Objective To discuss the short-term efficacy and safety of primary percutaneous reduction combined with robotic-assisted screw placement for the treatment of Sanders type Ⅲ and Ⅳ calcaneal frac-tures.Methods A total of 52 patients(52 feet)with Sanders type Ⅲ and Ⅳ calcaneal fractures admitted to this hospital from August 2022 to October 2024 were selected as the study subjects.33 patients were treated with robot assisted screw placement(the observation group),including 23 cases of Sanders type Ⅲ patients(4 cases of AC type,16 cases of AB type,3 cases of BC type)and 10 cases of Sanders type Ⅳ patients;19 patients underwent manual screw placement under C-arm X-ray fluoroscopy(the control group),including 14 cases of Sanders type Ⅲ(5 cases of AC type,9 cases of AB type)and 5 cases of Sanders Ⅳ type.The B?hler angle,Gissane angle,calcaneal height,calcaneal width,and calcaneal length were compared between the two groups at 3 and 12 months after surgery.The differences in the time from injury to surgery,intraoperative blood loss,number of intraoperative fluoroscopies,total incision length,operation time,number of screws inserted,num-ber of punctures,hospital stay,fracture healing time,and proportion of tarsal sinus incision-assisted reduction between the two groups were evaluated and compared.The American Orthopedic Foot and Ankle Society(AOFAS)ankle and hindfoot function score,excellent rate of function and visual analog scale(VAS)pain score after surgery were also compared,and the incidence of postoperative complications between the two groups were compared to evaluate safety.Results Both groups of patients were followed up for more than 12 months after surgery.At 3 and 12 months postoperatively,B?hler's angle,Gissane's angle,calcaneal length,calcaneal height,and calcaneal width in both groups showed significant improvements compared to preopera-tive measurements,but there was no statistically significant difference between the two groups(P＞0.05).The intraoperative blooding loss,number of intraoperative fluoroscopies,operation time,and number of punc-tures in the observation group were all lower than those in the control group,and the differences were statisti-cally significant(P＜0.05);There was no statistically significant difference in the time from injury to surger-y,total incision length,number of screws inserted,hospital stay,fracture healing time,proportion of tarsal si-nus incision-assisted reduction,and excellent rate of function between the two groups of patients(P＞0.05).The AOFAS ankle and hindfoot function score of the observation group was higher than that of the control group at 3 months after surgery,and the VAS pain scores in the early postoperative period was lower than that of the control group,the differences were statistically significant(P＜0.05).The incidence of complications such as lower ankle pain,traumatic arthritis,and plantar pain in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Com-pared with manual screw placement,primary percutaneous reduction combined with robotic-assisted screw placement for the treatment of Sanders type Ⅲ and Ⅳ calcaneal fractures is more effective,safe,precise,mini-mally invasive and efficient,with less intraoperative bleeding and lower incidence of complications.

Objective To evaluate the diagnostic rate and treatment effect of close renal trauma.Methods The clinical data of 129 cases of close renal trauma were analyzed retrospectively. Results Lumbago or bellyache occurred in 109 cases,hematuria 113 cases,coexistent injuries of other organs 81 cases. 129 cases were examined by type B-ultrasonography, 102 cases by CT scan open operation on 17 cases and others were treated non-operatively. 118 cases have been followed up for 3 months to 56 months with normal urine routine and IVU.Conclusions Usually urine inspection and B-ultrasonography were simple,instant reliable and safe. The accurate diagnosis rate was higher with CT scanning,CT scan was helpful in detecting the degree of renal injury and any coexistent injuries,and to estimate the treatment effect. Laparotomy should undertaken for the case of severe injury or with coexistent injuries in rime.

Objective To investigate the association of prognosis with clinical features,tumor imaging,and pathological grading and staging in small renal cell carcinoma(SRCC). Methods The clinical data of 76 cases of SRCC (no more than 3 cm in diameter) were analyzed retrospectively.According to the clinical symptoms,they were divided into two groups,symptomatic (hematuria and lumbago) group (n=17,accounting for 22.4%) and asymptomatic group (n=59,77.6%).All the 76 cases underwent CT scan,with the diagnosis rate of 94.7%;69 cases underwent B-ultrasound examination with the diagnosis rate of 84.1%. Results All the 76 cases underwent radical nephrectomy through oblique incision in the lumbus.The excised tumors were pathologically confirmed to be clear cell carcinoma.The patients were followed up for 32 to 87 months(mean,62.7 months).The 1-,3-,and 5-year cancer-free survival rates of the symptomatic and asymptomatic groups were 100% and 53.3%,33.3% and 100%,90.6% and 77.4%,respectively.There were statistically significant differences between the two groups in the 3- and 5-year cancer-free survival rates (P