ObjectiveTo assess the superiority of comprehensive therapy in the elder with osteoporotic hip fracture.Methods163 elderly patients with osteoporotic hip fracture were retrospectively analyzed,in which 50 patients accepted routine therapy only,and other 113 patients accepted routine therapy combined with anti-osteoporosis comprehensive therapy.The effect and the incidence of complications in two groups were compared. Results105 patients had been followed-up for 5—36 months. There were the high effective rate and the low complication rate in the group of comprehensive therapy(P<0.05),compared with the routine group. Conclusions Comprehensive therapy should be adopted in the elder with osteoporotic hip fracture.

BACKGROUND: Fracture is the main clinical manifestation of osteoporosis. Thus, a safe, feasible and low cost bone mineral density(BMD) measurement can help to prevent the osteoporosis-related fracture and other osteoporosis-related complications in clinical practices.OBJECTIVE: Quantitative ultrasound(QUS) measurement systems have been employed to evaluate bone status in middle-aged and aged females for better diagnoses and the prevention of osteoporosis-related fracture.DESIGN: Case controlled trial based on patients and healthy individuals.SETTING: The study was conducted at the orthopedic department of a municipal hospital.PARTICIPANTS: The study was conducted in the Orthopedic Department of the Sixth People' s Hospital of Guangzhou from February to September in 2002. Seventy-four middle-aged and aged female patients, diagnosed with fracture, entered the study procedure. A control group of 218 age-matched postmenopausal women was recruited for comparison. The patients in the control group were divided into 5 subgroups: 41 - 50 years old, 51 -60 years old; 61 - 70 years old; ＞ 80 years old. Both the patients and the healthy controls were divided into several groups according to their ages. Then each of them was measured by QUS, and the results were analyzed and compared among all the groups.MAIN OUTCOME MEASURES: The broadband ultrasound attenuation (BUA) and the speed of sound(SOS) of all the patients and the healthy women in this study.RESULTS: BUA values of over 61 years old patient groups equaled to (58.2 ± 6. 8), (54.2 ± 4.8) and(47.8 ± 3.5) dB/MHz respectively. The values were significantly different from those of the control group( P ＜ 0. 01 ).The SOS values of the over-51-year-old patient groups were( 1489.6 ± 24. 3),(1486.6 ± 17.7), (1483.7 ± 18.4) and(1442.7 ± 18.3) m/s respectively. They were also significantly different from those of the control group( P＜ 0.01).CONCLUSION: QUS measurement system not only can be used to obtain quantitative data of the bones but also can be used to evaluate the bone structure. It has various advantages such as no radiation, low cost and easiness of operation. It is a valuable method that can greatly contribute to early prediction, early diagnosis and timely treatment of osteoporosis-related fracture.

BACKGROUND: There have been many methods of fixation between lumbar-sacral spine and pelvis. However, a safe, firm, and ideal method of internal fixation has not been found.OBJECTIVE: This study was designed to investigate the stability of the fixation between lumbar-sacral spine and pelvis with the connectible skills using iliac screw and lumbar-sacral spine pedicle screw.DESIGN, TIME AND SETTING: This study, a control experiment, was performed at the Institute of Biomechanics, Sun Yat-sen University, Guangzhou, Guangdong Province, China between January 2006 and December 2007.MATERIALS: The lumbar-sacral spine and pelvis specimens were collected from six freshly cryo-preserved male adult corpses caused by trauma. Iliac screw (8.5mm×100mm), L5 pedicle screw (6.5mm×45mm), and S1 pedicle screw (6.5mm×35mm) were provided by Sofamor Company, USA. MTS 858 Bionix Material Testing System (USA) was also used.METHODS: The lumbar and iliac vertebrae, pelvis from six fresh frozen cadaveric specimens were operated in three different ways of fixation respectively: iliac ala lag screw, L5-S1 pedicle screw rod system, iliac screw and L5 pedicle screw connecting system. Three ways of fixation as mentioned above were compared with the intact group in biomechanical stability.MAIN OUTCOME MEASURES: The mobility of whirl, lateral bending, proneness, and backward stretching among groups.RESULTS: Using iliac screw for the fixation between lumbar-sacral spine and pelvis turned out to be the best in stability. The range of motion (ROM) decreased obviously in each situation. The three-dimensional mobility in the 6.4Nm moment of force was (1.07±0.86)° for whirl, (0.95±0.47)° for lateral bending, (1.22±0.67)° for proneness, and (1.80±0.73)° for backward stretching. There was significant difference between the intact group and the group carried out by iliac screw and L5 pedicle screw for the fixation between lumbar-sacral spine and pelvis (P<0.01).CONCLUSION: The connectible skills using iliac screw and the lumbar-sacral spine pedicle screw possesses the biomechanical advantages of maintaining the stability between lumbar-sacral spine and pelvis.