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BACKGROUND: Digital three-dimensional reconstruction technology is gradually applied to orthopedic diseases with the advantages of visualization, accuracy and non-invasiveness, but there is less evidence-based support for its use in artificial hip hemiarthroplasty for intertrochanteric fractures of the femur in the elderly. OBJECTIVE: To investigate the application value and economic effects of digital three-dimensional reconstruction techniques in artificial hip hemiarthroplasty of intertrochanteric fractures of the femur in the elderly. METHODS: One hundred and thirty elderly patients with intertrochanteric femur fractures admitted to Zunyi First People’s Hospital from January 2019 to December 2022 were selected and randomly divided into a control group (n=65) and an observation group (n=65). Artificial hip hemiarthroplasty was performed in both groups. The control group adopted the film template measurement method for manual preoperative planning while the observation group adopted a digital three-dimensional reconstruction technique. Preoperative planning and intraoperative actual application of prosthesis compliance rate, fibrinogen, D-dimer, bilateral femoral eccentric distance difference, bilateral lower limb length difference, Harris hip function score, visual analog scale score, excellent and good rate of hip function, complications, and hospitalization cost were observed in both groups. RESULTS AND CONCLUSION: (1) The proportion of acetabular side and femoral side prosthesis in grade 0 (fully compliant) was higher in the observation group than that in the control group (P < 0.05). (2) Fibrinogen and D-dimer levels in the observation group were lower than those in the control group 3 days after surgery (P < 0.05). (3) The difference in bilateral femoral eccentric distance and the difference in bilateral lower limb length in the observation group were smaller than those in the control group immediately after surgery (P<0.05). The differences in Harris and visual analog scale scores were not significantly different between the two groups preoperatively, 6 and 12 months postoperatively (P > 0.05). There was no significant difference in excellent and good rate of hip function between the two groups 12 months postoperatively (P>0.05). (4) There was no significant difference in the complication rate between the two groups (P > 0.05). The hospitalization cost of the observation group was higher than that of the control group (P<0.05). (5) It is indicated that digital threedimensional reconstruction technology applied in artificial hip hemiarthroplasty of intertrochanteric femoral fracture in the elderly can not only accurately determine the prosthesis type before surgery, but also accurately reconstruct the bilateral lower limbs offline, but its hospitalization cost is high. [ABSTRACT FROM AUTHOR]

METHODS: One hundred and forty-seven elderly patients (≥ 65 years of age) with displaced femoral neck fractures were admitted from January 2016 to January 2021, of whom 88 had total hip arthroplasty (total hip arthroplasty group) and 59 had artificial femoral head replacement (hemiarthroplasty group). For the patients' preoperative comorbidities, the age-corrected Charlson Comorbidity Scale was used to quantify the scores and calculate patient frailty. The propensity score matching method was used to match the two groups 1:1 and to compare the operation time, bleeding, postoperative hospitalization time, hospitalization cost, nutritional index, postoperative complications, and mortality between the two groups after matching. Postoperative survival time was determined by Kaplan-Meier Survival analysis. RESULTS AND CONCLUSION: (1) After propensity score matching, a total of 42 matched pairs were successful in both groups, and the preoperative data of patients in both groups were balanced and comparable after matching (P > 0.05). (2) Compared with the hemiarthroplasty group, operation time (79.71 minutes vs. 59.07 minutes, P < 0.001), bleeding volume (839.64 mL vs. 597.83 mL, P=0.001), and hospitalization cost (56 508.15 yuan vs. 41 702.85 yuan, P < 0.001) were significantly higher in the total hip arthroplasty group. However, the mortality rate was lower in the total hip arthroplasty group than in the hemiarthroplasty group (36% vs. 57%, HR=0.44, 95%CI: 0.23-0.87, P=0.018), and the mean survival time was longer in the total hip arthroplasty group than in the hemiarthroplasty group (59.4 months vs. 43.7 months, P=0.024). (3) There were no statistically significant differences in postoperative hospitalization time, preoperative and postoperative nutritional indicators, and overall postoperative complication rate between the two groups (P > 0.05). However, in terms of postoperative pain, the incidence of pain was significantly higher in the hemiarthroplasty group than that in the total hip arthroplasty group (24% vs. 7%, P=0.035). (4) Overall, total hip arthroplasty has a better prognosis for survival, while hemiarthroplasty is more appropriate for patients with poor physical fitness. At the same time, postoperative pain may largely affect the quality and survival time of patients after hip arthroplasty. