Pub Date : 2020-03-15DOI: 10.3760/CMA.J.CN115530-20190510-00176
Dongtao Yuan, Shao'an Zhang, Guangliang Wu, Dalong Wu, Lei Wan, Zhihao Li, Shikui Zhang, Zimin Wang
Objective To study the curative effect of platelet-rich plasma (PRP) combined with internal fixation with hollow screws on femoral neck fractures. Methods The clinical data of 160 patients with femoral neck fracture were retrospectively analyzed who had been treated by internal fixation with hollow screws at Orthopedic Department Ⅲ, The Second Affiliated Hospital to Luohe Medical College from May 2012 to May 2018. According to whether PRP was used or not to assist their internal fixation, they were divided into a PRP group (n=80) and a control group (n=80). In the PRP group, there were 46 males and 34 females with an age of 52.3 years±7.6 years, and one case of type Ⅰ, 5 cases of type Ⅱ, 57 cases of type Ⅲ and 17 cases of type Ⅳ by the Garden classification. In the control group, there were 41 males and 39 females with an age of 50.6 years ± 7.3 years, and 2 cases of type Ⅰ, 7 cases of type Ⅱ, 51 cases of type Ⅲ and 20 cases of type Ⅳ by the Garden classification. The 2 groups were compared in terms of fracture healing time, nonunion, femoral head necrosis and Harris hip scores. Results The 2 groups were comparable because their preoperative general data showed no significant differences (P>0.05). The 160 patients obtained follow-up for 12 to 36 months. The PRP group showed significantly shorter fracture healing time (4.3 months ± 1.0 months), significantly lower incidences of nonunion [0% (0/80)] and avascular necrosis of femoral head [3.8% (3/80)] than the control group [7.3 months ± 1.3 months, 7.5% (6/80) and 15.0% (12/80), respectively] (all P< 0.05). The Harris scores at 6 and 12 months after operation for the PRP group (88.7±5.3 and 94.2±4.8) were significantly higher than those for the control group (81.4±4.6 and 84.2±5.2) (both P<0.05). Conclusion In the treatment of femoral neck fractures, compared with internal fixation with hollow screws alone, platelet rich plasma combined with internal fixation with hollow screws can significantly shorten fracture healing time, reduce incidence of avascular necrosis of the femoral head and improve functional recovery of the hip joint. Key words: Femoral neck fractures; Platelet rich plasma; Fracture fixation, internal; Bone nails
{"title":"Platelet-rich plasma combined with hollow screw fixation for femoral neck fractures","authors":"Dongtao Yuan, Shao'an Zhang, Guangliang Wu, Dalong Wu, Lei Wan, Zhihao Li, Shikui Zhang, Zimin Wang","doi":"10.3760/CMA.J.CN115530-20190510-00176","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115530-20190510-00176","url":null,"abstract":"Objective \u0000To study the curative effect of platelet-rich plasma (PRP) combined with internal fixation with hollow screws on femoral neck fractures. \u0000 \u0000 \u0000Methods \u0000The clinical data of 160 patients with femoral neck fracture were retrospectively analyzed who had been treated by internal fixation with hollow screws at Orthopedic Department Ⅲ, The Second Affiliated Hospital to Luohe Medical College from May 2012 to May 2018. According to whether PRP was used or not to assist their internal fixation, they were divided into a PRP group (n=80) and a control group (n=80). In the PRP group, there were 46 males and 34 females with an age of 52.3 years±7.6 years, and one case of type Ⅰ, 5 cases of type Ⅱ, 57 cases of type Ⅲ and 17 cases of type Ⅳ by the Garden classification. In the control group, there were 41 males and 39 females with an age of 50.6 years ± 7.3 years, and 2 cases of type Ⅰ, 7 cases of type Ⅱ, 51 cases of type Ⅲ and 20 cases of type Ⅳ by the Garden classification. The 2 groups were compared in terms of fracture healing time, nonunion, femoral head necrosis and Harris hip scores. \u0000 \u0000 \u0000Results \u0000The 2 groups were comparable because their preoperative general data showed no significant differences (P>0.05). The 160 patients obtained follow-up for 12 to 36 months. The PRP group showed significantly shorter fracture healing time (4.3 months ± 1.0 months), significantly lower incidences of nonunion [0% (0/80)] and avascular necrosis of femoral head [3.8% (3/80)] than the control group [7.3 months ± 1.3 months, 7.5% (6/80) and 15.0% (12/80), respectively] (all P< 0.05). The Harris scores at 6 and 12 months after operation for the PRP group (88.7±5.3 and 94.2±4.8) were significantly higher than those for the control group (81.4±4.6 and 84.2±5.2) (both P<0.05). \u0000 \u0000 \u0000Conclusion \u0000In the treatment of femoral neck fractures, compared with internal fixation with hollow screws alone, platelet rich plasma combined with internal fixation with hollow screws can significantly shorten fracture healing time, reduce incidence of avascular necrosis of the femoral head and improve functional recovery of the hip joint. \u0000 \u0000 \u0000Key words: \u0000Femoral neck fractures; Platelet rich plasma; Fracture fixation, internal; Bone nails","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"263-267"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43588506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.CN115530-20190703-00233
