Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Objective:To evaluate trauma repair and reconstruction surgery mediated by near-infrared-Ⅱ (NIR-Ⅱ) imaging in practice of enhanced recovery after surgery (ERAS) principles.Methods:A retrospective study was conducted to analyze the data of 38 patients who had undergone trauma repair and reconstruction surgery mediated by near-infrared-Ⅱ (NIR-Ⅱ) imaging in practice of ERAS principles at Department of Orthopedic Trauma and Microsurgery, Zhongnan Hospital from May 2021 to December 2021. There were 22 males and 16 females with an age of (50.3±2.7) years. To implement ERAS, NIR-Ⅱ imaging was used for patency evaluation after vascular anastomosis in 14 cases, for skin flap harvesting and perfusion monitoring in 13 cases, and for evaluation of arterial/venous blood supply after finger replantation in 11 cases. Visual analogue scale (VAS) pain scores at 2, 7 and 14 days after surgery, length of hospital stay, patient satisfaction [by Chinese Hospital Patient Experience and Satisfaction Monitor (CHPESM)], limb function recovery (by Likert scale) and postoperative complications were recorded.Results:All patients were followed up for more than 14 days. All surgeries succeeded. The reconstructed limbs or flaps survived to recover basically normal shape and function. The VAS scores for all patients were (2.1±0.6) points, (1.6±0.6) points and (0.8±0.4) points on postoperative 2, 7 and 14 days, respectively. The length of hospital stay was (9.8±3.4) days, and the patient satisfaction was >95% at discharge. As for the recovery of limb function at the last follow-up evaluated by the Likert 5-point scale, 12 cases experienced no stiffness, 8 ones mild stiffness, 11 ones slightly severe stiffness, 3 ones moderate to severe stiffness, 2 ones severe stiffness, and 2 ones complete stiffness. Complications related to the surgery occurred in none of the patients.Conclusion:In practice of ERAS principles, application of NIR-Ⅱ imaging in trauma repair and reconstruction surgery can effectively alleviate pain, improve satisfaction, reduce hospital stay, and accelerate functional recovery for the patients.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Objective To investigate the surgical operation technique,clinical curative effect and the choice of the indication in the treatment of cervical spondylosis by radiofrequency nucleoplasty.Methods From January to July in 2006,the ArthroCare system 2000 radio frequency instrument that the American ArthroCare company produce were odopted,to treat 20 patients with cervical spondylosis by radiofrequency nucleoplasty under the leading of the C form grill X-ray fluoroscopic machine.Among them,there were 9 males and 11 females with age from 38 to 62 years,equally 45.12 years old,the average course of illness was 2 years. 15 cases with lumbar disc herniation,4 cases with nerve-root cervical sDandylosis and 1 case with spinal cervical spondylosis.Single segment affection in 4 cases,double or multistage segment affection in 16 cases.Among those multistage segment eases,all choose 2 segments for research according to fixed physical sign the body advertise for and the MRI image.After the operation all cases underwent follow-up.with follow-up time for 1-6 months.Results The results shown an effect among those 20 sufferers of excellence in 16 cases,valid in 4 cases,efficient power reach to 100%in short term.Ahhough this case was limited.the early case choice compares strictly,the subjective satisfaction of sufferer was higher.Conclusion Application of radiofrequency nucleoplasty in the treatment of cervical sDondylosis has advantages of small wound,safety and high efficacy in short term.However, its indication still need further research.

Aim To study the synergistic effect and its mechanism of polysaccharide from Ligustrum Lucidum Ait(PLLA)and polysaccharide from Cuscuta Chinensis Lam (PCCL)on antisenility. Methods To observe the effect on immune organs and antioxidation systems of mice with senile model caused by D-galatose (D-gal) and meanwhile administered with PLLA∶PCCL 50 ∶50 mg or 50 mg ∶200 mg or 200 mg ∶50 mg or 200 mg ∶200 mg?kg -1?d -1 designed by orthogonal method. Results Thymus index and spleen index differently rose,MDA differently dropped,activities of SOD and GSH-PX differently ascended in liver and kidneys,LF differently descended in brain of mouse with senile model administered with 50 mg∶50 mg or 50 mg ∶200 mg or 200 mg ∶50 mg or 200 mg ∶200 mg?kg -1?d -1 PLLA ∶PCCL.The statistical analysis indicated that the combination of PLLA with PCCL yielded of notable or extremely notable reciprocal effect on the experimental index of antisenility. Conclusion The combination of PLLA with PCCL can yield notable synergistic effect on antisenility,the optimal combination of both drugs is PLLA ∶PCCL 50 mg ∶200 mg, its mechanism is probably connected with immunity inhacement,eliminati on of oxyen free radicals and active oxyen and antilipoperoxidation.