1.Clinical efficacy analysis of seven pediatric patients with Acute myeloid leukemia and the t(16;21)(p11;q22) FUS::ERG fusion gene.
Lihuan SHI ; Shan HUANG ; Xing XIE ; Pengkai FAN ; Haili GAO ; Yanna MAO
Chinese Journal of Medical Genetics 2026;43(2):90-95
OBJECTIVE:
To analyze the clinical characteristics, treatment, and prognosis of seven pediatric patients with Acute myeloid leukemia (AML) positive for the t(16;21)(p11;q22) FUS::ERG fusion gene.
METHODS:
A retrospective analysis was carried out on the clinical data, treatment, and prognosis of seven AML patients with t(16;21)(p11;q22) FUS::ERG fusion gene admitted to Henan Children's Hospital between June 2015 and November 2024. Relevant literature was also reviewed. This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: 2024-102-001).
RESULTS:
Among 297 pediatric patients with AML, 7 cases (2.36%) were positive for the t(16;21)(p11;q22) FUS::ERG fusion gene, including 3 males and 4 females, with a median age of 11 years (range: 3 ~ 12 years). According to the FAB classification, these included 1 case of M2, 3 cases of M5, and 3 cases of AML-not otherwise specified (non-M3). All 7 patients were found to harbor the t(16;21)(p11;q22) translocation, with 3 cases showing additional chromosomal abnormalities. Immunophenotyping revealed universal expression of CD13, CD33, CD34, and CD117, with partial expression of CD56, CD4, CD64, CD123, CD15, CD38, CD11b, HLA-DR, cMPO, and CD16. One patient achieved complete remission (CR) after the first course of DAE (cytarabine + daunorubicin + etoposide) induction chemotherapy but relapsed and discontinued the treatment. Six patients received DAH (cytarabine + daunorubicin + homoharringtonine) induction therapy, of whom 2 achieved CR after two courses and underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), resulting in an overall CR rate of 42.86%. Five children did not receive allo-HSCT and had a median overall survival of 9 months (range: 6 ~ 18 months). Two children who underwent transplantation achieved bone marrow morphological and molecular biological relapse at 6 and 9 months post-transplantation, respectively. After receiving combined chemotherapy and donor lymphocyte infusion, one child failed to achieve remission and died at 22 months post-transplantation, while the other has been followed up to date with positive fusion gene status. Their overall survival was 25 months and 30 months, respectively.
CONCLUSION
The t(16;21)(p11;q22) FUS::ERG fusion gene is rare in pediatric AML and associated with poor prognosis. Allo-HSCT may mitigate the adverse prognostic impact of the FUS::ERG fusion gene and contribute to prolonged survival.
Humans
;
Male
;
Child
;
Female
;
Leukemia, Myeloid, Acute/drug therapy*
;
Oncogene Proteins, Fusion/genetics*
;
Translocation, Genetic
;
Retrospective Studies
;
RNA-Binding Protein FUS/genetics*
;
Chromosomes, Human, Pair 16/genetics*
;
Adolescent
;
Child, Preschool
;
Chromosomes, Human, Pair 21/genetics*
;
Prognosis
;
Treatment Outcome
2.Primary aldosteronism in a Malaysian Tertiary Centre: A retrospective audit of clinical characteristics, diagnostic pathways, and treatment outcomes (2018–2025)
Ahmad Hambal Bin Zamari ; Yusniza Yusof
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):19-20
Introduction:
Primary aldosteronism (PA) is a common yet underdiagnosed cause of secondary hypertension, associated
with increased cardiovascular and renal morbidity. Early
detection and subtype-directed management significantly
improve outcomes. However, adherence to recommended
diagnostic pathways in real-world practice remains
variable.
Case:
We conducted a retrospective audit of patients diagnosed
with PA in a Malaysian tertiary centre from January 2018
to December 2025. Data collected included demographics,
clinical presentation, biochemical parameters, diagnostic
workup (aldosterone-renin ratio [ARR], confirmatory
testing, adrenal imaging, and adrenal venous sampling
[AVS]), treatment modality, and outcomes. Audit standards
were based on established international guidelines.
A total of 14 patients were included, with equal gender
distribution. The cohort comprised 57% Malay and 43%
Chinese. Most patients presented with hypertension
(mean ~170/100 mmHg), and hypokalemia was present
in approximately 70% of the patients. ARR and adrenal
imaging were performed in all patients (100%), while
confirmatory testing was conducted in 85% of the patients.