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of direct anterior approach and posterolateral approach total hip arthroplasty in the treatment of femoral neck fracture and analysis of the influencing factors of postoperative hip function. Methods: A total of 96 patients with femoral neck fracture who were treated with total hip arthroplasty in the Affiliated Hospital of Xuzhou Medical University from May 2019 to December 2021 were selected, and they were divided into direct anterior approach group (n=48) and posterolateral approach group (n=48) according to different surgical methods. Perioperative indicators and complications of the two groups were observed, and Harris score and visual analog scale (VAS) were compared between the two groups before and after treatment. The influencing factors of postoperative hip function were analyzed by univariate and multivariate Logistic regression. Results: The time to get out of bed, the length of incision and the length of hospital stay in the direct anterior approach group were significantly shorter than those in the posterolateral approach group, the intraoperative blood loss and postoperative drainage volume were significantly lower than those in the posterolateral approach group, and the operation time was significantly longer than that in the posterolateral approach group (P<0.05) .Harris score at 1, 3 months after surgery in the direct anterior approach group was significantly higher than in the posterolateral approach group, and VAS score was lower than that in the posterolateral approach group (P<0.05) . There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). There was no significant difference in the excellent and good rate of hip function between the two groups after 6 months of treatment (P>0.05). Multivariate Logistic regression analysis showed that body mass index ≥24 kg/m², postoperative exercise time <3 h/d and combined with osteoporosis were the risk factors for postoperative hip dysfunction in patients with femoral neck fracture undergoing total hip replacement (P<0.05). Conclusion: The direct anterior approach total hip arthroplasty has obvious advantages over total hip arthroplasty with posterolateral approach in the short term, which is manifested as less trauma to patients and less postoperative pain, which is beneficial to the recovery of patients’ hip function. Body mass index ≥24 kg/m², postoperative exercise time <3 h/d, combined with osteoporosis are the risk factors for postoperative hip dysfunction in patients with femoral neck fracture undergoing total hip replacement. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of acupoint application combined with staged rehabilitation function training on functional rehabilitation, serum pain factors and bone metabolism markers in patients with femoral neck fracture after operation. Methods:150 patients with femoral neck fracture who were treated in Sichuan Orthopedic Hospital from January 2021 to October 2021 were included. According to the envelope lottery method, the patients were divided into control group (75 cases) and observation group (75cases) The control group received staged rehabilitation function training, and the observation group received acupoint application combined with staged rehabilitation function training. Both groups were intervened for 3 months. After 3 months, the functional rehabilitation, visual pain analogue scale (VAS) score, serum pain factors and bone metabolism markers in the two groups were observed, and the incidence of postoperative complications in the two groups was recorded. Results: 3 months after intervention, Barthel Index and Harris hip score in the two groups were higher than those before treatment, and the observation group was higher than that in the control group (P＜0.05) 1 month after intervention, 2 months after intervention and 3 months after intervention, the scores of visual pain analogue scale (VAS) in the two groups decreased gradually, and the scores in the observation group were lower than those in the control group (P＜0.05) 3months after intervention, bone specific alkaline phosphatase (BALP) and osteoprotegerin (OPG) increased in the two groups, and the observation group was higher than the control group. The levels of tartrate resistant hydrochloric acid phosphatase isomer (TRACP-5b), type I collagen carboxyl terminal peptide β Special sequence (β-CTX) were decreased, and the observation group was lower than the control group (P＜0.05) 3 months after intervention, the levels of bradykinin (BK), prostaglandin E2 (PGE2), 5-hydroxytryptamine (5-HT) and neuropeptide Y (NPY) in two groups were decreased, and the observation group was lower than the control group (P＜0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P＞0.05) Conclusion: Acupoint application combined with staged rehabilitation function training can promote the postoperative functional recovery of patients with femoral neck fracture and reduce postoperative pain, which may be related to regulating the level of markers related to bone metabolism. