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[PMID]: 29408208
[Au] Autor:Yue J; Wan F; Zhang Q; Wen P; Cheng L; Li P; Guo W
[Ad] Address:Beijing University of Chinese Medicine, Yinghuadong Road, Chaoyang District, Beijing, China; Department of Joint Surgery, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, China. Electronic address: 20150941122@bucm.edu.cn.
[Ti] Title:Effect of glucocorticoids on miRNA expression spectrum of rat femoral head microcirculation endothelial cells.
[So] Source:Gene;651:126-133, 2018 Apr 20.
[Is] ISSN:1879-0038
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:The study profiled the differential miRNA expression from femoral head bone microvascular endothelial cells (BMECs) between model group and control group to explore the pathogenesis of steroid-induced osteonecrosis of femoral head (ONFH). Twenty 8-week-old Female Sprague-Dawley (SD) rats were randomly divided into control and model groups. Rats in model group received an intraperitoneal injection of 20-µg/kg lipopolysaccharide (LPS) at an interval of 24 h. Then, 24 h later, rats received three doses of 40-mg/kg methylprednisolone by intramuscular injection at intervals of 24 h. In control group, rats received the same volume of normal saline. After 4 weeks, the femoral heads were sectioned to confirm the establishment of the model. To replicate the animal model ex vivo, BMECs were isolated. Different miRNAs were screened using Agilent Gene Spring GX software, and real-time quantitative polymerase chain reaction (qPCR) was used to confirm the results of miRNA microarray analysis. The differentially expressed miRNA were assessed by bioinformatics analysis. Four differentially expressed miRNAs were identified (two upregulated: miR-132-3p, miR-335 and two down regulated: miR-466b-2-3p, let-7c-1-3p). qPCR results were consistent with the gene-chip results. Steroid-induced ONFH may cause miRNA changes in BMSCs. miR-132-3p and miR-335 may be important in steroid-induced ONFH.
[Mh] MeSH terms primary: Endothelium, Vascular/metabolism
Femur Head Necrosis/metabolism
Femur Head/metabolism
Glucocorticoids/pharmacology
Methylprednisolone/pharmacology
MicroRNAs/biosynthesis
[Mh] MeSH terms secundary: Animals
Cells, Cultured
Computational Biology
Disease Models, Animal
Endothelium, Vascular/drug effects
Female
Femur Head/blood supply
Femur Head/drug effects
Femur Head Necrosis/blood
Femur Head Necrosis/chemically induced
Femur Head Necrosis/pathology
MicroRNAs/genetics
Microcirculation
Rats
Rats, Sprague-Dawley
Real-Time Polymerase Chain Reaction
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Glucocorticoids); 0 (MicroRNAs); X4W7ZR7023 (Methylprednisolone)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180207
[St] Status:MEDLINE

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[PMID]: 29390346
[Au] Autor:Zhao B; Li H; Yan J; Han LR; Yang XF
[Ad] Address:Department of Orthopaedics, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, China.
[Ti] Title:Pipkin type III femoral head fracture-dislocation combined with complicated acetabular fracture: A rare case report and literature review.
[So] Source:Medicine (Baltimore);96(50):e9214, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Pipkin III fracture, which is characterized by high risk of avascular necrosis of the femoral head, is extremely rare. It is more difficult to treat and has a worse prognosis when accompanied with severe acetabular fractures. Few studies show that both Pipkin type III femoral head fracture-dislocation and complicated acetabular fracture presented in one patient. PATIENT CONCERNS: A 34-year-old male suffered a terrible traffic accident with a serious damage to the left side when he was sitting in the car's cockpit. Pelvic radiograph and 3-dimensional reconstruction of computed tomography revealed characteristics of fractures before the emergency operation. DIAGNOSIS: Pipkin III fractures combined with complicated acetabular fracture. INTERVENTIONS: Firstly, we used combined anterior and posterior approach for treatment to fix the femoral head fractures. Then, we completed anatomical reduction of fractures with countersunk head screw, hollow screw, and reconstruction plate. OUTCOMES: At the 12-months follow-up, the patient could walk freely and perform activities of daily living without necrosis of femoral head and heterotopic ossification. LESSONS: Although there are serious complications in Pipkin III fractures combined with complicated acetabular fracture, early surgical treatment with appropriate approach and fixation could get satisfactory results.
