Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current rev...Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current review aims to compare the outcomes of adult tibia fractures treated with solid nails to those treated with hollow nails. Methods: A search on Scopus, PubMed, and Cochrane Library, using three keywords (Outcome, Tibia shaft fractures, Nail) was conducted in April 2023. Results were compiled and two independent reviewers screened and selected eligible articles After removing duplicates, titles and abstracts were read to exclude ineligible studies. Full-text articles of the remaining papers were read to select eligible studies which were further critically appraised to ascertain their methodological quality. The data extracted from the selected papers were synthesized using a combination of pooling of results, tests of statistical difference (t-test and chi-square) and narrative synthesis methods. Results: A total of 2295 articles were obtained from the databases and citation searching. A total of 9 papers were identified as eligible and included in the review. Findings revealed that there is no statistical difference in the outcomes of tibia fractures treated with either solid or hollow nail groups such as duration of surgery (p = 0.541), rate of delayed and non-union (p = 0.342), and rate of surgical site infections (p = 0.395). Conclusion: Intramedullary nailing of tibia shaft fractures with either solid or hollow nails have similar functional outcomes.展开更多
BACKGROUND Femoral lengthening is a procedure of great importance in the treatment of congenital and acquired limb deficiencies.Technological advances have led to the latest designs of fully implantable motorized intr...BACKGROUND Femoral lengthening is a procedure of great importance in the treatment of congenital and acquired limb deficiencies.Technological advances have led to the latest designs of fully implantable motorized intramedullary lengthening nails.The use of these nails has increased over the last few years.AIM To review and critically appraise the literature comparing the outcome of femoral lengthening in children using intramedullary motorized lengthening nails to external fixation.METHODS Electronic databases(MEDLINE,CINAHL,EMBASE,Cochrane)were systematically searched in November 2019 for studies comparing the outcome of femoral lengthening in children using magnetic lengthening nails and external fixation.The outcomes included amount of gained length,healing index,complications and patient reported outcomes.RESULTS Of the 452 identified studies,only two(retrospective and non-randomized)met the inclusion criteria.A total of 91 femora were included.In both studies,the age of patients treated with nails ranged from 15 to 21 years compared to 9 to 15 years for patients in the external fixation group.Both devices achieved the target length.Prevalence of adverse events was less in the nail(60%-73%)than in the external fixation(81%-100%)group.None of the studies presented patient reported outcomes.CONCLUSION The clinical effectiveness of motorized nails is equivalent or superior to external fixation for femoral lengthening in young patients.The available literature is limited and does not provide evidence on patient quality of life or cost effectiveness of the interventions.展开更多
In recent times,there had been reported cases of Pb poisoning in Anka gold mining area,Northwest Nigeria.Therefore,this study was carried out to determine the extent of bioaccumulation of heavy metals in the hairs and...In recent times,there had been reported cases of Pb poisoning in Anka gold mining area,Northwest Nigeria.Therefore,this study was carried out to determine the extent of bioaccumulation of heavy metals in the hairs and nails of children in the area.Forty samples(twenty nails and twenty hairs)samples were collected from ten boys and ten girls of ages 5–9 residing in the area.To ascertain the sources of heavy metals in children,15 soils samples,15 groundwater samples,5 samples of mine tailings,and 5 plants samples were collected.Hair and nails of the subjects were collected using internationally acceptable techniques.All samples were kept in uncontaminated ziplock bags prior to laboratory preparation and analysis.The samples were cleaned using nonionic detergent(triton X-100)and deionized water.The hairs and nails were digested with 10 mL of 6:1 mixture of nitric acid and perchloric acid.The soils,mine tailings,and plants were air-dried at room temperature,sieved,and chemically digested using the aqua regia method.The concentrations of metals in all the samples were determined using highperformance liquid chromatography–inductively coupled plasma–mass spectrometry.Statistical analysis was employed to unravel potential sources of metals in the media.Results showed that heavy metals in children of the area are above results from similar studies and pathological ranges for heavy metals in hairs and nails.Also,heavy metals in environmental media are above the recommended standards.Multivariate analysis showed that the metals are mainly from mining and other anthropogenic sources.Results of correlation between heavy metals in hairs and nails with those in geological samples revealed that heavy metal that bioaccumulates in the children of this area are mostly from contaminated environmental media.It is recommended that complete remediation and effective health education be carried out in the area.展开更多
