Background: Unstable pertrochanter femur fractures are common in orthopedic practice. They pose a surgical challenge in both reduction and fixation. The fixation devices used are based on hip intramedullary nailing wi...Background: Unstable pertrochanter femur fractures are common in orthopedic practice. They pose a surgical challenge in both reduction and fixation. The fixation devices used are based on hip intramedullary nailing with femur head lag screw or blade. The aim of this paper is to compare different types of unstable pertrochanter fractures. Materials & Methods: We retrospectively reviewed 386 unstable pertrochanter femur fractures surgically treated in our hospital from 2000 to 2009. These included 62 (16.1%) unstable pertrochanter fractures with fractured lesser trochanter (31.A2-2, 31.A2-3);63 (16.3%) reverse oblique fractures (31.A3-1), 51 (13.2%) transverse fractures (31.A3-2), 145 (37.6%) comminuted fractures (31.A3-3) and 65 (16.8%) subtrochanter fractures. We compared survival rates between fracture types. The clinical characteristics, surgery immediate outcome (e.g., tip apex distance, reduction quality), and long term results, i.e., complications were also compared between fracture types. Results: Survival analysis showed that the fracture types can be grouped into low and high risk fracture types. The former group included, reverse oblique and comminuted fractures. Lesser trochanter, transverse and subtrochanter fractures were included in the high risk group. The survival estimates for five years were 64.6% and 49.3% for the low and high risk fracture types, respectively (p value = 0.008). Multivariate survival analysis showed that the hazard ratio for the high risk fracture group was 1.9 (95% CI = 1.37-2.67). No differences were found between unstable pertrochanter femur fractures with regards to clinical and epidemiology characteristics. Optimal tip apex distance (TAD) of less than 25 mm was found in 66.7%, 57.1% and 66.7% of lesser trochanter, reverse oblique and sutrochanter fractures, respectively. TAD of less than 25 mm was found in 81.2% of both transverse and comminuted fractures (p value = 0.032). No statistically significant differ-ence was found between fracture types, in regards to complication or revision rates. Conclusions: Survival rates were higher in patients suffering from reverse oblique or comminuted pertrochanteric fractures. No differences were found between fracture types, in regards to clinical and other outcome parameters.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)virus has been a world-known pan-demic since February 2020.Multiple variances had been established;the most common variants in Israel were omicron and delta.AIM To anal...BACKGROUND The coronavirus disease 2019(COVID-19)virus has been a world-known pan-demic since February 2020.Multiple variances had been established;the most common variants in Israel were omicron and delta.AIM To analyze and compare laboratory values in the"omicron"and"delta"variants of the coronavirus by conducting follow-up examinations and laboratory audits on COVID-19 patients admitted to our institution.METHODS A retrospective study,two groups,50 patients in each group.Patients examined positive for COVID-19 were divided into groups according to the common variant at the given time.We reviewed demographic data and laboratory results such as complete blood count and full chemistry,including electrolytes and coagulation parameters.RESULTS The mean age was 52%,66.53±21.7 were female.No significance was found comparing laboratory results in the following disciplines:Blood count,hemo-globin,and lymphocytes(P=0.41,P=0.87,P=0.97).Omicron and delta variants have higher neutrophil counts,though they are not significantly different(P=0.38).Coagulation tests:Activated paritial thromoplastin test and international normalized ratio(P=0.72,P=0.68).We found no significance of abnormality for all electrolytes.CONCLUSION The study compares laboratory results of blood tests between two variants of the COVID-19 virus–omicron and delta.We found no significance between the variants.Our results show the need for further research with larger data as well as the need to compare all COVID-19 variants.展开更多
文摘Background: Unstable pertrochanter femur fractures are common in orthopedic practice. They pose a surgical challenge in both reduction and fixation. The fixation devices used are based on hip intramedullary nailing with femur head lag screw or blade. The aim of this paper is to compare different types of unstable pertrochanter fractures. Materials & Methods: We retrospectively reviewed 386 unstable pertrochanter femur fractures surgically treated in our hospital from 2000 to 2009. These included 62 (16.1%) unstable pertrochanter fractures with fractured lesser trochanter (31.A2-2, 31.A2-3);63 (16.3%) reverse oblique fractures (31.A3-1), 51 (13.2%) transverse fractures (31.A3-2), 145 (37.6%) comminuted fractures (31.A3-3) and 65 (16.8%) subtrochanter fractures. We compared survival rates between fracture types. The clinical characteristics, surgery immediate outcome (e.g., tip apex distance, reduction quality), and long term results, i.e., complications were also compared between fracture types. Results: Survival analysis showed that the fracture types can be grouped into low and high risk fracture types. The former group included, reverse oblique and comminuted fractures. Lesser trochanter, transverse and subtrochanter fractures were included in the high risk group. The survival estimates for five years were 64.6% and 49.3% for the low and high risk fracture types, respectively (p value = 0.008). Multivariate survival analysis showed that the hazard ratio for the high risk fracture group was 1.9 (95% CI = 1.37-2.67). No differences were found between unstable pertrochanter femur fractures with regards to clinical and epidemiology characteristics. Optimal tip apex distance (TAD) of less than 25 mm was found in 66.7%, 57.1% and 66.7% of lesser trochanter, reverse oblique and sutrochanter fractures, respectively. TAD of less than 25 mm was found in 81.2% of both transverse and comminuted fractures (p value = 0.032). No statistically significant differ-ence was found between fracture types, in regards to complication or revision rates. Conclusions: Survival rates were higher in patients suffering from reverse oblique or comminuted pertrochanteric fractures. No differences were found between fracture types, in regards to clinical and other outcome parameters.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)virus has been a world-known pan-demic since February 2020.Multiple variances had been established;the most common variants in Israel were omicron and delta.AIM To analyze and compare laboratory values in the"omicron"and"delta"variants of the coronavirus by conducting follow-up examinations and laboratory audits on COVID-19 patients admitted to our institution.METHODS A retrospective study,two groups,50 patients in each group.Patients examined positive for COVID-19 were divided into groups according to the common variant at the given time.We reviewed demographic data and laboratory results such as complete blood count and full chemistry,including electrolytes and coagulation parameters.RESULTS The mean age was 52%,66.53±21.7 were female.No significance was found comparing laboratory results in the following disciplines:Blood count,hemo-globin,and lymphocytes(P=0.41,P=0.87,P=0.97).Omicron and delta variants have higher neutrophil counts,though they are not significantly different(P=0.38).Coagulation tests:Activated paritial thromoplastin test and international normalized ratio(P=0.72,P=0.68).We found no significance of abnormality for all electrolytes.CONCLUSION The study compares laboratory results of blood tests between two variants of the COVID-19 virus–omicron and delta.We found no significance between the variants.Our results show the need for further research with larger data as well as the need to compare all COVID-19 variants.
