Objective To study the factors affecting the functional restoration of the hip joint with femoral intertrochanteric fractures.Method44 patients with femoral intertrochanteric fractures were treated from Aprail 2004 to June 2006.The function of the hip joint was evaluated with the Harris hip score. Seven factors including age,sex,preoperative ASA class,preoperative time,fracture type,therapeutic measures,time of functional exercise were analyzed statistically with x2 test and logistic multiple regression with a significant difference (P

[Objective]To explore the feasibility and effect of modified minimally invasive percutaneous pedicle screws osteosynthesis for the treatment of thoraco-lumbar vertebra compression fracture.[Method]Twelve cases of thoraco-lumbar fracture without neural impairment were enrolled who did not need laminotomy decompression from June 2005 to June 2007.With the help of C-arm image intensifier,the pedicle screws were inserted through four small longitudinal incisions(1-1.5 cm)and modified surgical instruments.Perioperative parameter,postoperative imaging index,visual analog scale(VAS)and Oswestry Disability Index(ODI)were compared with the treatment of conventional open pedicle screws osteosynthesis in other 18 cases.[Result]All cases were followed up from 8 to 25 months(mean 13.2 months).The operation time and length of stay in minimal invasive group were significantly shorter than that in conventional group,the amount of operative bleeding and drainage of postoperation decreased obviously(P

[Objective]To explore the clinical value of discography followed by computed tomography for the treatment of multi-level lumbar disc degeneration. [Methods]Twenty-eight cases were enrolled from January 2005 to January 2008.There were 12 males and 16 females with average age of 38.2 years,ranging from 30 to 56 years.The level of degenerated disc included L3、4 and L4、5(9 cases),L4、5 and L5S1(15 cases),L3、4,L4、5 and L5S1(4 cases).The level of discography included L2、3(10 cases),L3、4(28 cases),L4、5(28 cases),and L5S1(26 cases) with a total of 92 discs.The painful discs(or responsible discs) were screened according to diagnostic criteria of provocative discography and treated with interbody fusion.[Results]Thirty-two responsible discs were screened in total of 92 discs.ODI scores between pre and post operation were significantly different(P

0.05). Incision size,operating time,blood loss,hospital stay,medical device expenses,postoperative VAS and ODI,clinical outcomes,fusion rates,and complication rates were studied and tested with independent sample t test and x2 test.[Results]The mean follow-up was 19.1 months (range,12~25 months) in group A and 24.6 months (range,9~36 months) in group B.There were statistically significant differences in the incision size,operating time,blood loss,hospital stay and medical device expenses (P0.05).[Conclusion]Unilateral transforaminal lumbar interbody fusion with unilateral pedicle screw fixation has the advantages of small incision,little bleeding,no destruction of the contralateral structure,short operating time or hospital stay,low medical device expenses and good recovery.But the operation indications must be strictly defined.

[Objective]To explore the mechanism of nucleoplasty combined with oxygen-ozone for the treatment of lumbar disc herniation，and to evaluate its therapeutic effects.[Method]From June 2005 to June 2006，62 patients with lumbar disc herniation were treated by nueleoplasty combined with oxygen-ozone，34 were male and 28 were female，ranging in age from 32 to 76 years，with an average of 53.4 years.The course of this disease ranged from 3 to 56 months，meanly 1.3 years.Thirteen patients had the herniation at L4.5 and L3，4，thirty two patients at L4、5，eight patients at L4、5 and L5S1，and nine patients at L5S1.The curative effect was assessed by using a modified MacNab method.[Result]After 25～35 months'follow-up，there were no servious complications in all 62 cases.According to modified MacNab assessment，50 cases(80.7%)achieved excellent outcomes，8 cases(12.9%)good，2 cases(3.2%)fair and 2 cases(3.2%)poor.The excellent and good rate was 93.5%.[Conclusion]The micro-invasive technique of nueleoplasty combined with oxygen-ozone is effective in the treatment of lumbar disc herniation，and it has maximized the clinical effect and minimized the local damage：it also expanded adaptive cases with lumbar disc herniation and enlarged the applicable scope of minimally invasive technique in treating lumbar disc hemiation.

A retrospective analysis was performed among 8 patients with unilateral intraarticular calcaneal fracture, who were selected from the Department of Orthopaedics in Yangpu District Central Hospital of Shanghai. They were treated with the injectable bone graft MIIG[R] X3 combined with percutaneous reduction by leverage and axial fixation from June 2005 to November 2006. After treatment, the function of affected feet was evaluated according to the ankle-hindfoot score of the American Orthopaedic Foot & Ankle Society (totally 100 points). All the patients were rechecked with X-ray films periodically to observe the reaction between the materials and the host, the healing of fracture, the pain of limbs and joint motion. Eight patients were all followed up, the complication rate reached 12.5% (1/8), the improvement of Bohler angle excelled 18° to 25°, and that of Gissane angle exceeded 30° to 35°. Among the included patients, 6 cases achieved excellent effect and 2 cases good. All developed the bone union. None of all had complications, such as necrosis of skin, hematoma and deep infection.