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects and influencing mechanism of HGF regulating β-catenin signaling pathway on the repair of femoral neck fractures in rabbits. Methods: 15 rabbits with femoral neck fractures were randomly divided into semisynthetic extracellular matrix like hydrogel group (sECM group), sECmM+HGF group and demineralized bone matrix group (DBM group). The autologous right side was used as the experimental side and the left side as the control side. The general condition, fracture healing quality score, the maximum load, deflection and stiffness of callus and mRNA expression levels of BMP-2, TGF-β1, PDGF and bFGF and the protein expression levels of COL-I, Wnt5a, β-catenin and Lef-1 in BMSC cells were compared among the groups. Results: The fracture healing quality scores of the experimental side in sECM+HGF group and DBM group were higher than the control side at different weeks after surgery (P<0.05), and were higher than the experimental side in sECM group (P<0.05). At 8 weeks after surgery, the maximum load, deflection and stiffness of the experimental side callus in sECM+HGF group and DBM group were better than those in the control side (P<0.05), and the indicators were better than those of the experimental side in sECM group (P<0.05). At 2 weeks and 4 weeks after surgery, the expressions of BMP-2, TGF-β1, PDGF and bFGF in the experimental side were higher than those in the control side in sECM+HGF group and DBM group (P<0.05), and the expressions were higher than those in the experimental side of sECM group (P<0.05), and the expression of BMP-2 in the experimental side of sECM+HGF group and DBM group was higher than that in the experimental side of sECM group at 8 weeks after surgery (P<0.05). At 2 weeks after surgery, the expression of COL-I in the experimental side of sECM+HGF group and DBM group was higher than that in the control side (P<0.05). The expression of COL-I in the experimental side of sECM+HGF group and DBM group at 2 and 4 weeks after surgery was higher than that in the experimental side of sECM group during the same period (P<0.05). At 8 weeks after surgery, the expression of wnt5a in the experimental side of sECM+HGF group and DBM group was lower than that in the control side (P<0.05) and was lower than that in the experimental side of sECM group, while the expressions of β-catenin and Left-1 were higher than those in the control side (P<0.05) and were higher than those in the experimental side of sECM group (P<0.05). Conclusion: HGF up-regulates the expressions of BMP-2, TGF-β1, PDGF, bFGF and COL-1, and significantly promotes the fracture repair process of rabbits with femoral neck fractures by activating the Wnt/β-catenin signaling pathway. [ABSTRACT FROM AUTHOR]

Objective:To investigate the effect of dexmedetomidine (Dex) on postoperative recovery quality, quantitative electroencephalogram and delirium in elderly patients with osteoporosis complicated with femoral neck fracture. Methods: 97 elderly patients with osteoporosis complicated with femoral neck fracture who were treated in our hospital from January 2016 to March 2021 were selected, they were randomly divided into control group (48 cases) and Dex group (49 cases) by the random number table method. Total hip arthroplasty was performed in both groups, and Dex group was given 0.5 μg/kg Dex before anesthesia induction, and the control group was given the same amount of normal saline. The wake-up quality, hemodynamic changes and quantitative electroencephalogram frequency of the two groups were observed, and the occurrence of delirium and adverse anesthetic reactions were recorded. Results: Compared with the control group, the respiratory recovery time, extubation time and eye-opening time in Dex group were earlier (P<0.05). The heart rate (HR) at surgical excision of skin (T2)~finish the operation (T4) time point in both groups was lower than that at before anesthesia (T1) time point, and the mean arterial pressure (MAP) was higher than that at T1 time point, the intra-group comparison difference was statistically significant (P<0.05). HR at T2~T4 time point in Dex group was higher than that in control group, MAP was lower than that in control group at corresponding time points (P<0.05). δ wave frequencies of left frontal region, right frontal region, left temporal region and right temporal region in both groups at 1d after operation were increased compared with those before operation, and the Dex group was lower than the control group (P<0.05). The α1 wave frequencies of left frontal region, right frontal region, left temporal region and right temporal region in both groups at 1d after operation decreased compared with those before operation, and Dex group was higher than control group (P<0.05). The incidence of postoperative delirium in Dex group was lower than that in control group (P<0.05). There was no statistical difference in the incidence of adverse anesthetic reactions between the two groups (P>0.05). Conclusion: Dex is given to elderly patients with osteoporosis complicated with femoral neck fracture during operation, can improve the quality of postoper ative recovery without aggravating blood flow fluctuation, alleviate the influence on the δ, α1 wave frequency of the frontal lobe of the patient, and it can reduce the incidence of delirium. [ABSTRACT FROM AUTHOR]

