Rotator cuff injury is the most common shoulder joint disease in clinical practice, accounting for 50%-85% of shoulder diseases. With the increase in age, the risk of disease gradually increases, and the prevalence rate can reach 31% in people aged 60-69, while it is expected to reach 65% in people over 80. It is characterized by discontinuity of rotator cuff tendons (supraspinatus, infraspinatus, teres minor, and subscapularis), mainly manifested by shoulder joint pain and limited active activity. Arthroscopic suture repair of torn rotator cuff has become the gold standard for treating rotator cuff injury. Depending on the severity and size of the rotator cuff tear, the suture methods are also diversified, including the single-row anchor repair technique, double-row anchor repair technique, and suture bridge repair technique. A double-row suture anchor or suture bridge technique is usually used for medium to large rotator cuff tears. Although many factors affect the healing of the rotator cuff, most current studies believe that double-row suture anchor and suture bridge techniques have the same curative effect, and there is no significant difference between them in the rotator cuff healing score and retear rate. No matter what suture method is used, the purpose is to maximize the contact area between the rotator cuff and the footprint area to achieve as much anatomical healing of the repaired rotator cuff as possible. How to increase the contact area between tendon and bone and promote tendon-bone healing with fewer anchors to cover more of the footprint area has become the research direction of many scholars. Suture bridge technology is currently recognized as the first choice for treating medium to large-size rotator cuff tears. Biomechanical studies show that the suture bridge technique has advantages in repairing the rotator cuff, which can improve the compression contact area and average pressure between the tendon and fixed site, achieve strong fixation, and even distribution of suture tension, resulting in better healing effect of the rotator cuff. However, it also has disadvantages, such as many anchors used, high cost, complex and challenging operation, and relatively long operation time. The traditional internal and external technique can achieve rotator cuff repair by using one medial anchor and one lateral anchor, but it also has a defect that easily forms an "ear-like" deformity at the edge of the tendon. In order to prevent this defect, more medial and lateral anchors are usually implanted. As a result, the tendon-bone contact area in the footprint area is reduced, and the rotator cuff surface has too many linear knots, resulting in suture cutting of the tendon and other shortcomings. We propose an improved suture method, miming the "overlap" technique of increasing the coverage area of embroidery thread in "Sichuan embroidery" to optimize the contact area between the rotator cuff stop and the footprint area. This method is based on the conventional medial and lateral single anchor nail fixation row. After the medial row of the anchor suture line is drawn out, the cross Knot is imitative of the "V-Y knot" (shaped like V-Y), and then the lateral row is fixed. This method can prevent the formation of ear-like deformity at the tendon edge after rotator cuff repair and maximize the benefit, requiring only one internal and one external anchor.

To retrospectively compare the efficacy of two suture methods, the V-Y knot and the suture bridge technique, in repairing medium-sized (1-3 cm) rotator cuff tears.

A total of 60 patients underwent shoulder arthroscopic surgery to repair medium-size rotator cuff injury in our department from June 2019 to June 2022 and were effectively followed up and divided into two groups according to different suture methods. Group 1 was sutured with V-Y junction (30 cases), including 14 males and 16 females, with an average age of (58.60±4.61) years. Group 2 was sutured with suture bridge technique (30 cases), including 15 males and 15 females, with an average age of (58.37±4.60) years. After surgery, the patient was protected by an abduction bag for six weeks, passive shoulder movement was performed within six weeks, and active shoulder lifting exercise began after six weeks. Perioperative indexes of the two groups were compared. Shoulder joint motion, UCLA, ASES, Constant-Murley, and VAS scores were performed before surgery and at the last follow-up to compare the efficacy.

All patients were followed up for 12 to 24 months, with a mean of (16.05±3.34) months. There were no severe complications such as infection and nerve injury; all patients had Grade A wound healing. The operative time of the V-Y junction group was significantly less than that of the suture bridge group, and the difference was statistically significant (P<0.05). There were no significant differences in intraoperative blood loss, incision size, length of hospital stays, preoperative shoulder motion, and scores between the two groups (P>0.05). At the last follow-up, there were no statistically significant differences in shoulder joint motion, VAS score, UCLA score, Constant-Murley score, ASES score, and follow-up time between the two groups (P>0.05). At the last follow-up, the two groups' shoulder joint motion and scores were better than those before surgery (P<0.05) .