[Mh] MeSH terms primary: Femoral Neck Fractures/surgery
Fracture Dislocation/surgery
Fracture Fixation, Internal/methods
Hip Fractures/surgery
[Mh] MeSH terms secundary: Accidents, Traffic
Adult
Femoral Neck Fractures/classification
Femoral Neck Fractures/diagnostic imaging
Femoral Neck Fractures/etiology
Fracture Dislocation/classification
Fracture Dislocation/diagnostic imaging
Fracture Dislocation/etiology
Fracture Fixation, Internal/instrumentation
Hip Fractures/diagnostic imaging
Hip Fractures/etiology
Humans
Internal Fixators
Male
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009214

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[PMID]: 29457389
[Au] Autor:Chen ZW; Li TX; Wan XX; Wang RT; Chen WH
[Ad] Address:The Third Department of Bone and Joint, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China.
[Ti] Title:[Study on the risk factors for the misdiagnosis of femoral head osteonecrosis].
[So] Source:Zhongguo Gu Shang;30(11):1000-1003, 2017 Nov 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To evaluate the status and risk factors for the misdiagnosis of femoral head osteonecrosis, providing the basis for accurate diagnosis of osteonecrosis of femoral head. METHODS: The data of 314 hospitalized patients were collected from March 2015 to March 2016, and the risk factors for osteonecrosis of femoral head were analyzed by Logistic regression model. Misdiagnosis was defined that the diagnosis given on the first time was different from that on the second time or that given by expert group with the same symptoms and signs. The general data, predisposing factors, time of onset, hospital visits, clinical manifestations, X-ray film of hip joint, MRI and other data were statistically analyzed. RESULTS: Total 127 patients experienced misdiagnosis (up to 40.8%). Among them, the patients with osteonecrosis of femoral head misdiagnosed as other diseases accounted for 77.2% and the patients with other diseases misdiagnosed osteonecrosis of femoral head accounted for 22.8%. Statistical analysis showed that the predisposing factors, history of glucocorticoid and alcohol intake, diseased lower limb, pained lower limb, hidden disease attack, the level of first reception hospital and expert were significantly related with the misdiagnosis of femoral head osteonecrosis based on the logistic regression model ( <0.05) . The relationship between misdiagnosis and gender, age, primary disease taking glucocorticoid, approach and time of glucocorticoid use, the type of alcohol, drinking time had no statistical significance( >0.05). The Logistic regression analysis showed that the hidden disease attack(OR=3.059) and level of first reception expert(OR=2.778) were the high risk factors associated with the misdiagnosis in which the femoral head necrosis was misdiagnosed as other diseases( <0.01), and glucocorticoid intake history was the low risk factors(OR=0.387)( <0.05). The Logistic regression analysis showed that the level of first reception expert (OR=3.573) was the high risk factor associated with the misdiagnosis in which the other diseases were misdiagnosed as necrosis of femoral head. CONCLUSIONS: Misdiagnosis rate of femoral head necrosis is high. Hidden disease attack and low level of first reception expert are the high risk factors associated with the misdiagnosis in which the femoral head necrosis was misdiagnosed as other diseases, however, glucocorticoid intake history is the protective factor of misdiagnosis. Low level of first reception expert is the high risk factor associated with the misdiagnosis in which other diseases were misdiagnosed as necrosis of femoral head.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180219
[Lr] Last revision date:180219
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2017.11.006

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[PMID]: 29203431
[Au] Autor:Glorion C
[Ad] Address:Service d'orthopédie et traumatologie pédiatrique, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France. Electronic address: christophe.glorion@aphp.fr.
[Ti] Title:Surgical reduction of congenital hip dislocation.
[So] Source:Orthop Traumatol Surg Res;104(1S):S147-S157, 2018 Feb.