To study the efficacy and safety of early use of tranexamic acid (TXA) after femoral intertrochanteric fracture in the elderly. From April 2021 to August 2021, 70 elderly patients with femoral intertrochanteric fracture who met the inclusion criteria were selected as the research objects. According to the random number table, the patients were divided into TXA group and control group, with 35 cases in each group. TXA group was intravenously injected with txa1g (compatible with 100 mL normal saline, half an hour) within 6 hours after injury, and the control group was intravenously injected with 100 mL normal saline within 6 hours after injury. Outcome measures: hematocrit (HCT), red blood cell (RBC), hemoglobin (HB), fibrinogen (FIB) and D-Dimer (D-dimer) immediately after admission, on the first and second days after injury and in the morning before operation. The venous vessels of lower limbs were examined by B-ultrasound 2 hours before operation and 2 weeks after operation to determine whether there was deep venous thrombosis of lower limbs. The complications of postoperative wound infection and bleeding were observed and recorded. The efficacy indexes included preoperative occult blood loss and preoperative blood transfusion rate. The safety indexes were the incidence of perioperative deep venous thrombosis and the incidence of postoperative wound complications. (1) The hematocrit, red blood cell, hemoglobin level and D-dimer of the two groups of patients decreased gradually over time on the 1st and 2nd day after injury and early morning before operation, and fibrinogen gradually increased (P<0.05). The hematocrit, red blood cell and hemoglobin levels of TXA group were higher than those of the control group on the 1st and 2nd day after injury and early morning before operation (P＜ 0.001). (2) The hidden blood loss of the two groups gradually increased with time on the first and second days after injury and the early morning before operation. The hidden blood loss of the TXA group was lower than that of the control group (P<0.001). (3) The preoperative blood transfusion rate in the TXA group was significantly lower than that in the control group (P<0.001). Early application of TXA after injury can effectively reduce the preoperative occult blood loss of elderly patients with femoral intertrochanteric fracture, reduce the preoperative blood transfusion rate, do not increase the incidence of perioperative deep venous thrombosis, and reduce postoperative wound complications. [ABSTRACT FROM AUTHOR]

BACKGROUND: Early surgical treatments, mainly including internal fixation and joint replacement, are favored for unstable or significantly displaced proximal humeral fractures in clinical practice. However, there is still a controversy on the specific regimen for elderly osteoporotic patients. OBJECTIVE: To compare the clinical outcomes of Trigen intramedullary nailing versus shoulder hemiarthroplasty for varus proximal humeral fractures. METHODS: A retrospective study was performed on 54 patients with varus proximal humerus fractures treated with intramedullary nailing or shoulder hemiarthroplasty in the General Hospital of Central Theater Command from January 2016 to January 2019. There were 22 males and 32 females. According to the different treatment methods, all the patients were divided into two groups: 35 patients in the intramedullary nail group and 19 patients in the shoulder hemiarthroplasty. Operation time, intraoperative blood loss, length of hospital stay and shoulder joint mobility, Visual Analogue Scale score, Constant-Murley shoulder joint score, and complications at the last follow-up were recorded and compared between two groups. RESULTS AND CONCLUSION: There was no significant difference in the preoperative data between the intramedullary nail group and the shoulder hemiarthroplasty group (P > 0.05), and they were comparable. The operation time of the intramedullary nail group [(59.6±14.3) minutes] was significantly shorter than that in the shoulder hemiarthroplasty group [(95.7±17.2) minutes] (P < 0.05). The intraoperative blood loss in the intramedullary nail group [(78.5±18.9) mL] was significantly lower than that in the shoulder hemiarthroplasty group [(203.7±23.1) mL] (P < 0.05). There were no significant differences in hospitalization time and follow-up time between the two groups (P > 0.05). The intramedullary nail group was superior to the shoulder hemiarthroplasty group in shoulder mobility and Constant-Murley shoulder joint score at the last follow-up, and the differences were statistically significant (P < 0.05). There were no significant differences in Visual Analogue Scale score and complications at the last follow-up between the two groups (P > 0.05). To conclude, both intramedullary nail and shoulder hemiarthroplasty are effective surgical procedures for proximal humeral fracture with varus deformity. Intramedullary nailing is more invasive, with better recovery of shoulder function. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In hemiarthroplasty, the choice of prosthesis is particularly important, which directly affects the success rate of operation and postoperative complications. Hemiarthroplasty can be divided into bipolar hemiarthroplasty and unipolar hemiarthroplasty. This study systematically evaluated the clinical efficacy and safety of bipolar hemiarthroplasty and unipolar hemiarthroplasty in the treatment of displaced femoral neck fractures in the elderly so as to provide evidence-based support for prosthesis decision-making in hemiarthroplasty. METHODS: The databases including PubMed, The Cochrane Library, OVID, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database were searched to collect clinical randomized controlled trials of bipolar hemiarthroplasty and unipolar hemiarthroplasty for displaced neck femoral neck fractures in elderly patients at home and abroad. The Cochrane Handbook risk assessment tool was used to evaluate the quality of the included studies. The results of the included studies were meta-analyzed by RevMan 5.3 software. RESULTS: (1) Eighteen randomized controlled clinical trials with high quality were included, with a total of 1 988 fractures patients, including 998 cases in bipolar hemiarthroplasty group and 990 cases in unipolar hemiarthroplasty group. (2) There were no statistically significant differences in mortality, dislocation of prosthesis, loosening of prosthesis, local infection, hip pain, general complication, and surgical informations between bipolar hemiarthroplasty and unipolar hemiarthroplasty (P > 0.05). (3) Harris score was higher in the bipolar hemiarthroplasty group than that in the unipolar hemiarthroplasty group (MD=1.77, 95%CI:0.94-2.61, P < 0.001). The rate of acetabular erosion in bipolar hemiarthroplasty group was lower than that in unipolar hemiarthroplasty group (RR=0.25, 95%CI:0.13-0.47, P < 0.000 1). However, two studies have reported that bipolar implants may be more costly. CONCLUSION: Compared with unipolar hemiarthroplasty, bipolar hemiarthroplasty has lower acetabular wear rate and better recovery of hip function in elderly patients with displaced fem-oral neck fracture. However, whether bipolar prosthesis has better economic benefits than uni-polar prosthesis needs further evaluation in the future. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of open and closed reduction and internal fixation with hollow nails on the quality of fracture reduction and hip joint function in patients with displaced femoral neck fractures. Methods: This study is a retrospective study. The clinical data of 98 patients with displaced femoral neck fractures were selected. According to different surgical methods, the patients were divided into group A (n=50, open reduction) and group B (n=48, Closed reduction), compare the good and good rate, fracture reduction quality, hip joint function, perioperative index, postoperative complication rate and secondary operation rate between the two groups. Results: The excellent and good rate of patients in group A was 78.00% (39/50) at 6 months after surgery, which was higher than 58.33% (28/48) in group B (P<0.05). There was no difference between the two groups in postoperative weight-bearing time and intraoperative fluoroscopy time (P>0.05); the operation time and hospital stay in group B were shorter than those in group A, and the amount of intraoperative blood loss was less than that in group A (P<0.05). The Harris scores of hip joint function at 1 month, 3 months, and 6 months after operation were higher than those before operation in the two groups, and group A was higher than group B (P<0.05). There was no difference in the incidence of secondary operations and complications between the two groups (P>0.05). The number of type I and type II cases in group A were more than that in group B, and the number of type III cases was less than that in group B (P<0.05). Conclusion: Compared with closed reduction cannulated screw internal fixation, open reduction cannulated screw internal fixation is more damaging, but its postoperative fracture reduction quality and hip joint function improvement effect is better, and it does not increase the incidence of complications