Arthroscopic V-Y knot suture is a reliable suture method for repairing medium-sized rotator cuff tears, which can achieve clinical efficacy comparable to the suture bridge technique and requires fewer anchors and shorter operation time.

Rotator cuff injury, one of the common shoulder joint diseases in the clinic, refers to the injury of tendons, muscles, ligaments, and other tissue structures around the shoulder joint. There are various treatment methods for rotator cuff injury, among which surgical treatment is the most common and effective. However, postoperative functional recovery has become the focus of patients and doctors, and how to improve patients' postoperative quality of life and promote functional recovery has become an essential topic of current research. Arthroscopic rotator cuff repair (ARCR) is a commonly used surgical method for treating and repairing rotator cuff injuries. However, patients' postoperative shoulder mobility and function are still limited to a certain extent, so postoperative rehabilitation exercises are of great significance for improving shoulder function. The importance of rehabilitation after rotator cuff injury is self-evident. Conversely, postoperative rehabilitation can help joint fluid circulation, reduce swelling, and prevent joint adhesion. On the other hand, rehabilitation training can stimulate muscle growth, increase muscle strength, and improve joint stability, thereby improving patients' quality of life. However, in the process of postoperative rehabilitation, patients often face many problems, such as pain, limited joint activity, and decreased muscle strength, which seriously affect the rehabilitation process of patients. Therefore, exploring an effective method to improve patients functional recovery and quality of life after surgery is of great significance. Resistance strength training is a kind of resistance training and activity mode of muscle tissue, which can effectively improve the resistance ability of the trainer's muscles and is also a standard mode of sports training and rehabilitation. It has been applied significantly after hip surgery, but there are few studies on the influence of resistance training of the perishoulder muscle group on the postoperative function of patients with postoperative rotator cuff injury.

To analyze the effect of resistance strength training of shoulder muscles on functional recovery and prognostic quality of patients with rotator cuff injury after surgery.

A total of 90 patients with rotator cuff injury who underwent surgical treatment in our hospital were selected from January 2020 to June 2023 and were divided into conventional group (n=45) and resistance group (n=45) by random number table method. The conventional group was given routine perioperative nursing, and the resistance group was given resistance strength training for the shoulder muscle group based on the conventional group. The excellent and good rates of shoulder joint function between the two groups were compared, and the recovery of shoulder joint function between the two groups before treatment, one month after treatment, and three months after treatment [shoulder joint function score (CMS) ] was compared, and the scores of shoulder joint motion and quality of life between the two groups were compared before treatment and three months after treatment.

The excellent and good rates of shoulder joint function in the conventional and anti-resistance groups were 77.78% and 93.33%, respectively. The excellent and good rates of shoulder joint function in the anti-resistance group were significantly higher than those in the conventional group (P<0.05). At the time points of 1 month and three months after treatment, the CMS score of the anti-resistance group was significantly higher than that of the conventional group (P<0.05). Three months after treatment, the activity of flexion, abduction, external rotation, and internal rotation in the resistance group was significantly higher than in the conventional group (P<0.05). After three months of treatment, WHOQOL-BREF scores of patients in the anti-resistance group were significantly higher than those in the conventional group regarding physiological, psychological, social, and environmental dimensions (P<0.05) .

The resistance strength training of the perishoulder muscle group can effectively improve the functional recovery effect of the shoulder joint in patients with rotator cuff injury after surgery, improve the mobility of the shoulder joint, and enhance the quality of life of patients, and can be widely applied.

