Objective: The present research aims to determine if adherence to the Lewinnek safe zone, when exclusively considered, constitutes a pivotal element for ensuring stability in the context of total hip arthroplasty. Thi...Objective: The present research aims to determine if adherence to the Lewinnek safe zone, when exclusively considered, constitutes a pivotal element for ensuring stability in the context of total hip arthroplasty. This is done by examining the acetabular placement in instances of hip dislocation after total hip arthroplasty (THA). Methodology: The authors searched 2653 patient records from 2015 to 2022 looking for patients who had total hip arthroplasty at our facility. For the analysis, 23 patients were culled from 64 individuals who exhibited post-THA dislocations, employing a stringent exclusion criterion, and the resultant acetabular angulation and anteversion were quantified utilizing PEEKMED software (Peek Health S.A., Portugal) upon radiographic evidence. Results: Within the operational timeframe, from the cohort of 2653 subjects, 64 presented with at least a singular incident of displacement. Post-exclusion criterion enforcement, 23 patients were eligible for inclusion. Of these, 10 patients conformed to the safe zone demarcated by Lewinnek for both inclination and anteversion angles, while 13 exhibited deviations from the prescribed anteversion and/or inclination benchmarks. Conclusion: Analysis of the 23 patients reveals that 13 did not confirm to be in the safe zone parameters for anteversion and/or inclination, whereas 10 were within the safe zone as per Lewinnek’s guidelines. This investigative review, corroborated by extant literature, suggests that the isolated consideration of the Lewinnek safe zone does not suffice as a solitary protective factor. It further posits that additional variables are equally critical as acetabular positioning and mandate individual assessment.展开更多
Abstract Elements and natural radionuclides in the contact zone of two granites with different ages would migrate from one to the other because of the difference in their chemical contents and later water-rock interac...Abstract Elements and natural radionuclides in the contact zone of two granites with different ages would migrate from one to the other because of the difference in their chemical contents and later water-rock interactions. This migration could serve as an analogue for the near-field process of radwastes in a high-level radwaste deep geological disposal repository.展开更多
目的探讨基于解剖安全区的徒手置导针技术在股骨转子骨折股骨近端防旋髓内钉(PFNA)手术中的应用效果。方法选择2022年12月至2024年7月收治的60例股骨转子骨折患者,其中男性17例,女性43例;年龄66~97岁,平均年龄81.83岁;身体质量指数19.5~...目的探讨基于解剖安全区的徒手置导针技术在股骨转子骨折股骨近端防旋髓内钉(PFNA)手术中的应用效果。方法选择2022年12月至2024年7月收治的60例股骨转子骨折患者,其中男性17例,女性43例;年龄66~97岁,平均年龄81.83岁;身体质量指数19.5~26.9 kg/m^(2),平均身体质量指数23.7 kg/m^(2);骨折分型(AO/OTA分型),A1型17例,A2型25例,A3型18例;高血压27例,糖尿病12例。随机分为观察组(徒手置导针,基于大转子顶点前外侧的解剖安全区定位)与对照组(传统C型臂影像引导置针)。比较两组导针首次置入成功率、术中影像监测频次、术中失血量、手术时长、术后影像学评估、早期负重时间、髋关节功能评分(Harris髋关节功能评分)及切口感染情况。结果观察组在多项手术指标上均优于对照组(P<0.01)。观察组导针首次置入成功率(93.3%,28/30)较对照组(66.7%,20/30)显著提升;影像监测次数减少至(5.00±0.82)次,较对照组[(7.0±0.84)次]降低28.6%;术中失血量控制在(43.7±14.0)mL,仅为对照组[(117.0±90.8)mL]的37.3%;手术时长缩短至(46.6±9.7)min,较对照组[(68.8±24.8)min]减少32.3%。在术后恢复方面,观察组患者负重活动早于对照组(4.0 d±1.2 d vs 5.5 d±1.6 d),且切口感染发生率显著降低(3.3%vs 20.0%。P<0.05)。然而,两组在术后影像学表现及髋关节功能评分方面差异无统计学意义(P>0.05)。结论采用基于安全区的徒手导针置入技术能够有效降低PFNA术中的辐射暴露,减少术中出血及术后并发症,但治疗效果与传统C型臂影像引导置针相同。展开更多
