Background：Subcapital femoral neck fracture in young adults has many complications,and the incidence is increasing year-by-year.The selection of the proper operation method to avoid them is an ambiguous matter.This s...Background：Subcapital femoral neck fracture in young adults has many complications,and the incidence is increasing year-by-year.The selection of the proper operation method to avoid them is an ambiguous matter.This study aimed to evaluate the treatment effect of subcapital femoral neck fracture by the capsulotomy and internal fixation with iliac bone grafting or closed reduction and intemal fixation in young adults.Methods：From March 2003 to February 2010,65 young patients with subcapital femoral neck fractures were treated,including 39 males and 26 females with average age of 34.5 years （range,19-50 years）; 29 cases of the left side and 36 cases of the right side.They were randomly divided into Group A with 34 cases treated by closed reduction and internal fixation and Group B with 31 cases treated by the capsulotomy and internal fixation with iliac bone grafting.The two groups had no significant differences in sex,age,body mass index and preoperative Harris Hip Score.The observation criteria involved the length of the incision,blood loss,operation time,nonunion rate,avascular necrosis of the femoral head （ANFH） rate and Harris Hip Score.Results：Four of 65 patients were lost follow-up,and the follow-up rate was 93.8％,the average follow-up time was 38.7 months （range,33-47 months）.In Group A,the incision length was 5.1 ± 2.2 cm,blood loss was 84.0 ± 13.2 ml,and operation time was 52.9 ± 10.2 min.In Group B,the incision length was 15.4 ± 4.6 cm,blood loss was 396.0 ± 21.3 ml,and operation time was 1 16.5 ± 15.3 min.Nonunion occurred in 8 patients （25.2％） in Group A and 1 patient （3.3％） in Group B.ANFH occurred in 9 patients （29.1％） in Group A and 2 patients （6.7％） in Group B.Postoperative Harris Hip Score was 89.0 ± 5.6 in Group A and 95.0 ± 4.5 in Group B.The above index of two groups was considered statistically significant （P ＜ 0.05）.Conclusions：Capsulotomy and internal fixation with iliac bone grafting can improve fracture healing,reduce ANFH in young adults.It is a safe and effective operation for subcapital femoral neck fracture.展开更多
Purpose： Both cannulated cancellous screw （CCS） and sliding hip screw （SHS） are used in femoral neck fracture fixations, hut which is superior is yet to be determined. This study was aimed to compare the clinicor...Purpose： Both cannulated cancellous screw （CCS） and sliding hip screw （SHS） are used in femoral neck fracture fixations, hut which is superior is yet to be determined. This study was aimed to compare the clinicoradiological outcome of femoral neck fracture treated with SHS or CCS in young adults. Methods： Adults （16-60 years） with femoral neck fracture were divided into Group I fixed with SHS and Group 2 fixed with three CCS after closed reduction. Pain relief, functional recovery and postoperative radiographs at 6 weeks, 3 months, 6 months and then yearly for upto 4 years were analyzed. Results： Group 1 （n = 40） achieved radiological union at mean of Z6 months, with the union rate of 8Z5% （n = 35）, avascular necrosis （AVN） rate of 7.5% （n - 3） and mean Harris Hip Score （HHS） of 86.15 at the end of 4 years. In Group 2 （n = 45） these parameters were union at Z1 months, union rate of 82.22% （n = 37）, AVN rate of 6.67% （n = 3） and HHS of 88.65. Comparative results were statistically insignificant. Conclusion： There is no significant difference in clinicoradiological outcome between the two implants.展开更多
Purpose Understanding the femur load environment during daily activity is necessary for the understanding of risk of femoral pain,pain related falls,and femoral fractures,which could help the design of osteogenic exer...Purpose Understanding the femur load environment during daily activity is necessary for the understanding of risk of femoral pain,pain related falls,and femoral fractures,which could help the design of osteogenic exercises or the preventa-tive methods for older adults.Methods Using the finite element femur analysis,this study was to estimate the femoral strains at 9 cross-sections along the long axis of femur for stair ascent and descent(n=17;age:50-65 years).Motion analysis and inverse dynamics were com-bined with musculoskeletal modelling and optimization,then were used as input to a 3-D femur model to estimate femoral strains.Strains at the hip contact force peaks were calculated.Results The compressive and tensile strains during stair descent were greater than ascent for all or most cross-sections,especially for the proximal cross-sections of the femur:stair ascent produced−324.0±103.8 to−483.7±191.0μεcompressive strains and descent produced−608.8±288.4 to 1016.0±444.1με;stair ascent produced 336.2±105.4 to 391.8±136.9μεtensile strains and descent produced 546.9±252.8 to 741.7±333.6με.Conclusion Strains represent the material deformation effect on the bone due to the sum of all the bone external loads.Using bone strains could help future studies analyze load conditions in a more comprehensive way for other physical activities,which predicts the risk of stress fractures and tests if alternative methods(gait type change)could reduce stress and strain effectively.展开更多