Capitulum humeral fractures are rare elbow injuries, accounting for less than 1% of elbow fractures and 6% of distal humerus fractures. Due to the frequent underestimation of capitulum humeral fractures on X-rays, non-displaced or osteochondral fractures may go undetected, making them easily missed or misdiagnosed. Open reduction and internal fixation effectively restore articular surface fractures and allow early functional rehabilitation, thereby preventing elbow stiffness and secondary degenerative arthritis. Among internal fixation methods, K-wires may not provide sufficient stability for early functional recovery and may damage the articular cartilage. Buried screws may cause joint pain and exacerbate joint degeneration when exposed, particularly in patients with avascular necrosis or chondrolysis. Plates can provide sufficient stability and be removed after fracture healing to avoid similar problems. However, for Bryan-Morrey Type III capitulum humeral fractures, in which there is the posterior condylar fracture of the capitellum, the loss of anterior screw fixation in the anterior capitellar articular surface poses a challenge for fixation using only a lateral plate. In this regard, the authors use mini plates placed on the posterior and lateral aspects of the distal humerus to achieve adequate fixation of the anterior capitellar articular surface with screws inserted along the coronal fracture line and to address the issue of ineffective fixation of Dubberley Type B posterior capitulum humeral fracture.

To explore the effect of micro-plate reconstruction of humeral lateral condyle for treatment of Bryan-Morrey Ⅲ capitellum humeral fractures.

A retrospective analysis was performed on 20 patients with Bryan-Morrey typeⅢ capitellum humeral fractures treated with micro-plate through lateral elbow approach from November 2016 to April 2022.

All 20 patients were followed for a long time with a mean period of 14 months. Satisfactory reduction of the distal articular surface of the humerus was obtained by postoperative imaging evaluation. Bone healing was achieved in all patients at the last follow-up, and there was no sign of necrosis of the humeral capitellum. According to the Mayo functional score assessment, 17 cases (85.0%) were excellent, 2 cases (10.0%) were good, and 1 case (5.0%) was moderate. All the patients had no instability or dislocation of the elbow joint, 2 patients (10.0%) had symptomatic ectopic ossification, and none had neurological dysfunction or infection.

Lateral condylar reconstruction with micro-plate is practical and feasible for Bryan-Morrey type Ⅲ capitellum humeral fractures, especially for Dubberley type B fractures.

Distal coronal humerus fractures are relatively rare in clinical practice, accounting for only 6% of distal humerus fractures and 1% of elbow fractures. With this type of fracture involving the humeral head or trochlea, anatomic reduction and firm fixation of the ulnar and radio-radial articular surfaces are essential to achieve satisfactory recovery of elbow motion. The mechanism of injury is mainly due to the axial load imposed on the distal humerus by the force transmitted through the joint, resulting in a coronal shear fracture of the capitulum or trochlea. About 60% of distal humerus coronal fractures are associated with radial head fracture or ulnar tract injury of lateral collateral ligaments. While the integrity of the ligaments is equally essential for the recovery of elbow function, the attachment of the lateral collateral ligaments makes the fracture reduction and fixation of the distal posterior condyle of the humerus more difficult. Surgical treatment of distal humeral coronal fracture includes fracture mass excision, open reduction, internal fixation, arthroscopic assisted reduction and fixation, elbow joint replacement, etc. Surgical approaches mainly include lateral, anterolateral, and posterior olecranon osteotomy approaches. Given the complexity of the distal humeral coronal fracture, surgical exposure and fixation methods are controversial. Surgical treatment is highly challenging.

To observe the clinical effect of lateral, anterolateral, and posterior olecranon osteotomy approaches in treating distal humeral coronal fracture and to explore the indications and precautions of different fracture types.

Twenty-three patients with distal humerus coronal fractures admitted to our hospital from January 2010 to January 2023 were selected as the study objects and divided into lateral, anterolateral, and posterior olecranon osteotomy groups according to different surgical approaches. The clinical effects were observed, including operation time, incision length, blood loss, fracture healing time, Elbow motion, forearm rotation, Mayo elbow performance score (MEPS) and visual analogue scale (VAS) score, and complications.

A total of 23 patients were diagnosed with a mean age of (48.9±17.0) years, a mean injury to surgery time of (5.1±2.0) days, and a mean follow-up time of (18.4±5.4) months. Significant differences existed between the three groups in the cause of injury and the modified Dubberley fracture classification. The three groups had no significant differences in operative time, fracture healing time, forearm pronation, forearm pronation MEPS, and VAS scores. There were statistically significant differences in blood loss, incision length, elbow flexion, extension, and ROM between the osteotomy and lateral groups. The osteotomy group had longer incisions, more surgical blood loss, and worse recovery of elbow motion. There was no significant difference between the osteotomy and anterolateral groups and between the lateral and anterolateral groups.