文摘Objective: The present research aims to determine if adherence to the Lewinnek safe zone, when exclusively considered, constitutes a pivotal element for ensuring stability in the context of total hip arthroplasty. This is done by examining the acetabular placement in instances of hip dislocation after total hip arthroplasty (THA). Methodology: The authors searched 2653 patient records from 2015 to 2022 looking for patients who had total hip arthroplasty at our facility. For the analysis, 23 patients were culled from 64 individuals who exhibited post-THA dislocations, employing a stringent exclusion criterion, and the resultant acetabular angulation and anteversion were quantified utilizing PEEKMED software (Peek Health S.A., Portugal) upon radiographic evidence. Results: Within the operational timeframe, from the cohort of 2653 subjects, 64 presented with at least a singular incident of displacement. Post-exclusion criterion enforcement, 23 patients were eligible for inclusion. Of these, 10 patients conformed to the safe zone demarcated by Lewinnek for both inclination and anteversion angles, while 13 exhibited deviations from the prescribed anteversion and/or inclination benchmarks. Conclusion: Analysis of the 23 patients reveals that 13 did not confirm to be in the safe zone parameters for anteversion and/or inclination, whereas 10 were within the safe zone as per Lewinnek’s guidelines. This investigative review, corroborated by extant literature, suggests that the isolated consideration of the Lewinnek safe zone does not suffice as a solitary protective factor. It further posits that additional variables are equally critical as acetabular positioning and mandate individual assessment.
文摘Abstract Elements and natural radionuclides in the contact zone of two granites with different ages would migrate from one to the other because of the difference in their chemical contents and later water-rock interactions. This migration could serve as an analogue for the near-field process of radwastes in a high-level radwaste deep geological disposal repository.
文摘目的探讨基于解剖安全区的徒手置导针技术在股骨转子骨折股骨近端防旋髓内钉(PFNA)手术中的应用效果。方法选择2022年12月至2024年7月收治的60例股骨转子骨折患者,其中男性17例,女性43例;年龄66~97岁,平均年龄81.83岁;身体质量指数19.5~26.9 kg/m^(2),平均身体质量指数23.7 kg/m^(2);骨折分型(AO/OTA分型),A1型17例,A2型25例,A3型18例;高血压27例,糖尿病12例。随机分为观察组(徒手置导针,基于大转子顶点前外侧的解剖安全区定位)与对照组(传统C型臂影像引导置针)。比较两组导针首次置入成功率、术中影像监测频次、术中失血量、手术时长、术后影像学评估、早期负重时间、髋关节功能评分(Harris髋关节功能评分)及切口感染情况。结果观察组在多项手术指标上均优于对照组(P<0.01)。观察组导针首次置入成功率(93.3%,28/30)较对照组(66.7%,20/30)显著提升;影像监测次数减少至(5.00±0.82)次,较对照组[(7.0±0.84)次]降低28.6%;术中失血量控制在(43.7±14.0)mL,仅为对照组[(117.0±90.8)mL]的37.3%;手术时长缩短至(46.6±9.7)min,较对照组[(68.8±24.8)min]减少32.3%。在术后恢复方面,观察组患者负重活动早于对照组(4.0 d±1.2 d vs 5.5 d±1.6 d),且切口感染发生率显著降低(3.3%vs 20.0%。P<0.05)。然而,两组在术后影像学表现及髋关节功能评分方面差异无统计学意义(P>0.05)。结论采用基于安全区的徒手导针置入技术能够有效降低PFNA术中的辐射暴露,减少术中出血及术后并发症,但治疗效果与传统C型臂影像引导置针相同。