Xiaowei Wang, T. Sun, Zhi Liu, Jianzheng Zhang, Jian-wen Zhao
Objective To analyze the impacts of operative timing on the operative outcomes in elderly patients with hip fracture. Methods A cohort of 814 elderly patients with hip fracture were analyzed retrospectively who had been treated at Department of Orthopaedics, The 7th Medical Center, General Hospital of Chinese People's Liberation Army from January 2012 to December 2015. They were 272 males and 542 females, aged from 60 to 99 years (average, 79.9 years). They were divided into 2 categories according to their systemic status by the American Association of Anesthesiologists (ASA) classification. There were 403 cases of ASA class Ⅰ and Ⅱ in the good status category and 411 cases of ASA class Ⅲ and Ⅳ in the poor status category. Each category was further divided into one early operation group and one late operation group depending on whether the patients were operated on within 48 hours after admission. The 2 groups were compared in terms of hospital stay, incidence of complications, 30-day and 1-year mortalities, and 1-year activities of daily living(ADL) scores. Results In the good status patients there were no significant differences between the 2 groups in the preoperative general data, showing compatibility (P>0.05). The early operation group showed significantly lower 30-day mortality [0% (0/94)] and 1-year mortality [5.3% (5/94)], significantly shorter hospital stay (9.6 d ± 5.2 d) and significantly higher 1-year ADL scores [75 (70, 85)] than the late operation group [4.2% (13/309) and 14.2% (44/309), 12.3 d ± 5.9 d, and 70 (60, 80), respectively] (all P 0.05). In the poor status patients there were no significant differences between the 2 groups in the preoperative general data, showing compatibility (P>0.05). The incidence of complications in the early operation group [42.2% (35/83)] was significantly higher than in the late operation group [30.5% (100/328)] (P 0.05). Conclusion For the elderly patients with hip fracture, operation can be carried out as soon as possible if they are in good physical condition, and early operation is not necessary if they are in poor systemic condition because operation should be carried out at an appropriate time after evaluation of their physical condition allows. Key words: Hip fractures; Timing of surgery; Mortality
{"title":"Operative timing and outcomes in the elderly patients with hip fracture","authors":"Xiaowei Wang, T. Sun, Zhi Liu, Jianzheng Zhang, Jian-wen Zhao","doi":"10.3760/CMA.J.CN115530-20190703-00233","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115530-20190703-00233","url":null,"abstract":"Objective \u0000To analyze the impacts of operative timing on the operative outcomes in elderly patients with hip fracture. \u0000 \u0000 \u0000Methods \u0000A cohort of 814 elderly patients with hip fracture were analyzed retrospectively who had been treated at Department of Orthopaedics, The 7th Medical Center, General Hospital of Chinese People's Liberation Army from January 2012 to December 2015. They were 272 males and 542 females, aged from 60 to 99 years (average, 79.9 years). They were divided into 2 categories according to their systemic status by the American Association of Anesthesiologists (ASA) classification. There were 403 cases of ASA class Ⅰ and Ⅱ in the good status category and 411 cases of ASA class Ⅲ and Ⅳ in the poor status category. Each category was further divided into one early operation group and one late operation group depending on whether the patients were operated on within 48 hours after admission. The 2 groups were compared in terms of hospital stay, incidence of complications, 30-day and 1-year mortalities, and 1-year activities of daily living(ADL) scores. \u0000 \u0000 \u0000Results \u0000In the good status patients there were no significant differences between the 2 groups in the preoperative general data, showing compatibility (P>0.05). The early operation group showed significantly lower 30-day mortality [0% (0/94)] and 1-year mortality [5.3% (5/94)], significantly shorter hospital stay (9.6 d ± 5.2 d) and significantly higher 1-year ADL