文摘Background：Subcapital femoral neck fracture in young adults has many complications,and the incidence is increasing year-by-year.The selection of the proper operation method to avoid them is an ambiguous matter.This study aimed to evaluate the treatment effect of subcapital femoral neck fracture by the capsulotomy and internal fixation with iliac bone grafting or closed reduction and intemal fixation in young adults.Methods：From March 2003 to February 2010,65 young patients with subcapital femoral neck fractures were treated,including 39 males and 26 females with average age of 34.5 years （range,19-50 years）; 29 cases of the left side and 36 cases of the right side.They were randomly divided into Group A with 34 cases treated by closed reduction and internal fixation and Group B with 31 cases treated by the capsulotomy and internal fixation with iliac bone grafting.The two groups had no significant differences in sex,age,body mass index and preoperative Harris Hip Score.The observation criteria involved the length of the incision,blood loss,operation time,nonunion rate,avascular necrosis of the femoral head （ANFH） rate and Harris Hip Score.Results：Four of 65 patients were lost follow-up,and the follow-up rate was 93.8％,the average follow-up time was 38.7 months （range,33-47 months）.In Group A,the incision length was 5.1 ± 2.2 cm,blood loss was 84.0 ± 13.2 ml,and operation time was 52.9 ± 10.2 min.In Group B,the incision length was 15.4 ± 4.6 cm,blood loss was 396.0 ± 21.3 ml,and operation time was 1 16.5 ± 15.3 min.Nonunion occurred in 8 patients （25.2％） in Group A and 1 patient （3.3％） in Group B.ANFH occurred in 9 patients （29.1％） in Group A and 2 patients （6.7％） in Group B.Postoperative Harris Hip Score was 89.0 ± 5.6 in Group A and 95.0 ± 4.5 in Group B.The above index of two groups was considered statistically significant （P ＜ 0.05）.Conclusions：Capsulotomy and internal fixation with iliac bone grafting can improve fracture healing,reduce ANFH in young adults.It is a safe and effective operation for subcapital femoral neck fracture.
文摘Purpose： Both cannulated cancellous screw （CCS） and sliding hip screw （SHS） are used in femoral neck fracture fixations, hut which is superior is yet to be determined. This study was aimed to compare the clinicoradiological outcome of femoral neck fracture treated with SHS or CCS in young adults. Methods： Adults （16-60 years） with femoral neck fracture were divided into Group I fixed with SHS and Group 2 fixed with three CCS after closed reduction. Pain relief, functional recovery and postoperative radiographs at 6 weeks, 3 months, 6 months and then yearly for upto 4 years were analyzed. Results： Group 1 （n = 40） achieved radiological union at mean of Z6 months, with the union rate of 8Z5% （n = 35）, avascular necrosis （AVN） rate of 7.5% （n - 3） and mean Harris Hip Score （HHS） of 86.15 at the end of 4 years. In Group 2 （n = 45） these parameters were union at Z1 months, union rate of 82.22% （n = 37）, AVN rate of 6.67% （n = 3） and HHS of 88.65. Comparative results were statistically insignificant. Conclusion： There is no significant difference in clinicoradiological outcome between the two implants.
基金was provided by Chinese Universities Scientific Fund(Grant No.2020063).
文摘Purpose Understanding the femur load environment during daily activity is necessary for the understanding of risk of femoral pain,pain related falls,and femoral fractures,which could help the design of osteogenic exercises or the preventa-tive methods for older adults.Methods Using the finite element femur analysis,this study was to estimate the femoral strains at 9 cross-sections along the long axis of femur for stair ascent and descent(n=17;age:50-65 years).Motion analysis and inverse dynamics were com-bined with musculoskeletal modelling and optimization,then were used as input to a 3-D femur model to estimate femoral strains.Strains at the hip contact force peaks were calculated.Results The compressive and tensile strains during stair descent were greater than ascent for all or most cross-sections,especially for the proximal cross-sections of the femur:stair ascent produced−324.0±103.8 to−483.7±191.0μεcompressive strains and descent produced−608.8±288.4 to 1016.0±444.1με;stair ascent produced 336.2±105.4 to 391.8±136.9μεtensile strains and descent produced 546.9±252.8 to 741.7±333.6με.Conclusion Strains represent the material deformation effect on the bone due to the sum of all the bone external loads.Using bone strains could help future studies analyze load conditions in a more comprehensive way for other physical activities,which predicts the risk of stress fractures and tests if alternative methods(gait type change)could reduce stress and strain effectively.
