Surgical outcome and complications of posterior hip dislocation combined with femoral head fractures / 中华创伤杂志

Objective To investigate the short-term surgical effect and complications of posterior dislocation of the hip with femoral head fractures.Methods Twenty-two patients with posterior dislocation of the hip with femoral head fractures treated surgically from December 1999 to December 2008 were reviewed retrospectively.All the patients were males aged from 23-52 years (mean 39.2 years).According to Pipkin classification,fractures were type Ⅰ in nine cases (41％),type Ⅱ in seven (32％),type Ⅲ in two (9％) and type Ⅳ in four (18％).Different surgical approaches and treatment methods were employed together with a periodic follow-up.Harris score and Thompson & Epstein score were used as measurement standard in postoperative clinical and radiological follow-up.Postoperative complications were analyzed as well.Results All the patients were followed up for mean 36 months.Clinical outcome as assessed by Harris criteria was excellent in 10 cases,good in seven,fair in two and poor in three,with excellent-good rate of 77％.Complications included femoral head avascular necrosis in four cases and traumatic arthritis in six.Heterotopic ossification of the hip did not occur.One case complicated with idiopathic injury of sciatic nerve was recovered at one year after operation.Conclusions Posterior dislocation of the hip with femoral head fractures should be operated as soon as possible.Operational modalities should depend on the type of fractures for the sake of reducing complications.

Ti-alloy mesh and impaction morcellized cancellous allograft for acetabular deficiency in revision total hip arthroplasty / 中国组织工程研究

OBJECTIVE:To observe the effectiveness of using Ti-alloy mesh and morcellized cancellous allograft in treatment of acetabular deficiency in revision total hip arthroplasty. METHODS:A total of 31 patients with acetabular defects underwent impaction morsellized cancellous allografting combined with Ti-alloy mesh for the reconstruction of the defected acetabula at the Second Department of Orthopaedics,First Hospital,Jilin University from January 2003 to July 2008. There were 13 males and 18 females,aged from 56-77 years,averagely 65 years. The time from previous surgery to this revision surgery was 2.5-11.0 years,averagely 8.3 years. The defects were classified into various types according to AAOS:type Ⅱ in 14 hips,type Ⅲ in 17 hips. The average pre-operation Harris score were 37 points. Bone cement was used to fix the prosthesis in 31 patients,and clinical evaluation and X-ray assessment were conducted following surgery. RESULTS:Following-up was done in 31 patients for 3 months to 5 years. 24 hours following surgery,passive functional exercises were conducted in the lower limb of patients. At 3 weeks,20 patients could get out of bed,with incompletely loading. Eleven patients got out of bed at 5 weeks following surgery,and did normal activities at 3 months. Harris score elevated averagely 45 points half years following surgery compared with preoperation,including 20 excellent cases,9 good cases,and 2 average cases,resulting in the excellent and good rate of 94%. At 3 months following surgery,no infection,fracture around the prosthesis,dislocation,nerve vessel and pelvic cavity organ damages or embolism were detected. The wound was delayed union,with discontinuous effusion in 3 patients till 3 weeks following surgery. None of these patients needed to be revised again and 2 cases had radiolucent line in radiograph plain film,which indicated that the bone graft might be absorbed. CONCLUSION:The treatment of acetabular defects by Ti-alloy mesh and impaction allograft in hip revision operation is easy and effective method.

Femoral head replacement or internal fixation for 45 patients with intertrochanteric fractures / 中国组织工程研究

0.05).The bed confine time,discharging time and postoperative complications in femoral head replacement group were superior over internal fixation group(P