The lateral, anterolateral, and posterior olecranon osteotomy approaches for treating distal humeral coronal fractures have different indications, and the appropriate approach should be selected according to the fracture type. Fractures suitable for osteotomy approaches are more complex, and functional exercises should pay more attention to the recovery of elbow flexion and extension.

Tennis elbow, also known as lateral epicondylitis, is one of the most common causes of elbow joint pain. When conservative treatment fails to alleviate symptoms for more than six months, it is referred to as refractory tennis elbow, necessitating surgical intervention. Surgical options commonly include open surgery, percutaneous methods, and arthroscopic procedures. Open surgery involves more substantial trauma, while percutaneous techniques may affect postoperative outcomes due to difficulties in precise localization. Arthroscopic extensor carpi radialis brevis (ECRB) release, on the other hand, is gaining favor among surgeons due to its minimal invasiveness, clear intraoperative visualization, precise targeting, and rapid postoperative recovery. However, due to the prolonged learning curve associated with elbow arthroscopy, relatively few institutions in China are performing this procedure, resulting in limited literature on the subject.

To investigate the clinical effect of extensor carpi radialis brevis (ECRB) myotendolysis combined with joint debrideation by elbow arthroscopy in treating intractable tennis elbow.

A retrospective analysis of 18 cases treated with elbow arthroscopy for tennis elbow were conducted in our hospital between January 2021 and December 2022. Eight males and ten females were included, with ages ranging from 29 to 58 years and an average age of 42.4 years. All underwent arthroscopic release of the extensor carpi radialis brevis tendon at its attachment on the humerus, along with debridement of the elbow joint. Clinical efficacy was evaluated by comparing the Mayo elbow performance score (MEPS), and visual analogue scale (VAS) scores preoperatively and at 4 weeks, 3 months, 6 months, and final follow-up, combined with patient satisfaction.

All 18 cases were followed up for 6 to 24 months, with an average of 12.5 months. No complications such as wound infection, nerve or vascular damage, or elbow joint instability were observed postoperatively. The MEPS and VAS scores showed significant improvement compared to preoperative levels at 4 weeks, 3 months, 6 months, and the final follow-up (P<0.05). However, there was no significant difference in MEPS and VAS scores between 3 months, 6 months, and the final follow-up when compared to the scores at 4 weeks postoperatively (P>0.05). Of the 18 cases, 15 were highly satisfied, and 3 were satisfied, resulting in a satisfaction rate of 100%.

Elbow arthroscopic release of the extensor carpi radialis brevis (ECRB) combined with joint debridement is an effective treatment for refractory tennis elbow. It involves minimal surgical trauma and allows for rapid postoperative functional recovery, making it an effective and reliable surgical approach.

Posterolateral rotatory instability (PLRI) of the elbow is caused by damage to the lateral collateral ligament complex (LCLC). It is a common type of elbow joint instability. If the treatment is not timely or the post-treatment ligament is not well healed, the posterolateral rotation of the elbow will be chronic and unstable, seriously affecting the elbow joint function. Chronic PLRI usually occurs in the later stage of elbow trauma and also includes PLRI secondary to elbow varus deformity, severe lateral humeral epicondylitis (especially repeated corticosteroid injection), or iatrogenic injury after lateral elbow surgery. Regardless of the injury mechanism, the need to rebuild LCLC function remains challenging for orthopedic surgeons. It has been reported that several surgical techniques have been used to reconstruct LCLC, including the Yoke technique, Docking technique, single chain technique, etc. Most of them use autografts of the long palmar tendon or the lateral third of the triceps tendon at the same time. However, the allogeneic tendon and dual bundle technique for LCLC reconstruction in chronic PLRI is rarely reported.

To evaluate the clinical results of lateral ligament dual bundle reconstruction with allogeneic tendon in treating chronic posterolateral rotational instability of elbow joint.

