Comparative study of intertrochanteric fractures treated with proximal femur locking compress plate in aged / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinic outcomes of dynamic hip screw (DHS), intramedullary fixation (IF) and proximal femur locking plate (PF-LCP) in the treatment of intertrochanteric fractures in the elderly patients.</p><p><b>METHODS</b>From July 2000 to August 2009, 165 old patients with intertrochanteric fractures were treated respectively by DHS, IF, PF-LCP. Fifty-eight patients were in DHS group including 30 males and 28 females with an average age of 71 years old; there were 30 cases of type II fracture of Jensen, 28 cases of type III fracture. Sixty-five patients were in IF group including 35 males and 30 females with an average age of 73 years old; there were 37 cases of type II fracture of Jensen, 28 cases of type III fracture. Forty-two patients were in PF-LCP group including 23 males and 19 females with an average age of 74 years old; there were 22 cases of type II fracture of Jensen,20 cases of type III fracture. The operative procedures,complications and therapeutic effects were compared among 3 groups.</p><p><b>RESULTS</b>All patients were followed up from 15 to 21 months (averaged 18.3 months). The incision length and the operation time of IF group were shorter than that of DHS and PF-LCP, but there were no significant difference between DHS group and PF-LCP group. The intraoperattive blood loss, rehabilitation and healing time of IF and PF-LCP were less or shorter than that of DHS group, but there were no significant difference between IF group and PF-LCP group. The functional recovery of IF group and PF-LCP were better than that of DHS group, there were significant difference among 3 groups. The complications of PF-LCP group was fewer than that of IF group and DHS group.</p><p><b>CONCLUSION</b>PF-LCP is the credible method for intertrochanteric fractures in the elderly patients, especially for severe comminuted fracture and osteoporosis, for it can reduce operation complications and benefit for fracture healing and hip functional recovery.</p>

Percutaneous kyphoplasty and conservative therapy for osteoporotic vertebral compression fractures: a clinical comparative study / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of percutaneous kyphoplasty (PKP) and conservative therapy in patients with osteoporotic vertebral compression fractures (OVCF).</p><p><b>METHODS</b>The data of 63 patients with OVCF from Sep. 2007 to Apr. 2009 were retrospectively analyzed. There were 14 males and 49 females,ranging in age from 63 to 92 years, with an average of 73.4 years. Among them, 30 cases(38 vertebrae), 33 cases (35 vertebrae) were respectively treated with PKP, conservative therapy. The VAS score, the height of vertebral body and the neighboring vertebral fracture were observed during follow-up.</p><p><b>RESULTS</b>All the patients were followed up from 10 to 15 months with an average of 13.3 months. Pain relieved in 27 cases with PKP, and VAS scores decreased from 8.32 before treatment to 2.63 at the 1st week after treatment; VAS scores still remained under 2 at the later follow-up. VAS scores had not changed at the 1st week after conservative therapy. VAS scores with conservative therapy were higher than with PKP after 1, 3 months (P < 0.05), but after 6 months, there was no significant difference between conservative therapy and PKP (P > 0.05). The average height of vertebral body on the X-rays increased in 4.1 mm at the 1st week after treatment with PKP (P < 0.01) and unchanged posteriorly. The height of vertebral body had some improvement at 3, 6 months after conservative therapy, but the height of vertebral body with PKP was significantly higher than with conservative therapy (P < 0.01). New fractures occurred in 4 cases (5 vertebrae) with PKP, in 2 cases (2 vertebrae) with conservative therapy.</p><p><b>CONCLUSION</b>PKP is an effective method in treating osteoporotic vertebral compression fractures, which can relieve pain quickly, increase stability immediately, recover height of vertebral body, but maybe can increase the risk of new fracture. Conservative therapy is not without any merit, as long as systemic treatment can still make good prognosis.</p>