However, AVS utilization remained limited (50%).
Contributing factors included failed cannulation, technical
challenges in overweight patients, preference for medical
therapy, refusal of surgery, and limited access to AVS
services. The majority had unilateral adrenal adenoma
(~75%). Treatment was divided between surgical (55%) and
medical (45%) approaches. Post-treatment, hypokalemia
resolved in 90% of patients, with a significant reduction
in antihypertensive burden and complete hypertension
resolution in approximately 35% of the patients. Quality of
life improved in most patients.
Conclusion
This audit demonstrates good adherence to initial screening
and imaging in PA but highlights suboptimal utilization
of AVS. Barriers to AVS utilization are multifactorial,
encompassing technical, patient-related, and system level limitations. Addressing these barriers is essential to
optimize subtype-directed management and improve longterm cardiovascular outcomes in patients with PA. Despite
this, clinical outcomes were favorable. Strengthening
adherence to diagnostic pathways, particularly subtype
confirmation, may further improve patient outcomes.
Hyperaldosteronism
;
Treatment Outcome
;
Retrospective Studies
3.Impact of Glycemic Control on Tuberculosis Treatment Outcomes in Patients With Diabetes Mellitus: A Retrospective Audit
Chitra Devi Balasubramaniyam ; Mohammad Ulilamri Tukiman ; Yusniza Yusoff ; Mohammad Nur Syafiq Mohammad Azman ; Choo Jia Qing
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):37-38
Introduction:
Diabetes mellitus (DM) is a significant comorbidity
associated with adverse tuberculosis (TB) treatment
outcomes and remains an ongoing clinical challenge.
Chronic hyperglycemia impairs host immune responses,
particularly macrophage function, leading to delayed
bacillary clearance. This contributes to poorer outcomes,
including delayed sputum conversion, prolonged
treatment duration, relapse, and increased mortality. Poor
glycemic control is a key modifiable factor influencing
these outcomes. This study aimed to evaluate the impact
of glycemic control at diagnosis on TB treatment outcomes
in a Malaysian cohort.
Methodology:
A retrospective cross-sectional audit was conducted using
the TB clinic registry at Hospital Sungai Buloh from 2022
to 2025. Adult patients (≥18 years) with confirmed TB (any
form) and DM (Type 1 or Type 2) with complete records
were included. Of 241 patients screened, 131 were included
after exclusions due to incomplete records (29.9%), transfer
(29.9%), loss to follow-up (19.9%), and drug-resistant TB
(2.9%). Data collected included demographics, hemoglobin
A1c (HbA1c) at diagnosis, sputum conversion duration,
treatment duration, type of DM therapy, and clinical
outcomes.
Results:
The cohort had a mean age of 53 years, with 97% having
Type 2 DM.
Mean HbA1c at diagnosis was 10.5%. Poorer glycemic
control was associated with delayed sputum conversion.
Patients who achieved sputum conversion by 8 weeks had
an average HbA1c of 9.6%, compared to 11.8% in those
with delayed conversion. Longer treatment duration was
associated with higher HbA1c (mean 10.5, 8.6, and 11.8%
for 6-, 12-, and 18-month regimens, respectively). Relapse
analysis demonstrated a trend towards higher HbA1c with
increasing relapse episodes (11.2, 13.75, and 14.5% for one, two, and three relapses, respectively). Overall mortality
was 17% (22/131), with markedly higher mean HbA1c in
deceased patients compared to survivors (16.0% vs 10.5%).
Conclusion
Poor glycemic control at TB diagnosis is associated with
delayed sputum conversion, prolonged treatment duration,
and increased mortality. These findings are consistent with
regional evidence, including a South Asian systematic
review (Gautam et al., 2021), demonstrating higher mortality
and treatment failure in patients with TB and DM. Early
and aggressive optimization of glycemic control, alongside
standard anti-TB therapy, is essential to improve outcomes.
Humans
;
Glycemic Control
;
Retrospective Studies
;
Diabetes Mellitus
;
Treatment Outcome
;
Tuberculosis
4.Clinical efficacy of talonavicular arthrodesis combined with navicular stress adjustment in Müller-Weiss disease.