[Is] ISSN:1877-0568
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:Surgical reduction of congenital hip dislocation is technically challenging. In our practice, surgical reduction is usually reserved for patients who have failed non-operative treatment, which is the first-line strategy. However, primary surgery may be indicated if the dislocation is diagnosed late and can be performed until 8 years of age. The reduction step is crucial. It starts with painstaking exposure of the capsule. Identifying the lower part of the acetabulum is the key to accurate repositioning of the epiphysis. The main intra-articular procedures are resection of the ligament teres, adipose tissue within the acetabular cavity, and transverse acetabular ligament; and eversion of the radially incised limbus. In patients younger than 1 year of age, surgical reduction can be performed via the anterior approach or, in some cases, the obturator approach. No complementary steps are needed. If the diagnosis is made late, in contrast, reduction of the hip must be combined with corrective procedures on the femur and acetabulum designed to stabilise the reduction before the capsulorrhaphy, with the goal of optimising hip stability and minimising the risk of residual dysplasia. Femoral shortening and derotation osteotomy was classically reserved for children older than 3 years but has now been shown to be a useful and prudent procedure in younger patients. This osteotomy decreases pressure on the epiphysis, facilitates the reduction, and diminishes the risk of recurrence and avascular necrosis of the femoral head, which are the two dreaded complications. The outcome depends on the care directed to the procedure and on the quality of postoperative management.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180218
[Lr] Last revision date:180218
[St] Status:In-Data-Review

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[PMID]: 29424150
[Au] Autor:Jiang YQ; Huang J; Guo WK; Lai B; Wang J; Liang CX; Liu SL; Lin WM
[Ad] Address:Department of Joint Surgery, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou 514031, Guangdong, China; jiangyq77@126.com.
[Ti] Title:[Treatment of Pipkin type I and II femoral head fractures through modified Smith-Peterson approach and modified Hardinge approach-a case-control studies].
[So] Source:Zhongguo Gu Shang;30(7):616-621, 2017 Jul 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To compare clinical results of treatment of Pipkin type I and II femoral head fractures through modified Smith-Peterson(S-P) approach and modified Hardinge approach. METHODS: From July 2005 to July 2014, 42 patients with Pipkin type I and II femoral head fractures were treated with operation. A total of 23 patients in anterior group was treated with modified S-P approach including 17 males and 6 females with an average age of (29.3±9.4) years old, 5 cases of type I by excision of the fragement, 3 cases of type I and 15 cases of type II cases by fixation of the fragement. While a total of 19 patients in the lateral group was treated with modified Hardinge approach including 15 males and 4 females with an average age of (31.4±10.0) years old, 3 cases of type I by excision of the fragement, 4 cases of type I and 12 cases of type II by fixation of the fragement. Operative time, blood loss during operation and fracture healing time were observed and compared. The clinical and radiographic outcomes of the patients were measured using Thompson-Epstein scoring scale. The effect of hip reduction time of less than 6 h, 6 to12 h, and more than 12 h, the effect of surgery time within 24 h and more than 24 h after injury were compared. RESULTS: All patients were followed up from 24 to 60 months with an average of(30.29±6.95) months. The operation time (61.96±12.22) min, blood loss (46.09±18.03) ml, and (74.74±10.06) min, blood loss (72.11±19.88) ml in lateral group in the anterior group were better than those of lateral group( <0.05). In anterior group, fracture healing time was(12.22±1.70) weeks, the results were excellent in 8 cases, good in 10 cases, fair in 4 cases and poor in 1 case, the excellent and good rate was 78.3%, the incidence of avascular necrosis of femoral head was 8.69%(2/23), and the incidence of heterotopic ossification was 13.04%(3/23). While in lateral group, the fracture healing time was(12.42±1.95) weeks, the results were excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 3 cases, the excellent and good rate was 68.4%, the incidence of avascular necrosis of femoral head was 10.53%(2/19), and the incidence of heterotopic ossification was 5.26%(1/19). There was no significant difference in fracture healing time, postoperative effect and postoperative complications between the anterior group and lateral group( <0.05). The effect of patients with reduction time of hip dislocation less than 12 h was significantly better than that of more than 12 h, there was no significant difference in the effect between reduction time within 6 h and 6 to 12 h. There was no significant difference in the outcome between surgical patients within 24 h and more than 24 h after injury. CONCLUSIONS: Dislocated hip of Pipkin type I and II femoral head fractures should be closed reduction within 6 h. If conditions are limited, the reduction time can be accepted within 12 h. Both of modified S-P approach and modified Hardinge approach are effective in treating Pipkin type I and II femoral head fractures, and can obtain excellent outcomes. Moreover, modified S-P approach has advantage of less trauma, less blood loss, shorter operative time.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2017.07.007

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[PMID]: 29424146
[Au] Autor:Zhang J; Cao LH; Chen X; Su JC
[Ad] Address:Department of Orthopaedics, Changhai Hospital of Second Military Medical University, Shanghai 200433, China.
