BACKGROUND:The incidence of femoral head necrosis after internalfixation in femoral neck fracture is at highlevel, but the risk factors are stil under discussion. OBJECTIVE:To retrospectively propose and analyze the relative risk factors of femoral head necrosis after internal fixationwithfemoral neck fracture in patients younger than60years old. METHODS:Data from199 patients with femoral neck fractures,younger than60years,undergoingclosed reduction and internal fixation were analyzed retrospectively.Seven factors including age, sex, body mass index, Garden classification, fracture seasons, reduction quality and weight-bearing time after internal fixation were statisticalyanalyzedto evaluate their correlation with femoral head necrosis. RESULTS AND CONCLUSION:The incidence of femoral head necrosis was 13.1%amongthe199 cases. Body mass index, Garden classification, fracture seasons, reduction quality were significantly associated with femoral head necrosis. The age, sex and weight-bearing time wereinsignificantly associated with femoral head necrosis. In multivariate logistic regression analysis, Garden classification, reduction quality and fracture seasons (winterversussummer) hadoverteffectson development of femoral head necrosis. These results suggest that Garden classification and reduction quality make an important effect on the healing of femoral neck fracture. In addition, fracture in winter may be the risk factor of the femoral head necrosis after internal fixation in femoral neck fracture.

BACKGROUND:Knee osteoarthritis is prevalent among the middle-aged and senior people in Asian countries, however, the epidemiology survey of total knee arthroplasty is rarely reported in China.
OBJECTIVE: To retrospectively analyze the data of patients undergoing total knee arthroplasty from 2008 to 2013 in Hefei City, and explore the distribution of age and gender of these patients.
METHODS: A retrospective analysis among patients undergoing total knee arthroplasty from January 1st 2008 to December 31st 2013 in Hefei City was performed. Data were extracted from the database of Medical Records Room of Relevant Hospitals in Hefei City, including the patient’s gender, age, disease duration, education level, body mass index and surgical site. In addition, more clinical information in one hospital were selected and analyzed, to compare the difference of clinical features between men and women.
RESULTS AND CONCLUSION:From 2008 to 2013, totaly 1 146 patients underwent total knee arthroplasty due to knee osteoarthritis. The rate of total knee arthroplasty increased over the 6 years and was much higher in women than in men. The single-centre registry data revealed that there was no difference in age, disease duration, education level, and body mass index and surgical site between men and women. Our findings indicate that, the rate of total knee arthroplasty is increasing steadily from 2008 to 2013 in Hefei City and is higher in women than in men. Risk factors that account for such disparity in total knee arthroplasty utilization need to be further investigated.

BACKGROUND: The effectiveness of femoral nerve block in perioperative analgesia for total knee arthroplasty has been widely recognized, but the need for combined sciatic nerve block remains controversial.OBJECTIVE: To investigate the analgesic effect and rehabilitation training of femoral and sciatic nerve block in the perioperative period of total knee arthroplasty. METHODS: 150 patients undergoing total knee arthroplasty were randomly divided into three groups: general anesthesia, femoral nerve block and femoral and sciatic nerve block groups. The visual analogue scale scores at rest and in activity, range of motion of the knee, postoperative hospitalization time, adverse effects and the Hospital for Special Surgery scores were recorded and compared among groups.RESULTS AND CONCLUSION: (1) The order of visual analogue scale scores at rest and in activity at each time point postoperatively was as follows: general anesthesia group > femoral nerve block group > femoral and sciatic nerve block group (P < 0.05). (2) The range of motion of the knee at different time points postoperatively was largest in the femoral nerve block group, followed by the femoral nerve block group, and smallest in the general anesthesia group (P < 0.05). (3) The postoperative hospitalization time in the femoral nerve block and femoral and sciatic nerve block groups was significantly less than that in the general anesthesia group, and the time in the femoral and sciatic nerve block group was significantly less than that in the femoral nerve block group (P < 0.05). (4) The Hospital for Special Surgery scores at 1 month postoperatively in the femoral nerve block and femoral and sciatic nerve block groups were significantly higher than those in the general anesthesia group, and the scores in the femoral and sciatic nerve block group were significantly higher than those in the femoral nerve block group (P < 0.05). But the Hospital for Special Surgery knee scores at 3 and 6 months postoperatively did not differ significantly among groups (P > 0.05). (5) These results indicate that the femoral and sciatic nerve block has better postoperative analgesia effect compared with general anesthesia and femoral nerve block under multimodal analgesia in total knee arthroplasty, which is favorable for early rehabilitative training.