[Comparison of three methods of internal fixations for intertrochanteric femoral fractures in elderly patients].

OBJECTIVE: To compare the clinical effects of three methods of internal fixations in treating intertrochanteric fractures in elderly patients. METHODS: From 2004 to 2008, the clinical data of 112 patients with intertrochanteric fractures were retrospectively analyzed. There were 63 males and 49 females, aged from 60 to 80 years with an average of 66.2 years. The patients were treated respectively with dynamic hip screws (DHS group, 40 cases), anatomic plate (anatomic plate group, 36 cases) and proximal femoral intramedullary nails (PFN group, 36 cases). The data of each group were collected for statistical analysis on the following aspects: operative time, blood loss volume, clinical healing time of fracture, postoperative complications, and hip functional score of Harris. RESULTS: All these patients were followed up from 20 to 24 months with an average of 22.6 months. There was no significant difference in operative time, blood loss volume among three groups; there was significant difference in clinical healing time of fracture, Harris score and postoperative complications among three groups (P < 0.05). In the healing time, the PFN group was significantly less than that of other groups (P = 0.001), but there was no differences between DHS group and anatomic plate group. In the Harris score, the PFN group was significantly higher than that of other groups (P = 0.001), but there was no differences between DHS group and anatomic plate group. In the aspect of postoperation complication, there was 2 cases of coxa vara, 1 case of internal fixation loosening and 1 case of deep venous thrombosis in the DHS group; there were 2 cases of deep venous thrombosis in the PFN group; there were 2 cases of coxa vara and 1 case of internal fixation loosening in the anatomic plate group (P = 0.001). CONCLUSION: In the treatment of intertronchanteric fractures, proximal femoral intramedullary nail may be the best choice, which can decrease healing time as well as complications postoperatively.

[Study on the correlations between the bone quality and level of u-DPD and serum 1,25-(OH)2D3 in the ovariectomized osteoporosis rats].

OBJECTIVE: To study the correlations between the bone quality and level of u-DPD and serum 1,25-dihydroxyvitamin D3 in the ovariectomized osteoporosis rats. METHODS: Forty female rats were randomly divided into the ovariectomy group (the OVX group) and the sham-operation group (the Sham group), and draw materials in 12 and 24 weeks after operation. Bone mineral density (BMD) of the 1st lumbar, the femoral neck and femur was measured by dual-energy X-ray absorptionetry. The level of urine DPD was measured by ELISA. The concentration of 1,25-dihydroxyvitamin D3 in serum was measured by radioimmunoassay (RIA). The limit of compressive strength and elastic modulus of 1st lumbar and bending load of right femur were measured by photoelasticity meter. The osseous morphology of upper tibia was measured by the non-decalcifing section. The correlation of experimental data was analyzed by statistical method. RESULTS: In ovariectomy group, except the level of urine DPD/Cr was increase, all data decreased significantly compared with the samp group,and descending continually with the lapse of time. The results showed that there was a negative correlation between the urine DPD/Cr and BMD of the 1st lumbar, femur, the limit of compressive strength of 1st lumbar, bending load of femur and trabecular bone area. But there was a positive correlation significantly between the concentration of 1,25-dihydroxyvitamin D3 in serum and BMD of the 1st lumbar, the femoral neck and femur, trabecular bone area, the limit of compressive strength of 1st lumbar, bend load of femur. CONCLUSION: The correlation is remarkable between the bone quality and the level of urine DPD/Cr, 1,25-dihydroxyvitamin D3 in serum. We can predict the bone quality by measuring the level of urine DPD/Cr and 1,25-dihydroxyvitamin D3 in serum.

[Effect of jiangu granule on quality of bone in model rats with osteoporosis induced by ovariectomy].

OBJECTIVE: To study the effect of Jiangu granule (JGG) on quality of bone in model rats with osteoporosis. METHODS: Osteoporosis model was established by means of ovariectomy. Bone mineral density (BMD) was measured with dual energy X-ray densitometry. Osseous tissue structure of upper tibia was observed by ono-decalcified section and toluidine blue staining, and morphometry was carried out. Compressive strength limit and elastic modulus of first lumbar vertebrae, and bend load of femur were measured by light-based elastometer. RESULTS: JGG can significantly increase BMD, area of trabecula and thickness of bone cortex/diameter of marrow cavity ratio of model rats, to elevate the compressive strength limit of vertebrae and bend load of femur. CONCLUSION: JGG could increase BMD of osteoporosis model rats, and also could effectively improve the structure of osseous tissue, biomechanical property of bone and enhance the overall quality of bone.