Purpose:The present study aimed to systematically review and compare 2 femoral autograft fixation techniques,namely,interference screws and suture anchors,for isolated medial patellofemoral ligament reconstruction in ...Purpose:The present study aimed to systematically review and compare 2 femoral autograft fixation techniques,namely,interference screws and suture anchors,for isolated medial patellofemoral ligament reconstruction in patients with recurrent patellofemoral instability at mid-to long-term follow-up.Methods:A literature search was performed in September 2020.All studies reporting the outcomes of primary isolated medial patellofemoral ligament reconstruction for recurrent patellofemoral instability were considered for inclusion.Only studies reporting the type of femoral autograft fixation under examination were considered.Studies reporting data from patients with elevated tibial tuberosity-tibial groove,patella alta,and/or Dejour’s trochlear dysplasia types C and D,were not included.Only articles reporting data with a minimum follow-up period of 18 months were considered.Results:Data from 19 studies(615 patients)were retrieved.The overall age was 24.4±6.7 years(mean±SD).The mean follow-up was 46.5±20.9 months.There were 76 patients in the anchor group and 539 in the screw group.Comparability was found with regard to age and follow-up duration between the 2 study groups.There was comparability between the Kujala,Lysholm,and Tegner scores at baseline.At the last follow-up,no worthy differences were found in terms of mean Kujala(+2.1%;p=0.04),Lysholm(+1.7%;p=0.05),and Tegner(+15.8%;p=0.05)scores.Although complications occurred almost exclusively in the screw cohort,no statistically significant difference was found.Conclusion:Femoral autograft fixation through interference screws or suture anchors report similar clinical scores and rate of apprehension test,persistent joint instability,re-dislocations,and revisions.These results must be interpreted within the limitations of the present study.展开更多
Objective To compare the efficacy of 3 internal fixations,locking proximal femoral plate (LPFP),ASI-AN IMHS and InterTAN,for intertrochanteric femoral fractures in elderly patients.Methods A retrospective study was do...Objective To compare the efficacy of 3 internal fixations,locking proximal femoral plate (LPFP),ASI-AN IMHS and InterTAN,for intertrochanteric femoral fractures in elderly patients.Methods A retrospective study was done to analyse展开更多
Bone screws encounter complex mechanical environment in fracture fixation of weight-bearing bone.In the present study, high-purity magnesium（HP Mg） screws were applied in fixation of rabbit femoral intracondylar fra...Bone screws encounter complex mechanical environment in fracture fixation of weight-bearing bone.In the present study, high-purity magnesium（HP Mg） screws were applied in fixation of rabbit femoral intracondylar fracture with 3 mm gap. In the control group, HP Mg screws of the same design were implanted at corresponding position of contralateral leg. At 4, 8 and 16 weeks after surgery, retrieved femurs went through micro-computed tomography（micro-CT） scanning and hard tissue processing. Under mechanical stress involved in fracture fixation, bending of screw bolt was observed at the portion exposed to facture gap at 4 weeks. Then local corrosion at the same portion was detected 16 weeks after surgery,which indicated the accumulation effect of mechanical stress on Mg corrosion. HP Mg screws in the fracture group had no significant difference with the control group in screw volume, surface area, surfaceto-volume ratio（S/V）. And peri-implant bone volume/tissues volume（BV/TV） and bone volume density（BMD） in the fracture group was comparable to that in the control group. Furthermore, histological analysis showed new formed bone tissues in fracture gap and fracture healing 16 weeks after surgery. Under mechanical stress, HP Mg screw suffered bolt bending and local corrosion at the portion exposed to fracture gap. But it had no influence on the integral corrosion behaviors, osseointegration of HP Mg screw and the fracture healing. Therefore, HP Mg screws possessed good potential in fracture fixation of weightbearing bones.展开更多
The femoral neck in children is much stronger than that in adults and can only be fractured by a severe force. It is therefore rare and often associated with severe injury once it takes place. Besides, as the blood su...The femoral neck in children is much stronger than that in adults and can only be fractured by a severe force. It is therefore rare and often associated with severe injury once it takes place. Besides, as the blood supply to the femoral head is precarious, the fracture can lead to a high incidence of post-traumatic avascular necrosis of the femoral head.^(1,2) So, much attention should be paid to the treatment of femoral fractures in children. The authors have successfully cured an old femoral neck fracture of a girl by open reduction and internal fixation with 3 Kirschner wires supplemented by an external fixator across the hip joint and cancellous allograft at the fracture site. The patient has gotten a satisfactory functional recovery of the hip.展开更多
