Objective:To systematically analyze the risk factors for knee injury complicated with adolescent tibial tubercle fractures (ATTF).Methods:A retrospective study was conducted to analyze the clinical data of the 90 adolescent patients (the observation group) who had been treated and fully followed up for knee injury complicated with ATTF at Department of Pediatric Orthopedics, The Second General Hospital of Fuzhou from September 2017 to April 2024. There were 86 males and 4 females, with a mean age of 14.0 (13.0, 14.0) years. The injury was on the left side in 51 cases, on the right side in 34 ones, and on the bilateral sides in 5 ones. All their injuries resulted from sports activities. In addition, another contemporary 90 patients with knee injury but no exercise-induced ATTF were enrolled as the control group, including 54 males and 36 females with a mean age of 14.0 (13.0, 14.3) years. Their injury was on the left side in 45 cases, on the right side in 41 ones, and on the bilateral sides in 4 ones. Univariate analysis was conducted to compare gender, age, injury side, height, weight, body mass index, history of Osgood-Schlatter disease (OSD), and injury mechanism between the 2 groups. Variables with P<0.1 were included in a multivariate logistic regression analysis to screen independent risk factors for ATTF. The receiver operating characteristic (ROC) curve was used to evaluate their predictive values. The optimal cutoff value was determined by Youden index. Results:The univariate analysis showed that gender, height, weight, body mass index, and OSD history were significantly correlated with the occurrence of ATTF ( P<0.05). The multivariate logistic regression analysis further confirmed that male ( P=0.017), height ( P=0.021), weight ( P=0.014), body mass index ( P=0.032) and history of OSD ( P=0.003) were independent risk factors for ATTF. The ROC curve analysis showed that weight had the largest area under the curve (AUC) in prediction of the ATTF risk, suggesting that its predictive value was the most significant. Conclusion:Male, height, weight, body mass index, and prior OSD are independent risk factors for ATTF, with the highest predictive value in weight.

Objective:To systematically analyze the risk factors for knee injury complicated with adolescent tibial tubercle fractures (ATTF).Methods:A retrospective study was conducted to analyze the clinical data of the 90 adolescent patients (the observation group) who had been treated and fully followed up for knee injury complicated with ATTF at Department of Pediatric Orthopedics, The Second General Hospital of Fuzhou from September 2017 to April 2024. There were 86 males and 4 females, with a mean age of 14.0 (13.0, 14.0) years. The injury was on the left side in 51 cases, on the right side in 34 ones, and on the bilateral sides in 5 ones. All their injuries resulted from sports activities. In addition, another contemporary 90 patients with knee injury but no exercise-induced ATTF were enrolled as the control group, including 54 males and 36 females with a mean age of 14.0 (13.0, 14.3) years. Their injury was on the left side in 45 cases, on the right side in 41 ones, and on the bilateral sides in 4 ones. Univariate analysis was conducted to compare gender, age, injury side, height, weight, body mass index, history of Osgood-Schlatter disease (OSD), and injury mechanism between the 2 groups. Variables with P<0.1 were included in a multivariate logistic regression analysis to screen independent risk factors for ATTF. The receiver operating characteristic (ROC) curve was used to evaluate their predictive values. The optimal cutoff value was determined by Youden index. Results:The univariate analysis showed that gender, height, weight, body mass index, and OSD history were significantly correlated with the occurrence of ATTF ( P<0.05). The multivariate logistic regression analysis further confirmed that male ( P=0.017), height ( P=0.021), weight ( P=0.014), body mass index ( P=0.032) and history of OSD ( P=0.003) were independent risk factors for ATTF. The ROC curve analysis showed that weight had the largest area under the curve (AUC) in prediction of the ATTF risk, suggesting that its predictive value was the most significant. Conclusion:Male, height, weight, body mass index, and prior OSD are independent risk factors for ATTF, with the highest predictive value in weight.

