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Objective To detect the initial results of total hip arthroplasty (THA) after failure of internal fixation of femoral neck fractures and investigate the key points in surgical procedures and prosthesis selection.Methods A retrospective analysis was performed on 36 cases who had THA for femoral neck fractures due to the initially failed internal fixation between January 2007 and December 2012.There were 21 males and 15 females,with age ranging from 46 to 72 years (mean,58.6 years).After internal fixation,13 cases were complicated by femoral head necrosis,eight fracture nonunion,and 15 fracture nonunion combined with femoral head necrosis.All the 36 cases had cementless THA,including proximally fixed stem in 25 cases and distally fixed stem in 11 cases.Harris hip score was assessed before operation and at follow-up.Results All the cases received a follow-up of 26-52 months (mean,32.5 months).Mean Harris hip score improved from 26.3 to 83.6,including excellent results in 12 cases,good in 22,and fair in two,with excellence-good rate of 94％.Conclusion With respect to the failed internal fixation of femoral neck fractures,THA is an effective remedial method to improve hip function and quality of life of the patients.
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Objective To summarize the clinical features of bee sting caused aute kidney injury in children and the effect of he-modialysis therapy .Methods 60 children cases of bee sting caused acute renal injury were performed the retrospective analysis on the clinical features and laboratory data .Results Cystatin C ,serum creatinine ,blood urea nitrogen in children patients with acute kidney injury after hemodialysis were significantly decreased ,while procalcitonin ,high-sensitivity C-reactive protein ,acidosis and e-lectrolyte imbalance also were corrected or improved .After hemodialysis in 60 children cases ,45 cases were clinically cured ,13 cases were significantly improved and discharged and 2 cases died .Conclusion Bee sting is most likely to result in children acute renal in-jury .Hemodialysis is safe and effective treatment measures for acute kidney injury ,can actively improve the renal function without significant complications of acid-base balance and electrolyte imbalance .But the prognosis is closely related with the onset age of the aute kidney injury ,injury severity ,where or not accompanied by MOF ,opportunity of diagnose and treatment ,etc .
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Objective To investigate the effect and nursing experience of iliacus groin approaches and internal fixation treatment for patients with pelvic fractures. Methods Twenty- six patients with unstable pelvic fracture were obtained iliac groin approaches and internal fixation treatment, the changing symptoms in patients were monitored frequently, and all patients were performed general nursing. Results All patients were followed up for 0.5 to 5.0 years, without obvious complications, the results of surgical treatment included optimal 16 cases, good 7 cases, mean 3 cases. Conclusions Iliacus groin approaches and internal fixation with reconstruction plate treatment on pelvic fractures was proved to be reset accurate, reliable and strong, with better effects. Effective nursing measures can save life of patients with pelvic fractures, speed up rehabilitation of physiological function, improve life quality of the patients.
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[Objective]To explore the surgical management and its results of intercondylar fracture of humerus through approach of osteotomy of olecranon(AOO) with dual anatomical steel plate DASP.[Method]From July 2002 to March 2006,26 patients of intercondylar fracture of humerus were treated surgically through AOO,and the fracture was reduced and fixed with DASP.The patients were 19 males and 7 females with a mean age of 35 years (range 15～46 years),According to Riseborough and Radin classification,type Ⅱ fracture was found in 6 cases,type Ⅲ in 18,type Ⅳ in 2.Early rehabilitation exercises was taken.[Result]Twenty-five fractures were satisfactory reduced but one not too good,none had incision infection,injuries of the ulnar nerve.Twenty-two patients were followed up from 6 months to 19 months(average 13.5 months),of these 22 patients,all the osteotomies healed in 17 weeks averagely(range 14～24 weeks) and the injuried ulnar nerve recovered completely.The function of the elbow(according to Cassbaum scale) showed excellent in 5 cases,good in 13,fair in 3 and poor in 1.the good-excellent rate was 81.8%.[Conclusion]The technique of DASP for the treatment intercondylar fracture of humerus through transolecranon approach offers many advantages,such as sufficient exposure easy to get anatomical reduction,stable fixation and earlier exercise.
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Objective To discuss difficulties and techniques of standard video-assisted thoracoscopic or laparoscopic surgery(SVATS or SVALS) for spine internal fixation.Methods Between July 2004 and September 2005,6 cases of vertebral lesions located in the T_5～L_1 segment(including 2 cases of vertebral tuberculosis) were given SVATS under single-lung ventilation for resection of diseased vertebral body,reconstruction with autograft or titanium mesh cage,and fixation with the Z-plate system or the CD-Horizon system.Other 2 cases of vertebral tuberculosis located in the L_2～L_3 segment underwent retroperitoneal gasless SVALS for lesion debridement,reconstruction with autograft,and fixation with the Z-plate system.For cases of vertebral tuberculosis,(anti-tuberculosis) drugs were administrated preoperatively for 3 weeks and postoperatively for 6 months.Results The lesion debridement and anterior decompression was completed in all the 8 cases,including internal fixation with the Z-Plate system in 7 cases and with the CD-Horizon system in 1 case.There were 5 cases of iliac autografting and 3 cases of titanium mesh cage reconstruction.The operative time was 6.5~12.6 h(mean,8.7 h) and the blood loss during surgery was 250~1 800 ml(mean,950 ml).The correction of the Cobb angle was 5?~18?(mean,12?).During a follow-up period for 2~13 months(mean,7.4 months) in the 8 cases,nerve functions recovered by 1~2 Frankel grade in 5 cases,and the Cobb angle lost by 4? at 6 months postoperatively in 1 case of metastatic adenocarcinoma at the T_7 segment.Conclusions Spine internal fixation of T_5～L_3 segment can be conducted successfully with SVATS or SVALS.The key to the question is accurate orientation of the port site,proper hemostasis of the segment blood vessel,and careful resection of the anterior wall of the vertebral canal.