Research progress of caput femoris posterior tilt and its impact on prognosis in nondisplaced femoral neck fractures / 中国骨伤

There are still many unresolved problems in the treatment and prognosis of nondisplaced femoral neck fractures, such as nonunion and avascular necrosis of the caput femoris .In order to reduce the risk of various complications after non-displaced femoral neck fractures, the caput femoris posterior tilt of femoral neck fractures and its impact on prognosis have attracted more and more attention. A large number of scholars' studies have found that when the posterior tilt exceeds 20°, the risk of internal fixation failure increases significantly. Based on this concept, we can choose to use primary artificial joint replacement instead of three-screw internal fixation according to the different posterior tilt angles of patients to reduce the incidence of postoperative complications. At the same time, our analysis found that comminution of the posterior segment of the femoral neck would lead to an increase in the posterior inclination angles. The purpose of this review was to investigate the relationship between caput femoris posterior tilt of femoral neck fractures and surgical outcome, and to introduce a new method for measuring caput femoris posterior tilt of the femoral neck.

Risk Factors for Failure of Nonoperative Treatment for Unilateral Cervical Facet Fractures

STUDY DESIGN: Retrospective clinical study. PURPOSE: The purpose of this study was to determine what percentage of patients who underwent nonoperative management of unilateral non-displaced or minimally displaced facet fractures progressed radiographically and to determine what percentage of patients required surgical intervention and to identify risk factors for failure of conservative management. OVERVIEW OF LITERATURE: According to most commonly used classification systems, unilateral, non-and minimally displaced facet fractures are be amendable to nonoperative management. METHODS: A retrospective review of the Trauma Registry of a Level I trauma center was performed to identify all patients diagnosed with a non- or minimally displaced unilateral facet fracture which was managed nonoperatively. Several demographic variables and clinical outcomes were recorded. Using computed tomography scanning and plain radiographs, fracture pattern, listhesis, displacement, angle and percentage of the facet that included the fracture were determined. Radiographic progression was defined as the occurrence of listhesis of more than 10% of the anterior-posterior dimensions of the inferior vertebral body during radiographic follow-up. Failure of conservative management was defined as a patient requiring surgical intervention after initially being managed nonoperatively. RESULTS: Seventy-four patients were included. Fifteen patients (20%) progressed radiographically. However, only 2 developed radicular symptoms and none developed myelopathy or other catastrophic cord related symptoms. Seven patients (9%) underwent surgery. Indications for surgery included significant radiographic progression and/or radicular symptoms. Risk factors for failure of conservative management included presence of radiculopathy at the time of presentation, a higher body mass index, increased Injury Severity Score, greater initial fracture displacement and more than 2 mm of listhesis. CONCLUSIONS: Patients with non-displaced or minimally displaced facet fractures who do not have neurological symptoms at the time of presentation can safely be managed conservatively with careful observation and follow-up.

Study result of the influence of risk factors in bone setting treatment Colles fracture / Монголын Анагаах Ухаан

Introduction Irish surgeon Abraham Coll bone lower forearm Call an end in 1814 reports about the location extension breaks, fractures, called colles fractures. It is common fractures account for 10-20% of the total respectively fracture, the bottom end 75% of bone fracture forearm. Number of elderly patients in developed countries has increased, an increasing number of these refractive growth. In 2001, in the cases of 640,000 fracture United States forearm bone bottom colles. Purpose Study for the influence of risk factors in bone setting treatment Colles fracture Objectives: 1. Forearm bone assessment bottom Colles displaced, some of the causes which affect nondisplaced fractures, depending upon risk factors 2. Forearm bone to assess what the lower end Colles healing some of the risk factors that may affect the fracture Materials and Methods Trauma and Orthopedic research studies involving the term “Emergency Department” at the forearms of 80 people age 5-76 bone treatment in patients who received the peace at the lower end Colles fracture the national center. Respondents grooming, nongrooming divided into 2 groups, which may not be received and confirmed by refractive index difference in X-ray. To analyze the data elements of descriptive statistics was used (mean, standard deviation, percentage distribution). As a result of calculating the difference between the data expressed as a percentage Use Pearson’s chi-squares method. If using T-test method to calculate the difference between the data and the P value less than 0.05 considered statistically accurate. Calculating the relationship between the power of the data evaluated the relationship using spearman correlation coefficient. Result Some of the causes and risk factors are compared between groups, Colles difference nondisplaced fracture purity (r=0.18, p=0.21) or a weak relationship, Colles difference, compared to the nondisplaced fracture the use of calcium supplementation (r=0.21, p=0.06) associations, Colles difference, gender nondisplaced fracture compared (r=0.28, p=0.01) weaknesses related were statistically significant. Conclusion 1. Colles difference nondisplaced fractures when used in alcohol risk factors affect the injury took place, and menopause are diagnosed with osteoporosis, previous calcium intake is associated with weak damage. 2. Colles difference refraction healing has 24-hour loss of time covered detonations often bear physical therapy show his hand and damaged a hospital that affect healing.

