3969/j.issn.2095-4344.2017.19.018 Abstract ( 338 )   PDF (832KB) ( 410 )   Save BACKGROUND: Interverbral disc degeneration (IDD) is the major cause of low back pain, which is considered as the pathological basis of intervertebral disc herniation and other degenerative diseases that severely affect the patients’ quality of life. At present, neither conservative treatment nor operative treatment can reverse or inhibit the pathological development of IDD. OBJECTIVE: To summarize the progress of stem cell therapy for IDD, and to further analyze its challenge and potential solutions. METHODS: Relevant studies in PubMed database published before September 2016 were retrieved. Studies about stem cell therapy in IDD in vitro and vivo as well clinical trials were enrolled to analyze its existing problems. RESULTS AND CONCLUSION: (1) Stem cell therapy provides a new strategy for IDD treatment. So far, a large number of studies in vitro and vivo as well as clinical trials have reported the remarkable effect of stem cell therapy. (2) However, problems such as how to deal with microenvironment of interverbral disc, choose proper stem cells and master indications will be a challenge in the future.    中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Unicompartmental knee arthroplasty: the best technique and curative efficacy    Feng Shuo, Zha Guo-chun, Guo Kai-jin, Cai Peng, Chen Xiang-yang 2017, 21 (19):  3072-3079.  doi: 10.3969/j.issn.2095-4344.2017.19.019 Abstract ( 393 )   PDF (868KB) ( 331 )   Save BACKGROUND: With the rapid development of surgical techniques, unicompartmental knee arthroplasty has become an issue of concern in the treatment of osteoarthritis, which has achieved significant progress in reducing trauma and rapid rehabilitation. OBJECTIVE: To summarize the development history, curative effect of unicompartmental knee arthroplasty, and the research progress of lateral unicompartmental knee arthroplasty aided with computer navigation or robot system, thus providing reference for further study on unicompartmental knee arthroplasty. METHODS: Web of Science, and PubMed databases were searched for the literatures published from January 1955 to April 2017 with the keywords of “unicompartmental knee arthroplasty, osteoarthritis, unilateral compartment, lateral knee arthroplasty”. RESULTS AND CONCLUSION: A total of 562 articles were retrieved, and finally 75 English literatures were enrolled according to the inclusion and exclusion criteria. With the continuous improvement of unicompartmental knee arthroplasty, it can retain the cruciate ligament and more bone mass. Notably, strict indications and reasonable postoperative functional exercise are essential for obtaining optimal effectiveness. At the same time, the development of computer navigation and robot-assisted technology has opened up a new horizon for the treatment of osteoarthritis, which makes the operation more accurate and minimally invasive. But the application still needs to be studied in depth.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Unicompartmental knee arthroplasty treats anteromedial compartment osteoarthritis of the knee   Su Jun, Sun Chang-ying 2017, 21 (19):  3080-3087.  doi: 10.3969/j.issn.2095-4344.2017.19.020 Abstract ( 432 )   PDF (1281KB) ( 208 )   Save BACKGROUND: Unicompartmental knee arthroplasty (UKA) began in the early 1970s, which was once negated due to high postoperative repair rate. The methods for early unicompartment osteoarthritis of the knee include UKA, total knee arthroplasty, high tibial osteotomy and fibular truncation. A large number of retrospective studies and literatures have pointed that UKA is effective for unicompartment osteoarthritis of the knee and holds unique advantages. OBJECTIVE: To review the status and research progress of UKA for anteromedial compartment osteoarthritis of the knee in view of indications, contraindications, operation curve, operation process and main technical points and clinical efficacy. METHODS: The first author retrieved the databases of PubMed and CNKI from March 2006 to September 2016 using the keywords of “unicompartmental knee arthroplasty, knee, osteoarthritis, clinical application” in English and Chinese, respectively. A total of 95 literatures were searched, and 40 eligible articles were included in accordance with the inclusion criteria. RESULTS AND CONCLUSION: Only unilateral lesion (the degenerative cartilage surface of tibiofemoral joint) is replaced in UKA to treat early unicompartment osteoarthritis of the knee, which exhibits less trauma, rapid recovery, few complications, and normal postoperative proprioception of joint and high patient acceptance. Because of its narrow surgical indications, UKA application has been restricted compared with total knee arthroplasty. Indeed, total knee arthroplasty is matureand, and its long-term curative effect is clear. In contrast, UKA is carried out late in China, has not been popularized, and the long-term clinical efficacy remains to be verified further. But if we can accurately grasp the operation indications, choose appropriate patients, make careful preoperative preparation, and master mature skills, the clinical effect will be satisfactory. With the development of prosthesis, equipment design and operation technology, UKA will be prevailed in the treatment of anteromedial compartment osteoarthritis of the knee. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Advance in the diagnosis and treatment of infection after total knee arthroplasty Zhang Yao, Xu Zhe, Lv Hao, Feng Wei 2017, 21 (19):  3088-3094.  doi: 10.3969/j.issn.2095-4344.2017.19.021 Abstract ( 326 )   PDF (890KB) ( 305 )   Save BACKGROUND: With the prevalence of total knee arthroplasty, periprosthetic joint infection as a serious complication has been an issue of concern. OBJECTIVE: To summarize the advances in the diagnosis and treatment of infection after total knee arthroplasty. METHODS: The first author searched the PubMed and CNKI databases for the literatures related to the diagnosis and treatment of infection after total knee arthroplasty using the keywords of “total knee arthroplasty, infection” in English and Chinese, respectively. The repetitive articles were excluded, and the risk factors, diagnosis, classification and treatment of infection after total knee arthroplasty were summarized. RESULTS AND CONCLUSION: (1) The infection after artificial knee replacement is closely related to the patient’s preoperative condition, operation skills and postoperative status. (2) Diagnosis of infection is based on the detailed understanding of the patients’ situation and complete auxiliary examinations. (3) The treatment methods include antibiotics, debridement and retention, reversion, arthrodesis, as well as amputation. (4) Periprosthetic infection is a serious complication after total knee arthroplasty, and early diagnosis and treatment are critical. Furthermore, choosing an appropriate individualized treatment scheme for different patients is important. