Journal of orthopaedic surgery and research
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More elderly patients are suffering from intertrochanteric fractures. However, the choice of internal fixation is still controversial, especially in the treatment of unstable intertrochanteric fracture; thus, previous implants continue to be improved, and new ones are being developed. The purpose of our study was to compare the biomechanical advantages between the zimmer natural nail (ZNN) and proximal femoral nail antirotation-II (PFNA-II) in the treatment of elderly reverse obliquity intertrochanteric fractures. ⋯ The displacement in the two models was similar, but the stresses in the implant and bone were reduced with the ZNN. Therefore, the ZNN implant may provide biomechanical advantages over PFNA-II in reverse obliquity intertrochanteric fractures, as shown through the finite element analysis. These findings from our study may provide a reference for the perioperative selection of internal fixations.
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The risk factors, incidence, and clinical management of pulmonary cement embolism and neurological deficit during percutaneous vertebroplasty (PVP) were evaluated. ⋯ Cement leakage is relatively common but mostly of no clinical significance. Percutaneous vertebroplasty in thoracic spine and high amount of PMMA injected should be treated with caution in clinical practice.
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Comparative Study
Posterior open-door laminoplasty secured with titanium miniplates vs anchors: a comparative study of clinical efficacy and cervical sagittal balance.
Posterior open-door laminoplasty (PODL) is a common procedure for treating multilevel cervical spondylotic myelopathy (MCSM). Little information is available regarding the cervical sagittal balance and surgical efficacy of PODL when securing with different methods. Therefore, this study aims to investigate the clinical outcomes and the changes in cervical sagittal parameters and balance associated with PODL secured with titanium miniplates vs anchors. ⋯ PODL secured with titanium miniplates or anchors achieved good clinical efficacy in the treatment of MCSM. However, the patients with miniplates feel a better cervical functional status, while those with anchors spend less on hospitalization. Both methods lead to anteversion of cervical spine, but cervical sagittal balance after miniplates is better than that of anchors.
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The relationship between preoperative hip measurements and dislocation after bipolar hemiarthroplasty is presently unclear. In the current study, we investigated the morphological risk factors associated with dislocation after bipolar hemiarthroplasty of the hip in patients with femoral neck fractures. ⋯ Careful preoperative measurements before bipolar hemiarthroplasty of the hip are important. Surgical intervention for femoral neck fracture patients with a shallow acetabulum should be carefully planned and total hip arthroplasty should be considered when necessary.
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To investigate the feasibility and clinical efficacy of free vascularized iliac bone flap based on deep iliac circumflex vessels graft for the treatment of osteonecrosis of femoral head (ONFH) in young adults. ⋯ Free vascularized iliac bone flap based on deep circumflex iliac vessels graft is an acceptable treatment option for young adult ONFH in mid-late stage with low conversion to THA rate at short-term follow-up.