全麻下血管化游离皮瓣修复术后患者谵妄的危险因素

Objective To investigate the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.Methods Two hundred and sixteen ASA Ⅰ-Ⅲ patients aged 18-80 yr undergoing vascular free flap reconstruction surgery were enrolled in this study.Patient characteristics before and during operation were recorded.The patients were followed up for 5 days after operation.Their level of consciousness,severity of pain and sleep quality were evaluated daily.The patients were divided into 2 groups according to the occurrence of delirium during the 5 days after operation:delirium group and non-delirium group.The method of CAM-ICU was reed in the diagnosis of postoperative delirium.Multivariate logistic regression was used to analyze the risk factors for postoperative delirium.Results logistic regression analysis showed that old age,history of alcohol abuse and sleep diacrder after operation were risk factors for delirium developed after free flap surgery.Conclusion Old age,history of alcohol abuse and sleep disorder after operation were the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.     

全麻下血管化游离皮瓣修复术后患者谵妄的危险因素

Objective To investigate the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.Methods Two hundred and sixteen ASA Ⅰ-Ⅲ patients aged 18-80 yr undergoing vascular free flap reconstruction surgery were enrolled in this study.Patient characteristics before and during operation were recorded.The patients were followed up for 5 days after operation.Their level of consciousness,severity of pain and sleep quality were evaluated daily.The patients were divided into 2 groups according to the occurrence of delirium during the 5 days after operation:delirium group and non-delirium group.The method of CAM-ICU was reed in the diagnosis of postoperative delirium.Multivariate logistic regression was used to analyze the risk factors for postoperative delirium.Results logistic regression analysis showed that old age,history of alcohol abuse and sleep diacrder after operation were risk factors for delirium developed after free flap surgery.Conclusion Old age,history of alcohol abuse and sleep disorder after operation were the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.     

Relationship between surgical time and postoperative complications in senile patients with hip fractures

Objective：To elucidate the relationship between surgical time and postoperative complications in senile patients with hip fractures, and try to find out other factors which are related to these complications.Methods： Sixty-two patients, 28 males aged from 65 to 72 years with a mean age of 76.3 years and 34 females aged from 65 to 95 years with a mean age of 78.1 years, who had undergone orthopedic surgery because of hip fractures,were enrolled in a retrospective cohort study. The surgical time and pattern, the type of fracture, preoperative comorbidities, American Society of Anesthesiologists （ASA） score and the volume of blood transfusion during operation were obtained from these patients who were followed up by telephone calls for postoperative complications.All the patients were followed up at least for 1 year and were divided into subgroups according to their clinical characteristics and the results were analyzed by the Statistical Analysis System software.Results：There was no significant difference in the morbidity of postoperative eomplications with the gender,age,surgical time and pattern,or ASA score. There was significant difference in the morbidity of postoperative complications related to preoperative comorbidities and the volume of blood transfusion. There was a significant causality between preoperative comorbidities and postoperative complications. The morbidity of postoperative complications was 1.651 times higher in patients with preoperative comorbidities than those without.Conclusions：There is no relationship between the surgical time and postoperative complications in senile patients who received surgery for hip fracture within 1 year.No correlation is found between the postoperative complications and gender,age,type of fracture, surgical pattern,ASA score and the volume of blood transfusion. Preoperative comorbidities are an independent predictor for postoperative complications.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

提高股骨干骨折合并同侧股骨颈骨折早期诊断率的前瞻性研究

Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.     

Locational distribution characteristics and risk factors of heterotopic ossification following traumatic elbow stiffness北大核心CSCD

