Bone and Arthrosurgery Science

Analysis of the Impact of Modified Fuyuan Huoxue Decoction on Inflammatory Factors, Immune Function, and Bone Metabolism Indicators in Patients After Surgery for Limb Fractures

Jianguo Tang — 2026-07-07

Objective: This study aims to analyze the specific effects of modified Fuyuan Huoxue Decoction on inflammatory factor levels, immune function status, and bone metabolism-related indicators in patients after surgery for limb fractures. Methods: A total of 100 patients who underwent surgery for limb fractures in the orthopedics department of our hospital from January 2025 to January 2026 were selected and randomly divided into an observation group and a control group, with 50 patients in each group. The control group received only conventional Western medical treatment after surgery, while the observation group received additional intervention with modified Fuyuan Huoxue Decoction on the basis of the same treatment as the control group. Both groups were treated continuously for 4 weeks. Changes in serum inflammatory factors, immune function, and bone metabolism indicators were compared between the two groups before and after treatment. Results: After treatment, the reduction in serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) levels in the observation group was significantly greater than that in the control group (P < 0.05). The percentages of CD3⁺ and CD4⁺ T lymphocytes and the CD4⁺/CD8⁺ ratio increased significantly in both groups (P < 0.05), with the observation group showing significantly higher values than the control group (P < 0.05). Serum bone gla protein (BGP) and procollagen type I N-terminal propeptide (PINP) levels increased significantly in both groups (P < 0.05), while β-C-terminal telopeptide of type I collagen (β-CTX) levels decreased significantly (P < 0.05), with the observation group showing significantly greater improvement than the control group (P < 0.05). Conclusion: Modified Fuyuan Huoxue Decoction can effectively reduce postoperative inflammatory responses, improve immune function, regulate bone metabolism balance, and promote fracture healing in patients with limb fractures, making it worthy of clinical promotion.

Clinical Observation on the Efficacy of Hot Wax Therapy Combined with Acupotomy in the Treatment of Stage I Shoulder-Hand Syndrome

Xinyu Wang — 2026-07-07

Objective: To compare the clinical efficacy differences among hot wax therapy, acupotomy therapy, and their combined regimen in treating Stage I shoulder-hand syndrome (SHS). Methods: A total of 60 post-stroke SHS Stage I patients admitted to the Rehabilitation Department of Zhungeer Banner Hospital of Traditional Chinese and Mongolian Medicine from December 2024 to December 2025 were selected and randomly assigned to three groups: the hot wax group, the acupotomy group, and the combination group, with 20 patients in each group. The hot wax group received hot wax therapy combined with conventional rehabilitation; the acupotomy group received acupotomy release combined with conventional rehabilitation; and the combination group received both hot wax therapy and acupotomy release along with conventional rehabilitation. The treatment course for all groups was 4 weeks. The Visual Analogue Scale (VAS), Edema Evaluation Score (EES), and Fugl-Meyer Assessment (upper limb motor function) scores were compared among the three groups before treatment, after 2 weeks, and after 4 weeks of treatment. Results: After 4 weeks of treatment, all three groups showed significant reductions in VAS and EES scores and significant improvements in Fugl-Meyer upper limb motor function scores compared to before treatment (P < 0.05). Inter-group comparisons revealed that the improvement in all outcome measures in the combination group was significantly greater than that in the hot wax group and the acupotomy group after both 2 weeks and 4 weeks of treatment (P < 0.05). Furthermore, the acupotomy group demonstrated superior pain relief and edema reduction compared to the hot wax group (P < 0.05). Conclusion: The combination of hot wax therapy and acupotomy is more effective in alleviating pain and edema, and in promoting the recovery of upper limb motor function and activities of daily living in Stage I SHS patients, compared to either therapy alone or conventional rehabilitation. It represents a safe and effective comprehensive treatment approach.

Construction and Validation of a Risk Prediction Model for Perioperative Stroke in Patients with Hip Fracture

Ruijuan Ci — 2026-07-07

Objective: To construct a nomogram prediction model for the risk of stroke in patients with hip fractures during the perioperative period. Methods: The clinical data of patients with hip fracture surgery admitted to a Class III Grade A hospital from January 2019 to December 2023 were selected (n = 895). According to the presence or absence of perioperative stroke, the patients were divided into the case group (n = 53) and the control group (n = 842). Univariate and multivariate analyses were used to analyze the risk factors of stroke in patients, and a prediction model was constructed. A nomogram was drawn to visualize the logistic regression prediction model, and the ROC curve and decision curve were used to analyze the prediction efficiency of the logistic regression model. Results: Age ≥60 years, BMI ≥24 kg/m², history of hypertension, history of diabetes, history of stroke, general anesthesia, abnormal intraoperative blood pressure, and operation time were included in the final prediction model. The AUC of the validation set was 0.955 (95% CI: 0.923–0.986). The calibration curve showed that the predicted probability fitted the actual incidence well (Hosmer-Lemeshow test P = 0.005), and DCA confirmed that the model had a net clinical benefit. Conclusion: The risk prediction model constructed in this study can effectively identify patients with a high risk of perioperative stroke after hip fracture surgery, and has good prediction efficiency and clinical practicability, which is convenient for early and accurate prediction of perioperative stroke risk.

