ABSTRACT
BACKGROUND: At present, the treatment methods for intertrochanteric fracture of the femur in the aged are in two ways: Intramedullary fixation and extramedullary fixation. The advantages of intramedullary fixation with simple operation, small trauma and few complications have become the gold standard for the treatment of intertrochanteric fracture in the femur in the aged. OBJECTIVE: To explore the clinical curative effects of three internal fixation methods: dynamic hip screw, proximal femoral nail antirotation, and intramedullary nail InterTan in the treatment of intertrochanteric fractures of the femur in the aged. METHODS: A retrospective analysis of 120 cases of intertrochanteric fractures from January 2010 to January 2016 was performed. The patients were randomly divided into dynamic hip screw group (n=40), proximal femoral nail antirotation group (n=60) and InterTan group (n=20). The operative time, intraoperative blood loss, incision length, hospitalization time, postoperative weight-bearing time, fracture healing time, Harris score, and intraoperative and postoperative complications were recorded and compared among the three groups. RESULTS AND CONCLUSION: (1) Operative time, intraoperative blood loss, and incision length were significantly better in the InterTan group and proximal femoral nail antirotation group than in the dynamic hip screw group (P < 0.05). Above indexes were not significantly different between InterTan and proximal femoral nail antirotation groups (P > 0.05). (2) Postoperative weight-bearing time, fracture healing time, and Harris score one month after operation were significantly better in the InterTan group than in the proximal femoral nail antirotation and dynamic hip screw groups; above indexes were better in the proximal femoral nail antirotation group than in the dynamic hip screw group (P < 0.05). (3) Hospitalization time and Harris score at 6 and 12 months after operation were not significantly different among the three groups (P > 0.05). (4) The incidence rate of intraoperative and postoperative complications was significantly lower in the InterTan group and proximal femoral nail antirotation group than in the dynamic hip screw group (P < 0.05). (5) In summary, compared with dynamic hip screw system, proximal femoral nail antirotation and InterTan system are characterized by small trauma, simple operation, quick recovery, and fewer complications, and show good clinical therapy in the treatment of intertrochanteric fracture. Compared with proximal femoral nail antirotation system, InterTan system shows better fracture reduction and stability, shorter healing time, and better biomechanical advantages.
ABSTRACT
<p><b>OBJECTIVE</b>To determine the changes of Substance P in the substantia gelatinosa of the dorsal horn field after transient liquid nitrogen freezing of severed rat sciatic nerve for prevention of terminal neuroma.</p><p><b>METHODS</b>The bilateral sciatic nerves of 20 SD rats were severed, and the left sciatic nerves was subjected to transient liquid nitrogen freezing with the right sciatic nerve as control. After 20 and 28 weeks, the nerve ends were resected and prepared for microscopic examination, and Substance P in the substantia gelatinosa of the dorsal horn field was determined by immunohistochemistry.</p><p><b>RESULTS</b>Typical neuromas occurred in the severed ends of the right sciatic nerves but not in the left sciatic nerves. The distribution and optical density of Substance P in the substantia gelatinosa of the dorsal horn field was significantly smaller in the left than in the right nerves (P<0.05).</p><p><b>CONCLUSION</b>Liquid nitrogen freezing of the severed sciatic nerve results in decreased release of Substance P in the substantia gelatinosa of the dorsal horn field, suggesting that noxious stimulation may increase Substance P release in the substantia gelatinosa of the dorsal horn field.</p>
Subject(s)
Animals , Female , Male , Rats , Cryopreservation , Methods , Nerve Fibers , Metabolism , Pathology , Neuroma , Metabolism , Pathology , Nitrogen , Chemistry , Rats, Sprague-Dawley , Sciatic Nerve , Wounds and Injuries , Metabolism , Pathology , Substance P , Metabolism , Substantia Gelatinosa , Metabolism , PathologyABSTRACT
<p><b>OBJECTIVE</b>To explore measures to prevent motor endplate degeneration and muscular atrophy after motor nerve injury.</p><p><b>METHODS</b>Thirty Sprague-Dawley rats were randomized into 3 equal groups. In two of the groups, the right common peroneal nerves of the rats were transected and immediately sutured with implantation of collagen gel carrier of acidic fibroblast growth factor (aFGF) or the empty carrier into the denervated tibialis anterior muscles. In the control group, the transected nerves were sutured without implantation. Six weeks after the operation, morphological and electrophysiological examinations were performed.</p><p><b>RESULTS</b>In the control rats and those with empty collagen gel carrier implantation, obvious motor endplate degeneration and muscular atrophy occurred, which were not obvious in rats receiving aFGF carrier implantation. The decrement of repetitive nerve stimulation was significantly greater in the former two groups than in the latter.</p><p><b>CONCLUSION</b>Implantation of collagen gel carrier of aFGF may prevent motor endplate degeneration and facilitate functional recovery of the neuromuscular junction after motor nerve injury.</p>