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简介：AbstractPurpose:Treatment of irreducible femoral intertrochanteric fractures often requires open reduction. However, the technique unavoidably causes patients to suffer greater trauma. As such, minimally invasive techniques should be employed to reduce the surgical-related trauma on these patients and maintain a stable reduction of the fractures. Herein, a minimally invasive wire introducer was designed and used for the treatment of femoral intertrochanteric fractures. The effectiveness of using a wire-guided device to treat irreducible femoral intertrochanteric fractures was evaluated.Methods:Between 2013 and 2018, patients with femoral intertrochanteric fractures who were initially treated by intramedullary nail fixation but had difficult reduction using the traction beds were retrospectively reviewed. Decision for an additional surgery was based on the displacement of the fracture. The patients were then divided into two groups: those in the control group received an open reduction surgery while those in the observation group received a closed reduction surgery using a minimally invasive wire introducer to guide the wire that could assist in fracture reduction. The operation time, blood loss, visual analogue scale scores, angulation, reduction, neck-shaft angle, re-displacement, limb length discrepancy, and union time were then recorded and analyzed to determine the efficiency of the wire introducer technique. Categorical variables were analyzed by using Chi-square test, while continuous variables by independent t-test and the Mann-Whitney test accordingly.Results:There were 92 patients included in this study: 61 in the control group and 31 in the observation group. There were no significant differences in baseline demographic factors between the two groups. All surgeries were successful with no deaths within the perioperative period. The average follow-up time for the patients was 23.8 months. However, the observation group had a significantly shorter operation time, lower visual analogue scale score, less intraoperative bleeding, and shorter fracture healing time. There were no significant differences in the angulation, reduction, neck-shaft angle, and limb length discrepancy between the two groups.Conclusion:The minimally invasive wire guide achieved a similar effect to that of open reduction in the treatment of intertrochanteric fractures with difficult reduction. Moreover, the minimally invasive wire introducer is a good technology that accurately guides the wire during reduction. Indeed, it is an effective technique and achieves good clinical outcomes in restoration of irreducible femoral intertrochanteric fractures.

简介：Thescopeofinterventionalcardiologyhasrapidlyexpandedoverthelastseveraldecades.Inafieldwhereproceduraltreatmentoptionsforavarietyofcomplexcardiovascularconditionshavegrownexponentially,theimportanceofproceduralsafetycontinuestocometotheforefront.Thisismostevidentinthemovementtowardradialaccessastheinitialapproachforoperatorsinthecardiaccatheterizationlaboratory.Astheevidencegrowsforthesuperiorityofradialaccessoverfemoralaccesswithregardtoreducingbleedingeventsandimprovingclinicaloutcomes,wediscussthemodernapproachtoobtainingaccess,andhighlightbestpractices.

简介：Thispaperpresentsthedevelopmentofthebloodflowsimulationintwodimensionsovertherealgeometryofthefemoralartery.TheNavier-Stokesequationsaresolvedusingthefiniteelementmethod,toobtainthedistributionsofthebloodpressureandflowvelocityinmultipleinstantsoftimeanddifferentplacesofthefemoralarteryandthusdeterminethecurrentconditionofthebloodvessels.Thevelocityfieldshowsalaminarbehavior,where,thevelocityishigherinthecenterofthearteryanddecreasesasthebloodflowapproachesarterywalls.Inspiteofallarteryandbloodflowpropertiesnotbeingconsidered,thevaluesofpressureandvelocityobtainedarewithinthenormalranges.Finallythemodelisusedtoverifyifthereexistirregularitiesinthebloodflowinbothhealthysubjectsandsickpatients.