scores [75 (70, 85)] than the late operation group [4.2% (13/309) and 14.2% (44/309), 12.3 d ± 5.9 d, and 70 (60, 80), respectively] (all P 0.05). In the poor status patients there were no significant differences between the 2 groups in the preoperative general data, showing compatibility (P>0.05). The incidence of complications in the early operation group [42.2% (35/83)] was significantly higher than in the late operation group [30.5% (100/328)] (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000For the elderly patients with hip fracture, operation can be carried out as soon as possible if they are in good physical condition, and early operation is not necessary if they are in poor systemic condition because operation should be carried out at an appropriate time after evaluation of their physical condition allows. \u0000 \u0000 \u0000Key words: \u0000Hip fractures; Timing of surgery; Mortality","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"206-211"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44416706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.CN115530-20200304-00137
Kepeng Li, H. Xue, H. Chu, Guoju Ma
Objective To investigate the risk factors for delirium after intertrochanteric fracture surgery in the elderly. Methods The data of 423 elderly patients with femoral intertrochanteric fracture were retrospectively analyzed who had been treated by closed reduction and internal fixation with proximal femoral nail antirotation (PFNA) at Department of Orthopedics, The Second Central Hospital of Baoding from December 2010 to April 2018. They were 205 males and 218 females, aged from 70 to 98 years (mean, 78.6 years). By AO classification, 239 fractures were type 31-A1, 141 ones type 31-A2, and 43 ones type 31-A3. Of them, 362 were complicated with disease of internal medicine. The interval from injury to surgery ranged from 4 to 72 hours with an average of 46.6 hours. The incidence of postoperative delirium was recorded. The risk factors were screened by univariate analysis from the hidden blood loss, gender, age, body mass index, complications, anesthesia method, preoperative preparation time and electrolyte disturbance; multivariate logistic regression analysis was used to determine the independent risk factors from the factors with P< 0.05. Results Post-operative delirium occurred in 49 of the 423 patients (11.58%) (29 cases on the first postoperative day and 20 ones on the second postoperative day). It was not observed in the other 374 (88.42%) patients. Univariate analysis showed significant differences in the interval from injury to surgery, hidden blood loss and electrolyte disturbance between the patients with and without postoperative delirium (P 48 hours (OR=3.386, 95% CI: 1.362 to 6.638), hidden blood loss>600 mL (OR=10.292, 95% CI: 1.244 to 35.091) and electrolyte disturbance (OR=4.157, 95% CI: 1.595 to 7.626) were the independent risk factors for postoperative delirium in elderly patients with intertrochanteric fracture. Conclusion Long preoperative preparation, a large amount of hidden blood loss and postoperative electrolyte disturbance may be the risk factors for post-operative delirium in elderly patients with intertrochanteric fracture afterinternal fixation. Key words: Hip fractures; Latent blood loss; Delirium; Risk factors; Aged
{"title":"Risk factors for delirium after intertrochanteric fracture surgery in the elderly","authors":"Kepeng Li, H. Xue, H. Chu, Guoju Ma","doi":"10.3760/CMA.J.CN115530-20200304-00137","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115530-20200304-00137","url":null,"abstract":"Objective \u0000To investigate the risk factors for delirium after intertrochanteric fracture surgery in the elderly. \u0000 \u0000 \u0000Methods \u0000The data of 423 elderly patients with femoral intertrochanteric fracture were retrospectively analyzed who had been treated by closed reduction and internal fixation with proximal femoral nail antirotation (PFNA) at Department of Orthopedics, The Second Central Hospital of Baoding from December 2010 to April 2018. They were 205 males and 218 females, aged from 70 to 98 years (mean, 78.6 years). By AO classification, 239 fractures were type 31-A1, 141 ones type 31-A2, and 43 ones type 31-A3. Of them, 362 were complicated with disease of internal medicine. The interval from injury to surgery ranged from 4 to 72 hours with an average of 46.6 hours. The incidence of postoperative delirium was recorded. The risk factors were screened by univariate analysis from the hidden blood loss, gender, age, body mass index, complications, anesthesia method, preoperative preparation time and electrolyte disturbance; multivariate logistic