Tests of the capacity of shear connections consisting of nails in a row placed at distances 7, 10 and 14d, “d” being the cross-sectional dimension of the nail, versus single nail capacities, were executed. The perfo...Tests of the capacity of shear connections consisting of nails in a row placed at distances 7, 10 and 14d, “d” being the cross-sectional dimension of the nail, versus single nail capacities, were executed. The performed tests do support the connotation that no reduction should be required for nails of diameter 2.8 mm or less in a row, provided that nails are spaced sufficiently far apart for wood cracking not to occur. At the ultimate capacity of the joint, all such thin nails in a row will be yielding, having developed plastic hinges, i.e. each single nail will have developed its ultimate capacity. Hence, the ultimate capacity of the connection will be each nail’s capacity times the number of nails in the row. The force pr. nail increases subsequent to the development of a plastic hinge. This is likely due to the axial pullout-force, i.e. the ultimate capacity of a shear connection is higher than the force required for developing plastic hinges in the nails. This additional capacity-reserve may also partly be attributed to the rotational resistance of nails. The number of nails in a row should make insignificant difference in the pr. nail capacity, as long as no wood cracking takes place. Thus, applying elastic theory to nails in a row does not seem relevant. This is in contrast to bolt-connections.展开更多
Objective: To report 32 cases of femur supracondylar fracture treated with retrograde interlocking intramedullary nails in elderly patients. Methods: According to the AO classification, all of 32 cases were classifi...Objective: To report 32 cases of femur supracondylar fracture treated with retrograde interlocking intramedullary nails in elderly patients. Methods: According to the AO classification, all of 32 cases were classified as extra-articular type A. 32 cases were treated with interlocking intramedullary nail by closed insertion from intercondylar fossa of the knee. All cases accepted CPM exercise as early as possible after operation. Results: Following up 5 to 15 months, all fractures united within an average duration of 5.3 months (4-7 months). According to the Shelbourne scale, the excellent rate of the knee function was 86.3%. Conclusion: Retrograde interlocking intramedullary nail is useful alternative implant for the treatment of osteoporotic supracondylar fracture of femur, particularly of the type A fracture in the elderly population. Its merits include stable fixation, high rate of fracture union and few complications.展开更多
In the present work, elements concentration in fingernails samples of volunteers of different ages (males, females) were determined using atomic absorption spectroscopy (AAS) Perkin-Elmer, spectrophotometer. Fingernai...In the present work, elements concentration in fingernails samples of volunteers of different ages (males, females) were determined using atomic absorption spectroscopy (AAS) Perkin-Elmer, spectrophotometer. Fingernails samples of different groups were analyzed to determine the trace elements Ca, Mg, Mn, Fe, Ni, Cu, Co, Zn and Pb. Standards materials were prepared for concentration assessment that adjacent to samples from two cities in different location in eastern province of Sudan for elements concentrations finding. In addition, samples of hands fingernails and toenails were analyzed for comparison and method validation. Consequently, the significant levels of elements concentration in nails samples of Jabiat residents compared to Port Sudan resident’s area due to soil dispersion are supporting the possibility of external contamination. The data of component matrix and rotated component matrix of varimax normalization using principal component analysis revealed important predictors of nails elements Mg, Mn, Fe, Cu and Zn concentrations in soil of both areas under study. However, the Pb, Ni, Ca, and Co are possible to be indication of different sources associated with environmental contamination. The significant correlation and principal component analysis of the elements of nails concentrations in the two categories supported the probability of different expose environmental contamination.展开更多