简介：HistoricalperspectiveItwaswellknownthatin1918Takagiperformedthefirstarthroscopicinspectionofacadaver'skneeinJapan.1Hisinterestinthisarealaidthefoundationforarthroscopyandfacilitatedthedevelopmentofarthroscope.In1931,Burmanreportedanexperimentalstudyonthearthroscopicexplorationofc

简介：平坦破裂是的王牌的解剖结构复杂、起作用的暴露和固定是极其困难的。因为那些显然代替了王牌平坦破裂，更靠近的引出被注定引起致丑陋的愈合。有内部固定(ORIF)的开的减小不仅导致解剖减小，而且带复杂并发症。不管哪个方法将被采用，创伤的关节炎或大腿骨的头的脉管的坏死可能发生。以便treatacetabular更有效地断裂，矫形外科医生应该被要求充分为复杂并发症预防掌握theacetabular解剖，简历力学，分类和必要知识。

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简介：AbstractBackground:The reverse obliquity inter-trochanteric fracture is a distinct fracture pattern that is mechanically different from most inter-trochanteric fractures and the optional treatment of it is still controversial. The purpose of this study was to compare differences in the efficacy of a novel nail (medial support nail [MSN-II]) and proximal femoral nail anti-rotation (PFNA-II) in the treatment of reverse obliquity inter-trochanteric fractures (Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association [AO/OTA] 31-A3.1) using finite-element analysis.Methods:Modeling software was used to establish a three-dimensional model of MSN-II and PFNA-II and an A3.1 inter-trochanteric fracture model. Abaqus software was used to implement different force loads to compare finite-element biomechanical parameters such as the maximum stress in implant and the displacement of fracture site.Results:The femoral stress, implant stress and fracture site displacement of MSN-II was less than that of PFNA-II. The results indicated that the maximal femoral stress was 581 MPa for PFNA-II and 443 MPa for the MSN-II. The maximum stress values in the PFNA-II and MSN-II models were 291 and 241 MPa, respectively. The maximal displacements of the fracture site were 1.47 and 1.16 mm in the PFNA-II and MSN-II models, respectively.Conclusions:Compared with PFNA-II for inter-trochanteric fracture (AO/OTA 31-A3.1), MSN-II which was designed with a triangular stability structure can provide better biomechanical stability. The MSN-II may be a feasible option for the treatment of reverse obliquity inter-trochanteric fracture.

简介：大腿骨的髁的孤立的花冠破裂在成年人是稀罕的并且Hoffa骨折不属于工会被报导仅仅在文学的一些时间。我们分析了六个案例在三年的一个时期上的Hoffa破裂不属于工会。三个病人保存地被对待，三个病人有固定失败。表示的延期是到一年的2个月。治疗协议与膝arthrolysis一起由开的减小，pseudoarthrosis的切除，骨头grafting和内部固定组成了。联合在平均数16星期在所有病人被完成。治疗Hoffa破裂不属于工会要求小心的外科手术前的计划和过细的外科的技术。关于在破裂管理和外科的技术的争吵的文学被考察。

简介：Objective:tostudytheclinicalinfluenceoffemoralqualityoncementlesshipreplacementandtoevaluatecorticalindex(CI)forfemoralqualityinordertoguideprosthesischoiceandrehabilitation.Methods:forth-ninecasesofcementlesshipreplacementwerefollowedupforaverage3.5years,42ofwhonhadX-rayfilmsonpreoperationoroperationday.Results:Harrisscoresandpatients'satisfactionwerelowbutpainwassignificantandprolongedwhencorticalindiceswerelow.Conclusions:CIisareliablesemi-quantityparameterforclinicalevaluationoffemoralquality.Osteoporosispatientspredisposetothighpain.Lagforfull-weightloadingandavoidancefortorsionmotioncancontributetolesspainwhenCI≤2.2.

简介：AbstractFractures of the acetabulum in elderly patients were often caused by low energy trauma. Fractures involving anterior column are more common and often associated with impaction and comminution. Osteoporosis further complicates the management. Percutaneous fracture fixation has low morbidity but it is a technically demanding procedure. Open reduction and fracture fixation is done with or without simultaneous total hip replacement. Delayed total hip replacement is considered in posttraumatic arthritis patients. Patients with minimal displaced fractures, associated both-column fractures with secondary congruence of joint and patients who are medically unfit for surgery can be managed non-operatively. Whatever be the method of management, these elderly patients should be mobilised as early as possible.