and secondary complications. The incidence of surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: Venous thrombosis is a serious perioperative complication in elderly patients with hip fracture. It is necessary to select an effective intervention program to reduce its risk. OBJECTIVE: To compare the effects of enoxaparin and rivaroxaban on intraoperative hemorrhage and postoperative deep venous thrombosis during perioperative period of hemiarthroplasty in elderly patients with femoral neck fracture. METHODS: A total of 95 patients with femoral neck fractures aged 65 years and older were enrolled in the Department of Orthopedics, Beijing Jiangong Hospital from January 2016 to January 2018. These patients were assigned to two groups. Patients in the control group (n=43) were orally administered rivaroxaban once a day during the perioperative bed rest, and the drug was discontinued once on the operation day. Patients in the trial group (n=52) were given a subcutaneous injection of enoxaparin during the perioperative bed rest, and the drug was stopped 12 hours before the operation. Informed consent was obtained from all patients. This study was approved by the Hospital Ethics Committee. The intraoperative blood loss, postoperative blood loss, perioperative dominant and occult blood loss, postoperative bleeding rate and incidence of postoperative deep venous thrombosis were compared between the two groups. RESULTS AND CONCLUSION: (1) There was no significant difference in the amount of intraoperative blood loss, postoperative blood loss, perioperative dominant blood loss, postoperative bleeding rate, and incidence of postoperative deep venous thrombosis between the two groups (P>0.05). (2) However, the perioperative occult blood loss in the trial group was less than that in the control group (P<0.05). (3) It is suggested that enoxaparin is safe and reliable in the perioperative period of hemiarthroplasty for femoral neck fracture. Compared with rivaroxaban, enoxaparin can reduce the occult blood loss during the perioperative period. [ABSTRACT FROM AUTHOR]

BACKGROUND: Surgical treatment is an accepted method for intertrochanteric fractures. For the older adults accompanied by severe osteoporosis and other diseases, how to treat intertrochanteric fractures still remains controversial. OBJECTIVE: To evaluate the effectiveness and safety of proximal femoral nail antirotation versus hemiarthroplasty in the treatment of unstable intertrochanteric fractures in older adults through meta-analysis. METHODS: According to the Cochrane system evaluation, a computer-based retrieval of Medline, PubMed, SPINGER, John Wiley, Science Direct, EBSCO, CNKI, WanFang, and VIP databases between 2008 and 2018 was performed. The keywords were “proximal femoral nail antirotation or PFNA, hemiarthroplasty, unstable intertrochanteric fractures” in English and Chinese, respectively. The literate was screened based on inclusion and exclusion criteria, and then quality evaluation was conducted. Meta-analysis was undergone on the Rev-Man 5.1 software. RUSULTS AND CONCLUSION: (1) Thirteen clinical trials were included, involving 1 223 patients, and including 6 randomized controlled trials. (2) Meta-analysis results showed that the operation time in the proximal femoral nail antirotation group was shorter [MD=-6.54, 95%Cl (-12.81, -0.21), P < 0.01], intraoperative blood loss was lower [MD=-130.83, 95%CI (-190.99, -70.68), P < 0.01], and the incidence of implant complications was higher [RR=2.32, 95%Cl (1.12, 4.84), P < 0.01] compared with the hemiarthroplasty group. (3) In the hemiarthroplasty group, the ambulation time was earlier [MD=18.06, 95%CI (10.3, 25.79), P < 0.000 1], and the Harris scores were increased [MD=-8.19, 95%Cl (-9.45, -6.93), P < 0.01] compared with the proximal femoral nail antirotation group. (4) There was no significant difference in the postoperative complications, hospitalization time or excellent and good rate in Harris scores between two groups (P > 0.05). (5) In summary, the operation time in the proximal femoral nail antirotation group is shorter and the amount of bleeding was less than those in the hemiarthroplasty group, but the incidence of implant complications is higher than that in the hemiarthroplasty group. The hemiarthroplasty group has an advantage in postoperative Harris score and postoperative loading time. [ABSTRACT FROM AUTHOR]

Objective To compare the functional outcomes between cemented and uncemented hemiarthroplasty in the treatment of the elderly with femoral neck fractures． Methods A total of 221 patients older than 65 years with acute femoral neck fractures treated with hemiarthroplasty in the past 3 years were retrospectively studied． They were divided into groups according to the application of cemented or uncemented prosthesis． The follow-up was performed at 3，6，and 12 months after the operation． The operation time，bleeding，complications，time to walk after surgery，and Harris hip score ( HHS) were determined and compared between the groups． Results There were differences in mean operation time，intraoperative complications，and time to walk，but no differences in bleeding，complications，and HHS scores between the two groups． Conclusion Both prostheses may well use in the treatment of femoral neck fractures． Attention should be paid in the perioperative complications． [ABSTRACT FROM AUTHOR]

