ABSTRACT
Objective To evaluate the clinical outcomes of cemented bipolar femoral head arthroplasty in treatment of intertrochanteric fractures in elderly patients combined with heart,lung,brain and other diseases.Methods The study comprised 23 cases,aged 75-86 years old,treated with cemented bipolar artificial femoral head arthroplasty between January 2005 and October 2013 (replacement group).Evans' classification of the fracture was type Ⅰ in 3 cases,type Ⅱ in 9,type Ⅲ a in 5,type Ⅲ b in 2,type Ⅳ in 3 and reverse intertrochanteric fracture in 1.Additionally,23 cases with the similar physical condition treated with anatomical locking plates were chosen as controls.For comparisons between groups,operation time,amount of bleeding,drainage volume,mean time to extract drainage tub,antibiotics dosage,perioperative complications,complications of lying in bed,fracture complications and Harris score were measured.Results There were no significant differences between replacement and control groups with respect to operation time (52.7 minutes vs 52.0 minutes),amount of bleeding (160.9 ml vs 156.5 ml),drainage volume (162.2 ml vs 158.3 ml),Harris score (73.7 points vs 74.2 points),time to extract drainage tub (69.9 hours vs 68.9 hours) (P ＞ 0.05).Both groups had 5 days of preventive antibiotic usage.Better results were observed in replacement group than in control group concerning mean time of ambulation (8.1 days vs 109.3 days),rate of perioperative complications (19％ vs 59％),rate of bed rest complications (0 vs 36％) and rate of internal fixation complications (0 vs 18％) (P ＜ 0.05).Conclusion Cemented bipolar femoral head arthroplasty is effective to prevent the complications of internal fixation,bed rest as well as perioperation and improve the quality of life during the treatment of intertrochanteric fracture in elder patients with heart,lung,brain and other diseases.
ABSTRACT
Objective To summarize the keypoints of clinical diagnosis of chondroblastoma and the experience on the treatment Methods The clinical materials of 16 cases(11 males,aged from 12 to 26 years)from June 1992 to February 2003 of pathologically diagnosed chondroblastoma were analyzed retrospectively. The tumor located at distal femur in 6 cases,great trochanter in 1 case,proximal tibia in 6 cases,proximal humerus in 2 cases, talus in 1 case. The main symptoms were swelling and painful joint. All the 16 cases were treated with curettage and autologous bone graft from iliac crest. Results Twelve cases were followed up for 6 months to 5 years .averaging 3. S years. All the bone graft healed well. One case., recurred 2 years after the initial curettage and was treated with curettage again. No recurrence occurred at the last follow-up 6 months after the second curettage. The function of the involved joints was nearly normal in all cases except for one case with slight limitation of knee flexion. Conclusions Mastering the image and clinical characteristics of chondroblastoma can avoid misdiagnosis and mistreatment Curettage can control the tumor satisfactorily. Postoperative rehabilitation can improve the function of the involved limb.