Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August ...Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August 2021 to August 2024 were selected and randomly divided into two groups using a random number table.The experimental group(16 patients)underwent THA surgery,while the control group(16 patients)underwent proximal femoral nail antirotation(PFNA)surgery.Hip joint function and quality of life indicators were compared between the two groups.Results:Before surgery,there was no significant difference in hip joint function and quality of life scores between the two groups(P>0.05).However,at six months postoperatively,the experimental group had higher hip joint function and quality of life scores compared to the control group(P<0.05).The total effective rate was higher in the experimental group than in the control group(P<0.05).The complication rate in the experimental group was similar to that in the control group(P>0.05).Conclusion:THA can improve the clinical efficacy of elderly patients with IFF,minimize postoperative complications,effectively restore hip joint function,and optimize postoperative quality of life.展开更多
BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and o...BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management.AIM To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients.METHODS The elderly patients who had hip fracture surgery at our hospital between January 1,2021,and December 31,2022 were chosen for this retrospective clinical investigation.Patients with excellent and fair postoperative hip function had their clinical information and characteristics gathered and compared.Age,gender,fracture site,surgical technique,laboratory indices,and other variables that could have an impact on postoperative joint function were all included in a univariate study.To further identify independent risk factors affecting postoperative joint function in hip fractures,risk factors that showed statistical significance in the univariate analysis were then included in a multiple logistic regression analysis.In addition to this,we also compared other outcome variables such as visual analogue scale and length of hospital stay between the two groups.RESULTS A total of 119 elderly patients with hip fractures were included in this study,of whom 37 were male and 82 were female.The results of univariate logistic regression analysis after excluding the interaction of various factors showed that there was a statistically significant difference in interleukin(IL)-6,IL-8,IL-10,C-reactive protein(CRP),and complement C1q(C1q)between the fair and excellent joint function groups(P<0.05).The results of multiple logistic regression analysis showed that IL-6>20 pg/mL[Odds ratio(OR)3.070,95%CI:1.243-7.579],IL-8>21.4 pg/mL(OR 3.827,95%CI:1.498-9.773),CRP>10 mg/L(OR 2.142,95%CI:1.020-4.498)and C1q>233 mg/L(OR 2.339,95%CI:1.094-5.004)were independent risk factors for poor joint function after hip fracture surgery(all P<0.05).CONCLUSION After hip fractures in older patients,inflammatory variables are risk factors for fair joint function;therefore,early intervention to address these markers is essential to enhance joint function and avoid consequences.展开更多
Background： Preventing anterior cruciate ligament（ACL） injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether...Background： Preventing anterior cruciate ligament（ACL） injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether the functions of the hip abductor and rear-foot increase dynamic knee valgus. A two-dimensional（2D） video-based screening test focused on hip abductor and rear-foot functions among factors involved in dynamic knee valgus. The present study determined associations between hip and rear-foot dynamic alignment and dynamic knee valgus.Methods： This cross-sectional study recruited 130 female basketball players（258 legs） from nine high-school teams. The players performed single-leg squats and single-leg drop landings to provide knee-in（KID） and hip-out（HOD） distances on 2D video images. Hip and rear-foot dynamic alignment was evaluated using a dynamic Trendelenburg test（DTT） and a dynamic heel-floor test（HFT）.Results： The Chi-square test revealed no significant difference in the prevalence of DTT-positivity between single-leg squats（28.7%） and singleleg drop landings（23.3%）. The prevalence of HFT-positivity was significantly greater during landings（51.4%） than during single-leg squats（31.0%, p 〈 0.01）. The KID values for both single-leg squats and single-leg drop landings were greater in the DTT-positive than in the DTTnegative group（15.1 5.4 cm and 20.2 7.5 cm, p 〈 0.001）. The HOD values were similarly greater in the DTT-positive group（15.2 1.9 cm and 17.6 2.8 cm, p 〈 0.001）. The KID values for both single-leg squats and single-leg drop landings were greater in the HFT-positive than in the HFT-negative group（12.2 5.1 cm, p 〈 0.01; 14.7 7.2 cm, p 〈 0.001）, whereas HOD values for these tasks did not significantly differ between the two groups.Conclusion： Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.展开更多
Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in ad...Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in adults with disabling end-stage hip joint osteoarthritis. Setting: Orthopedic Hospital Setting on the East Coast of the United States. Study Design: Cross-sectional retrospective chart review. Methods: The desired demographic, physical and psychological attributes of 1040 adults with end-stage hip osteoarthritis hospitalized for hip surgery were recorded and subjected to comparison and correlational analyses. These data included gender, self-reported weight, height, numbers and nature of physical and psychological comorbidities, pain intensity, ambulatory capacity and discharge destination. Sub-group analyses of 808 candidates hospitalized for primary unilateral surgery were also conducted using SPSS 16. Results: There were significant (p 【0.05) associations between gender, pain scores, comorbidity numbers and ambulatory capacity. Specifically, women who exhibited higher comorbid disease rates than men, exhibited higher pre-surgery pain levels and greater functional limitations in walking ability before and after surgery than men with the same condition. In sub-group analyses of men and women with the same mean age, comorbid prevalence rates, and body mass indices, women were found to have significantly higher ideal weights on average than men, and those with higher ideal weights recovered more slowly after surgery (p 【0.05). Conclusion: The presentation of hip joint osteoarthritis is not uniform, and may be impacted differentially by gender. Women with high ideal body weights, may be specifically impacted. Whether genetic or other factors account for gender differences in pain and function among adults with disabling hip osteoarthritis observation needs to be examined.展开更多
目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFN...目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFNA选择加长型主钉,短钉组PFNA选择普通型主钉。比较两组围术期指标、骨折愈合时间、完全负重时间、住院时间,复位质量、术后稳定性、手术创伤应激因子[超氧化物歧化酶(SOD)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)]水平、髋关节活动度[髋伸屈活动度(ROM)、髋内-外旋ROM]、髋关节功能及并发症。结果相较于短钉组,长钉组患者手术时间、住院时间较长,失血量、术中X线透视次数较多,完全负重时间、骨折愈合时间较短(P<0.05);两组患者复位质量比较差异无统计学意义(P>0.05);长钉组患者术后稳定性优于短钉组(P<0.05);长钉组患者术后1、3 d SOD低于短钉组,AngⅡ、NE高于短钉组(P<0.05);术后3、6个月两组髋伸屈、髋内-外旋ROM比较差异无统计学意义(P>0.05);长钉组髋关节功能优良率[98.67%(74/75)]较短钉组[89.33%(67/75)]高(P<0.05);长钉组并发症总发生率[1.33%(1/75)]与短钉组[2.67%(2/75)]比较差异无统计学意义(P>0.05)。结论与普通型PFNA主钉相比,采用加长型PFNA主钉治疗31-A3.1~A3.3型IFF患者能促进骨折愈合,提高术后稳定性,改善患者髋关节功能,安全性良好,但创伤较大,围术期恢复较慢。展开更多
目的比较InterTAN髓内钉与股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗股骨转子间骨折(intertrochanteric fracture,IFF)的临床效果。方法回顾性分析2020年1月至2021年8月收治的IFF患者60例作为研究对象。根据手...目的比较InterTAN髓内钉与股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗股骨转子间骨折(intertrochanteric fracture,IFF)的临床效果。方法回顾性分析2020年1月至2021年8月收治的IFF患者60例作为研究对象。根据手术方式分为PFNA组和InterTAN组各30例。PFNA组采用PFNA固定治疗,InterTAN组采用InterTAN髓内钉固定治疗。比较两组围手术期指标、疼痛程度,随访并记录术前及术后3、6、12个月Harris髋关节评分,术后3个月复位质量,以及两组术后并发症发生情况。结果PFNA组手术时间短于InterTAN组,术中出血量少于InterTAN组,骨折愈合时间长于InterTAN组(P<0.05,P<0.01)。随着术后时间延长,两组疼痛视觉模拟评分法(VAS)评分呈下降趋势,且InterTAN组术后1.3d疼痛VAS评分低于PFNA组(P<0.05,P<0.01)。术后3、6个月,InterTAN组Harris评分高于PFNA组(P<0.01)。术后6个月,InterTAN组复位优良率[96.67%(29/30)]较PFNA组[76.66%(23/30)]高(P<0.05)。InterTAN组并发症总发生率[10.00%(3/30)]较PFNA组[36.66%(11/30)]低(P<0.05)。结论InterTAN髓内钉内固定能有效促进IFF患者髋关节功能恢复,减轻术后疼痛,提高复位质量,具有较好的稳定性,且安全性高。展开更多
文摘Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August 2021 to August 2024 were selected and randomly divided into two groups using a random number table.The experimental group(16 patients)underwent THA surgery,while the control group(16 patients)underwent proximal femoral nail antirotation(PFNA)surgery.Hip joint function and quality of life indicators were compared between the two groups.Results:Before surgery,there was no significant difference in hip joint function and quality of life scores between the two groups(P>0.05).However,at six months postoperatively,the experimental group had higher hip joint function and quality of life scores compared to the control group(P<0.05).The total effective rate was higher in the experimental group than in the control group(P<0.05).The complication rate in the experimental group was similar to that in the control group(P>0.05).Conclusion:THA can improve the clinical efficacy of elderly patients with IFF,minimize postoperative complications,effectively restore hip joint function,and optimize postoperative quality of life.
