BACKGROUND The Lisfranc ligament is crucial for maintaining the transverse and longitudinal arch of the foot. Owing to the disruption between the medial cuneiform bone and the base of the second metatarsal bone, the currently preferred fixation method remains controversial. Our fixation technique involves screwing one anchor to the medial and intermediate cuneiform bones and using the anchor to carry the ligament to bind the Lisfranc joint and first and second metatarsal joints altogether for elastic fixation. This study evaluated the clinical and functional outcomes of InternalBrace fixation for Lisfranc injury. MATERIAL AND METHODS This retrospective study included 58 patients who underwent InternalBrace fixation for Lisfranc injury between January 2019 and September 2022 by an experienced surgeon. One-way analysis of variance or t test was used. Preoperative classification was performed according to the Myerson classification with imaging data. Postoperative follow-up was performed based on intraoperative blood loss, fracture healing time, visual analog scale (VAS) score, the American Orthopedic Foot and Ankle Society (AOFAS) score, Tegner score, and complications. RESULTS Surgery was completed in all patients, and follow-up was performed. The patients\' ages ranged from 19 to 62 years (average: 34.6±9.4 years). The postoperative follow-up time was 12-24 months (average: 16.9±3.0 months). The average time for fracture healing was 12.8±3.0 (10-24) weeks. The VAS, AOFAS, and Tegner scores significantly improved postoperatively (from 5.33±1.0 (3-7) to 1.24±0.57 (0-2); 28.02±6.70 (18-51) to 91.59±4.76 (82-96); and 2.40±0.67 (1-4) to 6.53±0.54 (6-7), respectively), which was statistically significant (P<0.01), and the good rate of AOFAS was 91.4%. The postoperative complications were traumatic arthritis, incision infection, and temporary dorsal foot numbness, which gradually recovered. No other rejection reactions or Lisfranc fracture/dislocations recurrence occurred during the follow-up period. CONCLUSIONS InternalBrace fixation for Lisfranc injury is beneficial for restoring Lisfranc joint stability and function and allows for early and more aggressive rehabilitation for patients, with fewer surgical complications.

UNASSIGNED: To investigate the morphological characteristics of the glenohumeral joint (including the glenoid and coracoid) in the Chinese population and determine the feasibility of designing coracoid osteotomy based on the preoperative glenoid defect arc length by constructing glenoid defect models and simulating suture button fixation Latarjet procedure.
UNASSIGNED: Twelve shoulder joint specimens from 6 adult cadavers donated voluntarily were harvested. First, whether the coracoacromial ligament and conjoint tendon connected was anatomically observed and their intersection point was identified. The vertical distance from the intersection point to the coracoid, the maximum allowable osteotomy length starting from the intersection point, and the maximum osteotomy angle were measured. Next, the anteroinferior glenoid defect models of different degrees were randomly constructed. The arc length and area of the glenoid defect were measured. Based on the arc length of the glenoid defect of the model, the size of coracoid oblique osteotomy was designed and the actual length and angle of the coracoid osteotomy were measured. A limited osteotomy suture button fixation Latarjet procedure with the coracoacromial ligament and pectoralis minor preservation was performed and the position of coracoid block was observed.
UNASSIGNED: All shoulder joint specimens exhibited crossing fibers between the coracoacromial ligament and the conjoint tendon. The vertical distance from the tip of the coracoid to the coracoid return point was 24.8-32.2 mm (mean, 28.5 mm). The maximum allowable osteotomy length starting from the intersection point was 26.7-36.9 mm (mean, 32.0 mm). The maximum osteotomy angle was 58.8°-71.9° (mean, 63.5°). Based on the anteroinferior glenoid defect model, the arc length of the glenoid defect was 22.6-29.4 mm (mean, 26.0 mm); the ratio of glenoid defect was 20.8%-26.2% (mean, 23.7%). Based on the coracoid block, the length of the coracoid osteotomy was 23.5-31.4 mm (mean, 26.4 mm); the osteotomy angle was 51.3°-69.2° (mean, 57.1°). There was no significant difference between the arc length of the glenoid defect and the length of the coracoid osteotomy ( P>0.05). After simulating the suture button fixation Latarjet procedure, the highest points of the coracoid block (suture loop fixation position) in all models located below the optimal center point, with the bone block concentrated in the anteroinferior glenoid defect position.
