OBJECTIVETo analysis the reasons of fixation failure for intertrochanteric fractures, so as to select correct operation indications and fixation methods.

METHODSRetrospective analysis the clinical data of 13 patients with failed internal fixation of intertrochanteric fractures from September 1997 to September 2008, and the failure reasons were summarized. There were 7 males and 6 females,ranging in age from 58 to 93 years,averaged 71 years. Two patients were treated with intramedullary fixation, 4 patients with anatomical proximal femoral plate, 3 patients with DHS fixation, 2 patients with hollow compression screws, and 2 patients with external fixation. According to Evans types: 1 patient was type II, 7 patients were type III, and 5 patients were type IV.

RESULTSEight patients with unstable fractures and malreduction had no grafted bone. Six patients had bad position of neck screws in the femur neck. Postoperative collodiaphyseal angle: 3 patients were under 90 degree, 7 patients 90 to 110 degree, and 3 patients 110 to 130 degree. Five patients had internal fixed screw exited, 6 patients had neck screws cutting to superior lateral, 3 patients had early weight bearing, and 10 patients were osteoporosis occurred after operation from 6 weeks to 11 months, averaged 4.5 months.

CONCLUSIONThe fixation failure of intertrochanteric fractures was concerned with fractures types, reduction, fixation methods, osteoporosis and the time of weight bearing.

Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Treatment Outcome

Adolescent ; Adult ; Aged ; Clavicle ; injuries ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Scapula ; injuries

SARS-CoV-2 infection causes complicated clinical manifestations with variable multi-organ injuries, however, the underlying mechanism, in particular immune responses in different organs, remains elusive. In this study, comprehensive transcriptomic alterations of 14 tissues from rhesus macaque infected with SARS-CoV-2 were analyzed. Compared to normal controls, SARS-CoV-2 infection resulted in dysregulation of genes involving diverse functions in various examined tissues/organs, with drastic transcriptomic changes in cerebral cortex and right ventricle. Intriguingly, cerebral cortex exhibited a hyperinflammatory state evidenced by significant upregulation of inflammation response-related genes. Meanwhile, expressions of coagulation, angiogenesis and fibrosis factors were also up-regulated in cerebral cortex. Based on our findings, neuropilin 1 (NRP1), a receptor of SARS-CoV-2, was significantly elevated in cerebral cortex post infection, accompanied by active immune response releasing inflammatory factors and signal transmission among tissues, which enhanced infection of the central nervous system (CNS) in a positive feedback way, leading to viral encephalitis. Overall, our study depicts a multi-tissue/organ transcriptomic landscapes of rhesus macaque with early infection of SARS-CoV-2, and provides important insights into the mechanistic basis for COVID-19-associated clinical complications.
Animals ; COVID-19/genetics* ; Macaca mulatta ; SARS-CoV-2/genetics* ; Transcriptome