基金Supported by Leading Talents Training Program of Pudong New Area Health Commission,No.PWR 12020-06and Shanghai Science and Technology Commission,No.20Y11901800.
文摘BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management.AIM To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients.METHODS The elderly patients who had hip fracture surgery at our hospital between January 1,2021,and December 31,2022 were chosen for this retrospective clinical investigation.Patients with excellent and fair postoperative hip function had their clinical information and characteristics gathered and compared.Age,gender,fracture site,surgical technique,laboratory indices,and other variables that could have an impact on postoperative joint function were all included in a univariate study.To further identify independent risk factors affecting postoperative joint function in hip fractures,risk factors that showed statistical significance in the univariate analysis were then included in a multiple logistic regression analysis.In addition to this,we also compared other outcome variables such as visual analogue scale and length of hospital stay between the two groups.RESULTS A total of 119 elderly patients with hip fractures were included in this study,of whom 37 were male and 82 were female.The results of univariate logistic regression analysis after excluding the interaction of various factors showed that there was a statistically significant difference in interleukin(IL)-6,IL-8,IL-10,C-reactive protein(CRP),and complement C1q(C1q)between the fair and excellent joint function groups(P<0.05).The results of multiple logistic regression analysis showed that IL-6>20 pg/mL[Odds ratio(OR)3.070,95%CI:1.243-7.579],IL-8>21.4 pg/mL(OR 3.827,95%CI:1.498-9.773),CRP>10 mg/L(OR 2.142,95%CI:1.020-4.498)and C1q>233 mg/L(OR 2.339,95%CI:1.094-5.004)were independent risk factors for poor joint function after hip fracture surgery(all P<0.05).CONCLUSION After hip fractures in older patients,inflammatory variables are risk factors for fair joint function;therefore,early intervention to address these markers is essential to enhance joint function and avoid consequences.
文摘Background： Preventing anterior cruciate ligament（ACL） injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether the functions of the hip abductor and rear-foot increase dynamic knee valgus. A two-dimensional（2D） video-based screening test focused on hip abductor and rear-foot functions among factors involved in dynamic knee valgus. The present study determined associations between hip and rear-foot dynamic alignment and dynamic knee valgus.Methods： This cross-sectional study recruited 130 female basketball players（258 legs） from nine high-school teams. The players performed single-leg squats and single-leg drop landings to provide knee-in（KID） and hip-out（HOD） distances on 2D video images. Hip and rear-foot dynamic alignment was evaluated using a dynamic Trendelenburg test（DTT） and a dynamic heel-floor test（HFT）.Results： The Chi-square test revealed no significant difference in the prevalence of DTT-positivity between single-leg squats（28.7%） and singleleg drop landings（23.3%）. The prevalence of HFT-positivity was significantly greater during landings（51.4%） than during single-leg squats（31.0%, p 〈 0.01）. The KID values for both single-leg squats and single-leg drop landings were greater in the DTT-positive than in the DTTnegative group（15.1 5.4 cm and 20.2 7.5 cm, p 〈 0.001）. The HOD values were similarly greater in the DTT-positive group（15.2 1.9 cm and 17.6 2.8 cm, p 〈 0.001）. The KID values for both single-leg squats and single-leg drop landings were greater in the HFT-positive than in the HFT-negative group（12.2 5.1 cm, p 〈 0.01; 14.7 7.2 cm, p 〈 0.001）, whereas HOD values for these tasks did not significantly differ between the two groups.Conclusion： Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.