UNASSIGNED: The size of the coracoid is generally sufficient to meet the needs of repairing larger glenoid defects. The oblique osteotomy with preserving the coracoacromial ligament may potentially replace the traditional Latarjet osteotomy method.
UNASSIGNED: 探讨国人盂肱关节（包括关节盂、喙突）形态学特点；通过构造不同程度关节盂骨缺损模型并模拟弹性固定Latarjet手术，明确根据术前关节盂骨缺损弧长度设计喙突截骨的可行性。.
UNASSIGNED: 采用自愿捐赠的6具成年尸体12个肩关节标本，首先解剖观察喙肩韧带与联合腱是否相连，确定两者交叉点，测量喙突尖端距离喙突折返处的垂直长度、以交叉点为起点允许的最大截骨线长度以及最大截骨角度。然后，随机构建不同程度关节盂前下方骨缺损模型，测量关节盂骨缺损弧长度并计算缺损面积；根据模型中关节盂骨缺损弧长度设计喙突斜形截骨，测量实际喙突截骨长度及截骨角度；模拟保留喙肩韧带有限截骨弹性固定Latarjet手术，观察骨块中心位置。.
UNASSIGNED: 所有肩关节标本喙肩韧带与联合腱之间存在交叉纤维，喙突尖距离喙突折返处垂直长度为24.8～32.2 mm，平均28.5 mm；以交叉点为起点允许的最长截骨线长度为26.7～36.9 mm，平均32.0 mm；最大截骨角度为58.8°～71.9°，平均63.5°。基于关节盂前下方骨缺损模型，测量关节盂骨缺损弧长度为22.6～29.4 mm，平均26.0 mm；关节盂骨缺损比例为20.8%～26.2%，平均23.7%。基于喙突骨块，测量喙突截骨长度23.5～31.4 mm，平均26.4 mm；截骨角度51.3°～69.2°，平均57.1°。关节盂骨缺损弧长度与喙突截骨长度比较，差异无统计学意义（ P>0.05）。模拟弹性固定Latarjet手术后，所有模型中喙突截骨骨块最高点（线袢固定位置）均位于最适圆心下方，骨块集中于关节盂前下方。.
UNASSIGNED: 喙突大小基本能满足较大关节盂骨缺损修复需求，保留喙肩韧带的斜形截骨方式有望替代传统Latarjet截骨方式。.

UNASSIGNED: To evaluate the early-term effectiveness of Latarjet procedure with double EndoButtons fixation for recurrent anterior shoulder dislocation by coracoid osteotomy with preserving coracoacromial ligament.
UNASSIGNED: Between January 2021 and June 2023, 19 patients with recurrent anterior shoulder dislocations were treated by arthroscopic Latarjet procedure with double EndoButtons fixation, all of which underwent coracoid osteotomy with preserving the coracoacromial ligament. There were 11 males and 8 females, with an average age of 23.3 years (range, 17-32 years). Shoulder dislocations ranged from 3 to 11 times, with an average of 6.4 times. The disease duration ranged from 3 to 35 months, with an average of 12.9 months. All apprehension tests were positive. Imaging examination showed that the defect width of the ipsilateral glenoid bone was 13%-26%, with an average of 19.8%. After operation, the shoulder range of motion was examined, including flexion lift, lateral external rotation, extension 90° external rotation, and internal rotation. Shoulder joint function was evaluated by Walch-Duplay score, American Association for Shoulder and Elbow Surgery (ASES) score, and Rowe score. Imaging examinations were taken to observe the position and shaping of coracoid.