[Ti] Title:[Comparison of PFNA and InterTAN intramedullary nail in treating unstable femoral intertrochanteric fractures].
[So] Source:Zhongguo Gu Shang;30(7):597-601, 2017 Jul 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To compare the clinical effects of PFNA and InterTAN for the treatment of unstable intertrochanteric fractures in the elderly patients. METHODS: From April 2012 to February 2014, 113 elderly patients with unstable intertrochanteric fractures were treated by PFNA or InterTAN. There were 64 cases in PFNA group, including 25 males and 39 females with an average age of (73.3±6.5) years old (ranged, 66 to 85);while 49 cases in InterTAN group, including 20 males and 29 females with an average age of (74.2±5.4) years old (ranged, 65 to 85). According to the AO classification, there were 48 cases of type A2, 16 cases of type A3 in PFNA group and 37 cases of type A2, 12 cases with type A3 in InterTAN group. The time interval from injury ranged from 3 to 8 days with an average of 4.7±1.2. The blood loss, operation time, fluoroscopy time, lateral cortex fractures of the proximal femur, healing time of fracture, femoral shaft fractures, femoral head screw cut-out, necrosis of the femoral head, femoral neck shortening and Harris score of patients at the last follow-up were compared between the two groups. RESULTS: Fifty-eight patients in PFNA and 44 patients in InterTAN were followed up for 14 to 18 months with an average of 16.3±1.2. Wound healing was satisfying during the follow-up. Significant differences were observed between the two groups regarding the blood loss, operation time, fluoroscopy time. The complication rate of femoral shaft fractures, femoral head screw cut-out and femoral neck shortening in InterTAN group was less than that in PFNA group, showing significant difference between the two groups ( <0.05). At the latest follow-up, the average Harris scores were 90.7±5.1 in PFNA group and 90.4±3.9 in InterTAN group, there was no significant difference between the two groups( >0.05). CONCLUSIONS: InterTAN with stronger anti-rotation function is more suitable for patients with early weight-bearing and it reduces the incidence rates of hip varus, femoral head screw cut-out and femoral neck shortening. However, for those patients with osteoporosis or unfit for surgery, PFNA is a good option. As the limited follow-up duration, long-term effects of the two surgical methods needs to be further observed and studied.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2017.07.003

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[PMID]: 29349981
[Au] Autor:Piao S; Zhou YG; Du YQ; Ma HY; Sun JY; Gao ZS; Peng YW; Wu WM
[Ad] Address:Department of Orthopaedics, General Hospital of Chinese PLA, Beijing 100853, China.
[Ti] Title:[Clinical results in early and mid term of using the S-ROM femoral stem in revision].