Objective:To analyze the risk factors for ankle varus deformity after McFarland fracture surgery in children.Methods:A total of 48 children with McFarland fracture who underwent surgical treatment in the Second General Hospital of Fuzhou from January 2015 to December 2022 were retrospectively analyzed, including 24 males and 24 females, aged 11.2±3.2 years (range, 2-14 years), 19 cases on the left side and 29 cases on the right side. Salter-Harris classification: 34 cases of type III and 14 cases of type IV. Causes of injuries: 28 cases of sports injuries, 15 cases of fall injuries, and 5 cases of car accident injuries. The time from injury to operation was 2.6±1.7 d (range, 1-7 d). The reduction methods included closed reduction in 38 cases and open reduction in 10 cases. Tibial internal fixation: 42 cases of hollow screws, 6 cases of Kirschner pins. There were 30 cases of combined fibula fracture, 20 cases were fixed with plate, 8 cases were fixed with Kirschner's pin, and 2 cases were not treated with internal fixation. The internal fixation survival time was 6.4±2.8 months (range, 1-12 months). The lateral distal tibial angle (LDTA) was used to determine whether the child had ankle varus deformity. The general data and perioperative indicators of the two groups were compared, and the indicators with statistically significant differences were included in binary logistic regression analysis to determine the independent risk factors for ankle varus deformity after McFarland fracture surgery in children. The receiver operating characteristic curve was drawn and the area under the curve of each independent risk factor was calculated.Results:All patients successfully completed the operation and were followed up for 39.2±21.8 months (range, 15-98 months). At the last follow-up, all the 48 children with McFarland fracture had bone union and the internal fixation was successfully removed, and 5 of them had ankle varus deformity. The LDTA of the affected side was 98.6°±4.8° (range, 94°-106°) in the ankle varus deformity group and 89.0°±0.8° (range, 87°-91°) in the non-ankle varus deformity group. The age of children in the ankle varus deformity group was 6.6±5.1 years, which was younger than that in the non-ankle varus deformity group (11.7±2.5 years), and the difference was statistically significant ( t=3.772, P<0.001). The survival time of internal fixation in the ankle varus deformity group was 4.4±2.2 months, which was shorter than that in the non-ankle varus deformity group (6.6±2.8 months), and the difference was statistically significant ( t=1.750, P=0.087). There was no significant difference in gender, side, cause of injury, fracture type, initial displacement distance, fibular fracture, time from injury to operation, reduction method, or fixation method between the two groups ( P>0.05). Age and duration of internal fixation were included in binary logistic regression analysis. The results showed that age ( OR=0.717, 95% CI: 0.543, 0.945, P=0.018) was an independent risk factor for postoperative ankle varus deformity in children with McFarland fracture. The receiver operating characteristic curve of independent risk factors predicting postoperative ankle varus deformity in children with McFarland fracture was drawn and the area under the curve was calculated. The results showed that the best cut-off value of age was 5.5 years, and the area under the curve was 0.807, and the prediction efficiency of the prediction model was good. Conclusion:Age<5.5 years is an independent risk factor for postoperative varus ankle deformity in children with McFarland fracture.

Objective To observe and measure the morphology of diaphragm sella under MR imaging and its parameters in patients with pituitary adenoma,and to explore its clinical significance.Methods Forty-seven patients with pituitary adenoma,admitted to our hospital from March 2012 to April 2013,were collected in our study; the traditional MR imaging of all patients were obtained preoperatively and postoperatively,and 3D-GE sequence scanning was added preoperatively.The parameters of diaphragm sella were measured and compared between patients existed invasion and without invasion,and between patients enjoyed total resection and non-total resection; and the correlation between each two parameters were analyzed.Results Concave,horizontal and convex diaphragm sellae (n=3,10 and 34,respectively) were observed; tumor height of the patients whose diaphragm sella was convex was significantly higher than that of the concave cases ([28.82±11.29] mm vs.[13.57±4.42]mm,P＜0.05).The size and elevation angle of the diaphragmal opening were positively correlated with tumor height (r=0.224,P=0.003; r=0.586,P=0.000).The size ofdiaphragmal opening in the invasive group was significantly larger than that in non-invasive group ([10.30±5.79] mm vs.[5.55 ±3.29] mm,P=0.002).The size of diaphragmal opening in non-total resection group was significantly greater than that in the total resection group ([5.58±4.14] mmvs.[11.04±4.80] mm,P=0.000),and the width of diaphragrnal opening was negatively correlated with tumor resection ratio (r=-0.576,P=0.020).Conclusions Diaphragrna sellae could be displayed satisfactorily in contrast-enhanced 3D-GE MRI.The size of the diaphragmal opening and the elevated angle of drua besides diaphragrnal opening are positively correlated with tumor height.The size of diaphragmal opening of the invasive pituitary adenoma patients is larger than that ofnon-invasive ones.The larger the diaphragrnal opening size,the more difficult the tumor being totally resected by transsphenoidal approach.

Objective To explore the disease spectrum characteristics of hospitalized children having joined new rural cooperative medical system (NCMS) in Jinjiang, in order to provide reference for developing disease prevention and control measures for the children. Methods The disease spectrum of NCMS hospitalized children under 14 years old in Jinjiang from January to December 2013 were analyzed. Results The NCMS hospitalized children's disease attack was related to age and sex. Children in different age stages had different ranks of disease constitution, but respiratory and digestive system diseases always ranked the top 3 in each age group. The top 5 system diseases affecting children's health were respiratory diseases ( 63 . 60%) , digestive diseases ( 11 . 04%) , certain infectious and parasitic diseases (5.41%), certain conditions originated in perinatal period (3.17%), and certain consequences caused by injury, poison-ing and external causes (2.76%);The top 5 system diseases affected 85.99%of the total hospitalized children. Regard-ing to single disease rank, the top 5 diseases were all respiratory system diseases, (unspecified) bronchial pneumonia (22.83%), (unspecified) acute tonsillitis (9.26%), (unspecified) acute upper respiratory tract infection (8.99%), (unspecified) acute bronchitis (8.82%) and unspecified pneumonia (5.38%); The top 5 diseases affected 55.28% of the total hospital-ized children. Conclusion Respiratory disease is the major disease threatening the children's health in Jinjiang. It is suggested that medical and health resources be adjusted rationally, specific effective methods and measures be taken to prevent respiratory diseases, and relevant prevention and control measures be developed based on the disease constitu-tions of children in different age groups.