BACKGROUND: Many domestic and foreign literatures have reported that half hip replacement for unstable intertrochanteric fractures in the elderly has achieved good results, but the unstable intertrochanteric fracture with hemiarthroplasty is difficult to reconstruct the greater trochanter, and its reconstruction method is still controversial. OBJECTIVE: To discuss short-term effect of bipolar hemiarthroplasty and reconstruction of the femoral greater trochanter with cerclage band in the treatment of intertrochanteric fracture in elderly patients. METHODS: Clinical data of 15 elderly patients with intertrochanteric fracture undergoing bipolar hemiarthroplasty, and reconstruction of the femoral greater trochanter with cerclage band in the Xinjiang Uygur Autonomous Region People's Hospital were retrospectively analyzed. Posterolateral approach was selected. The patients were followed up in out-patient clinic yearly at postoperative 1, 3, 6 and 12 months. Fracture healing was judged using X-ray films, and the possibility of infection was observed. Hip function was evaluated using Harris scoring. Subjective satisfaction of patients was recorded. RESULTS AND CONCLUSION: (1) All patients walked within 3 days after operation. All patients were reviewed on time within a year. Postoperative X-ray revealed that the sample achieved initial stability, and had achieved fracture healing of greater trochanter. Blood examination did not show infection index. (2) The Harris score was (86.3±5.8) in final follow-up. Subjective satisfaction of patients was good. (3) In summary, bipolar hemiarthroplasty and reconstruction of the femoral greater trochanter with cerclage band in the treatment of intertrochanteric fracture in elderly patients can obtain good therapeutic effect, and it can achieve good prosthesis stability and large trochanter fracture reduction and fixation. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of hemiarthroplasty on unstable intertrochanteric fracture in elderly patients. Methods: 64 cases of elderly patients with unstable intertrochanteric fracture were selected and randomly divided into femoral intramedullary nail groups and hemiarthroplasty groups. The patients in hemiarthroplasty groups were taken hemiarthroplasty and the patients in femoral intramedullary nail groups were taken proximal femoral intramedullary nail. The operative time, volume of blood loss, medicine complications and function of hip joint were compared between two groups. Results: The operating time in hemiarthroplasty group was shorter than that of the intramedullary nail fixation group (P<0.05). There was no statistically significant difference in the intraoperative blood loss, postoperative complications and hip joint function recovery between two groups (P>0.05). Conclusion: Hemiarthroplasty has good clinical curative effect on unstable intertrochanteric fracture in elderly patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy of total hip and half hip hemiarthroplasty for elderly femoral neck fractures. Methods: 70 cases of femoral neck fracture patients in our hospital were randomly divided into observation group and control group with 35 cases in each group, the observation group was given total hip replacement while the control group was given half hip replacement, the operation time, intraoperative blood loss, postoperative Harris scores and the function of hip joint, postoperative complications, pain rate and revision rate of two groups were compared. Results: In the observation group, the operation time and the amount of bleeding was higher than those of the control group,[(113.6±19.3)min,(432.1±32.7)m L vs(73.1±10.2)min,(201.3±30.1)m L](all P<0.05); The total excellent and good rate and Harris score of hip function assessment in the observation group was significantly better than that of control group [91.4%,(91.13±5.09) points vs 77.14%,(80.15±4.71)points](all P<0.05); The incidence of adverse reaction and the revision rate of the observation group was lower than that of control group(20.00%, 0.00% vs 22.85%, 5.71%), but, there was no significant difference(all P>0.05); The pain rate in observation group was 5.71%, significantly lower than 25.71% of the control group(P<0.05). Conclusion: Both two methods, with their own advantages and disadvantages, were effective in the treatment for the elderly patients with femoral neck fracture, for the elderly patients with sensitive painfulness and more activity, the total hip arthroplasty will be a prior therapy. