Background The total hip arthroplasty (THA) has gained popularity in in the treatment of severe developmental dysplasia of the hip(DDH).the posterior lateral approach (PLA) has good clinical efficacy and has been confirmed by the majority clinicians.Nevertheless, controversy exists regarding longer-term benefits of the direct anterior approach(DAA) .The objective of this study was to investigate the clinical efficacy and placement of S-ROM prosthesis in the treatment of severe DDH by The total hip arthroplasty (THA) with different surgical approaches. Methods A retrospective analysis was performed on 41 patients with severe DDH admitted to our hospital from August 2015 to February 2022, who were treated with S-ROM prosthesis for total hip arthroplasty and subtrochanteric osteotomy of the femur. They were divided into DAA group and PLA group according to different surgical approaches. Perioperative indicators and imaging data were collected. Results The surgery time,intraoperative blood loss, and creatine kinase difference in DAA group and PLA group was without a statistically significant difference (P > 0.05). The postoperative length of hospitalization was shorter in the DAA group than in the PLA group (6.50 ± 3.15 vs 9.18 ± 4.93,P = 0.045).The acetabular abduction angles、the acetabular anteversion angles, the safe area ratio, The difference of femoral eccentricity, and the vertical difference of ofrotation center in DAA group and PLA group, there was no statistical significance (P > 0.05).Statistically signifificant differences were detected the horizontal difference of ofrotation center(P = 0.044). Conclusions Total hip arthroplasty with S-ROM prosthesis is a feasible procedure for severe dysplastic DDH. The clinical efficacy and prosthesis placement parameters of DAA approach are advanctage to those of PLA approach.

Background The purpose of this study was to compare the clinical and radiological outcomes of displaced intra-articular calcaneus fractures (DIACFs) treated with small locking plates alone versus small locking plates combined with screws. Methods Retrospective analysis of 120 patients with intra-articular fractures seen from May 2018 to June 2020, all of whom were surgically repositioned using sinus tarsal approach.60 cases received a small locking plate combined with screws fixation (observation group) and 60 cases received a small locking plate fixation alone (control group).Demographic variables were recorded and compared Gissane angle, Bohler's angle, calcaneal varus, and joint line parallel angle at 3 days and 2 years postoperative follow-up.The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Score and VAS were applied to assess postoperative foot function, and complications were also compared. Results Compared with the control group, the joint line parallel angle and calcaneal varus in the observation group had lower displacement changes from the postoperative period to the 2-year follow-up,they are 0.07 (0.15) degrees vs 0.47 (0.59) degrees(P < 0.001), 0.19 (0.35) degrees vs 1.18 (0.67) degrees(P < 0.001).There was no significant difference in Gissane angle and Bohler's angle between the observation group and the control group at the preoperative, 3-year and 2-year follow-up (P > 0.05).The final AOFAS score, VAS score and complications were not significantly different between the two groups (P > 0.05). Conclusion When STA is used to treat DIACFs, fixation with a small locking plate combined with screws appears to provide better posterior articular surface stability and better maintenance of calcaneal axial stability than fixation with a small locking plate alone,the two techniques had similar functional outcomes and complications after surgery.