Treatment of Unstable Intertrochanteric Fractures of the Femur Using an Anti-Hypersliding Compression Hip Screw and TSP

PURPOSE: This study evaluated the result of fixation of unstable intertrochanteric fractures using an anti-hypersliding compressive hip screw and a trochanter stabilizing plate. MATERIALS AND METHODS: One hundred patients with unstable intertrochanteric fractures who were given an anti-hypersliding compressive hip screw (Group A) or conventional compressive hip screw (Group B) were analyzed. The mean follow-up period was 23.5 months. Radiographic evaluation included the changes of neck-shaft angle, lateral displacement of proximal fragment, distal migration of the lag screw, fixation failure, and union time using plain radiographs taken at postoperative and last follow-up time. RESULTS: Lateral displacement of the proximal fragment averaged 1.62 mm in Group A and 3.97 mm in Group B, which was statistically significant (p<0.05). The neck-shaft angle was increased in Group B, but has no significance. The average of the Harris hip score and walking ability after surgery is higher in Group A than B, but there was no significant difference. The complication rate was significantly lower in Group A. But union time showed no difference in each group. CONCLUSION: Anti-hypersliding compression hip screw with a TSP, which reduces sliding of the lag screw and extreme change of the moment arm, is a another good option for the treatment of intertrochanteric femoral fractures against an increase of the failure rate from the hypersliding of the lag screw.

Effect of beta-Ig H3 on Chondrogenesis by Human Bone Marrow Mesenchymal Stem Cells / 대한정형외과학회잡지

PURPOSE: This study was undertaken to compare the activity of beta-Ig H3 (BigH3) and transforming growth factor (TGF)-beta on chondrogenesis by mesenchymal stem cells (MSCs). MATERIALS AND METHODS: MSCs in human bone marrow aspirated from 20 healthy donors were isolated by density gradient Ficoll-hypaque separation and expanded in culture. MSC-alginate beads were prepared and incubated for 28 days in the presence of 0.5 or 10 ng/mL of TGF-beta 1, TGF-beta 1+TGF-beta 3 or BigH3. Cellular viability, total collagen and glycosaminoglycan (GAG) contents were measured and compared. SPSS version 9.0 was used for the statistical analysis. RESULTS: TGF-beta 3 significantly enhanced cell viability in beads by day 21 (p=0.029). No significant differences were found in terms of cell viability (p=0.197) or in total GAG content (p=0.253) between 10 ng/mL of TGF-beta 1+3 and 10 ng/mL of BigH3. Total collagen content was higher in the BigH3 added group on day 21 (p=0.041). CONCLUSION: The replacement of BigH3 instead of TGF-beta produced appropriate external signals indicating the chondrogenic differentiation of human bone marrow MSCs.