Advanced alcoholic osteonecrosis of femoral head / 中国矫形外科杂志

[Objective]To discuss the relation-ship between AAONFH(advanced alcoholic osteonecrosis of femoral head)and extended overdose drinking.[Method]Reviewed 165 cases of total hip arthroplasty,to analyzed the clinical data among 27 AAONFH cases,reviewed the literatures,discussed the pathogenesis of AAONFH and the relation-ship between blood biochemistry and blood cloting funtion and compared the experimental results among literatures.[Result]Theres various factors resulted in osteonecrosis of the femoral head associated with alcohol long-term over intake.Individuals consuming more than 750 ml of alcohol daily were at greater risk of double or half ONFH,Theres no change in biochemical test,but blood clotting funtion in this case would degrade,osteoarthritis of hip would synchronize.[Conclusion]Individuals consuming more than 750 ml of alcohol daily have the potentiality of ONFH;Its no specificity significance in biochemical test,the necrosis extent of the femoral head is relative to the capacity and times of alcohol intake.THR(total hip replacement)is the best treatment for AAONFH,but theres more staxis potentiality in this cases.

The relevance between the clinical manifestion and operation of lumbar dise herniation / 中国基层医药

Objective To analyze the experience of 745 cases of lumbar disc herniation(LDH) and investigate the relevance between the clinical symptoms,signs and operative observation.Methods From 1982 to 2003,745 cases of LDH were treated operatively.In order to investigate the relationship between clinical presentations and operative results,a statistic analysis was conducted using the clinical symptoms,signs and operative observations.Results As the predominant manifestions,the pain in the low back and leg was seen in 96.4% of LDH,the pain aggravated by belly pressure in 93% of LDH,local tenderness and radicular pain around the lumbat spinous process in 70.8% of LDH,rectoleg elevation test(+) in 91.6% of LDH.operation observation:77.6% of LDH was classified as lateral type,10.9% as medial type and 11.5% as rupture or sequestration type.Weakness of extensor hallucis longus could seen in 65.6% of LDH of L_4,L_5,in 32.3% of LDH of L_5S_1.Conclusions Although the extensive usage of computed tomography(CT) and magnetic resonance imaging(MRI) provides a prompt and accurate basis for diagnosis of LDH,the physical examination remains the most important routine way to make a diagnosis.It is suggested that during the diagnosis and treatment of LDH,besides the common features of the disease,some individual presentations should not be neglected in few rare atypical cases,so as to diagnose and treat correctly.