Objective： To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation （PFNA）. Methods： From September 2008 to March 2009, 3...Objective： To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation （PFNA）. Methods： From September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 hours after injury. There were 10 type Ⅰ fractures, 19 type Ⅱand 6 type Ⅲ according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists （ASA）, there were 9 grade Ⅰ, 14 grade Ⅱ, 8 grade Ⅲ, and 4 grade Ⅳ. Results： The duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2-4 days after operation （mean 3.5 days）. Hospital stay was 4-7 days （mean 5.3 days）. Full weight bearing time was 10-14 weeks （mean 12.8 weeks）. During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15-18 weeks （mean 16.6 weeks）. No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had troehanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%. Conclusion： The emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation, less blood loss, shorter length of展开更多
Objective： Subtrochanteric femoral fractures are severe injuries. Although many treatment methods have been developed, controversy exists regarding the optimal management of these fractures. This study evaluated the ...Objective： Subtrochanteric femoral fractures are severe injuries. Although many treatment methods have been developed, controversy exists regarding the optimal management of these fractures. This study evaluated the clinical outcome of subtrochanteric femoral fractures fixed with long proximal femoral nail antirotation （PFNA-Iong）. Methods： Between October 2006 and February 2008, 25 patients with traumatic subtrochanteric fractures of the femur were treated with PFNA-long. Closed reduction and fixation were performed in 20 cases. In the remaining 5 cases, closed reduction was difficult, so limited open reduction was performed, with bone grafting in 4 cases and circumfer-ential wiring in 4 cases. Results： The average follow-up time was 16.1 months. All subtrochanteric femoral fractures healed uneventfully except one case of delayed union. The mean union time was 26.2 weeks. Technical difficulties with nail insertion were encountered in 3 cases. No implant failure was observed. Conclusion： PFNA-long is effective in treatment of subtrochanteric femoral fractures, with a high rate of bone union, minor soft tissue damage, early return to functional exercise and few implant-related complications.展开更多
The microstructure,mechanical properties and corrosion behavior of quaternary degradable Mg−1Zn−0.2Ca−xAg(x=1,2,4 wt.%)alloy wires,intended as anastomotic nails,were investigated.It was found that these Ag-containing ...The microstructure,mechanical properties and corrosion behavior of quaternary degradable Mg−1Zn−0.2Ca−xAg(x=1,2,4 wt.%)alloy wires,intended as anastomotic nails,were investigated.It was found that these Ag-containing alloy wires mainly consist of Mg matrix and Ag17Mg54 phase,characterized by SEM,EDS,XRD and TEM.Tensile and knotting tests results demonstrate the superior mechanical properties of these alloy wires.Especially,Mg−1Zn−0.2Ca−4Ag alloy exhibits the highest mechanical properties,i.e.an ultimate tensile strength of 334 MPa and an elongation of 8.6%.Moreover,with increasing Ag content,the corrosion rates of these alloy wires remarkably increase due to the formation of more micro-galvanic coupling between Mg matrix and Ag17Mg54 phase,shown by mass loss and scanning Kelvin probe force microscopy(SKPFM)results.The present alloy can be completely degraded within 28 d,satisfying the property requirements of anastomotic nails.展开更多
文摘Objective： To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation （PFNA）. Methods： From September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 hours after injury. There were 10 type Ⅰ fractures, 19 type Ⅱand 6 type Ⅲ according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists （ASA）, there were 9 grade Ⅰ, 14 grade Ⅱ, 8 grade Ⅲ, and 4 grade Ⅳ. Results： The duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2-4 days after operation （mean 3.5 days）. Hospital stay was 4-7 days （mean 5.3 days）. Full weight bearing time was 10-14 weeks （mean 12.8 weeks）. During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15-18 weeks （mean 16.6 weeks）. No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had troehanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%. Conclusion： The emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation, less blood loss, shorter length of
文摘Objective： Subtrochanteric femoral fractures are severe injuries. Although many treatment methods have been developed, controversy exists regarding the optimal management of these fractures. This study evaluated the clinical outcome of subtrochanteric femoral fractures fixed with long proximal femoral nail antirotation （PFNA-Iong）. Methods： Between October 2006 and February 2008, 25 patients with traumatic subtrochanteric fractures of the femur were treated with PFNA-long. Closed reduction and fixation were performed in 20 cases. In the remaining 5 cases, closed reduction was difficult, so limited open reduction was performed, with bone grafting in 4 cases and circumfer-ential wiring in 4 cases. Results： The average follow-up time was 16.1 months. All subtrochanteric femoral fractures healed uneventfully except one case of delayed union. The mean union time was 26.2 weeks. Technical difficulties with nail insertion were encountered in 3 cases. No implant failure was observed. Conclusion： PFNA-long is effective in treatment of subtrochanteric femoral fractures, with a high rate of bone union, minor soft tissue damage, early return to functional exercise and few implant-related complications.
基金The authors are grateful for the financial supports from the National Natural Science Foundation of China(51671017 and 51971020)the Beijing Municipal Natural Science Foundation,China(2202033)+2 种基金Beijing Laboratory of Metallic Materials and Processing for Modern Transportation,China,the Fundamental Research Funds for the Central Universities,China(FRF-IC-19-015)the Major State Research and Development Program of China(2016YFB0300801)the Opening Research Fund of State Key Laboratory for Advanced Metals and Materials,China(2018-Z04).
文摘The microstructure,mechanical properties and corrosion behavior of quaternary degradable Mg−1Zn−0.2Ca−xAg(x=1,2,4 wt.%)alloy wires,intended as anastomotic nails,were investigated.It was found that these Ag-containing alloy wires mainly consist of Mg matrix and Ag17Mg54 phase,characterized by SEM,EDS,XRD and TEM.Tensile and knotting tests results demonstrate the superior mechanical properties of these alloy wires.Especially,Mg−1Zn−0.2Ca−4Ag alloy exhibits the highest mechanical properties,i.e.an ultimate tensile strength of 334 MPa and an elongation of 8.6%.Moreover,with increasing Ag content,the corrosion rates of these alloy wires remarkably increase due to the formation of more micro-galvanic coupling between Mg matrix and Ag17Mg54 phase,shown by mass loss and scanning Kelvin probe force microscopy(SKPFM)results.The present alloy can be completely degraded within 28 d,satisfying the property requirements of anastomotic nails.
