A comparison of three fixations for intertrochanteric femoral fractures in the elderly

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

Comparative Study about Degradation of High-purity Magnesium Screw in Intact Femoral Intracondyle and in Fixation of Femoral Intracondylar Fracture

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.

Cure of an old pediatric femoral neck fracture: a case report

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.

To evaluate the role of platelet-rich plasma in healing of acute diaphyseal fractures of the femur

Purpose： New research is focusing on the use of autologous growth factors to increase the effect of bone fracture healing while decreasing the amount of healing time for the patient. Platelets have been demonstrated to be the natural storage vessel for several growth factors and cytokines that promote blood coagulation, tissue repair, and the process of bone mineralization. The present study aims to evaluate the role of platelet-rich plasma （PRP） in healing of acute femoral shaft fractures radiologically. We hypothesize that it provides artificial hematoma and releases various growth factors. Methods： This prospective randomized study was carried out in 72 patients of traumatic fracture of the femoral shaft operated with interlocking nails （closed or open）. Patients were divided into two groups： study group A （n - 33） treated with intramedullary nailing ＆ PRP injection/gel application in the same setting; and control group B （n - 39） treated with intramedullary nailing without PRP application. Both groups were further divided into two subgroups. Study group included subgroup AI （n = 14） operated with closed intTamedullary nailing and PRP injection at the fracture site under radiological control, and subgroup A2 （n = 19） operated with open intramedullary nailing and PRP gel along with fibrin membrane application at the fracture site; while control group included subgroup B1 （n - 16） operated with closed intramedullary nailing, and subgroup B2 （n -- 23） operated with open intramedullary nailing. Radiological assessment of fracture healing was done by measuring the cortex to callus ratio every month till union at 6 months. Results： Measurements of mean cortex to callus ratio revealed significant difference between the groups A ＆ B at third and fourth months. Measurements of mean cortex to callus ratio did not reveal significant difference between the subgroups at first and sixth months. A statistically significant difference was observed between subgroups A1 ＆ B2 and B1 ＆ B2 at the second month; between subgroups A1 ＆ B2, A2 ＆ B2 and BI ＆ B2 at the third month; and between subgroups A1 ＆ B2 at fourth and fifth months. Conclusion： PRP has no effect on femoral shaft fracture healing treated with closed intramedullary nailing. However, PRP and matrix scaffold provided by fibrin membrane may provide an artificial he- matoma effect in the initial phase of healing in open or failed closed intramedullarv nailing.