Research on the Application of Enhanced Recovery After Surgery (ERAS) Concept Combined with Wiltse Approach TLIF in Elderly Patients with Lumbar Spinal Stenosis

Wenkai Jiang — 2026-07-07

Objective: To evaluate the clinical efficacy and safety of the enhanced recovery after surgery (ERAS) concept combined with the Wiltse intermuscular approach transforaminal lumbar interbody fusion (TLIF) in the treatment of elderly patients with lumbar spinal stenosis. Methods: A prospective study was conducted on 63 elderly patients with lumbar degenerative diseases and lumbar spinal stenosis admitted to our hospital from February 2021 to June 2022, aged ≥60 years. Patients were randomly divided into an ERAS group (32 cases) and a control group (31 cases) using a random number table method. The ERAS group received standardized perioperative management based on the ERAS concept and underwent TLIF via the Wiltse intermuscular approach, while the control group received conventional perioperative management and underwent TLIF via the traditional posterior median approach. Perioperative indicators such as general patient information, length of hospital stay, operative time, intraoperative blood loss, and postoperative complications were compared between the two groups. Pain in the affected limb was assessed using the visual analogue scale (VAS) before surgery and on postoperative days 1, 3, and at 1 month and 3 months. Functional status was evaluated using the Oswestry disability index (ODI) before surgery and at 1, 3, and 6 months postoperatively. The overall therapeutic effect was evaluated according to the modified MacNab criteria at the last follow-up. Results: There were no statistically significant differences in general patient information between the two groups (P > 0.05). Compared with the control group, the ERAS group had significantly reduced intraoperative blood loss and postoperative hospital stay (P < 0.05). There were no statistically significant differences in operative time, preoperative VAS score for pain in the affected limb, or preoperative ODI score between the two groups (P > 0.05). The VAS scores in the ERAS group were significantly lower than those in the control group on postoperative days 1, 3, and at 1 month and 3 months (P < 0.05), with no significant difference between the two groups at 3 months postoperatively (P > 0.05). The ODI scores in the ERAS group were significantly better than those in the control group at 1, 3, and 6 months postoperatively (P < 0.05). At the last follow-up, according to the modified MacNab criteria, the ERAS group had 29 excellent cases, 2 good cases, and 1 fair case, with an excellent and good rate of 96.9%; the control group had 26 excellent cases, 2 good cases, and 3 fair cases, with an excellent and good rate of 90.3%. There were 4 postoperative complications in the ERAS group and 9 in the control group, with no postoperative readmissions or deaths within 30 days postoperatively in either group. Conclusion: The application of the ERAS concept combined with the Wiltse approach TLIF in elderly patients with lumbar spinal stenosis can reduce blood loss and complications, alleviate early postoperative pain, accelerate functional recovery, and shorten hospital stay while ensuring surgical safety, which is of great clinical significance.

Analysis of the Efficacy of 3M Physical Therapy in Adolescent Female Patients with Hallux Valgus

Hui Wang — 2026-07-07

Objective: To observe the clinical efficacy of safe and non-invasive 3M physical therapy on adolescent female patients with hallux valgus. Methods: From January 2024 to September 2025, 58 female hallux valgus patients aged 12–18 who received treatment at our hospital were selected and randomly divided into a treatment group and a control group, with 29 patients in each group. The treatment group received 3M physical therapy (including manual therapy, exercise therapy, and physical factor therapy); the control group received foot and toe function health education, requiring patients to improve their shoe-wearing and walking posture. After 8 weeks, hallux valgus angle (HVA), intermetatarsal angle (IMA), hallux valgus score American Orthopaedic Foot and Ankle Society (AO-FAS), and VAS scores were measured to evaluate rehabilitation effectiveness. Results: After 8 weeks, the VAS score in the control group was significantly lower compared to before treatment (P < 0.05); in the treatment group, HVA, IMA, and AO-FAS were significantly improved after 8 weeks compared to before treatment (P < 0.05), and the VAS score was decreased (P < 0.01); after 8 weeks of treatment, compared with the control group, HVA, IMA, and AO-FAS in the treatment group were significantly improved (P < 0.05), and the VAS score was decreased (P < 0.01). Conclusion: The application of 3M physical therapy in the treatment of adolescent female patients with hallux valgus can achieve significant therapeutic effects, significantly improve the hallux valgus angle, intermetatarsal angle, and pain, enhance the hallux valgus score level, and is suitable for the clinical rehabilitation treatment of adolescent female patients with hallux valgus.

Expanding Therapeutic Potential and Mechanisms of SIRT3 in Bone-Related Diseases through Mitochondrial Function Regulation

Fei Dou — 2026-07-07

As a representative degenerative joint disease, the pathological mechanism of osteoarthritis has increasingly highlighted the critical role of SIRT3 protein in various bone-related disorders. Beyond its significant impact on osteoarthritis, mitochondrial dysfunction is closely linked to the pathogenesis of multiple bone diseases, including osteoporosis, osteonecrosis, bone erosion in rheumatoid arthritis, abnormal fracture healing, and bone tumors. This review systematically explores how SIRT3 regulates mitochondrial function, thereby influencing metabolic processes, apoptosis, autophagy, and senescence in various bone-related cells such as osteoblasts, osteoclasts, osteocytes, and chondrocytes. By conducting cross-disease comparative analysis, we reveal the central role of the SIRT3-mitochondrial function axis in maintaining skeletal homeostasis, providing important theoretical basis and research directions for the future development of broad-spectrum skeletal protection strategies targeting SIRT3.