Xin-Kai ZHUANG ; Da-Wei XIN ; Lin-Ru ZENG
China Journal of Orthopaedics and Traumatology 2025;38(4):424-429
OBJECTIVE:
To evaluate the mid-term efficacy of talonavicular joint fusion alone combined with navicular stress adjustment in Müller-Weiss disease with significant paradoxical flatfoot deformity.
METHODS:
Between January 2016 and March 2021, a total of 13 patients diagnosed with Müller-Weiss disease underwent simple talonavicular joint fusion combined with navicular stress adjustmentadjustment.Among them, 5 patients were male and 8 patients were female;age ranged from 42 to 67 years old. The duration of the disease ranged from 8 to 20 years. According to Maceira staging system, 5 patients were in stage III and 8 patients were in stage IV. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and foot length were evaluated preoperatively and 10 months postoperatively. Additionally, the talonavicular coverage angle, the talus-first metatarsal angle, and the calcaneal inclination angle were assessed preoperatively and 6 months postoperatively.
RESULTS:
All 13 patients were followed up a period ranging from 24 to 40 months. All patients achieved clinical healing within a period of 3 to 6 months. However, one patient experienced a screw fracture. The VAS decreased from a range of 3 to 7 points preoperatively to a range of 0 to 2 points at the 10 months postoperative. The AOFAS midfoot score improved from a preoperative range of 12 to 66 points to a range of 72 to 100 points at the 10 months postoperative. Based on the AOFAS midfoot score evaluated at 10 months postoperatively, the outcomes were rated as excellent in 3 feet, good in 6 feet, and fair in 4 feet. The talo-navicular coverage angle, the preoperative talus-first metatarsal angle, calcaneal inclination angle were 14.3° to 33.4°, -4.6° to -19.6°, and 3.0°to 16.4° respectively. Six months postoperatively, these angles improved to 2.7°to 9.6°, -8.4°to 1.1°, and 18.8°to 24.9°respectively. Additionally, the foot length increased by 0 to 6 mm at 10 months post-surgery.
CONCLUSION
Simple talonavicular arthrodesis combined with scaphoid stress adjustment has satisfactory clinical efficacy in Müller-Weiss disease in terms of deformity, foot length, foot function and pain.
Humans
;
Male
;
Female
;
Adult
;
Middle Aged
;
Arthrodesis/methods*
;
Aged
;
Flatfoot/physiopathology*
;
Tarsal Bones/physiopathology*
;
Tarsal Joints/surgery*
;
Treatment Outcome
5.Comparison of the early and medium term efficacy of oblique lateral interbody fusion combined lateral fixation and transforaminal lumbar interbody fusion in lumbar spinal stenosis.
Ren-Jie LI ; Wei-Min JIANG ; Tang-Yi-Heng CHEN ; Sen YANG ; Yi-Jie LIU
China Journal of Orthopaedics and Traumatology 2025;38(5):465-472
OBJECTIVE:
To compare the clinical efficacy of oblique lateral interbody fusion(OLIF) combined with lateral fixation and transforaminal lumbar interbody fusion(TLIF) in patients with lumbar spinal stenosis.
METHODS:
Totally 47 patients with lumbar stenosis from November 2018 to December 2021 were analyzed retrospectively and were divided into two groups according to the surgical methods. Among them, 21 cases underwent oblique lumbar interbody fusion supplemental anterolateral screw and rod instrumentation, including 5 males and 16 females, with a mean age of (68.19±6.13) years old ranging 55 to 74 years; the other 26 cases underwent posterior pedicle screw fixation and reduction were recorded, including 8 males and 18 females with a mean age of (65.35±7.64) years old ranging 54 to 78 years. Visual analogue scale(VAS) of pain was recorded to evaluate the degree of low back pain and lower extremity pain. The radiographic parameters were collected to evaluate the efficacy of two approaches including disc height, foraminal height, canal sagittal diameter and cross-sectional area.
RESULTS:
All operations were completed successfully. The wound healed normally and bone fusion was obtained in the last final follow up. No serious complication was occurred in both groups. One case of dural tear occurred in direct compression group. Four cases of left thigh weakness and pain were recorded in indirect decompression group. The average postoperative follow-up was(21.69±4.37)months in direct compression group, while(20.43±4.80)months in another group. There were no significant difference in bone density, body mass index(BMI), hospital stay, Cobb angel(P>0.05). The differences in intra-operative blood loss, operation time, disc height, foraminal height between two groups were statistically significant(P<0.05). The area and sagittal diameter of the spinal canal in the two groups were significantly improved after surgery(P<0.05).