简介：破坏损害被定义为avery骨头和软纸巾的严重损坏。我们在一些破裂盒子中发现了那的Butin临床的实践，软纸巾的损坏不象“destructiveinjury”一样严重显示，而弄碎破裂stillcannot表演骨头损坏的严厉。因此我们proposeda新术语“destructivefractures”在把破坏损害的定义与典型诊所盒子相结合以后。破坏破裂指谁的破裂骨状的纸巾太严重被损坏被修理，但是软纸巾，神经和静脉是严重地伤害的更少，canbe修理。从一年2001～2010，破坏破裂的75个盒子被同意进入我们的部门。根据是否与外部环境连结的破裂和破裂地点，他们被划分成6种类型：al类型，关上的骨干破坏骨折；a2类型，开的骨干破坏骨折；bl类型，关上的包含关节的破坏骨折；b2类型，开的包含关节的destructivefracture；c1类型，关上的混合破坏骨折；c2类型，开的混合破坏骨折。相应临床的治疗为破坏骨折的新分类标准是的每type.The被进行简单、实际并且thuscan被用作一个重要指南为破坏破裂做合理treatmentplans。

简介：客观：为了在臀部以后学习大腿骨的新潮的修复术的压力分发，连接代替。方法：在新潮的联合代替以后，腿节和修复术什么时候完美地被认为柱体同样同心与banded接口，模仿界面的压力转移的一个相对完美的理论模型被建立。结果：最大值界面砍应力发生在Z=0。在大腿骨的颈的剖面图，界面砍应力随Z的增加指数地减少了。砍应力在Z0.1m变得很小，它意味着在大腿骨的新潮的修复术的远目的shear压力是很小的。为了避免压力集中和大腿骨的新潮的修复术，下沉、界面的应力必须在Z=0仍然保持与压力负担不变、平衡。大腿骨的新潮的修复术的半径随着变化了界面砍应力。半径的最大的价值发生在Z=0，然后，它在m减少了。特殊，在Z=10公里的a=18.2公里，在Z=98公里的a=5.36公里，这些是理想的半径。结论：模仿界面的压力的一个理论模型被证实腿节和修复术是否被认为柱体同样同心。分布界面砍并且有轴的位置的光线的压力被获得。为修复术的设计的一本理论参考书被提供。

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简介：骨盆的破裂是严重损害。在24个小时以内的死亡最经常是尖锐的血损失的结果。这些病人的紧急情况管理挑战性、争论。在它的管理的关键问题正在识别出血的地点然后控制流血。有骨盆的骨折的血液动力学地不稳定的病人的管理要求一个多学科的队。在这个管理算法处理的问题是诊断评估，损坏控制复活，为noninvasive的指示骨盆的稳定，preperitoneal有关外科的选择和angiography的骨盆的收拾行李和批评决定。这篇评论文章在那些决心上集中于知识的最近的身体。

简介：Objective:Toinvestigatetheinfluenceofhipandpelvicfracture,especiallyacetabularfracturecomplicatedbysciaticnerveinjuryonclinicalfeaturesandprognosisofsciaticnerveinjury.Methods:FromJanuary1987toJanuary2000,17patients(14maleand3female)whohadhipandpelvicfracturescomplicatedbysciaticnerveinjuryweretreatedwithoperativereductionandinternalfixationandfollowedupfrom10monthsto5years.Theaverageagewas38years(ranging23-56years).Theleftextremitieswereinvolvedin11patientsandtherightin6.Twelvepatientsunderwentprimaryexplorationandneurolysisand5patientsunderwentsecondaryoperation.Results:Preoperatively,8patientsweretreatedwithlargedosesoforalnarcoticstocontroltheirseveresciaticpain.Threeofthe8patientsunderwentpatient-controlledanalgesiaandepiduralanalgesia.Afteroperation,excellentandgoodratesofreductionandfunctionalrecoveryofsciaticnervewere94.1%and88%respectively.Fourpatientsstillhadsciaticpainand2patientsfailedtorecover.Sciaticnervefunctionimprovedwithin3-6monthsaftersurgeryin11patients.Conclusions:Hipandpelvicfracturescanresultinsciaticnerveinjury,especiallycommonperonealnerveinjuryandprognosisispoor.Openreductionandinternalfixationcombinedwithnerveexplorationandneurolysisshouldbeusedasearlyaspossibleforseveresciaticpain.

