ABSTRACT
In this retrospective study, we evaluated the efficacy of the reverse less invasive plating system [LISS] in the management of subtrochanteric fractures [STF] in elderly patients that are expected to be difficult to nail. Fifty-five patients with STF were treated from April 2005 to December 2007. Of these, 26 [16 females and 10 males, age >65 years, average 79.8 +/- 3] had nonpathologic fractures that were internally fixed with a LISS device. The average follow-up period was 24 months [range 15-30]. The main outcome measures evaluated were pain, union, varus deformity and implant failure. Radiographic and clinical evidence of functional outcome and complications were also evaluated. Mean perioperative blood loss was 120.5 +/- 12 ml [range 65-285], and mean postoperative hospital stay was 7.8 +/- 2 days [range 4-14]. Using the reverse LISS plates led to complete union of STF in all of the 26 elderly patients without additional procedures. Due to advantages like high union rate, early postoperative mobilization and short operation time, the reverse LISS device offers an alternative management of STF in elderly patients unsuitable for nailing procedures
Subject(s)
Humans , Male , Female , Femoral Fractures/surgery , Hip Fractures/surgery , Fracture Fixation, Internal/methods , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To respectively analyze the results and complications of hip arthroplasty for failed intertrochanteric hip fractures treating with internal fixation.Methods From July 2004 to June 2006,32 patients(24 males and 8 females)were treated with hip arthroplasty after the failed internal fixation of intertrochanteric fractures.The mean age was 71 years(range,57-81 years)at the time of the hip arthroplasty.The average interval from fracture to arthroplasty was 40 months(range,5-70 months).Fifteen patients had been treated with sliding hip screw,10 with intramedullary nail,5 with plate and screws,2 with multiple screws.The failure modes were nonunion in 8 patients,implant cut out from the femoral head in 9,avascular necrosis of the femoral head in 7,and traumatic arthritis in 8 patients.Cemented stems were used in 12 hips,and uncemented stems in 20 hips.Standard prostheses were used in 25,long-stem prostheses in 7.Results Twenty-eight patients were followed up for a minimum of 4 years after the hip arthroplasty,with the mean period of 5 years(range,4-6 yeas).For these 28 patients,the average preoperative Harris Hip Score was 37(range,32-45),and 88(range,84-95)at the latest follow-up.The average acetabular inclination was 44°(range,42°-48°).No loosing was found in cotyloid components.Nine of 10 cemented femoral components had cementation rated as grade C,and 1 as grade A.Three had heterotopic bone six months postoperatively,and 2 were Brooker type Ⅱ,one was type Ⅲ.Conclusion Hip arthroplasty is an effective salvage procedure after the failed treatment of an intertrochanteric fracture in an older patient.
ABSTRACT
Objective To investigate the inherited tendency of lateral discoid meniscus of the knee, and to evaluate the surgical efficacy for the disease in two consecutive generations. Methods There were 12 cases of lateral discoid meniscus, which were confirmed by arthroscopy, in 6 families. Arthroscopic total or partial meniscectomy or meniscoplasty were carried out in these cases. Results In concordance with the Watanabe’s classification, 9 cases were classified as “type Ⅰ” and 3 cases,“type Ⅱ”. Two cases underwent total meniscectomy, 3 cases received partial meniscectomy, and 7 cases, meniscoplasty. The results of surgery were assessed in accordance with the Ikeuchi criteria as follows: good in 3 cases, fair in 2 and poor in 1 in the first generation, while excellent in 5 and good in 1 in the second generation. Conclusions There may be a hereditary predisposition to discoid meniscus.