[Objective]To investigate the clinical outcomes of treatment of intertrochanteric and subtrochanteric fractures of the femur with the improved proximal femoral nail(PFN).[Method]Between April,2002 to Mach 2005,a total of 81 cases of intertrochanteric and subtrocha nteric femoral fractures were treated with close reduction and the improved PFN.There are 45 males and 36 females,with an average age of 63.6(35 to 91).According to the Evans classification: there are 5 cases of type Ⅰ,10 cases of type Ⅱ,12 cases of type ⅢA,21 cases of type ⅢB,28 cases oftypel Ⅴ,5 cases of type against femoral peritrochanteric.[Result]Sixty-two cases were followed up for 12 to 47 months,averaged 28.6 months.Fracture union was obtained in all the patients.Of 62 cases,one case had according to Harris criterion 56 cases were excellent,(rate 90.3%) and 2 cases good(3.2%) excellent and good rate of the function of the hip joint was 93.5%.[Conclusion]The improved PFN is a useful device in the treatment of perit rochanteric fractures of the femur.It is relatively easy with less surgical trauma,it and also has the advantages of anti-rotation,stress-dispersing,rigid fixation and allowing early functional exercises.The complications can be avoided with improved operative technique.

OBJECTIVE: To investigate the clinical outcomes of artificial bone (hydroxyapatite) and bone cement implantation in treating young patients with avascular necrosis of the femoral head caused by different reasons. METHODS: A total of 18 patients (23 hips) with Ficat stage Ⅲ and Ⅱ avascular necrosis of the femoral head were treated with dead bone debridement, artificial bone and cement implantation in Department of Orthopedics, Third Affiliated Hospital of Guangxi Traditional Chinese Medical College from October 2003 to July 2008. The patients were followed up for 24.6 months (ranging 3 months to 5 years). The affected hip function was evaluated by modified Merled'Aubigne Scores and X-ray. RESULTS: Mean hip scores improved significantly from 11.65 to 15.09 after surgery. Postoperative radiographs demonstrated the improved collapse and restoration of femoral head sphericity. The femoral heads of most patients remained the appearance after surgery, and the necrosis range did not enlarge. The patients were satisfactory to the treatment results. CONCLUSION: Artificial bone and cement implantation could restore head sphericity and prevent further collapse. The method can be used as an alternative for treatment of avascular necrosis of femoral head at Ficat stage Ⅱ and Ⅲ, especially for young patients.