Preliminary clinical outcome of the femur RetroButton combined with glaze allergenic cortical press-fit bolt fixation

Objective To investigate the preliminary clinical outcome of the femur RetroButton combined with glaze allogenic cortical press-fit bolt fixation in ACL reconstruction.Methods A series of 10 patients suffered from ACL ruptures

Treatment of supracondylar nonunions of the femur

To evaluate the result of dynamic condylar screw (DCS) and iliac bone autograft for treating supracondylar nonunions.Methods For 18 supracondylar nonunions,DCS was used as the internal fixation device.For patients with severe osteoporosis or with nonunion site close to the artificial surface,the head of the buttress plate was added,making the screws to fixate easily.Iliac bone autograft including iliac block and scum of spongy bone was used in order to fully arouse the inductive and conductive effect of the graft.Continuous postoperative passive motion (CPM) was performed for a short period,and the active and passive motion were intensively advised for one year long.The cases were followed up from 12 to 70 months (mean 34 months).Results All cases were healed,with average healing time of five months (3～6 months).The motion range for the knee joint was increased from 73 degrees (5～135 degrees) to 97 degrees (30～135 degrees).Excellent and good results were achieved in 13 cases,satisfactory in four and poor in one.Conclusion DCS with rigid fixation and compression effect,combined with porous condylar plate if necessary,with iliac bone autograft and long period of post-operative exercises of the knee joint,provides one efficacious technique for treating the supracondylar non-unions of the femur.11 refs,2 figs.

Comparison of Proximal Femoral Geometry and Risk Factors between Femoral Neck Fractures and Femoral Intertrochanteric Fractures in an Elderly Chinese Population

Background： Few studies have investigated the differences in proximal femoral geometry and risk factors between patients with different types of hip fracture, especially in elderly Chinese. This study aimed to assess the differences in proximal femoral geometry parameters between patients with femoral neck fractures and patients with intertrochanteric fractures to provide guidance for individualized customized prosthesis and accurate reconstruction of proximal femurs in elderly Chinese patients. Methods： We retrospectively studied the electronic medical records of 198 elderly patients over 65 years of age who were admitted to the orthopedic department with hip fractures between January 2017 and December 2017 in The Third Hospital, Hebei Medical University. Age, fracture site, gender, and proximal femoral geometry parameters （.neck shaft angle [NSA], center edge angle [CEA], femoral head diameter [FHD], femoral neck diameter [FND], femoral neck axial length [FNAL], hip axial length [HAL], and femoral shaft diameter [FSD]） were recorded. Student＇s t-test was used to compare the continuous variables, Chi-square test was used to analyze categorical variables, and multiple logistic stepwise regression analysis was used to evaluate the influencing factors of hip fracture type. Results： Statistically significant differences in NSA （137.63 ± 4.56° vs. 132.07 ± 4.17°, t = 1.598, P 〈 0.001）, CEA （37.62 ± 6.77° vs. 43.11 ±7.09°, t = 5.597, P 〈 0.001 ）, FND （35.21 ± 3.25 mm vs. 34.09 ±3.82 mm, t = 2.233, P = 0.027）, and FNAL （99.30 ± 7.91 mm vs. 103.58± 8.39 ram, t = 3.715, P 〈 0.001 ） were found between the femoral neck fracture group and femoral intertrochanteric fracture group. FHD, FND, FSD, HAL, and FNAL were different between sexes （all P 〈 0.001 ）. The greater NSA was the risk factor for femoral neck fractures （,odds ratio [OR]： 0.70, P 〈 0.001 ）, greater CEA and longer FNAL were risk factors for femoral intertrochanteric fractures （OR： 1.15, 1.17, all P 〈 0.001）, and greater FND was a protective factor for femoral intertrochanteric fractures （OR： 0.74, P 〈 0.001）. Conclusions： We demonstrate differences in geometric morphological parameters of the proximal femur in different hip fracture types, as well as an effect of sex. These differences should he considered in the selection of prostheses for fracture internal fixation and hip replacements. These data could help guide the design of individualized customized prostheses and improve the accurate reconstruction of the proximal femur for elderly Chinese hip fracture patients.