A systematic, accurate and robust evaluating method for fine pitch printed circuit board (PCB) positioning assessment in testing fixture is developed. Targeting reliability of bed-of-nails tester is successfully eva...A systematic, accurate and robust evaluating method for fine pitch printed circuit board (PCB) positioning assessment in testing fixture is developed. Targeting reliability of bed-of-nails tester is successfully evaluated by the 2D pattern transform. Probe offset vector with its Weibull and Gaussian distribution estimates are obtained for further investigation about the causes of misalignment on the basis of a batch tests for same kind of PCBs.展开更多
BACKGROUND Proximal femoral nails(PFNs)are the most common method for the treatment of unstable intertrochanteric femoral fractures(IFFs),but postoperative bed rest is required.There is a large amount of blood loss du...BACKGROUND Proximal femoral nails(PFNs)are the most common method for the treatment of unstable intertrochanteric femoral fractures(IFFs),but postoperative bed rest is required.There is a large amount of blood loss during the operation.Osteoporosis in elderly patients may cause nonunion of fractures and other complications.Arthroplasty can give patients early weight bearing and reduce financial burden,but whether it can replace PFNs remains controversial.AIM To compare the clinical outcomes of arthroplasty and PFNs in the treatment of unstable IFFs in elderly patients.METHODS A search was conducted in the PubMed,Embase,and Cochrane Library databases and included relevant articles comparing arthroplasty and PFN.The search time was limited from January 1,2005 to November 1,2020.Two investigators independently screened studies,extracted data and evaluated the quality according to the inclusion and exclusion criteria.According to the research results,the fixed effect model or random effect model were selected for analysis.The following outcomes were analyzed:Harris Hip score,mortality,complications,operation time,blood loos,hospital stay,weight-bearing time,fracture classification and type of anesthesia.RESULTS We analyzed four randomized controlled trials that met the requirements.A total of 298 patients were included in these studies.According to the AO/OTA classification,there are 20 A1 types,136 A2 types,42 A3 types and 100 unrecorded types.Primary outcome:The Harris Hip Score at the final follow-up of the PFN group was higher[mean difference(MD):9.01,95%confidence interval(CI):16.57 to 1.45),P=0.02].There was no significant difference between the two groups in the rate of overall mortality[risk ratio(RR):1.44,P=0.44]or the number of complications(RR:0.77,P=0.05).Secondary outcomes:blood loss of the arthroplasty group was higher(MD:241.01,95%CI:43.06–438.96,P=0.02);the operation time of the PFN group was shorter(MD:23.12,95%CI:10.46–35.77,P=0.0003);and the length of hospital stay of the arthroplasty group was shorter[MD:0.97,95%CI:1.29 to 0.66),P<0.00001].There was no difference between the two groups in the type of anesthesia(RR:0.99).There were only two studies recording the weight-bearing time,and the time of full weight bearing in the arthroplasty group was significantly earlier.CONCLUSION Compared with PFN,arthroplasty can achieve weight bearing earlier and shorten hospital stay,but it cannot achieve a better clinical outcome.Arthroplasty cannot replace PFNs in the treatment of unstable IFFs in elderly individuals.展开更多
Objective:To compare the outcomes of dynamic hip screws(DHS)and intramedullary nailing(IMN)in the treatment of extra-capsular metastatic carcinoma of the proximal femur.Methods:A retrospective case analysis method was...Objective:To compare the outcomes of dynamic hip screws(DHS)and intramedullary nailing(IMN)in the treatment of extra-capsular metastatic carcinoma of the proximal femur.Methods:A retrospective case analysis method was used to examine data of patients with proximal metastatic cancer of the femur who were treated with internal fixation in Department of Orthopaedics,Beijing Friendship Hospital,from January 2007 to December 2018.Blood loss,postoperative pain,functional score,length of stay,and survival rates were compared,and postoperative complications were assessed.Results:Complete follow-up data were available for 33 patients.The mean follow-up period was 12.2±3.6(range:9-32)months and the average age was 72.3±4.7(range:59-83)years old.There were 20 females and 13 males.Twenty-three patients had undergone IMN and 10 DHS,according to bone defects and the patient’s overall condition.The median survival time was 10 months in the IMN group and 11 months in the DHS group.Duration of surgery(t=-7.366,P<0.001)and length of hospital stay(t=-3.509,P<0.001)differed significantly between the two groups.There was one case of breakage of internal fixation in the IMN group.Conclusions:There was no significant difference between DHS and IMN in terms of surgical efficacy.IMN and DHS were different in terms of surgical time and hospital stay.However,due to the limited number of cases in this study,multi-factor analysis has not been performed and needs to be further verified in future analysis.When developing a surgical plan,it is recommended to consider the patient’s condition and the surgeon’s experience.展开更多
