A year of study outside the year of 2010, there is joy in the bitterness, there is pain in the bitterness, before resuming to the boring work, write a hasty work as a summary, also considered to remember it. Now, when I look back, I find that I have been working in orthopedics for eight years, but I am just a bone craftsman without a mind. Fortunately, now I feel that orthopedics is an interesting thing, it is not just my job and my job, it is also an art. I am particularly interested in the minimally invasive techniques of orthopedic injuries, which is what our hospital lacks, and it is the biggest and sweetest fruit I have harvested. If we talk about minimally invasive techniques in orthopaedics, we must talk about the ABCs of orthopaedics. ABCs often represent the most basic things, and often represent the most important things, just like the cornerstone of a building. 1. AO and BO What is AO? I think it is the biggest revolution in orthopaedics, without it, there is no modern orthopaedics. The four principles of AO are: anatomical reduction of fracture; compression and strong internal fixation between fracture ends; non-invasive technique; and early and painless functional exercise, the core of AO technique is compression and fixation between fracture ends to increase the stability of fracture fixation and achieve the purpose of early limb movement. The close contact between the fracture ends after compression achieves one-stage fracture healing with good blood flow. Excellent results have been achieved for complex and intra-articular fractures. However, some problems have arisen. Although the AO principle also contains the content of non-invasive operation, in order to achieve the purpose of strong fixation and anatomical repositioning, the blood supply of bone is often severely damaged at the expense of non-invasive operation, which is practically impossible. Due to the pursuit of strong internal fixation, especially in comminuted and complex fractures, in order to achieve strong fixation between the fracture ends, sometimes extensive stripping has to be performed, which destroys the surrounding blood supply and leads to osteoporosis at the fixed end, delayed healing or non-healing of the fracture, and even infection. The healing is a direct healing or one-stage healing, which is not strong and often re-fractures occur after removal of the plate. To resolve this paradox, BO was created. BO is an abbreviation of biologicalosteosynthesis, which means biological and rational osteosynthesis, and consists of: repositioning away from the fracture site to protect the local soft tissue attachment; not forcing the anatomical repositioning of the fracture, but still requiring anatomical repositioning of the intra-articular fracture; using low elastic modulus internal fixation; reducing the contact area between the internal fixation and the bone cortex, etc. The purpose of BO is to protect the blood supply of bone. Under the action of BO, the fracture healing is typical of the second stage of healing, i.e. bone healing goes through the stages of hematoma mechanization, bone scab formation and bone scab shaping, which is manifested by the formation of a large number of bone scabs on X-rays. It is the opposite of the previous AO pursuit of non-crust healing. The relationship between AO and BO is the change from “anatomical repositioning + strong fixation” to “indirect repositioning + effective fixation”, and the progress of its principles and concepts reflects the characteristics of minimally invasive trauma orthopedics, and the core is to fully protect the local blood flow of the fracture. Of course, it is worth noting that minimally invasive surgery and non-surgical treatment of fracture are not contradictory. From the perspective of minimally invasive treatment, it is obvious that manipulative treatment is more in line with the spirit of minimally invasive treatment, and it is only a matter of choosing the indications for surgery and the choice of patients. 3. What is CO? Combined Chinese and Western medicine treatment of fracture is called Chinese Osteosynthesis (CO), the core of which: tendons and bones, dynamic and static combination, internal and external treatment, and cooperation between doctors and patients. This transformation makes the CO system change from the original bloodless therapy to blood therapy. It seems that CO and BO share the same philosophy of minimally invasive fracture treatment, except that CO incorporates traditional Chinese medicine. So what are the minimally invasive techniques in orthopaedics and traumatology, let’s briefly talk about them: 1. Percutaneous internal fixation therapy. Including percutaneous pry repositioning, percutaneous kerfing, percutaneous intramedullary pin internal fixation, percutaneous hollow screw absorbable screw internal fixation and so on. Its technical characteristics are the use of manipulation to reset the fracture or dislocation, with internal or external fixation, to maximize the preservation of the blood flow of the broken end of the fracture, for difficult manipulation can be combined with limited incision reset, the destruction of the blood flow is also greatly reduced than the traditional incision internal fixation. 2.Bone external fixator therapy. External fixation brace has been considered as the preferred method in the treatment of severe open fractures, and its use of signs, although limited, is indispensable. 3.Arthroscopic technique. Although it is an innovative technology, it has been popularized in many county and municipal hospitals, and its treatment of meniscus injury of the knee and microscopic reconstruction of cruciate ligament rupture is indeed a real and significant improvement to the previous open surgery. 4. Minimally invasive percutaneous plate jointing. We are familiar with the plate internal fixation, and we do not think he is a minimally invasive technology, but with the emergence of compression locking plate, this status quo has been completely overturned, the emergence of compression locking plate I think is another not small leap in orthopedics, and with its application of Mippo technology and AO invented LISS system is really a blessing for many fracture patients. 5. Others. There are many more, such as minimally invasive interventional therapy, percutaneous osteotomy orthopedics, percutaneous drilling and decompression, microneedle technique, etc. It should be said that no method of internal fixation is perfect. Sometimes, under the guidance of minimally invasive surgery, it needs to be applied in combination to complement the strengths and weaknesses, and it is wrong to think that the direction of fracture treatment is surgery, especially for the treatment of children’s fractures. Minimally invasive is a concept, a technique, and an art, which I will pursue.