[So] Source:Zhongguo Gu Shang;30(4):322-328, 2017 Apr 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To investigate and the clinical effect of S-ROM modular stem in femur reconstruction in hip revision arthroplasty. METHODS: From January 2008 to January 2016, 21 patients received revision hip arthroplasties using S-ROM stems. There were 5 males and 16 females with an average of 48.33 years old(range, 29 to 73 years old). There were 13 cases caused by aseptic loosening, 4 cases by infection, 2 cases by nonunion of sub-tuberosity osteotomy, 1 case for repeated dislocation, 1 case for traumatic great trochanter fracture. Primary THA reasons:12 cases for DDH(9 cases for Crowe IV), 5 cases for femoral neck fracture, 2 cases for necrosis of femoral head, 2 cases for proximal femoral deformity caused by early infection. The femur bone defects included Paprosky II in 11 cases, IIIa in 9, and IIIb in 1. Harris hip score , pain score and hip flexion were recorded before and after operation. The subjective satisfaction was recorded at the last follow-up. RESULTS: The operation time and blood loss were 189 min(125 to 290 min) and 867 ml (200 to 2 000 ml). At the final followup, the pain score improved from (17.14±9.56) points preoperatively to (41.71±2.03) points ( =11.42, =0.00). The function score improved from (24.01±11.02) points preoperatively to (49.95±5.38) points ( =9.73, =0.00). Harris hip score improved from (41.15±14.81) points preoperatively to(91.67±5.83) points( =15.33, =0.00). The degree of hip flexion increased from (93.10±27.27) points preoperatively to (121.90±16.62) points at the last follow-up ( =4.59, =0.00). The mean subjective satisfaction was 9.48(10 points system), 14 of which were completely satisfactory. The last follow-up hip X-ray showed 21 cases of bone ingrowth, and other femoral stem without loosening or sinking sign significantly. There were 5 cases with bone anchor syndrome around proximal femoral cuff. There were 5 cases of proximal femur fracture, 3 cases of lesser trochanter fracture, 2 cases of greater trochanter fracture intra-operatively. Due to femoral canal stenosis, there were 4 cases of pre-tied wire at lesser trochanter to prevent fractures. There was 1 case of traumatic femoral fracture around stems with a distal oblique fracture, open reduction and locking plate fixation was performed. Other patients had no nerve stretch injury, dislocation, infection and lower limb deep vein thrombosis and other complications at the final follow-up. CONCLUSIONS: S-ROM prosthesis has satisfactory results in hip revision arthroplasty with Paprosky II and III femoral defects. Especially for patients with Crowe IV DDH and other proximal femoral deformities, it is possible to adapt to the medullary cavity morphology. Excellent initial stability, less complications and long-term biological fixation can be achieved with S-ROM in femur revision.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180119
[Lr] Last revision date:180119
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2017.04.008

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[PMID]: 29349973
[Au] Autor:Ye YH; Chen K; Jin KK; Zhang YF; Chen L
[Ad] Address:The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China.
[Ti] Title:[Progress on surgical treatment for femoral head-preservering in the precollapse stage of femoral head necrosis].
[So] Source:Zhongguo Gu Shang;30(3):287-292, 2017 Mar 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:Osteonecrosis of the femoral head(ONFH), a refractory disease characterized by death of the osteocytes and the bone marrow due to inadequate blood supply caused by various mechanisms, usually leads to the collapse of the femoral head and malfunction of the hip joint. The crux is to diagnose ONFH early in the precollapse stage and prevent subsequent progression of collapsing through early interventions, thus delaying or avoiding the replacement of the hip joint. A number of joint salvaging operation treatments for early stage ONFH are available. However, there has been no consensus with regard to the ideal treatment. The main trend now is to unite core decompression with bone-grafting, tantalum rod, bone marrow mesenchymal stem cell (BMSC) and other treatments. Also there are ways of osteotomy altering the angle of the femoral neck to relocate necrotic tissue from the weight-bearing segment. The implanting of tantalum rod remains controversial and the advent of bone marrow mesenchymal stem cell (BMSC) holds huge potential.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1801
[Cu] Class update date: 180119
[Lr] Last revision date:180119
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2017.03.021

  9 / 7707 MEDLINE  
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[PMID]: 29292638
[Au] Autor:Zhang RY; Zhou YG; Ma HY; Lin F; Hao LB; Chen JY; Tang PF
[Ad] Address:Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China.
[Ti] Title:[Clinical results of arthroscopic suture for meniscal tear in middle aged adults].