regression analysis was used to determine the independent risk factors from the factors with P< 0.05. \u0000 \u0000 \u0000Results \u0000Post-operative delirium occurred in 49 of the 423 patients (11.58%) (29 cases on the first postoperative day and 20 ones on the second postoperative day). It was not observed in the other 374 (88.42%) patients. Univariate analysis showed significant differences in the interval from injury to surgery, hidden blood loss and electrolyte disturbance between the patients with and without postoperative delirium (P 48 hours (OR=3.386, 95% CI: 1.362 to 6.638), hidden blood loss>600 mL (OR=10.292, 95% CI: 1.244 to 35.091) and electrolyte disturbance (OR=4.157, 95% CI: 1.595 to 7.626) were the independent risk factors for postoperative delirium in elderly patients with intertrochanteric fracture. \u0000 \u0000 \u0000Conclusion \u0000Long preoperative preparation, a large amount of hidden blood loss and postoperative electrolyte disturbance may be the risk factors for post-operative delirium in elderly patients with intertrochanteric fracture afterinternal fixation. \u0000 \u0000 \u0000Key words: \u0000Hip fractures; Latent blood loss; Delirium; Risk factors; Aged","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"255-258"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49365332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.CN115530-20191006-00343
Zhenwei Wang, Di Ai, Teng Zhang, Meng Yu, Li Hongchuan, L. Peng, Daxin Yu, Guoqiang Chen, Xiao-ming Yuan, Fang Yu, Liu Wei, Q. Yao
Objective To explore multidisciplinary team (MDT) for the treatment of hip fracture in the elderly. Methods A retrospective analysis was done of the 196 elderly patients who had been admitted to Department of Joint Surgery, Beijing Shijitan Hospital from September 2017 to December 2018 for hip fractures. They were divided into 2 groups depending on whether MDT had been applied or not. In the MDT group of 102 patients, there were 43 males and 59 females with an age of 81.9±8.4 years, and 63 femoral neck fractures and 39 intertrochanteric fractures. In the traditional treatment group of 94 patients, there were 37 males and 57 females with an age of 81.3±8.6 years, and 55 femoral neck fractures and 39 intertrochanteric fractures. The 2 groups were compared in terms of complications and mortality during hospitalization, interval from admission to surgery, total hospital stay, and Harris hip scores at 6 months after surgery. Results There were no statistically significant differences in general data before surgery between the 2 groups, indicating comparability (P>0.05). Eighty-four patients (89.4%) in the traditional treatment group and 98 patients (96.1%) in the MDT group underwent surgery, showing no significant difference between the groups (χ2=3.327, P=0.068). In the patients undergoing surgery in the MDT group, the incidences of postoperative delirium [12.2% (12/98)], pulmonary infection [11.2% (11/98)], cardiogenic disease [13.3%(13/98)], electrolyte disturbance[12.2%(12/98)] and deep venous thrombosis of lower extremity [6.1% (6/98)] were significantly lower, the interval from admission to surgery (1.9 d±0.9 d) and total hospital stay (10.2 d±0.9 d) significantly shorter, and Harris hip scores (81.3±6.2) at 6 months after surgery significantly higher than those in the patients undergoing surgery in the traditional treatment group [31.0%(26/84), 22.6% (19/84), 25.0% (21/84), 28.6% (24/84), 16.7%(14/84); 3.1 d±1.6 d and 14.1 d±6.2 d; 75.4±7.8; respectively] (all P<0.05). Conclusion In the treatment of hip fracture in the elderly, multidisciplinary team is effective in reducing complications during hospitalization, shortening the interval from admission to surgery and total hospital stay, and promoting functional recovery of the hip. Key words: Hip fractures; Fracture fixation, intramedullary; Bone nails; Arthroplasty, replacement, hip; Multidisciplinary team
{"title":"Multidisciplinary team for treatment of hip fracture in the elderly","authors":"Zhenwei Wang, Di Ai, Teng Zhang, Meng Yu, Li Hongchuan, L. Peng, Daxin Yu, Guoqiang Chen, Xiao-ming Yuan, Fang Yu, Liu Wei, Q. Yao","doi":"10.3760/CMA.J.CN115530-20191006-00343","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115530-20191006-00343","url":null,"abstract":"Objective \u0000To explore multidisciplinary team (MDT) for the treatment of hip fracture in the elderly. