Clinical efficacy of DHS and PFNA for treatment of senile patients with intertrochanteric fracture and Parkin-son’ s disease / 局解手术学杂志

Objective To explore the clinical efficacy of dynamic hip screw( DHS) and proximal femoral nail anti-rotation( PFNA) in treatment of patients with Parkinson’ s disease and intertrochanteric fracture. Methods A total of 62 elderly patients of Parkinson’ s disease with femoral intertrochanteric fracture in our hospital from February 2010 to February 2014 were divided into two groups according to different internal fixations,with 31 cases in DHS group and PFNA group respectively. The operation time,X-ray fluoroscopy times,intraoperatve blood soss,the healing time of fracture,postoperative complications and Harris score between two groups were recorded and compared statistically. Results The operation time,intraoperatve blood soss and the clinical healing time of PFNA group were significantly lower than those of DHS group,the differences were statistically significant (P0. 05). Conclusion The PFNA has the advantages of shorter operation time,less bleed-ing,faster healing time in treatment for elderly patients with Parkinson’ s disease and intertrochanteric fracture,worth clinical promotion.

Treatment for culture-negative periprosthetic joint infection after total hip arthroplasty with revision / 局解手术学杂志

Objectives To compare the effect of one-stage revision and two-stage revision for the treatment of culture-negative peripros-thetic joint infection after total hip arthroplasty.Methods A retrospective study was conducted with the clinical data of 41 patients who had chronic periprosthetic joint infection after total hip arthroplasty and then underwent one or two-stage revision surgery from February 2006 to February 2014.The patients were divided into two groups according to different surgical way,namely the 16 patients who received the one-stage revision surgery were regarded as the OSR group,and the other 25 cases who underwent the two-stage revision surgery were regarded as the TSR group.The clinical efficacy of the two surgical way were assessed with Harris Hip score,visual analogue scale (VAS),and rate of infection clearance.Results The average duration of follow up was 29.7 months (9 to 48 months).At the last follow-up,Harris Hip score of TSR group was higher than that of the OSR group,and the difference was statistically significant (P =0.04),and the VAS score of TSR group was lower than that of the OSR group with statistical differences (P =0.02).Additionally,the rate of infection clearance in TSR group was significantly higher than OSR group (P =0.04).Conclusion Culture-negative periprosthetic joint infection can be effectively controled by one or two-stage revision surgery.However,patients got a better prognosis after two-stage revision surgery.

Analysis on surgical treatment efficacy of lumbar spondylolisthesis patients with modic change / 局解手术学杂志

Objective To investigate the treatment efficacy of lumbar spondylolisthesis patients with modic change. Methods The da-ta of 45 lumbar spondylolisthesis patients with modic change were analyzed retrospectively,which were admitted into hospital from January 2010 to December 2013 and received posterior lumbar interbody fusion ( PLIF) surgery. Those patients were tested by X-ray and Magnetic resonance imaging ( MRI) and confirmed the type of spondylolisthesis and Modic change. Based on the degree of spondylolysis and whether combined or not with Modic change,all the patients were divided into six groups:group A with Ⅱ grade spondylolisthesis;group B with Ⅲgrade spondylolisthesis;group C with Ⅱ grade spondylolisthesis with Modic typeⅠ;group D withⅡgrade spondylolisthesis with Modic typeⅡ;group E with Ⅲ grade spondylolisthesis with Modic type Ⅰ;group F with Ⅲ grade spondylolisthesis with Modic type Ⅱ. Those patients were evaluated preoperatively and postoperatively the scores according to the Visual Analogue Scale ( VAS) and Oswestry Disability Index ( ODI) systems,the obtained data were statistically analyzed and then were used to evaluated the treatment efficacy. Results The treatment efficacy of those patients were evaluated by follow-up work based on the scores of VAS and ODI systems,the results indicated that all those patients were improved in the scores of pain and ODI at different agrees. Within groups,the scores of low back and leg pain in VAS system and ODI preoperative were all significantly lower than that of postoperative (P0. 05). Conclusion Those spondylolisthesis patients with Modic change could obtained satisfactory clinical efficacy after posterior lumbar interbody fusion ( PLIF) surgery.