CONCLUSION
Both two fusion methods have achieved good clinical results in the treatment of lumbar spinal stenosis, with the advantages of good stability, fast recovery and high fusion rate. Compared with TLIF, the advantage of OLIF has greater advantages in less bleeding and less trauma.
Humans
;
Male
;
Female
;
Spinal Stenosis/surgery*
;
Spinal Fusion/methods*
;
Aged
;
Middle Aged
;
Lumbar Vertebrae/surgery*
;
Retrospective Studies
;
Treatment Outcome
6.Comparison of clinical efficacy of transmetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy in the treatment of moderate to severe hallux valgus.
Feng-Ping WEN ; Xing LIU ; Chong-Yang CHEN ; Shi-Kun TIAN
China Journal of Orthopaedics and Traumatology 2025;38(6):559-565
OBJECTIVE:
To compare clinical efficacy of intermetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy in treating moderate to severe hallux valgus (HV).
METHODS:
A retrospective analysis was conducted on clinical data of 42 patients with moderate to severe HV admitted from January 2022 to December 2022. According to different incisions, the patients were divided into medial incision group with 22 patients (22 feet) and intermetatarsal incision group with 20 patients (20 feet). In medial incision group, there were 3 males and 19 females, aged from 40 to 69 years old with an average of (55.0±11.4) years old;body mass index (BMI) ranged from 21 to 29 kg·m-2 with an average of (25.2±2.1) kg·m-2;the courses of disease ranged from 8 to 16 years with average of (12.0±2.2) years;11 patients with moderate deformity and 11 patients with severe deformity. In transplantar incision group, there were 3 males and 17 females, aged from 39 to 68 years old with an average of (53.0±7.5) years old;BMI ranged from 20 to 28 kg·m-2 with an average of (24.8±1.9) kg·m-2;the courses of disease ranged from 9 to 17 years with an average of (14.0±3.1) years;9 patients with moderate deformity and 11 patients with severe deformity. Hallux valgus angle (HVA) and the first-second intermetatarsal angle (IMA), American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores and complications between two groups before operation and 12 months after operation were observed and compared.
RESULTS:
All patients were successfully completed the surgery and were followed up for 12 to 15 months with an average of (13.52±1.65) months. There were no statistically significant difference in HVA and IMA between two groups before operation and 12 months after operation (P>0.05). AOFAS forefoot scores of medial incision group before operation and 12 months after operation were (45.0±6.8) and (86.0±6.7) respectively, and those of transmetatarsal incision group were (46.0±7.4) and (83.0±7.5) respectively. Postoperative AOFAS forefoot scores between two groups at 12 months were statistically significant compared with those of before operation (P<0.01). According to AOFAS forefoot scores, 8 patients got excellent result, 14 good in medial incision group;while 6 excellent and 14 good in transplantar incision group. At 12 months, postoperative AOFAS forefoot score of functional score of in medial incision group(38.0±2.5), was better than that in transplantar incision group (34.0±2.2), and the difference was statistically significant (P<0.05). One patient in medial incision group occurred HV deformity, mild numbness occurred in 3 toes in transplantar incision group, and 3 patients were dissatisfied with scar. No complications such as infection, nonunion of bones or ischemic necrosis of metatarsal heads occurred in either group.
CONCLUSION
Both intermetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy can effectively treat moderate to severe HV. The functional recovery after medial incision is better than that after intermetatarsal incision.
Humans
;
Male
;
Female
;
Hallux Valgus/physiopathology*
;
Middle Aged
;
Osteotomy/methods*
;
Adult
;
Aged
;
Retrospective Studies
;
Treatment Outcome
;
Metatarsal Bones/surgery*
7.Clinical efficacy of hallux valgus under the guiding of minimally invasive hallux valgus diagnosis and treatment system.
Pei-Biao CAI ; Yi-Biao DOU ; Chuang-Jian LIN ; Guan-Nan WEN ; Hai-Bo CHEN ; Chuang-Ming WANG
China Journal of Orthopaedics and Traumatology 2025;38(6):566-571
OBJECTIVE:
To explore short-term clinical efficacy of minimally invasive diagnosis and treatment system for hallux valgus in guiding the treatment of hallux valgus.