Objective To investigate the effect of hyperglycemia at admission in patients with acute ischemic stroke on endovascular treatment outcome.Methods From May 2012 to December 2016,200 consecutive patients with acute ischemic stroke (excluding patients with diabetes mellitus) underwent endovascular mechanical thrombectomy at the Department of Neurosurgery,the First People's Hospital of Changzhou were enrolled retrospectively.They were divided into either a hyperglycemia group (hyperglycemia was defined as glucose ＞7.8 nmol/L at admission,n =57) or a non-hyperglycemia group (n =143) according to the blood glucose levels at admission.The neurological function of the patients was evaluated by the National Institutes of Health Stroke Scale (NIHSS) at admission and discharge.The modified thrombolysis in cerebral infarction (mTICI) grade was used to evaluate the degree of recanalization.The modified Rankin scale (mRS) was used to evaluate the prognosis of the patients at 90 d after procedure.The general information of the patients were analyzed,including sex,age,past history,hospitalization time,onset to recanalization time (ORT),TOAST classification of cerebral infarction,and recanalization.The endovascular treatment outcomes of both groups were compared.Results (1) There were no significant differences in TOAST classification,age,hypertension history,atrial fibrillation history,stroke history,coronary heart disease history,ORT,NIHSS at admission between the patients of the two groups (all P ＞ 0.05).(2) There were no significant differences in days of hospitalization,mTICI grade,and number of thrombectomy between the patients of the two groups (P ＞0.05).(3) The discharge mortality and incidence of in-hospital neurological deterioration in the patients of the hyperglycemia group were 28.1％ (16/57) and 31.6％ (18/57) respectively,while those in the non-hyperglycemia group were 14.7％ (21/143) and 18.2％ (26/143) respectively.There were significant differences between the two groups (P =0.028 and 0.039 respectively).Conclusion Hyperglycemia at admission may have adverse effects on the prognosis in patients after receiving mechanical thrombectomy.

OBJECTIVE: To investigate the short- and mid-term effectiveness of unicompartmental knee arthroplasty (UKA) for post-traumatic arthritis (PTA) of knee. METHODS: The clinical data of 30 patients with PTA of unilateral knee between March 2014 and September 2021 was retrospectively analyzed. There were 14 males and 16 females with an average of 64.5 years (range, 33-81 years). The average body mass index was 26.7 kg/m ² (range, 19.8-35.6 kg/m ²). The types of injuries that caused PTA included intra-articular fracture in 16 cases, extra-articular fracture in 8 cases, and soft tissue injury in 6 cases. The initial injuries were treated by conservative therapy in 12 cases and by surgical therapy in 18 cases. Ten cases were medial compartment osteoarthritis and 20 cases were lateral compartment osteoarthritis. According to Kellgren-Lawrence staging, there were 19 cases of grade Ⅲ and 11 cases of grade Ⅳ. The operative time, the length of hospital stay, complications, and subjective satisfaction were recorded. The Oxford Knee Function Score (OKS), Hospital for Special Surgery (HSS) score, and knee range of motion (ROM) were used to evaluate knee function. Weight-bearing X-ray films were taken to measure the femoro-tibial angle (FTA) and to assess alignment correction of the lower limb. RESULTS: The operative time ranged from 50 to 95 minutes (mean, 63.7 minutes), the length of hospital stay ranged from 3 to 8 days (mean, 6.9 days). Superficial infection occurred in 2 patients, while the remaining incisions healed by first intention. There was no deep vein thrombosis or neurovascular injury. All patients were followed up 17-109 months (median, 70 months). At last follow-up, OKS score, HSS score, and ROM in 30 cases significantly improved when compared with those before operation (P<0.05). Lower limb alignment was significantly corrected and there was significant difference in FTA of the varus and valgus knees between pre- and post-operation ( P<0.05). The patient satisfaction rate was 86.7% (26/30). Two cases developed contralateral osteoarthritis progression during follow-up. No bearing dislocation, prosthesis loosening or sinking occurred and none required further revision. CONCLUSION For patients with PTA of knee, UKA can obtain definite short- and mid-term effectiveness with high patient satisfaction.
Male ; Female ; Humans ; Arthroplasty, Replacement, Knee ; Retrospective Studies ; Knee Prosthesis ; Osteoarthritis, Knee/surgery* ; Treatment Outcome ; Knee Joint/surgery* ; Lower Extremity/surgery* ; Range of Motion, Articular