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects and the influencing factors of hemiarthroplasty for proximal humeral splintered fracture. Methods: 80 cases of proximal humeral splintered fracture patients administered in our hospital between January 2010 and December 2013 were selected and randomly divided into the study group and the control group, 40 cases were in each group. The study group used artificial semi shoulder joint replacement therapy, while the control group was treated with open reduction and internal fixation. Degree of pain, postoperative adverse circumstances were compared. Constant-Murlay score was used to evaluate the postoperative shoulder joint function. Multiple factor Logistic regression analysis was used to evaluate the factors influencing the efficacy. Results: The amount of bleeding, operation time of study group were significantly lower and shorter than those of the control group (P<0.05). According to the Constant-Murlay scores, ADL, ROMand pain scores of the study group were significantly better than those of the control group (P<0.05). Before operation, the VAS scores of the two groups showed no significant difference (P>0.05), Afrer operation, VAS score decreased significantly, after 5 d, 15 d, 30 d and 60 d, VAS scores of the study group were significantly lower than those of the control group (P<0.05). More adverse reactions, including insufficient muscle strength and heterotopic ossification, were observed in the study group than in the control group (P<0.05). With Constant-Murlay score as the dependent variable, age, sex, complicated internal medicine diseases, cause of injury, fracture type, injured time as variables, the Logistic analysis showed that such items as age, internal medicine diseases, fracture type and injury time were the influencing factors of proximal comminuted fracture of humerus (P<0.05). Conclusion: Hemiarthroplasty for proximal humeral splintered is safety and effective, and is of high clinical value, which worth the clinical promotion. At the same time, for improving the therapeutic effect, the influencing factors should be paid attention to. [ABSTRACT FROM AUTHOR]

Purpose: We compared visible blood loss and calculated blood loss after bipolar hemiarthroplasty in femoral neck fracture, and evaluated correlation between blood loss and its risk factors. Materials and Methods: A total of 356 patients who underwent bipolar hemiarthroplasty in femoral neck fracture between 2004 and 2010 were enrolled in this study. The total blood loss was calculated using the formula reported by Mercuiali and Brecher. We analyzed several factors, including gender, age, body mass index (BMI), anesthesia method, cardiovascular and cerebrovascular disease, preoperative anemia, American Society of Anesthesiologists (ASA) score, use of cement, and use of antithrombotic agents. Results: Total calculated blood loss(1,408±72 ml) differed significantly from visible blood loss(980±102 ml). In addition, calculated blood loss differed between risk factors(1,526±369 ml in cardiovascular disease, 1,588± 279 ml in general anesthesia, 1,645±920 ml in obesity, and 1,605±439 ml in use of antithrombotic agents). Conclusion: Total calculated blood loss was much greater than visible blood loss. Patients with risk factors such as cardiovascular disease, obesity, use of antithrombotic agents, and general anesthesia should be treated with care in order to reduce blood loss. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical curative effect of total hip arthroplasty (THA) and bipolar hemiarthroplasty (BHA) on the treatment of senile femoral neck fracture for elderly patients. Methods: 90 elderly patients with femoral neck fracture who were treated in our hospital from July 2013 to March 2015 were selected, and according to the different treatment methods, the patients were divided into the total hip arthroplasty group (THA) and the bipolar hemiarthroplasty group (BHA), with 45 cases in each group. Then the operation time, the intraoperative blood loss, the hospitalization, the incidence of postoperative complications and the clinical effects in the two groups were observed and compared. Results: There was no statistically significant difference about the operation time, the intraoperative blood loss and the hospitalization of the patients in the two groups (P>0.05); The incidence of postoperative complications in the THA group was lower than that of the BHA group (P<0.05); There was no statistically significant difference about the clinical effects in the two groups after the treatment for one year (P>0.05); The clinical effects in the THA group after the treatment for two and three years were significantly higher than those of BHA group, and the differences were statistically significant (P<0.05). Conclusion: THA and BHA have a good clinical efficacy on the treatment of senile femoral neck fracture for elderly patients, and THA is better for a long-termcurative effect and lower postoperative complications. [ABSTRACT FROM AUTHOR]