Abstract: The paper put forward the academic concept of phase-pivot syndrome. Phase refers to time phase and place phase. Pivot refers to helm. The syndrome differentiation of time phase and place phase emphasizes the combination of local and overall syndrome differentiation in orthopedic diseases. It mainly includes the combination of immediate syndrome differentiation in acute attack period and basic syndrome differentiation in chronic prolongation period (time phase) and the combination of specific syndrome differentiation of the affected part and physical basis syndrome (place phase). The helm is mainly aimed at the chronic diseases which are are difficult for orthopedic experts to heal. Grasping the main contradiction and controlling the core symptoms are key to grasping the essential of the phase-pivot dialectic. It is believed that the introduction of phase-pivot dialectic system to the clinical syndrome differentiation of orthopedics in traditional Chinese medicine can not only improve the pertinence of principle-method-recipe-medicines in orthopedics， but also help shorten the learning curve of young doctors.