UNASSIGNED: All incisions healed by first intention and no nerve or vessel injury occurred. All patients were followed up 9-24 months (mean, 14.5 months). There was no recurrence of shoulder dislocation and the apprehension tests were negative during follow-up. There was no significant difference in the shoulder range of motion (flexion lift, lateral external rotation, extension 90° external rotation, and internal rotation) between preoperation and at last follow-up ( P>0.05). The Walch-Duplay score, ASES score, and Rowe score significantly improved when compared with those before operation ( P<0.05). Postoperative imaging showed that coracoid graft was at the same level with the glenoid in all cases; the center of coracoid graft was located between 3 to 5 o\'clock. During follow-up, there was no glenohumeral joint degeneration, the acromiaohumeral distance was not reduced when compared with preoperation, and the coracoid bone gradually formed concentric circles with the humeral head.
UNASSIGNED: The Latarjet procedure with double EndoButtons fixation can effectively treat recurrent anterior shoulder dislocation by coracoid osteotomy with preserving coracoacromial ligament, and the early-term effectiveness is satisfactory.
UNASSIGNED: 探讨双袢弹性固定Latarjet手术中采用保留喙肩韧带喙突截骨治疗复发性肩关节前脱位的早期疗效。.
UNASSIGNED: 2021年1月—2023 年6月，采用关节镜下双袢弹性固定Latarjet手术治疗19例复发性肩关节前脱位患者，术中均采用保留喙肩韧带喙突截骨方式。男11例，女8例；年龄17～32岁，平均23.3岁。肩关节脱位3～11次，平均6.4次。病程3～35个月，平均12.9个月。患者肩关节恐惧试验均为阳性；肩关节CT示患侧肩胛盂骨缺损宽度达13%～26%，平均19.8%。比较手术前后肩关节活动度（前屈上举、体侧外旋、外展90° 外旋和内旋）以及肩关节功能评分 ［Walch-Duplay评分、美国肩肘外科协会（ASES）评分和Rowe 评分］；随访影像学复查喙突骨块位置及塑形情况。.
UNASSIGNED: 术后切口均Ⅰ期愈合，无血管、神经损伤等并发症发生。患者均获随访，随访时间9～24个月，平均14.5个月。随访期间无肩关节再脱位发生，肩关节恐惧试验均为阴性。末次随访时，肩关节活动度（前屈上举、体侧外旋、外展90° 外旋以及内旋）与术前比较，差异均无统计学意义（ P>0.05）；肩关节功能Walch-Duplay评分、ASES评分、Rowe评分均较术前改善，差异有统计学意义（ P<0.05）。影像学复查示肩峰下间隙与术前比较无明显变化；喙突骨块与肩胛盂齐平，骨块中心均位于肩胛盂3:00～5:00位置，喙突骨块塑形与肱骨头轨迹逐渐匹配；随访期间未见盂肱关节退变。.
UNASSIGNED: 采用保留喙肩韧带喙突截骨的双袢弹性固定Latarjet手术可有效治疗复发性肩关节前脱位，早期疗效满意。.

UNASSIGNED: To review the development and research progress of suture button fixation Latarjet procedure.
UNASSIGNED: A comprehensive literature review was conducted to summarize the development and related modified techniques of the suture button fixation Latarjet procedure.
