ObjectiveTo observe the clinical effects of locking proximal humerus plate(LPHP) in the treatment of complex proximal humeral fracture of aged patients and to analyze the influencing factors. Methods Among 39 cases with complex humeral fractures (aged 60-83 years),there were 29 cases with three-part fractures and 10 with four-part fractures according to the Neer classification.They were operated by LPHP via deltoid-pectoral approach. Neer numerical rating system was employed to evaluate postoperative function of shoulders.Results39 cases were followed up for average of 16 months.According to Neer numerical rating system,the excellence rates of three-part fractures and four-part fractures were 86.2％ (25 cases) and 50.0％ (5 cases),respectively,with total excellence rate of 76.9％(30 cases). Age (OR =1.314, P＜0.05) and fracture type ( OR =1.295, P＜0.05)ofpatientswereindependentriskfactorsforprognosis of proximal humeral fracture of aged patients by multiple logistic regression. Conclusions LPHP is an effective implant for treating complex proximal humeral fracture of aged patients,with age and fracture types as important risk factors of prognosis.<英文关键词>=humeral fractures

Objective To compare the clinical results of arthroscopic rotator cuff repair using a suture bridge technique and conservative therapy as treatment of traumatic shoulder dislocation combined with rotator cuff injury in older patients. Methods From August 2010 to August 2013 a total of 63 patients were prospectively enrolled. In the case of documented tears of the rotator cuff in combination with symptoms persisting after conservative therapy, patients were free to decide between arthroscopic rotator cuff repair using a suture bridge technique and conservative treatment. Patients were monitored for changes in visual analogue scale (VAS) scores, range of motion, the Simple Shoulder Test (SST), the Constant score and recurrences over a minimum follow-up period of 1 year. Results 60 pa-tients (30 in surgical group and 30 in conservative treatment group) were follow-up for at least 1 year. There was no significant difference between the two groups at baseline. The surgical group resulted in better improvements in pre-operative to postoperative VAS scores, range of motion, SST scores and the Constant score. There were five recur-rences in the conservative treatment group, while no recurrences were documented in surgical group. Conclusion In this selected patient group, we believe arthroscopic repair using a suture bridge technique for the treatment of symp-tomatic rotator cuff tear can improve shoulder function and decrease recurrences in older patients suffered from trau-matic shoulder dislocation combined with rotator cuff injury. The long-term outcomes remain to be determined.

Objective To investigate the clinical outcomes of arthroscopic rotator cuff repair using improved-press-ift double-row technique for patients of large rotator cuff tear.Methods From December 2013 to November 2014, 52 patients (20 males, 32 females) with a full-thickness large rotator cuff tear underwent arthroscopic improved-press-ift double-row repair were retrospectively analyzed. The mean age of the patients was 65.6 years (range 51 to 76 years). The visual analog pain scale scores (VAS), the range of motion (ROM), University of California at Los Angeles (UCLA), and American Shoulder and Elbow Surgeons (ASES) were used for clinical and functional evaluations before surgery and at the time of 6 months after arthroscopy.Results The mean duration of follow-up was 10.9 months (range 6 to 17 months). At the time of 6 months after arthroscopy, the mean subjective pain score (VAS) was (1.6 ± 0.9), the mean active forward flexion was (145.6 ± 10.7)°, whereas the mean external rotation at the side was (30.8 ± 8.5)°. The mean UCLA score improved to (32.3 ± 3.5), the mean ASES score improved to (81.8 ± 8.7). There was significant difference postoperatively (P < 0.05). No re-tear occurred.Conclusion The improved-press-ift DR technique is effective in arthroscopic large rotator cuff repairing. Compared with suture-bridge technique, this technique can decrease operation time, costs, and is much easier to process.