The aim of this article was to report a case of toe nails disorder associated with metformin use in an elderly patient with type2diabetes. Two years ago, after receiving metformin 0.5 g three times daily for 6 months,...The aim of this article was to report a case of toe nails disorder associated with metformin use in an elderly patient with type2diabetes. Two years ago, after receiving metformin 0.5 g three times daily for 6 months, a 60-year-old Chinese man found his ten toe nails gradually thickened and yellowed (especially two thumbs). The symptoms improved and recovered after metformin discontinuance. Half year ago, metformin 0.5 g three times daily adopted again and toe nails disorder occurred again. Physician modified the therapy plan and replaced metformin with acarbose to control blood glucose level of this patient. According to the follow up 3 months after his discharge, ten toe nails recovered significantly and new parts of the nails were normal. Nail disorder was rarely reported in the worldwide, but the physicians should keep awareness of this adverse drug reaction (ADR), proper actions should be taken once it occurred to avoid unnecessary suffering of the patient.展开更多
Background: Management of femoral diaphyseal fractures in the age group 616 years is controversial. There has been a resurgence worldwide for operative fixation. Material and methods: Twenty children (15 boys, 5 girls...Background: Management of femoral diaphyseal fractures in the age group 616 years is controversial. There has been a resurgence worldwide for operative fixation. Material and methods: Twenty children (15 boys, 5 girls) aged 616 years with femoral diaphyseal fractures (20 fractures, one in each) were stabilized with Titanium Elastic Nail (TEN). Patients underwent surgery within ten days of their injury. The results were evaluated using Flynn’s Scoring Criteria.Two nails were used in each fracture. Results: All 20 patients were available for evaluation and follow up for a mean duration of 24 months (1532 months). Radiological union in all cases was achieved in a mean time of 8 weeks. Full weight bearing was possible in a mean time of 10 weeks (812 weeks). The results were excellent in 14 patients (70%) and successful in 6 patients (30%). Few complications that occurred were infection (in 2 cases), knee joint stiffness(in 4 cases), angulation less than 10 degrees( in 4 cases), shortening less than 10 mm(in 4 cases). Conclusion: Intramedullary fixation by TEN is an effective treatment of fracture of femur in properly selected patients of the 616 years age group.展开更多
Surgical management of femoral shaft fractures with intramedullary nails has become the standard ofcare,with multiple options for entry point described,including piriformis entry,trochanter entry andretrograde femoral...Surgical management of femoral shaft fractures with intramedullary nails has become the standard ofcare,with multiple options for entry point described,including piriformis entry,trochanter entry andretrograde femoral nails.Our present review describes the surgical anatomy of the proximal and distalfemur and its relation to different entry points for intramedullary femoral nails.In addition,we reviewedrelative indications for each technique,difficulties associated and possible complications.展开更多
文摘Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current review aims to compare the outcomes of adult tibia fractures treated with solid nails to those treated with hollow nails. Methods: A search on Scopus, PubMed, and Cochrane Library, using three keywords (Outcome, Tibia shaft fractures, Nail) was conducted in April 2023. Results were compiled and two independent reviewers screened and selected eligible articles After removing duplicates, titles and abstracts were read to exclude ineligible studies. Full-text articles of the remaining papers were read to select eligible studies which were further critically appraised to ascertain their methodological quality. The data extracted from the selected papers were synthesized using a combination of pooling of results, tests of statistical difference (t-test and chi-square) and narrative synthesis methods. Results: A total of 2295 articles were obtained from the databases and citation searching. A total of 9 papers were identified as eligible and included in the review. Findings revealed that there is no statistical difference in the outcomes of tibia fractures treated with either solid or hollow nail groups such as duration of surgery (p = 0.541), rate of delayed and non-union (p = 0.342), and rate of surgical site infections (p = 0.395). Conclusion: Intramedullary nailing of tibia shaft fractures with either solid or hollow nails have similar functional outcomes.
基金Supported by Children’s Hospital Charity and Industry(Nuvasive,CA,United States),No.5431.