UNASSIGNED: Since the Latarjet procedure was first introduced by French scholar Latarjet in 1954, it has undergone three key transformations, resulting in suture button fixation Latarjet procedure, which has shown satisfactory outcomes in treatment of recurrent shoulder dislocation. However, there are still drawbacks such as the risk of impingement of the graft on surrounding tissues, and the surgical disruption of anatomical structures like the coracoclavicular ligament and the pectoralis minor muscle. The scholars have proposed several modified techniques based on the suture button fixation Latarjet procedure to further reduce complications from impingement of the graft, to lower the glenohumeral contact pressure, and to eliminate the impact of surgery on the physiological structures of the shoulder joint. The modified techniques include the arthroscopic suture button fixation Latarjet procedure using FiberTape Cerclage, reconstruction of the coracoacromial ligament during congruent-arc Latarjet procedures, and limit unique coracoid osteotomy suture button Latarjet procedure (LU-tarjet procedure). These modified techniques have also shown good clinical outcomes. Additionally, other related modified techniques for reconstruction of the glenoid, such as Chinese unique Inlay Bristow procedure (Cuistow procedure), arthroscopic glenoid bone grafting with soft fixation, and all-arthroscopic modified Eden-Hybinette procedure, have also demonstrated favorable efficacy. However, there is still a lack of long-term follow-up results for these techniques and comparative studies between them.
UNASSIGNED: Suture button fixation Latarjet procedure is an effective method for the treatment of recurrent shoulder dislocation. There are various techniques, but there is no recognized gold standard, and further clinical and basic research is needed.
UNASSIGNED: 综述弹性固定Latarjet手术发展历程及研究进展。.
UNASSIGNED: 查阅国内外弹性固定Latarjet手术相关研究文献，对该术式发展历程及相关改良技术进行总结。.
UNASSIGNED: 自1954年法国Latarjet教授首次提出Latarjet手术以来，该术式经历了3次关键变革，并逐渐形成了弹性固定Latarjet手术。目前临床应用结果显示弹性固定Latarjet手术治疗复发性肩关节脱位可获得满意疗效，但是仍存在移植骨块与周围组织撞击、手术破坏喙肩弓及胸小肌等解剖结构等不足。为了进一步减少移植骨块撞击带来的并发症、降低盂肱关节接触压力、消除手术对于肩关节原有生理结构的影响，学者们在其基础上提出了使用 FiberTape Cerclage 的关节镜下弹性固定 Latarjet 手术、一致弧Latarjet手术合并重建喙肩韧带、喙突有限截骨线袢固定Latarjet手术（LU-tarjet手术）等相关改良技术，临床应用也获得较好疗效。同时，关节镜下改良嵌入式喙突移位手术（Cuistow手术）、特殊关节盂骨移植技术、关节镜自体髂嵴骨移植术等关节盂重建改良技术也具有良好疗效。但是，目前尚缺乏各项技术的远期随访结果以及各项技术之间的对比研究。.
UNASSIGNED: 弹性固定Latarjet手术是治疗复发性肩关节脱位的有效术式，有多种改良术式，但尚无公认“金标准”，需要进一步进行临床及基础研究。.

The purpose of this meta-analysis was to conduct a comparative analysis of clinical scores and complication rates among patients experiencing recurrent patellar dislocation who underwent medial patellofemoral ligament (MPFL) reconstruction using both single and double tunnel techniques. A comprehensive search was conducted across electronic databases including PubMed, the Cochrane Library, Web of Science, and Google Scholar to retrieve articles relevant to MPFL reconstruction utilising the tunnel technique. Subsequently, meta-analyses were undertaken to assess complication rates and changes in clinical scores before and after surgery. Following this, sensitivity analysis and meta-regression analysis were performed to scrutinise potential confounding variables. A total of thirty-two studies were included in the analysis, comprising twenty-seven non-comparative studies and five comparative studies. The findings revealed a similarity in postoperative complication rates between the single and double tunnel fixation techniques: [9.0% (95%CI, 4.0%-15.6%) versus 8.9% (95%CI, 4.7%-14.1%, p = 0.844)]. Likewise, no statistically significant differences were observed in Lysholm scores [34.1 (95%CI, 26.7-41.5) versus 33.8 (95%CI, 27.7-40.0, p = 0.956)], Kujala scores [29.4 (95%CI, 22.3-36.4) versus 27.3 (95%CI, 22.3-32.3, p = 0.637)], and Tegner score change [1.1 (95%CI, 0.8-1.4) versus 0.7 (95%CI, -0.2-1.6, p = 0.429)] before and after MPFL reconstruction, respectively, using these two techniques. In conclusion, the authors found that the clinical functional improvement and complication rates in MPFL reconstruction using the single tunnel fixation technique are comparable to those achieved with the double tunnel fixation approach. However, to further advance the understanding in this field, additional randomised controlled studies must be conducted to provide further insights. Key Words: MPFL reconstruction, Bone tunnel, Patellar dislocation, Meta-analysis.