Objective To study the treatment effect of synovectomy under arthroscope on elbow rheumatoid arthritis.Methods 38 patients with elbow rheumatoid arthritis were selected as the research subjects,received arthroscopic synovial treatment,surgical procedures require more than one direction into the intra -articular,cleaning elbow joint synovial,complete removal of the foreign body cavity.Postoperative follow -up for 30 months,and com-pared the patients'Mayo elbow performance score and joint activity situation before and after surgery.Results After surgery,Elbow pain score[(30.12 ±8.11)points],activity level[(17.01 ±2.88)points],joint function[(20.67 ± 5.01)points]and total score[(73.04 ±12.01)points]were significantly higher than the pre -operative[(3.98 ± 3.89)points,(9.78 ±5.02)points,(13.77 ±3.69)points,(33.04 ±10.01)points](t =18.38,P <0.05;t =7.90, P <0.05;t =7.01,P <0.05;t =16.18,P <0.05 ).After surgery,elbow flexion activity score [(113.12 ± 15.11)points]was significantly higher than the preoperative flexion elbow activity score[(93.03 ±19.89)points] (t =5.09,P <0.05 ).Conclusion Treated elbow rheumatoid arthritis by synovectomy under arthroscope could effectively improve the disease status of patients,relieve pain,enhance mobility,allowing patients to gradually return to normal life,and it can be widely used in clinical practice.

Objective To investigate the clinical results of arthroscopic FaxT -Fix technology vertical mat-tress suture for patients with meniscal tear Ⅲ level.Methods 50 cases with the level of meniscal Ⅲ orthopedic treatment of torn were divided into two groups using random number table,25 cases in each group.The control group received a simple meniscectomy,the observation group was given arthroscopic FaxT -Fix technology vertical mattress suture.Surgery and prognosis function were observed and compared in the two groups during recovery.Results The operation time (26.53 ±7.34)min,postoperative functional activity recovery time (25.01 ±9.55)d and hospital stay (5.68 ±2.01)d of the observation group were significantly shorter than the control group[(46.66 ±12.28)min, (39.53 ±11.28)d,(9.98 ±3.34)d],the differences were statistically significant (t =7.04,4.91,5.52,all P <0.05).3,6,12,18 months after operation,the improvements of Lysholm and IKDC scores of the observation group were significantly better than the control group (t =3.60,2.64,2.81,3.03,4.94,2.12,2.28,2.32,all P <0.05). During the postoperative follow -up period,the incidence rate of complications of the observation group (4.00%) was significantly lower than the control group (24.00%)(χ2 =4.15,P <0.05).Conclusion For patients with level of Ⅲ meniscus tear,arthroscopic FaxT -Fix technology vertical mattress suture can effectively reduce the surgery and hospitalization time,promote functional recovery of the patients 'knee,significantly improve the postoperative Lysholm knee score and IKDC,but also significantly reduce postoperative wound infection,hematoma,nerve damage vascular complication rate.

Objective To evaluate the early clinical outcomes of arthroscopic suture-bridge repair of media to large full-thickness rotator cuff tear.Methods One hundred patients that underwent arthroscopic suture-bridge (suture-bridge group,n =50) or single-row repair (single-row suture group,n =50) for media to massive full-thickness rotator cuff tear from June 2010 to June 2014 were enrolled in this study.The patients (63 males and 37 females),aged 58.7 years (range,46 to 75 years),were all available to the follow-up.Thirty-one patients were injured in traffic crashes,30 in falls,27 in strains and 12 with no apparent reasons.Early passive activity was allowed in suture-bridge group,while shoulder abduction was maintained for 6 weeks postoperatively in control group.Clinical and functional outcomes were measured using the visual analogue scale (VAS),range of motion,University of California at Los Angeles (UCLA) score,and American Shoulder and Elbow Surgeons (ASES) score.Results Mean duration of follow-up was 16.7 months (range,8 to 24 months).Prior to the surgery,these measurements were similar between the two groups.After a follow-up of 3 months,the differences were significant in suture-bridge group compared to control group:VAS [(1.7 ± 1.5) points vs (3.9 ± 2.1) points],forward flexion [(168.3 ± 30.2)° vs (120.2 ± 51.6)°],external rotation [(47.0 ± 11.0)° vs (31.8 ± 13.8)°],UCLA score [(31.7±4.2) points vs (18.2±4.8) points],ASES score [(86.2±14.6) points vs (35.9 ±17.7) points] (P ＜0.05).No re-tear occurred after operation.Conclusion Arthroscopic suture-bridge repair of moderate to massive full-thickness rotator cuff tear results in significant improvement of function outcomes and clinical results,indicating a reliable and effective treatment technique.