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was done of the 196 elderly patients who had been admitted to Department of Joint Surgery, Beijing Shijitan Hospital from September 2017 to December 2018 for hip fractures. They were divided into 2 groups depending on whether MDT had been applied or not. In the MDT group of 102 patients, there were 43 males and 59 females with an age of 81.9±8.4 years, and 63 femoral neck fractures and 39 intertrochanteric fractures. In the traditional treatment group of 94 patients, there were 37 males and 57 females with an age of 81.3±8.6 years, and 55 femoral neck fractures and 39 intertrochanteric fractures. The 2 groups were compared in terms of complications and mortality during hospitalization, interval from admission to surgery, total hospital stay, and Harris hip scores at 6 months after surgery. \u0000 \u0000 \u0000Results \u0000There were no statistically significant differences in general data before surgery between the 2 groups, indicating comparability (P>0.05). Eighty-four patients (89.4%) in the traditional treatment group and 98 patients (96.1%) in the MDT group underwent surgery, showing no significant difference between the groups (χ2=3.327, P=0.068). In the patients undergoing surgery in the MDT group, the incidences of postoperative delirium [12.2% (12/98)], pulmonary infection [11.2% (11/98)], cardiogenic disease [13.3%(13/98)], electrolyte disturbance[12.2%(12/98)] and deep venous thrombosis of lower extremity [6.1% (6/98)] were significantly lower, the interval from admission to surgery (1.9 d±0.9 d) and total hospital stay (10.2 d±0.9 d) significantly shorter, and Harris hip scores (81.3±6.2) at 6 months after surgery significantly higher than those in the patients undergoing surgery in the traditional treatment group [31.0%(26/84), 22.6% (19/84), 25.0% (21/84), 28.6% (24/84), 16.7%(14/84); 3.1 d±1.6 d and 14.1 d±6.2 d; 75.4±7.8; respectively] (all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000In the treatment of hip fracture in the elderly, multidisciplinary team is effective in reducing complications during hospitalization, shortening the interval from admission to surgery and total hospital stay, and promoting functional recovery of the hip. \u0000 \u0000 \u0000Key words: \u0000Hip fractures; Fracture fixation, intramedullary; Bone nails; Arthroplasty, replacement, hip; Multidisciplinary team","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"200-205"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49564258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.CN115530-20200306-00148
P. Tang
{"title":"Current and future management of hip fracture in the elderly","authors":"P. Tang","doi":"10.3760/CMA.J.CN115530-20200306-00148","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115530-20200306-00148","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"197-199"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42521370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To evaluate the application of a 3D printed positioner for hip rotation center in total hip arthroplasty. Methods From August 2015 to December 2017, 14 patients were treated by unilateral total hip arthroplasty at Department Ⅰ of Joint Surgery, Orthopaedics Hospital of Zhengzhou for avascular necrosis of femoral head or femoral neck fracture. They were 8 males and 6 females with an average age of 51.8 years (from 37 to 65 years). All their surgeries were assisted by a 3D printed positioner for hip rotation center. Postoperatively, the abduction and anteversion of acetabular cup and the hip rotation center were measured, the agreement between the hip rotation center of the affected side (O2) and the anatomical rotation center of the healthy side (O1) was assessed, and the function of the affected hip and complications were recorded at the last follow-up. Results The 14 patients were followed up for an average of 18 months (from 6 to 24 months). The postoperative ordinates of O2 and O1 were respectively 19.36 mm±3.61 mm and 18.33 mm±3.41 mm while their abscissas 39.93 mm±2.97 mm and 39.99 mm±3.16 mm, indicating agreement between O2 and O1 (P>0.05). The postoperative abduction and anteversion of the cup were within a normal range (39.3°±3.2°and 14.6°±1.2°, respectively). The last follow-up showed that their preoperative Harris hip scores (42.3±3.2) were significantly improved (94.3±4.7) (t=2.873, P=0.002) and that 13 cases were rated as excellent and one as good. X-ray follow-up showed good position of their acetabular prostheses, no loosening of the cups or femoral prostheses, and no heterotopic ossification. Conclusion A 3D printed positioner for hip rotation center can effectively assist reconstruction of the hip rotation center and accurate implantation of acetabular prosthesis in total hip arthroplasty. Key words: Arthroplasty, replacement, hip; 3D printing techniques; Center of rotation; Positioner
