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BACKGROUND: Lower extremity deep venous thrombosis is commonly seen after hip arthroplasty. The time of thrombosis after arthroplasty in senile patients with osteoporotic femoral neck fractures is little reported.OBJECTIVE: To investigate the time of perioperative lower extremity deep venous thrombosis in senile patients with osteoporotic femoral neck fractures undergoing hip arthroplasty. METHODS: The data of 178 patients with femoral neck fractures undergoing hip arthroplasty were analyzed, and were then allocated to anticoagulant and non-anticoagulant groups according to the preoperative use of low-molecular-weight heparins or not. Doppler ultrasonography of both lower extremity arteries was conducted at 1, 3, 5 and 5-7 days after injury, and 2, 5, 7 and 14 days postoperatively to monitor the lower extremity deep venous thrombosis, and the number and incidence of thrombosis in the two groups were recorded at different time points. The time of thrombosis occurred frequently after injury and surgery was determined through drawing the frequency distribution table and line chart.RESULTS AND CONCLUSION: (1) The incidence of thrombosis showed significant difference between anticoagulant (n=6, 8%) and non-anticoagulant (n=22, 21%)) groups (P < 0.05). (2) Thrombosis frequently occurred at 3 days after injury and 1 day postoperatively. (3) These results suggest that the thrombosis in patients with femoral neck fractures frequently occurs at 1-3 days after injury and 1 day after replacement. Additionally, active prevention measures after injury can significantly reduce the incidence of lower extremity venous thrombosis.
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BACKGROUND:In rabbit femur fracture model experiment, there are a few studies on whether quadriceps tendon wil affect the stability of the fixed device. OBJECTIVE:To analyze the effects of quadriceps tendon to the stability of external fixator in rabbit models of femur fracture. METHODS:The 48 New Zealand white rabbits were randomly divided into two groups. External fixator was used to make fracture model. In the experiment group, quadriceps tendon was cut. In the control group, quadriceps tendon was retained. 2 weeks later, X-ray examination was utilized to observe the number of failed external fixator in both groups from modeling to success. RESULTS AND CONCLUSION:(1) X-ray examination:2 weeks after model establishment, external fixation frame screw was free from femur in one rabbit of the experiment group, and seven rabbits in the control group. Of them, one screw was broken. Threaded portion retained in the femur. (2) External fixation failure rate:failed external fixator was found in one rabbit in the experiment group, resulting in a failure rate of 4%, and 12 rabbits in the control group, resulting in a failure rate of 50%(P<0.05). These findings suggested that cutting off the rabbit quadriceps tendon can effectively ensure the stability of the external fixator, and indirectly improve success rate of the experiment.
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BACKGROUND:The risk of lower-extremity deep venous thrombosis was high in patients with the osteoporotic hip fracture. The aged age and hip fracture surgery are major risk factors for thrombosis. No study concerned the critical point in time course to the lower extremity deep venous thrombosis in the osteoporotic hip fracture patients. OBJECTIVE:To analyze the incidence of the perioperative deep venous thrombosis of lower extremity limb at different time slots in senile osteoporotic intertrochanteric fracture patients repaired by proximal femoral nail antirotation fixation. METHODS:From June 2012 to January 2016, 220 cases diagnosed as osteoporotic intertrochanteric fracture and performed closed reduction and proximal femoral nail antirotation fixation were selected from the Department of Orthopedics, the Affiliated Hospital of Chengde Medical Col ege in China. Based on administered low-molecular-weight heparins (LMWH) or not after trauma, there were two groups:LMWH group and the non-LMWH group. Vascular Doppler ultrasound was conducted at 1, 3 and 5 days after trauma, more than 5 days after trauma, 2, 5, 7 and 14 days after surgery. The total number of cases and incidence of thrombosis were recorded and compared between the two groups. The number of cases and the incidence of new thrombosis were recorded at different time points in both groups. Frequency distribution table was used to analyze the time of suffering thrombosis after injury and surgery. RESULTS AND CONCLUSION:(1) Among 220 cases, 18 cases in the LMWH group (n=154) affected thrombosis, with an incidence of 12%, and 15 cases in the non-LMWH group (n=66) experienced deep vein thrombosis, with an incidence of 23%. Significant differences in the incidence of thrombosis were detected between the two groups (P=0.041). (2) Peak time of thrombus was 3 days before injury and 1 day after surgery in both groups. (3) Results suggested that the incidence of deep vein thrombosis was high in proximal femoral nail antirotation fixation for intertrochanteric fracture. The peak time of deep vein thrombosis was 3 days before injury and 1 day after surgery. The prevention of deep vein thrombosis should begin from injury. Prophylactic anticoagulation after injury can dramatical y decrease the incidence of deep vein thrombosis.
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Objective To investigate the epidemiological features of 937 patients wounded in China Wenchuan earthquake. Methods An analysis was done on 937 patients treated in the city of Deyang in aspects fo their gender,age,injury causes,wound sites,complications and misdiagnosis.Results There were more wounded females than males,with ratio of male to female of 1:1.12.The main injury causes were crush injury and falling injury.The most frequent injury sites include head,chest,ankle and foot,tibia and fibula,spine and hip.The rate of misdiagnosis was as high as 15.5%,mainly brain injuries and chest iniuries. Conclusion The main causes are crush iniury and falling in-jury.Lower limb fractures account for the most.While close brain and thoracic injuries are likely to be misdiagnosed.
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[Objective]To evaluate the surgical technique and effectiveness of extra-articular arthroscopic debridement in patients with rotator cuff calcifying tendinitis unresponsive to conservative treatment.[Methods]Arthroscopic debridement was performed in 18 patients(5 males,13 females;mean age 56.4,range 34 to 78) in whom pain and functional disability persisted for more than 3 months despite conservative therapy for rotator cuff calcifying tendinitis.Arthroscopy was inserted into subacromial interspace and bursectomy was done.Calcified plaques in supraspinatus tendon were explored and eliminated outside shoulder joint under arthroscopy.VAS pain score,Constant-Murley score and plain radiograph was adopted for evaluation before and after surgery.[Results]The mean follow-up period was 9 months(6 to 15 months)[KG-58x].Pain and functional disturbance of the shoulder disappeared or obviously improved.The average VAS pain score was(7.8?0.6) preoperatively and(1.7?0.4) postoperatively.The average Constant-Murley score was(61?7)preoperatively and(91?4)at the last follow-up.Radiograph showed little residual deposits in 2 cases but without preoperative symptoms.No case need rotator cuff repair.[Conclusion]Extra-articular arthroscopic removal of calcium deposits together with bursectomy is effective and reliable in patients with chronic calcifying tendinitis unresponsive to conservative treatment.