A retrospective study was conducted from December 2016 to December 2022, in which 16 consecutive patients with chronic PLRI of the elbow underwent allogeneic tendon dual bundle reconstruction of the LCLC of the elbow joint. Clinical data includes 13 males and 3 females; Age range from 21 to 61 years old, with an average age of 36.4 years; 11 cases (11/16, 68.7%) had poor healing of ligaments after trauma, 3 cases (3/16, 18.7%) had malunion of supracondylar fractures of the humerus in childhood, and 2 cases (2/16, 12.5%) had iatrogenic injuries to the tennis elbow due to chronic strain. Inclusion criteria: All patients had chronic PLRI of the elbow joint, positive posterior lateral rotation drawer test, and increased space between the humeral and radial joints in the X-ray stress position. Patients less than 1 month after acute injury were excluded. The selected patients received dual bundle transplantation of allogeneic tendons from the lateral elbow joint to reconstruct the lateral ligament complex LCLC, and the humerus and ulna were fixed with bone tunnels on the radial side. Postoperative use of elbow joint stress imaging to evaluate posterolateral stability and posterolateral rotation drawer test to evaluate stability; Clinical efficacy and function were evaluated using the elbow joint range of motion. Mayo elbow joint function score (MEPS), quick-disabilities of the arm, shoulder, and hand (Q-DASH), and visual analog scale (VAS) were used to evaluate the functional and pain of patients.

All patients were followed up for 6-36 months, averaging 19.2 months. Elbow joint stress imaging was used to evaluate posterolateral stability, and the posterolateral rotation drawer test was used to evaluate stability. Sixteen cases were positive before, and sixteen cases were negative after surgery, and postoperative stability was significantly better. Preoperative MEPS were poor in 14 cases (14/16, 87.5%) and fair in 2 cases (2/16, 12.5%). The final test had 13 excellent cases, 2 good cases, and 1 moderate case. The excellent and good rate is 93.7%. All patients were considered to have significantly improved elbow joints at the final follow-up. The MEPS, Q-DASH, and VAS at the last follow-up significantly differed from those before surgery. There was no significant difference in elbow joint range of motion between preoperative and postoperative comparison.

The lateral ligament dual bundle reconstruction with allogeneic tendon can effectively improve chronic posterolateral rotational instability of the elbow joint and improve elbow joint function.

Terrible triad injury of the elbow (TTE) is a complex dislocation of the elbow caused by severe violent impact. The elbow is usually in a straight state when the patient is injured, and the impact force is transmitted to the elbow along the longitudinal axis of the forearm and is often accompanied by large shear force. Young people who are involved in car accidents or crashes are the main demographic for TTE. It is mainly characterized by posterior dislocation of the elbow joint with fractures of the coronoid process of the ulna and the head of the radius. TTE is mainly caused by compression and shear force exerted on the longitudinal axis of the extended upper limb. Currently, TTE is mainly treated by surgery in order to restore elbow joint function and improve prognosis. Currently, the mainstream surgical approaches for TTE include medial approach, lateral approach and combined internal and external approach. The selection of reasonable approach and internal fixation can effectively reduce postoperative elbow pain, stiffness, ectopic ossification, traumatic arthritis and other complications, and have certain positive effects on the recovery of elbow joint function of patients, thus improving the quality of life of patients.

To compare the intraoperative indexes and postoperative efficacy of the combined internal and lateral approach and the single lateral approach in the treatment of TTE.

According to the search strategy, the literature published in Embase, Pubmed, Cochrane Library, Cinahl, WanfangData, CNKI and other databases on the treatment of elbow terror triad by combined internal-lateral approach and lateral approach was searched respectively. A total of 679 relevant literatures were retrieved, and 13 literatures were finally included. The literature quality was evaluated according to Cochrane systematic Review methodology, and the extracted data was used for meta-analysis using Review manager 5.4 software.

In the treatment of elbow terror triad, the operative time and intraoperative blood loss of the combined internal-lateral approach were higher than those of the lateral approach, and the differences were statistically significant [95% CI (5.43, 34.01), P=0.007][95% CI (5.57, 23.46), P=0.001]. However, the results of the comparison showed that the postoperative joint motion of the combined internal-lateral approach was higher than that of the lateral approach [95% CI (9.16,19.25), P<0.01]. In addition, there were no significant differences in VAS score, MEPS score, excellent rate and complications between the two groups.

In the treatment of TTE, the lateral approach has the advantages of short operation time and less blood loss, but the elbow joint motion after the combined internal and lateral approach is better. Therefore, the choice of the two surgical approaches needs to be analyzed according to the specific conditions of the disease.