{"title":"A 3D printed positioner for hip rotation center used in total hip arthroplasty","authors":"Yuehui Wang, Liangliang Cao, Shiping Zou, Wenteng Si, Aiguo Wang, Cheng-wei Chen","doi":"10.3760/CMA.J.CN115530-20190615-00208","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115530-20190615-00208","url":null,"abstract":"Objective \u0000To evaluate the application of a 3D printed positioner for hip rotation center in total hip arthroplasty. \u0000 \u0000 \u0000Methods \u0000From August 2015 to December 2017, 14 patients were treated by unilateral total hip arthroplasty at Department Ⅰ of Joint Surgery, Orthopaedics Hospital of Zhengzhou for avascular necrosis of femoral head or femoral neck fracture. They were 8 males and 6 females with an average age of 51.8 years (from 37 to 65 years). All their surgeries were assisted by a 3D printed positioner for hip rotation center. Postoperatively, the abduction and anteversion of acetabular cup and the hip rotation center were measured, the agreement between the hip rotation center of the affected side (O2) and the anatomical rotation center of the healthy side (O1) was assessed, and the function of the affected hip and complications were recorded at the last follow-up. \u0000 \u0000 \u0000Results \u0000The 14 patients were followed up for an average of 18 months (from 6 to 24 months). The postoperative ordinates of O2 and O1 were respectively 19.36 mm±3.61 mm and 18.33 mm±3.41 mm while their abscissas 39.93 mm±2.97 mm and 39.99 mm±3.16 mm, indicating agreement between O2 and O1 (P>0.05). The postoperative abduction and anteversion of the cup were within a normal range (39.3°±3.2°and 14.6°±1.2°, respectively). The last follow-up showed that their preoperative Harris hip scores (42.3±3.2) were significantly improved (94.3±4.7) (t=2.873, P=0.002) and that 13 cases were rated as excellent and one as good. X-ray follow-up showed good position of their acetabular prostheses, no loosening of the cups or femoral prostheses, and no heterotopic ossification. \u0000 \u0000 \u0000Conclusion \u0000A 3D printed positioner for hip rotation center can effectively assist reconstruction of the hip rotation center and accurate implantation of acetabular prosthesis in total hip arthroplasty. \u0000 \u0000 \u0000Key words: \u0000Arthroplasty, replacement, hip; 3D printing techniques; Center of rotation; Positioner","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"243-248"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46199759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.CN115530-20200224-00098
Yingze Zhang
{"title":"Intercondylar ridge fracture: broad and narrow definitions and their clinical significance","authors":"Yingze Zhang","doi":"10.3760/CMA.J.CN115530-20200224-00098","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115530-20200224-00098","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"185-186"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42847077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate whether the Garden indexes can serve as a criterion for rotational displacement of femoral neck fracture. Methods Ten cadaveric specimens of healthy human proximal femur were used for this study. They came from 3 males and 2 females who had died at the age from 45 to 70 years old. A Kirschner wire of 2.0 mm in diameter was implanted into the center of the femoral head. Osteotomy was conducted perpendicular to the middle line of the femoral neck. The rotational angles were marked on the distal osteotomy surface. Each cadaveric specimen was rotated sequentially at pronation and supination angles of 0°, 10°, 20°, 30°, 40°, 50°, 70° and 90°, respectively. X-ray images of anterior-posterior and lateral views were taken to record all the rotations of the specimens. Picture Archiving and Communication Systems (PACS) were used to measure the Garden indexes and compare them among anterior-posterior and lateral X-ray films of different pronation and supination angles. Changes in the area of the femoral head fovea at different rotation angles were observed as well. Results There were no significant differences in the auterior-posterior or latera Garden indexes from 0° to pronation or supination 30°, with all the Garden values >155° (P>0.05); from pronation of 40° to pronation of 90°, the Garden indexes were 152.36°±1.41°, 146.04°±1.64°, 143.95°±0.60° and 141.73°±0.60° for anterior-posterior views and 172.54°±0.86°, 168.57°±0.98°, 157.18°±1.17° and 156.47°±1.63° for lateral views, showing a significant difference between rotational angles (P<0.05); from supination of 40° to supination of 90°, the Garden indexes were 151.67°±1.06°, 147.32°±1.82°, 142.77°±0.75° and 139.88°±1.48° for anterior-posterior views and 172.28°±0.79°, 166.76°±1.02°, 155.67°±1.74° and 154.16°±1.27° for lateral views, showing a significant difference between rotational angles (P<0.05). The area of the femoral head fovea decreased gradually with the increase in pronation angle, and increased gradually with the increase in supination angle. Conclusions The Garden indexes cannot serve as an accurate indication of rotational displacement in reduction of femoral neck fracture when the pronation or supination angles ranges from 0° to 30°. Changes in the area of the femoral head fovea can help determine the rotational displacement of the femoral neck fracture. Key words: Femoral neck fractures; Reduction; Garden indexes; Rotational displacement