文摘Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in adults with disabling end-stage hip joint osteoarthritis. Setting: Orthopedic Hospital Setting on the East Coast of the United States. Study Design: Cross-sectional retrospective chart review. Methods: The desired demographic, physical and psychological attributes of 1040 adults with end-stage hip osteoarthritis hospitalized for hip surgery were recorded and subjected to comparison and correlational analyses. These data included gender, self-reported weight, height, numbers and nature of physical and psychological comorbidities, pain intensity, ambulatory capacity and discharge destination. Sub-group analyses of 808 candidates hospitalized for primary unilateral surgery were also conducted using SPSS 16. Results: There were significant (p 【0.05) associations between gender, pain scores, comorbidity numbers and ambulatory capacity. Specifically, women who exhibited higher comorbid disease rates than men, exhibited higher pre-surgery pain levels and greater functional limitations in walking ability before and after surgery than men with the same condition. In sub-group analyses of men and women with the same mean age, comorbid prevalence rates, and body mass indices, women were found to have significantly higher ideal weights on average than men, and those with higher ideal weights recovered more slowly after surgery (p 【0.05). Conclusion: The presentation of hip joint osteoarthritis is not uniform, and may be impacted differentially by gender. Women with high ideal body weights, may be specifically impacted. Whether genetic or other factors account for gender differences in pain and function among adults with disabling hip osteoarthritis observation needs to be examined.
文摘目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFNA选择加长型主钉,短钉组PFNA选择普通型主钉。比较两组围术期指标、骨折愈合时间、完全负重时间、住院时间,复位质量、术后稳定性、手术创伤应激因子[超氧化物歧化酶(SOD)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)]水平、髋关节活动度[髋伸屈活动度(ROM)、髋内-外旋ROM]、髋关节功能及并发症。结果相较于短钉组,长钉组患者手术时间、住院时间较长,失血量、术中X线透视次数较多,完全负重时间、骨折愈合时间较短(P<0.05);两组患者复位质量比较差异无统计学意义(P>0.05);长钉组患者术后稳定性优于短钉组(P<0.05);长钉组患者术后1、3 d SOD低于短钉组,AngⅡ、NE高于短钉组(P<0.05);术后3、6个月两组髋伸屈、髋内-外旋ROM比较差异无统计学意义(P>0.05);长钉组髋关节功能优良率[98.67%(74/75)]较短钉组[89.33%(67/75)]高(P<0.05);长钉组并发症总发生率[1.33%(1/75)]与短钉组[2.67%(2/75)]比较差异无统计学意义(P>0.05)。结论与普通型PFNA主钉相比,采用加长型PFNA主钉治疗31-A3.1~A3.3型IFF患者能促进骨折愈合,提高术后稳定性,改善患者髋关节功能,安全性良好,但创伤较大,围术期恢复较慢。
文摘目的比较InterTAN髓内钉与股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗股骨转子间骨折(intertrochanteric fracture,IFF)的临床效果。方法回顾性分析2020年1月至2021年8月收治的IFF患者60例作为研究对象。根据手术方式分为PFNA组和InterTAN组各30例。PFNA组采用PFNA固定治疗,InterTAN组采用InterTAN髓内钉固定治疗。比较两组围手术期指标、疼痛程度,随访并记录术前及术后3、6、12个月Harris髋关节评分,术后3个月复位质量,以及两组术后并发症发生情况。结果PFNA组手术时间短于InterTAN组,术中出血量少于InterTAN组,骨折愈合时间长于InterTAN组(P<0.05,P<0.01)。随着术后时间延长,两组疼痛视觉模拟评分法(VAS)评分呈下降趋势,且InterTAN组术后1.3d疼痛VAS评分低于PFNA组(P<0.05,P<0.01)。术后3、6个月,InterTAN组Harris评分高于PFNA组(P<0.01)。术后6个月,InterTAN组复位优良率[96.67%(29/30)]较PFNA组[76.66%(23/30)]高(P<0.05)。InterTAN组并发症总发生率[10.00%(3/30)]较PFNA组[36.66%(11/30)]低(P<0.05)。结论InterTAN髓内钉内固定能有效促进IFF患者髋关节功能恢复,减轻术后疼痛,提高复位质量,具有较好的稳定性,且安全性高。