[So] Source:Zhongguo Gu Shang;29(11):1016-1021, 2016 Nov 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To study the characteristics and clinical effect of total hip arthroplasty(THA) for osteoarthritis and (or) avascular necrosis of femoral head after failure of internal fixation of acetabular fracture. METHODS: From February 2009 to October 2014, 31 patients (31 hips) with hip traumatic osteoarthritis and (or) femoral head avascular necrosis after failure of internal fixation of acetabular fracture were treated with THA including 26 males and 5 females, who injured when the average age of(41±12) years. THA were performed, and the duration ranged from 3 to 132 months with a mean of(20.6±26.9) months secondary to traumatic osteoarthritis and(or) femoral head avascular necrosis. All THA were performed with posterior-lateral approach. The postoperative complications were observed. VAS and Harris hip scores were compared pre-operation and post-operation. RESULTS: Twenty-seven cases were followed up, and the duration ranged from 12 to 80 months with a mean of (43.2±11.7) months. One patient had infection around prosthesis. Aseptic loosening occurred in 1 patient, dislocation of prosthesis in 1 patient. No sciatic nerve injury occurred. Hip function and gaits were obviously improved. To the last follow-up, VAS score was decreased from 7.6±1.2 pre-operatively to 1.2±0.9 post-operatively, while the Harris score was improved from 45.5±13.6 pre-operatively to 88.5±7.8 post-operatively, both differences were statistically significant( <0.01). The post-operative ROM of hip was significantly improved compared to pre-operative ROM( <0.05), in addition to extension motion. X-ray showed all the acetabular cups were stable, one femur stem subsided 3 mm. Heterotopic ossification occurred in 2 cases. CONCLUSIONS: Correct dealing with of internal fixation implants, looking out potential infection and reasonable reconstruction of acetabular bone deficiency were the key to the success of THA for osteoarthritis and(or) avascular necrosis of femoral head after failure of internal fixation of acetabular fracture.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180102
[Lr] Last revision date:180102
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2016.11.009

  10 / 7707 MEDLINE  
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[PMID]: 29292632
[Au] Autor:Hou HT; Li WY; Liu YW; Chen K; Tong ZF; Hai Y; Wu YX; Ma WL; Ye Y; Tian KW; Chen WL; Wang KZ
[Ti] Title:[Subtype classification of Garden III femoral neck fractures in the elderly based on frontal Garden index and its clinical significance].
[So] Source:Zhongguo Gu Shang;29(11):982-988, 2016 Nov 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To retrospectively study postoperative Garden III femoral neck fractures in the elderly so as to explore the different degree of displacement of Garden III femoral neck fracture, and discuss the basis and clinical significance of the subtype classification. METHODS: A total of 492 patients with complete clinical data out of the 1397 patients with femoral neck fractures treated by closed reduction and internal fixation with cannulated compression screws from September 2005 to September 2010 were included in the study. Each patient's frontal Garden Index was measured. On the basis of the frontal Garden Index, these cases were divided into three types:type A, which frontal Garden Index was more than or equal to 140°, included 53 males and 84 females with an average age of(65.3±7.2) years old ranging from 60 to 75 years old; type B, more than 120°and less than 140°, included 79 males and 172 females with an average age of (67.5±3.6) years old;and type C, less than or equal to 120°, included 38 males and 66 with an average age of(68.6±5.7) years old. Aspects were followed up including complications, consequences and hip joint function. The fracture healing and femoral head necrosis were compared among three types. RESULTS: Operative incision of 492 cases was primary healing, and no infection and other complications occurred. All patients were followed up from 2 to 10 years with an average of 6.3 years, the healing of femoral neck fracture occurred in 432 cases, and the total union rate was 87.8%. Femoral head necrosis occurred in 83 cases, and the total necrosis rate of femoral head was 16.9%. The nonunion rate of type A was 6.6%, type B was 13.5%, and type C was 16.3%, there were significant differences among three types( ²2AB=4.377, =0.036; ²2AC=5.872, =0.015; ²2BC=0.469, PBC=0.494). The necrosis rate of femoral head of group A was 8.8%, group B was 16.7%, and group C was 27.9%, there were significant differences among three groups( ²2AB=4.704, =0.030; ²2AC=15.317, =0.000; ²2BC=5.715, =0.017). CONCLUSIONS: It is different for the degree of displacement of Garden III femoral neck fracture in the elderly. Based on frontal Garden Index to differentiate degree of fracture displacement, Garden III femoral neck fracture would be divided into A, B and C subtypes. The prognosis of Garden III femoral neck fracture in the elderly is negatively related to its degree of displacement, which has clinical significance to make treatment plan for Garden III femoral neck fracture in the elderly.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180102
[Lr] Last revision date:180102
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2016.11.003


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