{"title":"Re-evaluation of Garden indexes as a criterion for reduction of femoral neck fracture: a cadaveric study","authors":"L. Cai, Xiao-shan Guo, Wenhao Zheng, Chunhui Chen, Hua Chen, Yongzeng Feng","doi":"10.3760/CMA.J.CN115530-20191023-00366","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115530-20191023-00366","url":null,"abstract":"Objective \u0000To investigate whether the Garden indexes can serve as a criterion for rotational displacement of femoral neck fracture. \u0000 \u0000 \u0000Methods \u0000Ten cadaveric specimens of healthy human proximal femur were used for this study. They came from 3 males and 2 females who had died at the age from 45 to 70 years old. A Kirschner wire of 2.0 mm in diameter was implanted into the center of the femoral head. Osteotomy was conducted perpendicular to the middle line of the femoral neck. The rotational angles were marked on the distal osteotomy surface. Each cadaveric specimen was rotated sequentially at pronation and supination angles of 0°, 10°, 20°, 30°, 40°, 50°, 70° and 90°, respectively. X-ray images of anterior-posterior and lateral views were taken to record all the rotations of the specimens. Picture Archiving and Communication Systems (PACS) were used to measure the Garden indexes and compare them among anterior-posterior and lateral X-ray films of different pronation and supination angles. Changes in the area of the femoral head fovea at different rotation angles were observed as well. \u0000 \u0000 \u0000Results \u0000There were no significant differences in the auterior-posterior or latera Garden indexes from 0° to pronation or supination 30°, with all the Garden values >155° (P>0.05); from pronation of 40° to pronation of 90°, the Garden indexes were 152.36°±1.41°, 146.04°±1.64°, 143.95°±0.60° and 141.73°±0.60° for anterior-posterior views and 172.54°±0.86°, 168.57°±0.98°, 157.18°±1.17° and 156.47°±1.63° for lateral views, showing a significant difference between rotational angles (P<0.05); from supination of 40° to supination of 90°, the Garden indexes were 151.67°±1.06°, 147.32°±1.82°, 142.77°±0.75° and 139.88°±1.48° for anterior-posterior views and 172.28°±0.79°, 166.76°±1.02°, 155.67°±1.74° and 154.16°±1.27° for lateral views, showing a significant difference between rotational angles (P<0.05). The area of the femoral head fovea decreased gradually with the increase in pronation angle, and increased gradually with the increase in supination angle. \u0000 \u0000 \u0000Conclusions \u0000The Garden indexes cannot serve as an accurate indication of rotational displacement in reduction of femoral neck fracture when the pronation or supination angles ranges from 0° to 30°. Changes in the area of the femoral head fovea can help determine the rotational displacement of the femoral neck fracture. \u0000 \u0000 \u0000Key words: \u0000Femoral neck fractures; Reduction; Garden indexes; Rotational displacement","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"232-237"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44351806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-24DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.002
Tang Peifu, Zhi-Yong Hou, Wu Xinbao, Chang Zhang, Jun-Wen Wang, Xin Xing, Zengwu Shao, Ai-Xi Yu, Gang Wang, Bin Chen, Ping Zhang, Yan Hu, Bo-Wei Wang, Xiao-dong Guo, Xin Tang, Dongsheng Zhou, Fan Liu, Ai-Mi Chen, Z. Kun, Li KaiNan, Yan-bin Zhu
{"title":"Expert consensus on management principles for orthopaedic emergency in the epidemic period of Corona Virus Disease 2019","authors":"Tang Peifu, Zhi-Yong Hou, Wu Xinbao, Chang Zhang, Jun-Wen Wang, Xin Xing, Zengwu Shao, Ai-Xi Yu, Gang Wang, Bin Chen, Ping Zhang, Yan Hu, Bo-Wei Wang, Xiao-dong Guo, Xin Tang, Dongsheng Zhou, Fan Liu, Ai-Mi Chen, Z. Kun, Li KaiNan, Yan-bin Zhu","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.002","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44435695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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