Objective To study the locational distribution characteristics of the heterotopic ossification (HO) following traumatic elbow stiffness and the risk factors for HO development at different locations. Methods Consecutively included according to our inclusion criteria in the present study were the patients who had been admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from January 2018 to December 2018 for elbow release due to traumatic elbow stiffness but developed postoperative HO. Their baseline data and CT data were collected and processed using Mimics 20. 0. The HO distribution for each patient was characterized at the anteromedial, anterolateral, posteromedial, posterolateral, posterior, medial, lateral, and proximal radioulnar locations. The patient's original injury was categorized into 5 types： distal humerus fracture, olecranon fracture, radial head fracture, coronoid fracture, and elbow dislocation -After the univariate analysis with the HO occurrence at a specific location as the dependent variable and the original injury and baseline data as the independent variables, the factors with P value less than 0. 1 were included in the logistic regression analysis to determine the risk factors for HO at each location. Results A total of 91 patients were included in this study. Of them, 88 had posteromedial HO (96. 7%, 88/91), 62 posterior HO (68.1%, 62/91), 60 posterolateral HO (65. 9%, 60/91), 41 an-teromedial HO (45. 1%, 41/91), 26 anterolateral HO (28.6% ， 26/91), 13 proximal radioulnar HO (14.3%, 13/91), 8 lateral HO (8.8%， 8/91), and 7 medial HO (7.7%， 7/91) . Logistic regression analysis showed that presence of ulnar nerve symptoms (OR - 4. 354, P = 0. 017) and presence of original elbow dislocation (OR = 2. 927, P = 0. 042) were the independent risk factors for the anteromedial HO development and that presence of original olecranon fracture (OR = 0. 277, P = 0. 023) was the protective factor for the anteromedial HO development. Presence of original radial head fracture was the independent risk factor for the anterolateral HO development (OR =2. 891， P = 0. 033) and the posterolateral HO development (OR = 3. 123, P = 0. 043). Conclusions HO development in patients with posttraumatic elbow stiffness is closely related to their original injury. Posteromedial HO may develop in almost all the patients. Patients with ulnar nerve symptoms and original elbow dislocation are more prone to anteromedial HO development, but patients with o-riginal olecranon fracture are less likely to develop anteromedial HO. Patients with original radial head fracture are more likely to develop anterolateral and posterolateral HO. © The Author(s) 2022.     

Strategy for prevention of hip fractures in patients with Parkinson’s disease

Hypovitaminosis D and K due to malnutrition or sunlight deprivation,increased bone resorption due to immobilization,low bone mineral density(BMD)and an increased risk of falls may contribute to an increased risk of hip fractures in patients with Parkinson’s disease.The purpose of the present study was to clarify the efficacy of interventions intended to prevent hip fractures in elderly patients with Parkinson’s disease.Pub Med was used to search the literature for randomized controlled trials(RCTs)regarding Parkinson’s disease and hip fractures.The inclusion criteria were 50 or more subjects per group and a study period of 1 year or longer.Five RCTs were identified and the relative risk and95%confidence interval were calculated for individual RCTs.Sunlight exposure increased serum hydroxyvitamin D[25(OH)D]concentration,improved motor function,decreased bone resorption and increased BMD.Alendronate or risedronate with vitamin D supplementation increased serum 25(OH)D concentration,strongly decreased bone resorption and increased BMD.Menatetrenone(vitamin K2)decreased serum undercarboxylated osteocalcin concentration,decreased bone resorption and increased BMD.Sunlight exposure(men and women),menatetrenone(women),alendronate and risedronate with vitamin D supplementation(women)significantly reduced the incidence of hip fractures.The respective RRs(95%confidence intervals)according to the intention-to-treat analysis were 0.27(0.08,0.96),0.13(0.02,0.97),0.29(0.10,0.85)and 0.20(0.06,0.68).Interventions,including sunlight exposure,menatetrenone and oral bisphosphonates with vitamin D supplementation,have a protective effect against hip fractures elderly patients with Parkinson’s disease.     

Does total hip arthroplasty provide better outcomes than hemiarthroplasty for the femoral neck fracture? A systematic review and meta-analysis

Purpose: By comparing the outcomes of total hip arthroplasty with hemiarthroplasty in elderly patients with a femoral neck fracture to investigate the one-year mortality, dislocation, infection, reoperation rate, and thromboembolic event. Methods: The PubMed, EMBASE databases, and Cochrane library were systematically searched from the inception dates to April 1, 2020 for relevant randomized controlled trials in English language using the keywords: “total hip arthroplasty”, “hemiarthroplasty” and “femoral neck fracture” to identify systematic reviews and meta-analyses. Two reviewers independently selected articles, extracted data, assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’ stools, and discussed any disagreements. The third reviewer was consulted for any doubts or uncertainty. We derived risk ratios and 95% confidence intervals. Mortality was defined as the primary outcome. Secondary outcomes were other complications, dislocation, infection, reoperation rate, and thromboembolic event. Results: This meta-analysis included 10 studies with 1419 patients, which indicated that there were no significant differences between hemiarthroplasty and total hip arthroplasty in reoperation, infection rate, and thromboembolic event. However, there was a lower mortality and dislocation rate association with total hip arthroplasty at the one-year follow-up. Conclusion: Based on our results, we found that total hip arthroplasty was better than hemiarthroplasty for a hip fracture at one-year follow-up.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.