METHODS:
From March 2021 to November 2023, 68 patients (136 feet) with hallux valgus were treated under guidance of minimally invasive diagnosis and treatment system, including 12 males and 56 females;aged from 25 to 68 years old with an average of (42.5±8.5) years old, the course of disease ranged from 3.2 to 15.6 years with an average of (10.3±2.6) years. The changes of hallux valgus angle (HVA) and intermetatarsal angle (IMA), visual analog scale (VAS) and American Orthopaedic Foot Ankle Society (AOFAS) forefoot score were recorded and compared before operation and 12 months after operation.
RESULTS:
Sixty-five patients (130 feet) were followed up for 12 to 15 months with an average of (13.8±0.5) months, 3 patients (6 feet) were not followed up as required. HVA and IMA improved from (35.5±3.5) ° and (12.5±2.0) ° before operation to (10.5±2.5) ° and (8.5±1.5) °12 months after operation, respectively, with statistically significant differences (P<0.05);VAS decreased from (5.5±1.2) before operation to (1.2±0.5) at 12 months after operation, and the difference was statistically significant (P<0.05);AOFAS forefoot score increased from (50.6±5.1) before operation to (93.8±5.6) at 12 months after operation, with a statistically significant difference (P<0.05). Among them, 102 feet were got excellent result, 24 feet good, and 4 feet fair. Two patients were developed calf intermuscular vein thrombosis, and were cured after 3 months of symptomatic treatment.
CONCLUSION
Under the guidance of minimally invasive diagnosis and treatment system for hallux valgus, the treatment of HV could obviously improve HVA and IMA, and significantly alleviate pain symptoms, and accelerate functional recovery.
Humans
;
Hallux Valgus/diagnosis*
;
Male
;
Female
;
Middle Aged
;
Adult
;
Aged
;
Minimally Invasive Surgical Procedures/methods*
;
Treatment Outcome
8.Comparison of the clinical efficacy in staged open reduction internal fixation and external fixation combined with limited internal fixation for the treatment of high-energy tibial Pilon fracture.
Wei-Qing CHEN ; Ye-Hai CHEN ; Jun-Rong SHU ; Bao-Ping XU ; Bao-Lin CHEN ; Jun-Tao YANG ; Xiu-Po HU
China Journal of Orthopaedics and Traumatology 2025;38(7):716-721
OBJECTIVE:
To compare the clinical efficacy and complication rates of staged open reduction internal fixation (ORIF) and external fixation combined with limited internal fixation (EFLIF) in the treatment of high-energy Pilon fractures.
METHODS:
A retrospective selection was conducted on 78 patients diagnosed with high-energy tibial Pilon fractures who received treatment between January 2021 and October 2023. These patients were categorized into the staged ORIF group and the EFLIF group according to their respective treatment protocols. The staged ORIF group comprised 48 patients, including 29 males and 19 females, aged from 33 to 53 years old with a mean age of (43.25±4.67) years old. The time from injury to treatment averaged (6.54±2.21) hours. All patients received staged ORIF treatment. The EFLIF Group consisted of 30 patients, including 18 males and 12 females, aged from 36 to 54 years old with a mean age of (43.37±3.24) years old. The time from injury to treatment averaged (6.87±1.96) hours. All patients received EFLIF treatment. The recovery of ankle joint function, fracture reduction quality, fracture healing time, and surgical-related indicators between two groups were observed and compared six months after surgery. Additionally, the postoperative complications of the two groups were recorded.
RESULTS:
Both groups of patients were followed up and the duration ranged from 6 to 12 months, with an average of (8.97±1.26) months. At 6-month postoperative follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) score in the ORIF group was (83.15±20.93), which did not show a statistically significant difference compared to the EFLIF group (81.88±20.67), P>0.05. The excellent and good rate of fracture reduction in the staged ORIF group was 33.33% (16/48), which did not show a statistically significant difference compared to the EFLIF group (30.00%, 9/30), P>0.05. The hospitalization duration and fracture healing time in the staged ORIF group were (16.57±1.25) days and (12.14±1.15) weeks, respectively. When compared to the EFLIF group, which demonstrated a hospitalization duration of (15.97±2.16 ) days and a fracture healing time of (12.36±1.17) weeks, no statistically significant differences were observed (P>0.05). The intraoperative blood loss in the staged ORIF group was (76.54±11.65) ml, which was significantly higher than that in the EFLIF group (70.15±10.29) ml, and the difference was statistically significant (P<0.05). The incidence of superficial tissue infection was 2.08%(1/48), which was significantly lower than that observed in the EFLIF group at 16.67% (5/30), and this difference was statistically significant (P<0.05).
