[Comparison of total hip arthroplasty with conventional instrument OCM approach and posterolateral approach in supine position].

OBJECTIVE: To compare the clinical efficacy of total hip arthroplasty with conventional instrument OCM approach and posterolateral approach in supine position. METHODS: From February 2017 to January 2019, 67 patients underwent hip arthroplasty due to hip diseases, including 21 patients in the minimally invasive group, 12 males and 9 females;there were 10 cases of femoral neck fracture, 5 cases of aseptic necrosis of femoral head and 6 cases of hip osteoarthritis. In the traditional group, 46 cases were treated by traditional posterolateral approach, including 28 males and 18 females;there were 24 cases of femoral neck fracture, 12 cases of aseptic necrosis of femoral head and 10 cases of hip osteoarthritis. All patientsused biological ceramic artificial joint prosthesis. The operation time, intraoperative bleeding, incision length, preoperative and postoperative creatine kinase (CK-NAC), underground activity time, hospital stay, abduction angle and anteversion angle of prosthesis were observed and compared between two groups. Harris scores before operation and 12 months after operation were compared between two groups. RESULTS: All cases were followed up for 14 to 26(18.4±3.6) months. There was no significant difference in intraoperative bleeding, postoperative anteversion and abduction angle between two groups (P>0.05). There were significant differences in operation time, incision length, postoperative creatine kinase, underground time and hospital stay between two groups (P<0.05). There was no significant difference in Harris function score between two groups before operation and 12 months after operation(P>0.05). CONCLUSION: The two approaches of total hip arthroplasty can obtain satisfactory results.OCM approach has less damage and rapid postoperative recovery. It is a reliable surgical approach and can be popularized and used.

[Pressure interlocking intramedullary nailing fixation and bone grafting for treatment of tibial fracture nonunion].

OBJECTIVE: To explore the curative effect of intramedullary nailing pressure within a fixed period with a bone graft taken from the opening of intramedullary nailing on tibial fracture nonunion. METHODS: From February 2008 to October 2010, 18 patients with nonunion of tibial shaft were treated by pressurized intramedullary nail fixation and bone grafting taken from the opening of intramedullary nailing. They included 12 males and 6 females ranging in age from 31 to 67 (mean 42) years. The time from injury to surgery was 6-18 months (mean 8 months). There were 11 cases of nonunion and 7 cases of delayed union. After operation, the knee function was evaluated according to HSS scoring. The therapeutic effect was assessed by Tenny-Wiss scoring system. RESULTS: All patients were followed up for 12-36 (mean 18) months. The wound healed well without infection or skin necrosis. All patients had no nonunion, infection, deformity, and re-fracture. The bone healing time was from 4 to 8 months (mean 6 months). The HHS score of knee function 1 year after surgery averaged (89.97 +/- 3.21). The effect result of Tenny and Wiss scoring system was excellent in 16 cases and good in 2 cases. CONCLUSION: Open reduction by intramedullary nail fixed within a period with bone graft (from the opening of intramedullary nailing) for treatment of nonunion and delayed union of tibial fracture can improve the fracture healing rate, avoid complications from iliac bone grafting, and reduce medical expenses.