Acetabular erosion following bipolar hemiarthroplasty: A role for the size of femoral head?

Introduction

Femoral neck fractures are the most frequent fractures in the elderly and hemiarthroplasty is the treatment of choice. The objective of this multicenter study is to identify predictive factors of acetabular erosion after bipolar hemiarthroplasty (surgery between 1997 and 2007) in a mobile independent population during a follow-up of ten years.

Development of a Core Outcome Set for studies evaluating the effects of anaesthesia on perioperative morbidity and mortality following hip fracture surgery

Background

Perioperative studies of patients following hip fracture have large heterogeneity within their reported outcomes. This study aimed to develop a core outcome set for use in perioperative studies comparing the types of anaesthesia for hip fracture surgery.

The safety and feasibility of minimal invasive plate osteosynthesis (MIPO) of the posterior aspect of the humerus: A cadaveric study

The aim of this study was to determine the feasibility of applying MIPO of the humerus via the posterior approach and to observe the tension of the radial nerve in different elbow positions. Two separate incisions were made on the posterior aspect of the humerus in ten fresh cadavers (20 humeri). The radial nerve was identified at the proximal incision and the distances through which the nerve could be elevated from the bone with the elbow in flexion and extension were measured. A 10‐hole extra‐articular distal humeral locking compression plate was inserted and fixed through the submuscular tunnel. The tunnel was then explored to identify any entrapment of the radial nerve and to observe the anatomical relationship of the radial nerve to the plate and bone. There was no entrapment of the radial nerve or its branches. The distances through which the radial nerve could be elevated were greater with the elbow in extension than in flexion (P < 0.01). The radial nerve crossed the medial and lateral borders of the posterior surface of the humerus at 80.1–132 mm (average 104.7 mm) and 116.6–175.5 mm (average 142.7 mm) of its total length, respectively. The axillary nerve was located at 38.7–61.7 mm (average 47.9 mm) of total humeral length. MIPO of the humerus using the posterior approach is an alternative option for treating distal humeral shaft fracture. The risk of radial nerve injury can be minimized by careful dissection in the proximal incision. Clin. Anat. 32:176–182, 2019. © 2018 Wiley Periodicals, Inc.     

手法整复可调式外固定支具治疗第5掌骨颈骨折临床研究

目的:探讨可调式外固定支具治疗第5掌骨颈骨折的可行性及有效性。方法:选取2014年1月～2017年6月我院收治的54例第5掌骨颈骨折患者作为研究对象,随机分为A组和B组,每组27例。A组行闭合复位交叉克氏针固定,B组行手法整复可调式外固定支具固定,比较两组末次随访第5掌指关节活动度和主观满意度。结果:随访4～10个月,两组患者第5掌指关节活动度(ROM)值相比较,差异无统计学意义,P0.05;两组的主观满意度相比较,差异无统计学意义,P0.05。结论:手法整复可调式外固定支具固定可为第5掌骨颈骨折提供可靠、有效的固定,有助于患者的早期功能恢复,是一种有效的治疗方法。     

垫枕法联合经皮椎体成形术治疗老年骨质疏松胸腰椎压缩性骨折

目的：观察垫枕法联合经皮椎体成形术治疗老年骨质疏松胸腰椎压缩性骨折的效果。方法：选择老年骨质疏松胸腰椎压缩性骨折患者 40 例，予垫枕法联合经皮椎体成形术治疗，并观察患者术前及术后 1 个月在疼痛缓解、伤椎前缘高度、后凸畸形改善的情况。 结果：40 例患者术前疼痛视觉模拟评分（visual analogue scale，VAS）（6.76±1.16）、伤椎前缘高度（16.38±2.26）mm 及 Cobb 角（22.17±3.46）?，术后 1 个月 VAS 评分（2.34±0.73）、伤体前缘高度（28.45±6.46）mm及 Cobb 角（8.43±4.34）?，术后 1 个月患者在疼痛缓解、伤椎前缘高度、后凸畸形改善等方面较术前有明显区别（P<0.05）。结论：老年骨质疏松胸腰椎压缩性骨折经垫枕法联合经皮椎体成形术治疗，可明显减轻患者疼痛，改善后凸畸形。     

Complications of hand surgery

Hand surgery involves the surgical treatment of hand conditions and encompasses small bone fixation, arthroscopy, joint replacement and reconstruction of tendon and nerves. Complications following surgery to the hand may be due to patient factors, surgical decisions and the complex anatomy of the hand. Here we describe the complications associated with common surgical interventions for both elective and traumatic injuries to the hand. Following hand surgery, a balance between immobilisation and early range of motion is offset by the risk of wound complications, non-union of fractures and tendon re-rupture with stiffness and reduced range of motion of the digits. Superficial infection is relatively common following procedures to the hand, however long-term sequelae are rare. Implant failure, subsidence, instability and reduced range of motion are seen following arthroplasty procedures. Complex regional pain syndrome offers a significant challenge following injury to the hand and specifically after surgical procedures. Surgeons should consider the risk of particular surgical techniques, other perioperative factors and patient factors that may contribute to the development of complications following hand surgery. Patients should be adequately counselled in order to make an informed decision regarding the management of their condition.