Objective: To compare and analyze the clinical outcomes of the proximal humeral internal locking system (PHILOS) alone and the PHILOS combined with fibular allograft in the treatment of Neer three-and four-part proximal humerus fractures (PHF) in the elderly. , a total of 42 elderly patients with Neer three-or four-part PHF admitted to our hospital were randomly divided into observation group and control group, with 21 patients in each group. The observation group was treated with the PHILOS combined with fibular allograft. The control group was treated with the PHILOS alone. Perioperative parameters and fracture classification were recorded in the two groups. Function results were assessed by Visual Analog Scale (VAS), Constant-Murley score (CMS), American Shoulder and Elbow Surgeons (ASES) score, and the Disability of Arm-Shoulder-Hand (DASH) score. Radiological results were evaluated using the neck-shaft angle (NSA) and humeral head height (HHH), and complications were also recorded in each group.Results: There were no significant differences between the two groups in terms of preoperative status, age, gender, cause of trauma, fracture site, and fracture classification. The average follow-up time was 12 months. At the last follow-up, the VAS and DASH observation groups were lower than the control group, and there was significant difference between the two groups (P < 0.05). The CMS and ASES were higher in the observation group than the control group, and there was significant difference between the two groups (P < 0.05). The mean difference in the NSA and HHH were lower in the observation group than the control group, and there was a significant difference between the two groups (P < 0.05). There was one postoperative complication in the observation group, which was humeral head avascular necrosis (AVN). There were seven postoperative complications in the control group, including three cases of humeral head collapse and three cases of screw cutout and one case of humeral head AVN. The incidence of postoperative complications in the observation group was significantly lower than the control group (P < 0.05), there was a significant difference between the two groups.Conclusions: For Neer three-or four-part PHF in the elderly patients, PHILOS fixation with fibular allograft shows satisfactory short-term results with respect to humeral head support and maintenance of reduction, and may reduce the incidence of complications associated with fixation using a PHILOS alone.

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Background: To uncover the role of LINC00266-1 in the development of osteosarcoma (OS) and identify the underlying mechanism.Methods: LINC00266-1 levels in OS tissues in the GSE12865 dataset were analyzed. Binding sites between the DNA of LINC00266-1 and SMAD2 and potential miRNAs binding LINC00266-1 were predicted via databases. The effects of LINC00266-1 on the proliferative, migratory, invasive and apoptotic abilities were evaluated by a series of functional experiments. Interactions in the LINC00266-1/miR-548c-3p/SMAD2 feedback loop were assessed by RNA immunoprecipitation (RIP), Chromatin immunoprecipitation (ChIP)-qPCR and dual luciferase reporter assays. Tumorigenesis assay was then conducted in nude mice. The potential influence of LINC00266-1 on the positive expression of Ki67 in nude mice bearing OS xenografts was elucidated through immunohistochemistry.Results: LINC00266-1 was upregulated in OS tissues and cells. SMAD2 was able to bind sites in the LINC00266-1 promoter and thus upregulate LINC00266-1. Knockdown of LINC00266-1 suppressed the proliferative and metastatic abilities but promoted the apoptosis of OS cells. LINC00266-1 sponged miR-548c-3p, an action that partially reversed the regulatory effects of LINC00266-1 on OS cell phenotypes. Moreover, miR-548c-3p bound to the 3’-UTR of SMAD2 and thus downregulated SMAD2. Overexpression of SMAD2 partially reversed the regulatory effects of LINC00266-1 on OS cell phenotypes. Knockdown of LINC00266-1 significantly alleviated the growth of OS in vivo.Conclusions: The LINC00266-1/miR-548c-3p/SMAD2 feedback loop stimulates the development of OS.

The aim of the study was to explore the clinical implications of median approach combined with radial auxiliary plate in the treatment of C-type distal radius fractures. Material/Method:From January 2017 to January 2022, a total of 20 cases were collected, including 6 male and 14 female patients with closed fresh distal radius fractures. All patients received volar medium approach T-shaped locking plate treatment, as well as radial auxiliary plate open reduction and internal fixation. We recorded the incidence of median nerve injury, incidence of radial artery and vein or their branches injury, postoperative X-ray measurement of radial styloid process height, ulnar declination, palmar inclination, and Gartland-Werley score. Results:All surgical procedures were successful, and all patients were monitored for 3 to 12 months after the procedure. In the postoperative follow-up, there was no obvious loss of reduction. At the last follow-up, all patients' articular surface flatness was less than 2 mm, and the mean values for palmar inclination and ulnar declination were (14.36°±3.55°) and (19.79°±2.57°), respectively. The average height of a radial styloid was 117±2.42 mm; functional evaluation: excellent in 12 (60%), good in 6 (30%), and fair in 2 cases (10%) cases. Five patients showed slight nerve injury, but all recovered quickly within 6 months. Conclusions:The volar median approach, which combines a T-locking plate with a radial auxiliary plate for open reduction and internal fixation, is an effective treatment for unstable distal radius fractures.

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