文摘BACKGROUND Femoral lengthening is a procedure of great importance in the treatment of congenital and acquired limb deficiencies.Technological advances have led to the latest designs of fully implantable motorized intramedullary lengthening nails.The use of these nails has increased over the last few years.AIM To review and critically appraise the literature comparing the outcome of femoral lengthening in children using intramedullary motorized lengthening nails to external fixation.METHODS Electronic databases(MEDLINE,CINAHL,EMBASE,Cochrane)were systematically searched in November 2019 for studies comparing the outcome of femoral lengthening in children using magnetic lengthening nails and external fixation.The outcomes included amount of gained length,healing index,complications and patient reported outcomes.RESULTS Of the 452 identified studies,only two(retrospective and non-randomized)met the inclusion criteria.A total of 91 femora were included.In both studies,the age of patients treated with nails ranged from 15 to 21 years compared to 9 to 15 years for patients in the external fixation group.Both devices achieved the target length.Prevalence of adverse events was less in the nail(60%-73%)than in the external fixation(81%-100%)group.None of the studies presented patient reported outcomes.CONCLUSION The clinical effectiveness of motorized nails is equivalent or superior to external fixation for femoral lengthening in young patients.The available literature is limited and does not provide evidence on patient quality of life or cost effectiveness of the interventions.
基金sponspored by research opening fund of State Key Laboratory of Environmental Geochemistry,Guiyang,Guizhou Province,China with grant No.SKLEG2017910。
文摘In recent times,there had been reported cases of Pb poisoning in Anka gold mining area,Northwest Nigeria.Therefore,this study was carried out to determine the extent of bioaccumulation of heavy metals in the hairs and nails of children in the area.Forty samples(twenty nails and twenty hairs)samples were collected from ten boys and ten girls of ages 5–9 residing in the area.To ascertain the sources of heavy metals in children,15 soils samples,15 groundwater samples,5 samples of mine tailings,and 5 plants samples were collected.Hair and nails of the subjects were collected using internationally acceptable techniques.All samples were kept in uncontaminated ziplock bags prior to laboratory preparation and analysis.The samples were cleaned using nonionic detergent(triton X-100)and deionized water.The hairs and nails were digested with 10 mL of 6:1 mixture of nitric acid and perchloric acid.The soils,mine tailings,and plants were air-dried at room temperature,sieved,and chemically digested using the aqua regia method.The concentrations of metals in all the samples were determined using highperformance liquid chromatography–inductively coupled plasma–mass spectrometry.Statistical analysis was employed to unravel potential sources of metals in the media.Results showed that heavy metals in children of the area are above results from similar studies and pathological ranges for heavy metals in hairs and nails.Also,heavy metals in environmental media are above the recommended standards.Multivariate analysis showed that the metals are mainly from mining and other anthropogenic sources.Results of correlation between heavy metals in hairs and nails with those in geological samples revealed that heavy metal that bioaccumulates in the children of this area are mostly from contaminated environmental media.It is recommended that complete remediation and effective health education be carried out in the area.
文摘Tests of the capacity of shear connections consisting of nails in a row placed at distances 7, 10 and 14d, “d” being the cross-sectional dimension of the nail, versus single nail capacities, were executed. The performed tests do support the connotation that no reduction should be required for nails of diameter 2.8 mm or less in a row, provided that nails are spaced sufficiently far apart for wood cracking not to occur. At the ultimate capacity of the joint, all such thin nails in a row will be yielding, having developed plastic hinges, i.e. each single nail will have developed its ultimate capacity. Hence, the ultimate capacity of the connection will be each nail’s capacity times the number of nails in the row. The force pr. nail increases subsequent to the development of a plastic hinge. This is likely due to the axial pullout-force, i.e. the ultimate capacity of a shear connection is higher than the force required for developing plastic hinges in the nails. This additional capacity-reserve may also partly be attributed to the rotational resistance of nails. The number of nails in a row should make insignificant difference in the pr. nail capacity, as long as no wood cracking takes place. Thus, applying elastic theory to nails in a row does not seem relevant. This is in contrast to bolt-connections.
文摘Objective: To report 32 cases of femur supracondylar fracture treated with retrograde interlocking intramedullary nails in elderly patients. Methods: According to the AO classification, all of 32 cases were classified as extra-articular type A. 32 cases were treated with interlocking intramedullary nail by closed insertion from intercondylar fossa of the knee. All cases accepted CPM exercise as early as possible after operation. Results: Following up 5 to 15 months, all fractures united within an average duration of 5.3 months (4-7 months). According to the Shelbourne scale, the excellent rate of the knee function was 86.3%. Conclusion: Retrograde interlocking intramedullary nail is useful alternative implant for the treatment of osteoporotic supracondylar fracture of femur, particularly of the type A fracture in the elderly population. Its merits include stable fixation, high rate of fracture union and few complications.
文摘In the present work, elements concentration in fingernails samples of volunteers of different ages (males, females) were determined using atomic absorption spectroscopy (AAS) Perkin-Elmer, spectrophotometer. Fingernails samples of different groups were analyzed to determine the trace elements Ca, Mg, Mn, Fe, Ni, Cu, Co, Zn and Pb. Standards materials were prepared for concentration assessment that adjacent to samples from two cities in different location in eastern province of Sudan for elements concentrations finding. In addition, samples of hands fingernails and toenails were analyzed for comparison and method validation. Consequently, the significant levels of elements concentration in nails samples of Jabiat residents compared to Port Sudan resident’s area due to soil dispersion are supporting the possibility of external contamination. The data of component matrix and rotated component matrix of varimax normalization using principal component analysis revealed important predictors of nails elements Mg, Mn, Fe, Cu and Zn concentrations in soil of both areas under study. However, the Pb, Ni, Ca, and Co are possible to be indication of different sources associated with environmental contamination. The significant correlation and principal component analysis of the elements of nails concentrations in the two categories supported the probability of different expose environmental contamination.
基金This project is supported by US Pennsylvania Dept. of Community & Economic Development(No.20-906-0015)National Natural Science Foundation of China(No.50390064, No.50575230)National Basic Research Program of China(973 Program, No.2003CB716202).
文摘A systematic, accurate and robust evaluating method for fine pitch printed circuit board (PCB) positioning assessment in testing fixture is developed. Targeting reliability of bed-of-nails tester is successfully evaluated by the 2D pattern transform. Probe offset vector with its Weibull and Gaussian distribution estimates are obtained for further investigation about the causes of misalignment on the basis of a batch tests for same kind of PCBs.
文摘BACKGROUND Proximal femoral nails(PFNs)are the most common method for the treatment of unstable intertrochanteric femoral fractures(IFFs),but postoperative bed rest is required.There is a large amount of blood loss during the operation.Osteoporosis in elderly patients may cause nonunion of fractures and other complications.Arthroplasty can give patients early weight bearing and reduce financial burden,but whether it can replace PFNs remains controversial.AIM To compare the clinical outcomes of arthroplasty and PFNs in the treatment of unstable IFFs in elderly patients.METHODS A search was conducted in the PubMed,Embase,and Cochrane Library databases and included relevant articles comparing arthroplasty and PFN.The search time was limited from January 1,2005 to November 1,2020.Two investigators independently screened studies,extracted data and evaluated the quality according to the inclusion and exclusion criteria.According to the research results,the fixed effect model or random effect model were selected for analysis.The following outcomes were analyzed:Harris Hip score,mortality,complications,operation time,blood loos,hospital stay,weight-bearing time,fracture classification and type of anesthesia.RESULTS We analyzed four randomized controlled trials that met the requirements.A total of 298 patients were included in these studies.According to the AO/OTA classification,there are 20 A1 types,136 A2 types,42 A3 types and 100 unrecorded types.Primary outcome:The Harris Hip Score at the final follow-up of the PFN group was higher[mean difference(MD):9.01,95%confidence interval(CI):16.57 to 1.45),P=0.02].There was no significant difference between the two groups in the rate of overall mortality[risk ratio(RR):1.44,P=0.44]or the number of complications(RR:0.77,P=0.05).Secondary outcomes:blood loss of the arthroplasty group was higher(MD:241.01,95%CI:43.06–438.96,P=0.02);the operation time of the PFN group was shorter(MD:23.12,95%CI:10.46–35.77,P=0.0003);and the length of hospital stay of the arthroplasty group was shorter[MD:0.97,95%CI:1.29 to 0.66),P<0.00001].There was no difference between the two groups in the type of anesthesia(RR:0.99).There were only two studies recording the weight-bearing time,and the time of full weight bearing in the arthroplasty group was significantly earlier.CONCLUSION Compared with PFN,arthroplasty can achieve weight bearing earlier and shorten hospital stay,but it cannot achieve a better clinical outcome.Arthroplasty cannot replace PFNs in the treatment of unstable IFFs in elderly individuals.
基金Capital’s Funds for Health Improvement and Research(No.2018-1-2072)。
文摘Objective:To compare the outcomes of dynamic hip screws(DHS)and intramedullary nailing(IMN)in the treatment of extra-capsular metastatic carcinoma of the proximal femur.Methods:A retrospective case analysis method was used to examine data of patients with proximal metastatic cancer of the femur who were treated with internal fixation in Department of Orthopaedics,Beijing Friendship Hospital,from January 2007 to December 2018.Blood loss,postoperative pain,functional score,length of stay,and survival rates were compared,and postoperative complications were assessed.Results:Complete follow-up data were available for 33 patients.The mean follow-up period was 12.2±3.6(range:9-32)months and the average age was 72.3±4.7(range:59-83)years old.There were 20 females and 13 males.Twenty-three patients had undergone IMN and 10 DHS,according to bone defects and the patient’s overall condition.The median survival time was 10 months in the IMN group and 11 months in the DHS group.Duration of surgery(t=-7.366,P<0.001)and length of hospital stay(t=-3.509,P<0.001)differed significantly between the two groups.There was one case of breakage of internal fixation in the IMN group.Conclusions:There was no significant difference between DHS and IMN in terms of surgical efficacy.IMN and DHS were different in terms of surgical time and hospital stay.However,due to the limited number of cases in this study,multi-factor analysis has not been performed and needs to be further verified in future analysis.When developing a surgical plan,it is recommended to consider the patient’s condition and the surgeon’s experience.
基金Foundation item: Project(NTF 12015) supported by the Scientific Research Foundation for Talent of Shantou University, China Project(PolyU 5320107E) supported by the Research Grants Committee General Research Fund, China
文摘The aim of this article was to report a case of toe nails disorder associated with metformin use in an elderly patient with type2diabetes. Two years ago, after receiving metformin 0.5 g three times daily for 6 months, a 60-year-old Chinese man found his ten toe nails gradually thickened and yellowed (especially two thumbs). The symptoms improved and recovered after metformin discontinuance. Half year ago, metformin 0.5 g three times daily adopted again and toe nails disorder occurred again. Physician modified the therapy plan and replaced metformin with acarbose to control blood glucose level of this patient. According to the follow up 3 months after his discharge, ten toe nails recovered significantly and new parts of the nails were normal. Nail disorder was rarely reported in the worldwide, but the physicians should keep awareness of this adverse drug reaction (ADR), proper actions should be taken once it occurred to avoid unnecessary suffering of the patient.
文摘Background: Management of femoral diaphyseal fractures in the age group 616 years is controversial. There has been a resurgence worldwide for operative fixation. Material and methods: Twenty children (15 boys, 5 girls) aged 616 years with femoral diaphyseal fractures (20 fractures, one in each) were stabilized with Titanium Elastic Nail (TEN). Patients underwent surgery within ten days of their injury. The results were evaluated using Flynn’s Scoring Criteria.Two nails were used in each fracture. Results: All 20 patients were available for evaluation and follow up for a mean duration of 24 months (1532 months). Radiological union in all cases was achieved in a mean time of 8 weeks. Full weight bearing was possible in a mean time of 10 weeks (812 weeks). The results were excellent in 14 patients (70%) and successful in 6 patients (30%). Few complications that occurred were infection (in 2 cases), knee joint stiffness(in 4 cases), angulation less than 10 degrees( in 4 cases), shortening less than 10 mm(in 4 cases). Conclusion: Intramedullary fixation by TEN is an effective treatment of fracture of femur in properly selected patients of the 616 years age group.
文摘Surgical management of femoral shaft fractures with intramedullary nails has become the standard ofcare,with multiple options for entry point described,including piriformis entry,trochanter entry andretrograde femoral nails.Our present review describes the surgical anatomy of the proximal and distalfemur and its relation to different entry points for intramedullary femoral nails.In addition,we reviewedrelative indications for each technique,difficulties associated and possible complications.