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Objective To investigate the clinical effect of salmon calcitonin in the treatment of senile osteoporosis , and to observe the effect of salmon calcitonin on bone mineral density ( BMD ) and pain.Methods 180 cases of patients diagnosed as osteoporosis from September 2015 to September 2016 in our hospital were retrospectively analyzed, the patients were divided into control group and treatment group according to the random number table method.The clinical efficacy and side effects of the two groups were evaluated.The bone mineral density (BMD) of the lumbar vertebrae, femur and radius were measured by dual energy X-ray absorptiometry.The VAS was used to evaluate the two groups before and after the treatment.( ODI) were used to evaluate the functional status of the patients before and after treatment.The self-made questionnaire was used to evaluate the quality of life of the patients before and after treatment.Results The total effective rate of treatment group was 94.44%, significantly higher than the control group 75.56%(P<0.05).After treatment, the treatment group of lumbar spine bone mineral density, bone mineral density and radial bone mineral density was significantly higher than the control group (P<0.05).After treatment, spontaneous low back pain, flexion extension pain, turn over pain and weight pain were significantly lower in the treatment group than in the control group (P<0.05).The ODI index of the treatment group was significantly lower than that of the control group (P<0.05).After treatment, the quality of life scores in the two groups were significantly higher than those before treatment, and the treatment group was higher than the control group(P<0.05).No significant adverse reactions occurred in two groups during the treatment.Conclusion Salmon calcitonin treatment of osteoporosis in elderly patients with a significant effect, help to improve bone mineral density, reduce pain and improve its dysfunction, and has high security.
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Objective To compare dynamic hip screw (DHS),InterTan and proximal femoral nail antirotation-Ⅱ (PFNA-Ⅱ) in the treatment of femoral intertrochanteric fracture in terms of their effects on postoperative hidden blood loss (HBL) and deep venous thrombosis (DVT).Methods We retrospectively analyzed the 133 patients with femoral intertrochanteric fracture who had been treated in our hospital from November 2011 to November 2015.Of them,42 received DHS treatment,including 22 males and 20 females;43 underwent InterTan fixation,including 21 males and 22 females;48 had PFNA-]Ⅱtreatment,including 25 males and 23 females.At preoperation,1,3 and 7 days postoperation,all of them had tests of hemoglobin (Hb),hematocrit value (Hct),blood platelet (PLT),thrombin time (TT),activated partial thromboplastin time (APTT),prothrombin time (PT),human fibrinogen (FIB) and D-dimer.DVT was detected using color Doppler ultrasound at 7 days postoperation.Results At 1,3 and 7 days postoperation,the DHS patients had the smallest values of Hb,Hct,TT,PT and APTT while the PFNA-Ⅱ patients the largest.The DHS patients had the largest values of intraoperative bleeding,PLT,FIB and D-dimer while the PFNA-Ⅱ patients the smallest.There were significant differences between the 3 groups in all the indexes (P ＜ 0.05) except in TT at 7 days postoperation and APTT at 1 and 7 days postoperation between the InterTan and PFNA-Ⅱ groups (P ＞ 0.05).The incidence of DVT in the InterTan group (2.3％,1/43) and in the PFNA-Ⅱ group (0) was significantly lower than in the DHS group(7.1％,3/42) (P ＜ 0.05).Conclusion In the treatment of femoral intertrochanteric fracture,PFNA-Ⅱ may be superior to InterTan and DHS in reducing postoperative HBL and control of DVT.
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Objective To discuss the anatomical and radiographic parameters of medullary screw fixation of anterior acetabular column so as to provide reference for clinical application. Methods Thirty cadaveric pelvic specimens (including 18 males and 12 females) were involved in the study and fixated re-spectively with 30 retrograde medullary cannular lag screws through pubic tubercle to acetabular posterosu-perior on the left side and with 30 anterograde medullary cannular lag screws through acetabular posterosu-perior to pubic tubercle on the right side. Then, two-dimensional multiplanar CT reconstruction was done to measure the angle and length of the anterograde and retrograde medullary screw trajectory, the relationship of screws with acetabular bone and penis and determine optimal point and angle of screw insertion. Re-suits The entrance of the retrograde medullary screw was located at pubic tubercle, with vertical dimen-sion of ( 17.15±1.82) mm to pubic symphysis and that of (20.51±2.19) mm to superior margin of pu-bis. For the anterograde medullary screw, the distance from the entrance of the screw to greater sciatic notch was (33.25±2.35) mm, with safe insertion angle of (32.1±2.7)°of cephalon tilting at the sagittal plane and (46.5±3.6)°of lateral tilting at the coronal plane. The entrance angle of the anterugrade and retrograde medullary screw trajectory was similar, with only opposite direction and minor difference between the left and the right sides (P>0.05). The length of medullary screw trajectory was (119.5±2.2) mm, with insignificant difference between both sides ( P >0.05). The maximum diameter of the screw was 7.2 mm. Conclusions Medullary screw fixation of anterior acetabular column is clinically feasible but needs rather high accuracy and can be used as an alternative to plate fixation.
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Objective To evaluate the clinical effectiveness of the combined use of S1 pedicle screws and the iliac screws in treatment of sacroiliac dislocation and fracture. Methods 11 patients with sacroiliac dislocation and fracture were treated with S1 pedicle screw and iliac screw fixation technique. In this group, the dislocation was associated with vertical displacement of the sacroiliac joint and rotational deformity of the pelvic ring. They were classified as type B or type C pelvic disruption according to the Tile's classification. 7 patients with disruption of the symphysis pubis or pubic branch fracture underwent additional fixation of the pelvic ring using a reconstruction plate. The remaining 4 patients were treated by the posterior procedure alone. Results The vertical displacement was completely reduced in 7 patients, and the rotational deformity completely corrected in 4 patients. The reduction was maintained at the time of final follow up evaluation. No perioperative complications were found. The combined use of S1 pedicle screws and the iliac screws provided immediate stability and sufficient reduction for sacroiliac dislocation in the 11 patients in this study. Conclusion This hybrid internal fixation procedure is useful for reduction and fixation of sacroiliac dislocation associated with the vertical and rotational instability of the pelvic ring.