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Objective To investigate the perioperative characteristics of hip fractures and the effects of early rehabilitation in elderly patients. Methods Clinical data of 123 elderly patients admitted to our department from January 2012 to January 2014 were retrospectively analyzed. Patients were divided into a rehabilitation group and a control group ,based on whether rehabilitation therapy was offered.Comparison was made between the two groups on postoperative mortality and postoperative complications. Results Of 123 patients ,there were 51 males and 72 females ,with a mean age of (83.5 ± 4.8)years(aged 67~96 years).Femoral fractures were seen in 32 patients and femoral intertrochanteric fractures in 91 patients.Before operation ,112 (91.1% ) patients had concomitant diseases. There were significant differences in postoperative complications and one-year mortality after operation between patients receiving early rehabilitation and controls (5/60 or 8.3% vs.14/63 or 22.2% ,4/60 or 6.7% vs.13/63 or 20.6% ,χ2=4.539 and 5.034 ,P=0.033 and 0.025 , respectively ). Conclusions Elderly hip fracture patients have many concomitant diseases before operation.With appropriate perioperative management ,well-chosen methods of anesthesia and surgery ,and early postoperative rehabilitation measures ,the incidence of perioperative complications and one-year mortality can be decreased ,and desirable surgical outcomes can be attained.
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Orthopaedic rehabilitation is an important part of rehabilitation resident standardization training, that is complex and unique. Introduction of the discipline, as well as optimizing teaching methods, clinical practice and test are very important for a satisfactory out-come, such as combination of theory and practice, and systematical rehabilitation procedures, principles and operation.
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@#Objective To compare the effects of non-steroidal anti-inflammatory drugs (NSAIDs) and free radical scavengers (FRS) on formation of traumatic heterotopic ossification (HO) in rabbits. Methods 48 New Zealand rabbits were randomly divided into control group (n=12), NSAIDs group (n=12), FRS group (n=12) and combination group (n=12). The model of traumatic HO was established, and the NSAIDs group, FRS group and combination group were administered indometacin intragastrically, edaravone intravenously and both, respectively, while the control group was administered normal saline for 4 weeks. The incidence and severity of HO were observed with X-ray 8 and 12 weeks after modeling. Results 8 and 12 weeks after operation, the incidence of HO was 33.3% and 41.7% in the NSAIDs group, 43.0% and 45.8% in the FRS group, 29.2% and 37.5% in the combination group, and 70.8% and 75.0% in the control group, respectively. The incidence and severity of HO in all the treatment groups were significantly less than those in the control group (P<0.05), and there was no significant difference among the treatment groups (P>0.05). Conclusion The systemic application of FRS may prevent the formation of HO effectively, similar with the NSAIDs. There is no synergistic effect between them.
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Objective To compare the effects of non-steroidal anti-inflammatory drugs (NSAIDs) and free radical scavengers (FRS) on formation of traumatic heterotopic ossification (HO) in rabbits. Methods 48 New Zealand rabbits were randomly divided into control group (n=12), NSAIDs group (n=12), FRS group (n=12) and combination group (n=12). The model of traumatic HO was established, and the NSAIDs group, FRS group and combination group were administered indometacin intragastrically, edaravone intravenously and both, re-spectively, while the control group was administered normal saline for 4 weeks. The incidence and severity of HO were observed with X-ray 8 and 12 weeks after modeling. Results 8 and 12 weeks after operation, the incidence of HO was 33.3%and 41.7%in the NSAIDs group, 43.0%and 45.8%in the FRS group, 29.2%and 37.5%in the combination group, and 70.8%and 75.0%in the control group, respectively. The incidence and severity of HO in all the treatment groups were significantly less than those in the control group (P0.05). Conclusion The systemic application of FRS may prevent the formation of HO effectively, similar with the NSAIDs. There is no synergistic effect between them.
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@#ObjectiveTo investigate the characteristics of knee stiffness and the results of rehabilitation after the fractures of distal femur （DF）, tibial plateau （TP） or patella （PF）. Methods70 cases with knee stiffness after DF, TP or PF were analyzed retrospectively. ResultsNo significant difference was observed in passive range of motion (PROM) among three groups (F=1.671，P=0.196) before rehabilitation. The differences were significantly different (F=19.264, P=0.000) 8 weeks after rehabilitation. Further LSD analysis revealed that there was significant difference between DF and TP (P=0.000) as well as DF and PF (P=0.000), but no significant difference was observed between TP and PF (P=0.114). ConclusionThe outcome of rehabilitation is associated with the locations of fracture, and the distal femoral fractures is the worst.
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@#Objective To analyze the outcome of total knee arthroplasty with retaining patellar in osteoarthritis.Methods 45 knee joints in osteoarthritis were performed operatively with posterior stabilized knee arthroplasty between January 2005 and June 2008. The series include 7 sides(males) and 38 sides(females). The mean age of patients was 65.7 years ranging from 52 to 79 years, and the data were analyzed by The Hospital for Special Surgery(HSS) score system. Results The follow-up period was averagely 25 months ranging from 8 to 51 months. According to HSS score system, 28 sides were rated as excellent（62.2%）, 12 sides as good（26.7%）, 4 fair（8.9%）and 1 poor（2.2%）, and the excellent-good rate was 88.9%. Conclusion Posterior stabilized knee arthroplasty with retaining patellar represents a simple and valuable treatment methodology for the most osteoarthritis of the knee joint.
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@# Objective To evaluate prospectively clinical significance and consequence of type Ⅰ bone bruise in acutely sprained knee. Methods 23 outpatients were selected, meeting our criteria from 2005 to 2008. All the injured knees were immobilized with gypsum for 4 to 6 weeks, and the knee complaints and MRI were followed up regularly.Results 18 patients were followed up, averaged 24 months, the bone bruise showed notable resolution in average 3 months and vanished in 6.7 months averagely; the knee pain alleviated obviously in about 4.8 months; 5 out of 9 cases, who were more than 45 years old, still complained knee pain and uncomfortable after 2 years.Conclusion Grade Ⅰ knee sprain can lead to bone bruise in condyles of femur or tibia, and knee immobilization should be given to avoid the further damage; the bone bruise may be a precursor of knee osteoarthritis for people older than 45 years.