RISK FACTORS THAT INFLUENCE THE CLOSED REDUCTION MANAGEMENT OF THE COLLES’ FRACTURE / Мэс засал

Introduction: In 1814 Irish surgeon Abraham Coll first introduced distal radial bone fracture in clinical practice as a colles fracture. It is one of the most common fractures account for 10-20% of the total respectively fracture. Case of Colles fracture has being increased in the developed country year by year besides the increasing number of elderly patients. Depending on severity displaced of the fracture, management includes closed reduction or surgical procedure. The aim of study was to study result of risk factors that influence the closed reduction management of the Colles fracture. Materials and Methods: From hospital based population 80 patients aged between 5-76 years (mean age 47.31 years, male 61.25%, female 38.7%) were recruited by cross sectional and randomized method. Participants were divided into displaced and non-displaced groups which confirmed by refractive index difference on X-ray. Results: The risk factors that influence the colles fracture closed reduction management was osteoporosis (p=0.38), menopause (r=0.18, p=0.27), calcium supplement intake (r=0.21, p=0.05), received hospital care in 24 hour (p=0.39), apply plaster (p=0.64), hand sling immobilizer brace (p=0.5) and physical therapy (p=0.5). Conclusion: Osteoporosis and menopause were the risk factors that influenced the closed reduction management of Colles fracture. The patient cases that not receiving emergency medical care in first 24 hours, not applying plaster, not using the hand sling immobilizer brace and not receiving physical therapy was risk factors for extending the closed reduction management of the Colles fracture.

RISK FACTORS THAT INFLUENCE THE CLOSED REDUCTION MANAGEMENT OF THE COLLES’ FRACTURE / Мэс засал

Introduction: In 1814 Irish surgeonAbraham Coll first introduced distal radialbone fracture in clinical practice as a collesfracture. It is one of the most commonfractures account for 10-20% of the totalrespectively fracture. Case of Colles fracturehas being increased in the developed countryyear by year besides the increasing numberof elderly patients. Depending on severitydisplaced of the fracture, managementincludes closed reduction or surgicalprocedure. The aim of study was to studyresult of risk factors that influence theclosed reduction management of the Collesfracture.Materials and Methods: From hospitalbased population 80 patients aged between5-76 years (mean age 47.31 years, male61.25%, female 38.7%) were recruited bycross sectional and randomized method.Participants were divided into displaced andnon-displaced groups which confirmed byrefractive index difference on X-ray.Results: The risk factors that influence thecolles fracture closed reduction managementwas osteoporosis (p=0.38), menopause(r=0.18, p=0.27), calcium supplement intake(r=0.21, p=0.05), received hospital care in24 hour (p=0.39), apply plaster (p=0.64),hand sling immobilizer brace (p=0.5) andphysical therapy (p=0.5).Conclusion: Osteoporosis and menopausewere the risk factors that influenced theclosed reduction management of Collesfracture. The patient cases that not receivingemergency medical care in first 24 hours,not applying plaster, not using the hand slingimmobilizer brace and not receiving physicaltherapy was risk factors for extending theclosed reduction management of the Collesfracture.