OBJECTIVE: Multiple ligament knee injuries (MLKIs) are disruptive injuries, however, there are controversies in the results of acute and delayed reconstruction. Also, clinical outcomes between patients older or younger than 40 have not been compared in MLKIs. This study was designed to investigate the influence of age and timing of reconstruction on the outcomes of single-stage reconstruction of MLKIs.
METHODS: The patients who underwent reconstruction of multiple injured ligaments because of MLKIs between May 2013 and July 2019 were added to the cohort. The postoperative complications, knee range of motion (ROM), Lysholm score, International Knee Documentation Committee (IKDC) 2000 score, Tegner activity level, patient satisfaction, and SF-36 score were compared between young (≤ 40 years old, n = 41) and old patients (n = 61); acute (≤ 3 weeks after injury, n = 75) and delayed reconstruction (n = 27), using Mann-Whitney U test or χ2 test.
RESULTS: A total of 102 MLKI patients managed by single-stage multi-ligament reconstruction were retrospectively reviewed. Patients were followed up after surgery for a mean of 7.3 years (5.2-10.7 years). At the last follow-up, no significant difference was found in knee ROM, functional scores, and patient-reported outcomes between patients older or younger than 40; acute and delayed reconstruction (p > 0.05). The rate of complications in the delayed reconstruction group was higher than that of the acute reconstruction group (22.2% vs 5.3%, p < 0.05). The IKDC objective scores reached grade A in 63.7%-80.4% of patients, and grade B in 11.8%-23.5% patients.
CONCLUSIONS: The single-stage reconstruction of MLKIs can obtain comparative long-term functional and objective outcomes regardless of patients older or younger than 40; acute and delayed reconstruction, however, delayed reconstruction is related to a high rate of postoperative complications.

Ossification of the sacrotuberous ligament is a rare occurrence in soft tissue, with only 15 cases reported in the past few decades. We reported two cases of bilateral ossification in sacrotuberous ligaments and provided a concise review of the literature on this pathology. Clinical data, radiographic outcomes, and diagnostic and treatment details were obtained. This study aimed to summarize this disease\'s characteristics and investigate its pathogenesis through a review of literature from the last thirty years. This condition is often incidentally confirmed in elderly males via imagiological examination or gross anatomy and presents a low morbidity rate. Its pathogenesis may be related to stress concentration, excessive intake of element ions, injury repair, and improper operative technique. The majority of patients may not exhibit any clinical symptoms or signs and typically do not require medical interventions. It may be complicated with pudendal nerve entrapment syndrome. The long-term effects of surgical resection and the most effective treatment approach remain areas for further research.

暂无摘要。

BACKGROUND: Medial patellar ligament reconstruction (MPFL-R) in combination with derotational distal femoral osteotomy (DDFO) for treating recurrent patellar dislocation (RPD) in the presence of increased femoral anteversion is one of the most commonly used surgical techniques in the current clinical practice. However, there are limited studies on the clinical outcomes of MPFL-R in combination with DDFO to treat RPD in the presence of increased femoral anteversion.
OBJECTIVE: To study the role of MPFL-R in combination with DDFO in the treatment of RPD in the presence of increased femoral anteversion.