CONCLUSION
Both staged ORIF and EFLIF were effective treatment options for high-energy closed Pilon fractures of the tibia. However, regarding the prevention of superficial tissue infection, staged ORIF demonstrates superior risk control compared to EFLIF.
Humans
;
Male
;
Female
;
Middle Aged
;
Adult
;
Tibial Fractures/physiopathology*
;
Fracture Fixation, Internal/methods*
;
Retrospective Studies
;
External Fixators
;
Open Fracture Reduction/methods*
;
Treatment Outcome
9.Analysis of early efficacy and safety of hip arthroscopy in patients with borderline developmental dysplasia of the hip.
Ke AI ; Lei WANG ; Jun YANG ; Jie-Neng CHEN
China Journal of Orthopaedics and Traumatology 2025;38(8):828-834
OBJECTIVE:
To explore the early efficacy and safety of hip arthroscopy in the treatment of patients with borderline developmental dysplasia of the hip(BDDH).
METHODS:
A total of 111 patients diagnosed with BDDH from January 2020 to December 2022 were selected and divided into two groups according to the surgical method. Among them, 63 patients who underwent arthroscopy were assigned to the arthroscopy group, including 22 males and 41 females with an average age of (35.67±6.83) years;48 patients who underwent periacetabular osteotomy were assigned to the PAO group, including 18 males and 30 females with an average age of (36.85±7.10) years. The operation time, hospital stay, blood loss, rehabilitation time, complication rate, and reoperation rate were recorded in both groups. Imaging indicators of the two groups were measured and recorded. The modified Harris hip score (mHHS), nonarthritic hip score (NAHS), and hip outcome score-activity of daily living scale (HOS-ADL) were used to evaluate hip function and quality of life before and after surgery.
RESULTS:
All patients were followed up for 12 months. The operation time (90.43±9.85) min, hospital stay(4.32±0.56) days, rehabilitation time (15.22±2.15) weeks, blood loss (25.69±6.57) ml, and number of complications (15 cases) in the arthroscopy group were all lower than those in the PAO group (117.25±15.83) min, (5.81±0.92) days, (21.10±3.74) weeks, (358.52±126.73) ml, 30 cases, with statistically significant differences (P<0.05). At the last follow-up after treatment, the lateral center edge angle (LCEA) (19.82±1.90)° and anterior center edge angle (ACEA) (20.01±1.85)° in the arthroscopy group decreased compared with those before treatment (21.43±2.10)°, (21.54±2.05)°, while in the PAO group, the LCEA (33.03±3.45)° and ACEA (33.48±4.22)° at the last follow-up after treatment increased compared with those before treatment, with statistically significant differences (P<0.05). The T?nnis angle in the arthroscopy group after treatment (11.05±1.83)° increased compared with that before treatment, while in the PAO group, the T?nnis angle at the last follow-up after treatment (2.98±0.75)° decreased compared with that before treatment, with statistically significant differences (P<0.05). In the arthroscopy group, the extrusion index (30.68±2.85) and T?nnis grade after treatment increased compared with those before treatment, while the α angle after treatment (38.79±4.27)° significantly decreased compared with that before treatment, with statistically significant differences (P<0.05);in the PAO group, the extrusion index (15.03±2.18) and α angle (53.58±6.02)° after treatment significantly decreased compared with those before treatment, with statistically significant differences (P<0.05). The mHHS score at the last follow-up after treatment in the arthroscopy group (86.41±7.33) was higher than that in the PAO group (81.02±6.49), with a statistically significant difference (P<0.05). At 6 months after treatment, the NAHS (69.83±6.53) and HOS-ADL scores (78.84±7.39) in the arthroscopy group were higher than those in the PAO group (64.10±6.02), (75.31±7.01), with statistically significant differences (P<0.01);at the last follow-up after treatment, the NAHS (87.63±7.60) and HOS-ADL scores (88.94±8.11) in the arthroscopy group were higher than those in the PAO group (81.63±7.03), (83.63±7.92), with statistically significant differences (P<0.05).