文摘Purpose:The present study aimed to systematically review and compare 2 femoral autograft fixation techniques,namely,interference screws and suture anchors,for isolated medial patellofemoral ligament reconstruction in patients with recurrent patellofemoral instability at mid-to long-term follow-up.Methods:A literature search was performed in September 2020.All studies reporting the outcomes of primary isolated medial patellofemoral ligament reconstruction for recurrent patellofemoral instability were considered for inclusion.Only studies reporting the type of femoral autograft fixation under examination were considered.Studies reporting data from patients with elevated tibial tuberosity-tibial groove,patella alta,and/or Dejour’s trochlear dysplasia types C and D,were not included.Only articles reporting data with a minimum follow-up period of 18 months were considered.Results:Data from 19 studies(615 patients)were retrieved.The overall age was 24.4±6.7 years(mean±SD).The mean follow-up was 46.5±20.9 months.There were 76 patients in the anchor group and 539 in the screw group.Comparability was found with regard to age and follow-up duration between the 2 study groups.There was comparability between the Kujala,Lysholm,and Tegner scores at baseline.At the last follow-up,no worthy differences were found in terms of mean Kujala(+2.1%;p=0.04),Lysholm(+1.7%;p=0.05),and Tegner(+15.8%;p=0.05)scores.Although complications occurred almost exclusively in the screw cohort,no statistically significant difference was found.Conclusion:Femoral autograft fixation through interference screws or suture anchors report similar clinical scores and rate of apprehension test,persistent joint instability,re-dislocations,and revisions.These results must be interpreted within the limitations of the present study.
文摘Objective To compare the efficacy of 3 internal fixations,locking proximal femoral plate (LPFP),ASI-AN IMHS and InterTAN,for intertrochanteric femoral fractures in elderly patients.Methods A retrospective study was done to analyse
基金supported by the National Natural Science Foundation of China (Nos. 51271117 and 81371935)the Biomedical Program of Science and Technology Innovation Project supported by Shanghai (Nos. 14441901800 and 14441901802)
文摘Bone screws encounter complex mechanical environment in fracture fixation of weight-bearing bone.In the present study, high-purity magnesium（HP Mg） screws were applied in fixation of rabbit femoral intracondylar fracture with 3 mm gap. In the control group, HP Mg screws of the same design were implanted at corresponding position of contralateral leg. At 4, 8 and 16 weeks after surgery, retrieved femurs went through micro-computed tomography（micro-CT） scanning and hard tissue processing. Under mechanical stress involved in fracture fixation, bending of screw bolt was observed at the portion exposed to facture gap at 4 weeks. Then local corrosion at the same portion was detected 16 weeks after surgery,which indicated the accumulation effect of mechanical stress on Mg corrosion. HP Mg screws in the fracture group had no significant difference with the control group in screw volume, surface area, surfaceto-volume ratio（S/V）. And peri-implant bone volume/tissues volume（BV/TV） and bone volume density（BMD） in the fracture group was comparable to that in the control group. Furthermore, histological analysis showed new formed bone tissues in fracture gap and fracture healing 16 weeks after surgery. Under mechanical stress, HP Mg screw suffered bolt bending and local corrosion at the portion exposed to fracture gap. But it had no influence on the integral corrosion behaviors, osseointegration of HP Mg screw and the fracture healing. Therefore, HP Mg screws possessed good potential in fracture fixation of weightbearing bones.
文摘The femoral neck in children is much stronger than that in adults and can only be fractured by a severe force. It is therefore rare and often associated with severe injury once it takes place. Besides, as the blood supply to the femoral head is precarious, the fracture can lead to a high incidence of post-traumatic avascular necrosis of the femoral head.^(1,2) So, much attention should be paid to the treatment of femoral fractures in children. The authors have successfully cured an old femoral neck fracture of a girl by open reduction and internal fixation with 3 Kirschner wires supplemented by an external fixator across the hip joint and cancellous allograft at the fracture site. The patient has gotten a satisfactory functional recovery of the hip.
