ABSTRACT
Objective To compare the clinical effects of hip replacement and internal lixation treatment for aged patients with fracture of femoral neck.Methods One hundred and twelve cases patients with fracture of femoral neck were choosed and divided into the control group (n =56) and observation group (n =56) according to the will of patients and family.The control group was treated by incision fixation while the observation group was given hip replacement therapy.All patients were followed up for 6 months after the operation time.Intraoperative blood loss,hospital stay,bed time,postoperative complications and Harris joint scores of the two groups were compared.Results The operation time and intraoperative blood loss of the observation group were significantly higher than those of the control group((98.6±23.8) min vs.(54.2± 16.4) min,(324.6 ±43.8) ml vs.(158.6±26.8) ml;t=4.468,5.624;P＜0.05);The bed time was much shorter than that of the control group((16.6±2.8) d vs.(68.6±5.8) d;t=8.248,P＜0.05).The case of pressure sores,lung infection and mode again of the observation group were significantly less than those of the control group(P＜0.05),while the Harris joint scores were significantly higher than the control group (89.7％ vs 58.9％,x2 =14.423,P ＜0.05).Conclusion Hip replacement can improve the joint function and enhance the quality of life for patients of fracture of femoral neck.
ABSTRACT
This paper describes briefly the newest progress in the early diagnosis and prediction of the osteonecrosis of the femoral head (ONFH) after femoral head fracture. It is necessary that early operative intervention and aspiration of the intracapsular blood should be done in order to minimize the occurrence of ONFH. It is wise to avoid positioning the hip in extension and internal rotation until surgery. Traction with hip in flexion is recommended. Using the contrast enhanced (Gd DTPA) MRI with T1 fat saturation imaging within 24 hours after injury, the prediction of ONFH will be possible. It is recommended the ONFH should be divided into two types, namely silent and clinical ones.
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Objective To analyze the clinical characteris tics and diagnostic outline and to elucidate the effects of different managements of femoral shaft fractures with ipsila teral femoral neck fractures.Methods A retrospective study was carried out in 18patients with ipsilateral femo ral neck and femoral shaft fractures from 1998to 2001,and their managements and final clinical outcomes were reviewed.Results The follow -up ranged from8to 40months with an average of 16mon ths.All the fractures united except one femoral shaft fracture and one femoral neck fracture.Conclusion Retrograde intramedullary nailing with multiple cancellous screws to t reat ipsilateral femoral neck and femora l shaft fractures has been proved an e ffective technique.For the cases overlooked initially,treatment with multiple nailing around the intramedullary n ail is a good choice.[
ABSTRACT
Objective To study the clinical value of CR system in diagnosing fracture of femoral neck.Methods 108 cases hospital ized with fracture of femoral neck were examined by CR,the results were analysed comparatively with that of the conventional X-ray film taken at the same time.Results CR system could show clearly the various fracture lines according to Garden four types of arthrosteopedic surgery,while 3 cases of Ⅰ type and 5 cases of Ⅱ type were failed to indicate the distinct difference on conventional X-ray films,there were obvious different in positive detecting rate between these two methods.Conclusion CR system,by its function of computer treatment afterwards,can make an early diagnose in time to different types of the fracture of femoral neck,especially in the respect of Ⅰand Ⅱ type which is superior to the conventional X-ray film.
ABSTRACT
The femoral neck fracture in children is rare and occurred by severe trauma and the treatment method and prognosis are different from adult, and it is difficult to treat due to frequent complication, which is so called “unsolved fracture”. Twelve cases of children's femoral neck fracture were treated at Chon Buk National University Hospital from July, 1981 to May, 1988 were analysed clinically and radiologically and following results were obtained 1. The commonest age group was between the age of 14 and 16 years and the ratio of boys and girls was 2:l. 2. The main cause of fracture was traffic accident(6 cases) and fall down was 5 cases and slip down was 1 case. 3. According to the Delbet and Colona's classification, the transcervical fracture was most common type and displaced fracture was 8 cases. 4. Associated injuries were extremity fracture(3 cases) and pelvic bone fracture(2 cases) and head injury(2 cases), etc. 5. Seven cases were treated by open reduction and internal fixation and five cases by cast immobilization after skin or skeletal traction. 6. The commonest complication was coxa vara(5 cases) and other complication was avascular necrosis of femoral head(3 cases) premature epiphyseal closure(3 cases), nonunion (2 cases). 7. According to Ratliff's assessment of results, eight cases were good result and two fair results and two poor results. 8. Secondary operation (muscle pedicle bone graft, corrective subtrochanteric valgus osteotomy) was done in three cases and showed one good result, one fair result and one poor result.
Subject(s)
Adult , Child , Female , Humans , Classification , Clinical Study , Extremities , Femoral Neck Fractures , Femur Neck , Head , Hip , Immobilization , Methods , Necrosis , Pelvic Bones , Prognosis , Skin , Traction , TransplantsABSTRACT
The authors have reviewed 16 cases of the fracture of the femoral neck in children which were treated at Pusan Gospel Hospital during the period of 5 years from March 1975 to January 1980. 12 of the 16 fractures of femoral neck had sustained the injury by automobile accidents. The ratio between boy and girl was 1.6:1. There were five Type-II (Transcervical), nine Type-III (Cervicotrochanteric) and two Type-IV (In-tertrochanteric) femoral fractures by Delbets classiflcation. 2. cases of undisplaced and displaced Type-IV were treated with abduction plaster spics cast. 14 cases, which were displced and had associated injury, were reduced by closed reduction and internal fixation with hagie pin, cortical screw and cancellous screw under general anesthesia. 11 of 16 cases were followed for 7 months to 29 months, average 14 months. The results were rated according to criterias of the Ratliff. Satisfactory results were obtained in 9 cases and those of 5 cases were treated by closed reduction and internal fixation wlth cancellous screw. Pain was developed in a Type-II and Type-II due to loosening of metal devices for internal fixation.