CONCLUSION
Compared with PAO, hip arthroscopy shows better early to mid-term clinical efficacy in the treatment of BDDH patients. However, PAO has more advantages in improving acetabular imaging indicators of BDDH patients, while hip arthroscopy only improves the α angle of patients. Meanwhile, hip arthroscopy causes less trauma to patients, reduces blood loss, and is more conducive to the subsequent recovery of patients.
Humans
;
Female
;
Male
;
Arthroscopy/methods*
;
Adult
;
Developmental Dysplasia of the Hip/physiopathology*
;
Middle Aged
;
Treatment Outcome
10.Early clinical observation of the efficacy of a three-stage traditional Chinese medicine external treatment plan for talus Bone bruises caused by acute ankle sprain.
Mei-Qi YU ; Lei ZHANG ; Tian-Xin CHEN ; Ting-Ting DONG ; Yan LI ; Jun-Ying WU ; Bo JIANG ; Sheng ZHANG ; Xiao-Hua LIU ; Jin SUN ; Qing-Lin WANG
China Journal of Orthopaedics and Traumatology 2025;38(8):835-841
OBJECTIVE:
To explore the early clinical efficacy of a three-stage external treatment with traditional Chinese medicine (TCM) in the treatment of talar bone contusion caused by acute ankle sprain.
METHODS:
A retrospective analysis was performed on 360 patients with primary lateral ankle sprain admitted from September 2021 to July 2024. Patients with talar bone contusion were selected based on MRI examination, and 73 cases were finally included. According to different treatment methods, they were divided into the observation group and the control group. The observation group consisted of 35 cases, including 16 males and 19 females, aged 24 to 37 years old with an average of (30.34±2.68) years old, and received the three-stage external TCM treatment combined with the "POLICE" protocol. The control group included 38 cases, including 18 males and 20 females, aged 24 to 35 years old with an average of (29.87±2.57) years old, and was treated with the "POLICE" protocol alone. The volume of bone marrow edema (BME) area shown by MRI before treatment and 6 weeks after treatment was measured using 3D Slicer software, and the BME improvement rate was calculated. The "Figure of 8" measurement method was used to assess ankle swelling before treatment and at 1 and 3 weeks after treatment. The visual analogue scale (VAS) was used to evaluate ankle pain before treatment and at 1 and 6 weeks after treatment. At 6 weeks after treatment, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Karlsson ankle function score system were used to evaluate the improvement of ankle function.
RESULTS:
A total of 73 patients with talar bone contusion caused by ankle sprain completed the 6-week follow-up. At 6 weeks after treatment, the BME improvement rate in the observation group was (39.18±0.06)%, which was higher than (26.75±0.03)% in the control group, with a statistically significant difference (P<0.05). After 1 week of treatment, the VAS score in the observation group was (2.89±0.72) points, lower than (3.37±0.79) points in the control group, and the difference was statistically significant (P<0.05). The ankle swelling degree in the observation group was (50.20±3.19) cm, lower than (52.00±3.60) cm in the control group, with a statistically significant difference (P<0.05). After 3 weeks of treatment, there was no statistically significant difference in ankle swelling between the two groups. At 6 weeks after treatment, there was no statistically significant difference in VAS scores between the two groups. At 6 weeks after treatment, the AOFAS ankle-hindfoot score and Karlsson score in the observation group were (87.43±4.18) and (82.77±5.93) points, respectively, which were higher than (82.92±4.87) and (76.45±6.85) points in the control group, with statistically significant differences (P<0.05). According to the AOFAS ankle-hindfoot score, 8 cases were excellent and 27 cases were good in the observation group;2 cases were excellent, 33 cases were good, and 3 cases were fair in the control group. The difference between the two groups was statistically significant (χ2=7.089, P=0.029).
CONCLUSION
The three-stage external TCM treatment combined with the "POLICE" protocol has a significant early clinical efficacy. It can significantly reduce ankle pain and swelling in patients with bone contusion caused by acute lateral ankle sprain, promote the absorption of bone marrow edema, and accelerate the recovery of ankle function.
Ankle Injuries/drug therapy*
;
Drugs, Chinese Herbal/administration & dosage*
;
Talus/injuries*
;
Retrospective Studies
;
Administration, Cutaneous
;
Magnetic Resonance Imaging
;
Humans
;
Male
;
Female
;
Young Adult
;
Adult
;
Contusions/etiology*
;
Visual Analog Scale
;
Musculoskeletal Pain/etiology*
;
Recovery of Function/drug effects*
;
Treatment Outcome
;
Follow-Up Studies


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