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Research progress of the osteonecrosis of the femoral head after internal fixation for femoral neck fractures   Sun You-qiang, Chen Lei-lei, Liu Yu-hao, Zou Xu-ting, Hong Zhi-nan, He Wei 2017, 21 (19):  3095-3101.  doi: 10.3969/j.issn.2095-4344.2017.19.022 Abstract ( 578 )   PDF (1027KB) ( 794 )   Save BACKGROUND: Osteonecrosis of the femoral head (ONFH) following internal fixation of femoral neck fractures is difficult to be cured in clinic. OBJECTIVE: To analyze the literatures concerning ONFH in patients with femoral neck fractures treated with screw internal fixation in recent 15 years, and to summarize the research progress in views of epidemiology, etiology, diagnosis, treatment and rehabilitation. METHODS: Databases of CNKI, WanFang, CqVip, PubMed, Medline, Web of Science were searched with the keywords of “femoral neck fracture, osteonecrosis of femoral head, osteonecrosis, internal fixation, internal fixation with screw” in English and Chinese, respectively. Afterwards, the reviews and case reports were excluded. RESULTS AND CONCLUSION: (1) A total of 54 eligible articles addressing the ONFH following internal fixation for femoral neck fractures were included, and the incidence of ONFH varied from 8.1% to 37.2%, which was found at an average of 17 months after injury. (2) ONFH was found to be related to age, preoperative fracture displacement, preoperative traction, reduction condition, time from injury to operation, elderly patients companied with other diseases, older patients undergoing removal of the screws, closed or open internal fixation, restored time postoperatively, high body mass index, hyperlipidemia, season, and depression. (3) Early prevention and remedial surgery were used to treat ONFH. (4) The patients without weight-bearing activities at 3-6 months postoperatively could be beneficial for functional recovery. (5) These results suggest that choosing appropriate surgical programs and rehabilitation plan can reduce the incidence of ONFH and achieve good treatment outcomes, such as reasonable preoperative planning, standardized operation skills, correct diagnosis and treatment, proper postoperative rehabilitation and good doctor-patient cooperation. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Pedicle screw fixation for thoracic and lumbar diseases: a comparative analysis and prospects   Liu Zheng, Li Hong-wei, Wang Shuang 2017, 21 (19):  3102-3107.  doi: 10.3969/j.issn.2095-4344.2017.19.023 Abstract ( 443 )   PDF (978KB) ( 198 )   Save BACKGROUND: Pedicle screw fixation is mainly used to treat thoracolumbar disorders, and accurate placement is the key to success; thereafter, how to improve the accuracy of placement and reduce the secondary nailing is an issue of concern. OBJECTIVE: To compare the advantages and disadvantages of various pedicle screw placement methods and their application value.  METHODS: CNKI and PubMed databases were retrieved for clinical research concerning the pedicle screw fixation for thoracolumbar disorders published before May 2016 using the keywords of “pedicle screw fixation, free-hand technique, 3D-printing technology, computer navigation technology, clinical application prospect” in English and Chinese, respectively. The repetitive literatures were excluded, and the advanced pedicle screw technologies were collected and evaluated in views of feasibility, universality and practicability. RESULTS AND CONCLUSION: (1) Computer-assisted navigation system and three-dimensional printing technology are the focus of research, but only applied in the treatment of pedicle congenital malformations or complicated cases. (2) Free-hand technique is still the most widely used, which is the essential skills that surgeons must master. (3) Traditional technology is still the mainstream in clinic, so improved preoperative planning, and individualized scheme are needed. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

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Modified Stoppa approach versus Ilioinguinal approach for pelvic and/or acetabular fractures: a meta-analysis   Chen Xiao, Ma Kun-long, Xu Hai-tao, Shao Gao-hai 2017, 21 (19):  3108-3116.  doi: 10.3969/j.issn.2095-4344.2017.19.024 Abstract ( 442 )   PDF (897KB) ( 276 )   Save BACKGROUND: Ilioinguinal approach and modified Stoppa approach are commonly used to treat pelvic and acetabular fractures, but which one is safer and more effective remains controversial, so a meta-analysis is necessary. OBJECTIVE: To compare the efficacy of modified Stoppa approach and ilioinguinal approach for pelvic and/or acetabular fractures. METHODS: A computer-based retrieval of Cochrane library, PubMed, Embase, OVID, CNKI, WanFang, CBM and VIP databases was performed for the randomized controlled trials concerning modified Stoppa approach and ilioinguinal approach for pelvic and/or acetabular fractures published before October 2016. Meta-analysis was performed on RevMan5.3 software. RESULTS AND CONCLUSION: (1) Finally 11 randomized controlled trials were enrolled, including 722 patients. (2) Meta-analysis showed that the operation time, intraoperative blood loss, length of incision, volume of drainage and hospitalization time in the modified Stoppa approach group were significantly less than those in the ilioinguinal approach group (P < 0.05), and the clinical efficacy in the modified Stoppa approach group was significantly superior to that in the ilioinguinal approach group (P < 0.05). But there were no significant differences in Matta scores and postoperative complications between two groups (P > 0.05). (3) To conclude, modified Stoppa approach is safer and more effective for pelvic and/or acetabular fractures. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics