Objective:To assess the effect of proximal femur nail anti-rotation on the functional and radiological outcome of unstable intertrochanteric fractures.Methods:This prospective observational study was conducted in the ...Objective:To assess the effect of proximal femur nail anti-rotation on the functional and radiological outcome of unstable intertrochanteric fractures.Methods:This prospective observational study was conducted in the orthopedic department of a tertiary care hospital.Altogether 86 patients with unstable intertrochanteric fractures treated with proximal femur nail anti-rotation between January 2010 and January 2015 were included.Patients were followed in the outpatient clinic at regular intervals after discharge to assess the radiological union of fractures and complications.The functional outcomes were evaluated after 2 years by Harris hip score.Results:All patients achieved a radiological union of fractures after a mean duration of 24.6 weeks.The follow up showed 23 complications(systemic and local).Eight patients developed urinary tract infections,and three patients developed chest infections,two patients had screw cut-out,one patient had knee stiffness,one patient developed superficial surgical site infection,and four patients developed varus collapse and shortening subsequently.The two year follow up showed that 69(80.2%)patients had an excellent and good functional outcome according to Harris hip score.Conclusions:With lower complication rates,proximal femur nail is a valid and reasonable option especially in treating unstable intertrochanteric fractures.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
文摘Objective:To assess the effect of proximal femur nail anti-rotation on the functional and radiological outcome of unstable intertrochanteric fractures.Methods:This prospective observational study was conducted in the orthopedic department of a tertiary care hospital.Altogether 86 patients with unstable intertrochanteric fractures treated with proximal femur nail anti-rotation between January 2010 and January 2015 were included.Patients were followed in the outpatient clinic at regular intervals after discharge to assess the radiological union of fractures and complications.The functional outcomes were evaluated after 2 years by Harris hip score.Results:All patients achieved a radiological union of fractures after a mean duration of 24.6 weeks.The follow up showed 23 complications(systemic and local).Eight patients developed urinary tract infections,and three patients developed chest infections,two patients had screw cut-out,one patient had knee stiffness,one patient developed superficial surgical site infection,and four patients developed varus collapse and shortening subsequently.The two year follow up showed that 69(80.2%)patients had an excellent and good functional outcome according to Harris hip score.Conclusions:With lower complication rates,proximal femur nail is a valid and reasonable option especially in treating unstable intertrochanteric fractures.
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.
