Objective:To explore the classification and treatment strategy of femoral neck fracture combined with ipsilateral intertrochanteric fracture.Methods:A retrospective analysis was performed of the 44 patients who had been admitted to Department of Orthopedics, Liangxiang Teaching Hospital, Capital Medical University from March 2003 to March 2019 for femoral neck fracture combined with ipsilateral intertrochanteric fracture. They were 19 males and 25 females, aged from 37 to 93 years (average, 77.9 years). According to the anatomical location and displacement severity, the femoral neck fractures were divided into 3 types while the intertrochanteric fractures were classified as stable or unstable ones. There were 3 cases of type Ⅰ which were completely extracapsular ones, 31 cases of type Ⅱ which were intracapsular stable ones, and 10 cases of type Ⅲ which were intracapsular unstable ones. Types Ⅰ and Ⅱ fractures were treated with intramedullary fixation, and type Ⅲ fractures with cemented hip hemi-replacement+reduction and fixation of the intertrochanteric fracture with Kirschner wires and steel cables. Recorded were fracture healing time, function of the affected hip and complications.Results:The 44 patients were followed up for at least 2 years. The fracture healing time for the 3 patients with type I fracture averaged 5.6 months (from 4.4 to 6.8 months); their hip function at the last follow-up, evaluated by the Harris scoring system, was excellent in 2 cases and good in one case. For 30 of the 31 patients with type Ⅱ fracture, the fracture healing time averaged 7.2 months (from 5.1 to 9.3 months); their hip function at the last follow-up, evaluated by the Harris scoring system, was excellent in 18 cases, good in 6 cases, fair in 5 cases, and poor in 2 cases, giving an excellent and good rate of 77.4% (24/31). As for complications, withdrawal or cutting-out of the head screw happened in 6 cases, infection in one case and nonunion in one case. In 10 patients with type Ⅲ fracture, the hip function at the last follow-up was excellent in 7 cases, good in 2 cases and poor in one case.Conclusions:For type Ⅰ and type Ⅱ femoral neck fractures combined with ipsilateral intertrochanteric fracture, intramedullary fixation with angulation stability may be a proper choice. For type Ⅲ ones, hip joint replacement should be the first choice.

Objective To investigate the effects of coronary artery bypass grafting in different bypass grafts on survival rate,angina recurrence rate and cardiac function in patients with diffuse right coronary artery disease.Methods Sixty-four patients with diffuse right coronary artery stenosis admitted to the hospital were enrolled.All patients underwent coronary artery bypass grafting and were divided into large saphenous vein group(40 cases) and internal mammary artery group(24 cases) according to the difference of graft vessels.The follow-up survival rate,bypass graft vascular/cardiac venous patency rate,angina recurrence rate,NYHA classification before and after surgery,left ventricular ejection fraction(LVEF),and left ventricular diastolic end diameter(LVEDD) level of both groups were compared.Results Comparison in the same group,NYHA cardiac function grading,LVEF and LVEDD levels were better than those before surgery(P ＜ 0.05).Compared with the great saphenous vein group,the difference of the venous patency/intracardiac venous patency rate and angina pectoris was better in the internal mammary artery group (P ＜ 0.05).At 1 year after operation,there was no significant difference in NYHA cardiac function grading,LVEF,LVEDD level and follow-up survival rate(P ＞0.05).Conclusion There is no significant difference in follow-up survival rate and long-term improvement of cardiac function between patients with diffuse right coronary artery stenosis undergoing coronary venous artery bypass grafting with saphenous vein and internal mammary artery bypass graft.However,the internal mammary artery is more helpful to improve the patency of the bypass graft vessel/cardiac vein and avoid the recurrence of angina pectoris.