Hemiarthroplasty vs Total Hip Arthroplasty for the Management of Displaced Neck of Femur Fractures: A Systematic Review and Meta-Analysis

BackgroundDisplaced femoral neck fractures (DFNF) are common and can be treated with osteosynthesis, hemiarthroplasty (HA), or total hip arthroplasty (THA). There is no consensus as to which intervention is superior in managing DFNF.MethodsStudies were identified through a systematic search of the MEDLINE database, EMBASE database, and Cochrane Controlled Trials. Included studies were randomized or controlled trials (1966 to August 2018) comparing THA with HA for the management of DFNF. (https://www.crd.york.ac.uk/PROSPERO Identifier: CRD42018110057).ResultsSeventeen studies were included totaling 1364 patients (660 THA and 704 HA). THA was found to be superior to HA in terms of risk of reoperation, Harris Hip Score and Quality of Life (Short Form 36). Overall, the risk of dislocation was greater in THA group than HA in the first 4 years, after which there was no difference. There was no difference between THA and HA in terms of mortality or infection.ConclusionOverall, THA appears to be superior to HA. THA should be the recommended intervention for DFNF in patients with a life expectancy >4 years and in patients younger than 80 years. However, both HA and THA are reasonable interventions in patients older than 80 years and with shorter life expectancy.     

来华MBBS留学生物理诊断实践课教学探讨与思考

全英文教学的本科临床医学专业(bachelor of medicine and bachelor of surgery,MBBS)留学生物理诊断学实践课带教中存在缺乏统一教材、语言交流障碍、文化背景差异、纪律性较差等问题.带教教师需努力提高自身语言和专业水平,加强对留学生的管理和交流.针对MBBS留学生的特点可采用多元教学模式和考核评估系统,努力提高留学生的教学质量.