METHODS: A systematic review was performed according to the PRISMA guidelines by searching the Medline, Embase, Web of Science, and Cochrane Library databases through June 1, 2023. Studies of patients who received MPFL-R in combination with DDFO after presenting with RPD and increased femoral anteversion were included. Methodological quality was assessed using the MINORS (Methodological Index for Nonrandomized Studies) score. Each study\'s basic characteristics, including characteristic information, radiological parameters, surgical techniques, patient-reported outcomes, and complications, were recorded and analyzed.
RESULTS: A total of 6 studies with 231 patients (236 knees) were included. Sample sizes ranged from 12 to 162 patients, and the majority of the patients were female (range, 67-100%). The mean age and follow-up ranges were 18 to 24 years and 16 to 49 months, respectively. The mean femoral anteversion decreased significantly from 34° preoperatively to 12° postoperatively. In studies reporting preoperative and postoperative outcomes, significant improvements were found in the Lysholm score, Kujala score, International Knee Documentation Committee score, and visual analog scale for pain. Postoperative complications were reported in all studies, with an overall reported complication rate of 4.7%, but no redislocations occurred during the follow-up period.
CONCLUSIONS: For RPD with increased femoral anteversion, MPFL-R in combination with DDFO leads to a good clinical outcome and a low redislocation rate. However, there was no consensus among researchers on the indications for MPFL-R combined with DDFO in the treatment of RPD.

UNASSIGNED: To improve the clinical utility of the plantaris tendon mainly by summarizing its anatomical characteristics, biomechanical properties, harvesting methods, and its applications in ligament reconstruction.
UNASSIGNED: The relevant literature from domestic and international databases regarding the anatomical and biomechanical characteristics of the plantaris tendon and its applications in ligament reconstruction was comprehensively reviewed and systematically summarized.
UNASSIGNED: The plantaris tendons have an absence. The majority of plantaris tendon forms a fan-shape on the anterior and medial sides of the Achilles tendon and terminates at the calcaneal tuberosity. There are significant differences in biomechanical parameters between plantaris tendon with different numbers of strands, and multi strand plantaris tendon have significant advantages over single strand tendon. The plantaris tendon can be harvested through proximal and distal approaches, and it is necessary to ensure that there are no obvious anatomical variations or adhesions in the surrounding area before harvesting. The plantaris tendon is commonly utilized in ligament reconstruction around the ankle joint or suture reinforcement for Achilles tendon rupture, with satisfactory effectiveness. There is limited research on the use of plantar tendon in the reconstruction of upper limb and knee joint ligaments.
UNASSIGNED: The plantaris tendon is relatively superficial, easy to be harvested, and has less impact on local function. The plantaris tendon is commonly utilized in ligaments reconstruction around the ankle joint or suture reinforcement for Achilles tendon rupture. The study on the plantaris tendon for upper limbs and knee joints ligament reconstruction is rarely and require further research.
UNASSIGNED: 总结跖肌腱解剖特点、生物力学特征、切除方式以及在韧带重建中的应用，提高其临床利用度。.
UNASSIGNED: 查阅国内外关于跖肌腱解剖、生物力学及其在韧带重建中应用的研究文献，并进行系统归纳总结。.
UNASSIGNED: 解剖研究显示跖肌腱存在缺失情况，大部分跖肌腱呈扇形在跟腱前、内侧止于跟骨结节。不同股数的跖肌腱生物力学参数存在明显差异，多股跖肌腱相较于单股有明显优势。跖肌腱的切取方式可分为近端和远端两种，在切取前需确保周围无明显解剖变异和粘连。目前，跖肌腱多用于踝关节周围韧带重建或跟腱断裂缝合加强，临床疗效满意；用于上肢和膝关节韧带重建的研究较少。.
UNASSIGNED: 跖肌腱位置相对表浅、容易切取，切取后对局部功能影响较小，可用于踝关节周围韧带重建或跟腱断裂缝合加强，但能否作为上肢和膝关节韧带重建自体移植物有待进一步研究。.