简介：Objective:Toevaluatetheefficacyandsignificanceofposterolateralfusioninpreventingfailureofshort-segmentstabilizationforthetreatmentofthoracolumbarburstfractures.Methods:Sixtypatientswiththoracolumbarburstfractureswereincludedinthestudy.Thepatientswereclassifiedintotwogroups(n=30ineachgroup).InGroupA,patientsweretreatedinourhospitalwithshort-segmentinstrumentationviaposterolateralfusionwithiliacbone.InGroupB,patientsweretreatedinotherhospitalwithshort-segmentfixationwithoutfusion.Allcasescametoourhospitalforreexamination.Therewere18malesand12femalesinGroupAwithameanageof42.3years(range,24to52years)and16malesand14femalesinGroupBwithameanageof41.5years(range,19to54years).Radiographic(Cobbangle,kyphosisofthevertebralbody,andsagittalindex)andclinicaloutcomes(LowBackOutcomeScore)wereanalyzedafteranaveragefollow-upof16months.Results:Afteroperation,Cobbanglewasreducedfrom19.3°to3.1°inGroupAandfrom19.1°to3.3°inGroupB(P>0.05).Itwas5.9°inGroupAand11.9°inGroupBatthefinalfollow-up(P<0.01).Itsaveragelossofcorrectionwas2.8°inGroupAand8.6°inGroupB.Averagekyphosisofthevertebralbodywasreducedfrom21.3°to6.2°inGroupAandfrom21.7°to7.4°inGroupB(P>0.05).Itwasdecreasedto7.9°inGroupAand13.5°inGroupBatthefinalfollow-up(P<0.01).Itsaveragelossofcorrectionwas1.7°inGroupAand6.1°inGroupB.Sagittalindexwasreducedfrom21.3°to3.6°inGroupAandfrom20.5°to3.8°inGroupB(P<0.05).Itwasdecreasedto5.1°inGroupAand9.8°inGroupBatthefinalfollow-up(P<0.01).Itsaveragelosswas1.5°inGroupAand6.0°inGroupB.InGroupA,73.3%ofpatientshadanexcellentresultbasedonLowBackOutcomeScoresystem,whilethatinGroupBwasonly43.3%.Conclusions:Posterolateralfusionisaneffectivemeasuretopreventimplantfailure,anddecreaselo

简介：与ipsilateral联系的臀部的创伤的以后的脱臼代替了大腿骨的颈骨折是稀罕损害。而且，如此的病人的管理唤起考虑主要代替或保存大腿骨的头的强壮的看法。我们与如此的损害介绍了年轻成年人的一个盒子。他被操作在之上与大腿骨的颈的脱臼和固定的减小，在cancellous的帮助下的骨折拧紧。二年以后，破裂联合起来，病人是无征状的。我们进一步为如此的破裂建议了损害的机制并且在发展中的世界的变化损伤情形讨论了管理。

简介：From1990to2000,weusedHanssonpin,AOhollow-pullingscrew,andbendablescrewtotreat150casesoffreshfemoralneckfractureandtheresultwasanalysedtocomparetheefficacyofthethreemethodsofinternalfixation.

简介：Developingtheradiographicimagesfromtwotothree-dimensional,finiteelementanalysis(FEA)technologycansetupthemodel,predictingdiagnosis,treatmentdesign,aswellassurgicalplan.FEAprovidesanaccuratethree-dimensionalfiniteelementbiomechanicalstudyinosteonecrosisoffemoralhead(ONFH).Thepapersinthelatest5yearsrelatedtofemoralheadosteonecrosisandfiniteelementanalysisapplicationareconcentratedon.Wesummarizethelatestresearchprogressandproblems,includingtheappliedresearchcarriedoutinthefemoralheadosteonecrosisclinicalcases,innovationalskills,soastopointoutthedirectionoffutureresearchinFEA.