ABSTRACT
Abstract@#The physical health of children and adolescents has received widespread attention in recent years, and a series of problems due to unbalanced energy expenditure have come into focus. Energy expenditure in children and adolescents is influenced by multiple factors including body composition and physical activity level. By analyzing and summarizing the characteristics and specificities of energy expenditure in children and adolescents at different ages, the review aims to formulate a targeted design and implementation plans for future intervention studies.
ABSTRACT
Objective:To evaluate the emergency iliosacral screw fixation assisted by TiRobot for unstable posterior pelvic ring fracture.Methods:The 26 patients with unstable pelvic fracture were analyzed retrospectively who had undergone emergency iliosacral screw fixation at Department of Orthopedics & Traumatology, Beijing Jishuitan Hospital from June 2018 to December 2020. They were divided into 2 groups depending on whether orthopaedic TiRobot was used to assist screw insertion. In the observation group of 14 cases subjected to TiRobot-assisted insertion of iliosacral screws, there were 10 males and 4 females with an age of (45.9 ± 10.1) years; in the control group of 12 cases subjected to conventional manual insertion of iliosacral screws, there were 9 males and 3 females with an age of (49.2 ± 11.3) years. All the surgeries were conducted within 24 hours after injury. The 2 groups were compared in terms of screw insertion time, pin insertion, intraoperative blood loss, fluoroscopy time, postoperative screw position, fracture reduction and Harris hip score at the final follow-up.Results:The 2 groups were comparable because there was no significant difference between them in their preoperative general clinical data or follow-up time ( P>0.05). The screw insertion time [(16.1 ± 3.4) min] and fluoroscopy time [(8.1 ± 3.3) s] in the observation group were significantly shorter than those in the control group [(26.4 ± 5.4) min and (25.2 ± 7.4) s], and the pin insertions [1 (1, 2) times] and intraoperative blood loss [(10.5 ± 6.4) mL] in the former were significantly less than those in the latter [6 (3, 8) times and (24.8 ± 6.7) mL] (all P<0.05). Postoperatively, the sacroiliac screw position was excellent in 18 cases and good in 2 in the observation group while excellent in 14 cases, good in 2 and poor in 2 in the control group; the fracture reduction was excellent in 12 cases, good in one and fair in one in the observation group while excellent in 10 cases, good in one and fair in one in the control group, showing insignificant differences in the above comparisons ( P>0.05). There was no significant difference either in the Harris hip score at the final follow-up between the 2 groups ( P>0.05). Conclusion:Compared with conventional manual insertion of iliosacral screws, emergency iliosacral screw fixation assisted by TiRobot can effectively decrease surgical time and reduce operative invasion due to a higher accuracy rate of screw insertion.
ABSTRACT
Objective:To identify the risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection.Methods:The clinical data of pediatric patients with congenital scoliosis who underwent posterior hemivertebra resection in our hospital from May 2017 to July 2019 were collected.The children were divided into group A (massive blood loss, blood loss/blood volume ≥30%) and group B (non-massive blood loss, blood loss/blood volume <30%) according to intraoperative blood loss.Logistic regression analysis was used to stratify the risk factors.Results:A total of 108 pediatric patients were enrolled in the study including 29 cases in group A and 79 cases in group B, respectively.There were significant differences in the preoperative Cobb angle, body mass index, the number of fused levels, the number of screws and operative time between the two groups ( P<0.05). Logistic regression analysis showed that the preoperative Cobb angle, operative time, the number of fused levels and body mass index were the risk factors for intraoperative massive blood loss ( P<0.05). Conclusion:Lower BMI, larger Cobb angle, increased operative time and more fused levels are the risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection.
ABSTRACT
Objective To compare the clinical outcome of internal fixation(IF)and total hip arthroplasty (THA)for the elderly patients with displaced femoral neck fracture. Methods A total of 128 patients with dis-placed femoral neck fracture admitted from January 2010 to December 2012 were selected and divided into IF group(61 cases)and THA group(67 cases). The operation and hospitalization index were compared between the 2 groups. All patients underwent follow-ups after operation. The functional recovery scale for hip fracture (FRS) and EQ-5D index were applied to evaluate the clinical outcomes periodically. Results Compared to THA group, the intraoperative trauma ,operation time and bed days were less in IF group(P0.05). Follow-ups at all time points revealed hip function in THE group is better than that in IF group(P 0.05). Within 3 years,the costs related to fracture were 41772 yuan for IF group and 61174 yuan for THA group respectively. Conclusion Both internal fixation and total hip arthroplasty can provide satisfactory outcome for elderly patients with displaced femoral neck fracture. Compared with IF ,THA causes bigger trauma and costs more ,but ends up with lower complication incidences ,and improve hip function in a shorter period.
ABSTRACT
Objective:To analyze the clinical parameters of the patients with femoral neck fracture such as general condition,therapy method,hospitalized expense so as to provide more effective management plan for the clinical work.Methods:The patients with femoral neck fracture above 50 years who received in-patient treatment from 2008 January to 2012 December were admitted into this study.We collected and analyzed the information,such as age,chronic medical disease,therapy method,hospitalized duration and expense and so on.Results:There were 1 794 femoral neck fracture patients above 50 years (male/female=1/2.06)in our hospital in recent 5 years and the annual average rate of increase was 7.3%. The average age of the patients was (69.9 ±10.7)years and the annual average rate of increase was 0.6%.The chronic medical disease diagnosis ratio was 55.0%.The average waiting time for operation was (6.8 ±4.2)days and the average hospitalized duration was (12.9 ±4.9)days which showed down-ward trend in recent years. The most popular operations were cannulated screw internal fixation (41.8%)and artificial femoral head replacement (34.1%).In the study,146 cases (7.9%)received nonsurgical treatment which showed downward trend.The average hospitalized expense was (35 075 .7 ± 1 1 343.2)yuan which showed no obvious change in recent years.The cost for the females was more than that for the males.The expense for hemiarthroplasty and total hip arthroplasty increased while that for cannulated screw internal fixation decreased gradually.Conclusion:The cannulated screw internal fixa-tion and artificial femoral head replacement were the most important operations for the patients with femo-ral neck fracture.The number and the average age of the patients were on the rise while the expense showed no obvious change in recent years.
ABSTRACT
Objective To evaluate the mid‐term efficacy of microendoscopic discectomy (MED) and microsurgical lumbar discectomy (MSLD) for treating lumbar disc herniation (LDH) .Methods 98 patients with single segment LDH in the Orthopedic department of the Second Hospital of Lanzhou University from March 2009 to April 2010 were divided into 2 groups ,including 44 cases undergoing MED and 54 cases undergoing MSLD .The operative efficacies were assessed by the visual analogue scale (VAS) , Japanese Orthopedic Association (JOA) scores and Oswestry Disability Index (ODI) .Results There were statistically significant differences in the skin incision length ,amount of intraoperative blood loss and time of returning to work between the two groups (P0 .05) .The mean follow‐up duration was 49 .13 months in the MED group and 47 .24 months in the MSLD group respectively .At the last follow‐up the postoperative back and leg pain VAS scores ,JOA scores and ODI in each group were signifi‐cantly improved compared with the preoperative data (P<0 .01) .However ,there were no statistically significant differences in the intergroup comparison .Conclusion MED and MSLD are the effective methods for treating single segment LDH .However ,MED has less trauma and early out‐of‐bed ambulation ,is an ideal minimally invasive surgery .