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【Abstract】Objective: To introduce bipolar hemiarthroplasty with a two-step osteotomy technique and observe its clinical result for unstable intertrochanteric frac-tures in senile patients. Methods: Fifteen consecutive patients with unstable intertrochanteric fractures aged from 81 to 92 years with a mean of 85 years were treated in our hospital from August 2006 to October 2011 (Evans type III in 4 cases, Evans type IV in 11 cases), who received bipolar hemiarthroplasty with a two-step osteotomy technique performed by a senior or-thopedic surgeon through posterior approach under general anesthesia. All cases were evaluated by Zuckerman func-tional recovery score (FRS) and operative risk assessment software 1, based on the patients' physical and laboratory examinations preoperatively. The duration and blood loss have been recorded. There were 4 male cases (4 hips) and 11 female cases (11 hips). All prostheses consisted of Link SP II femoral stem and bipolar femoral head. All patients were followed up for more than 1 year. Results: The average preoperative FRS, predictive value of operative morbidity and mortality were 83.7 (81.7-85.9), 9.3% (7.3%-15.0%) and 3.5% (2.3%-4.2%), respectively. The average operation time was 50 minutes with a mean intraoperative blood loss of 310 ml. There were no operative or anesthetic complications or deaths within 30 days after operation. Sitting up was permitted 3 to 4 days, and partial weight bearing was allowed 5 to 7 days after operation. The average FRS was 79.3 at 30 days and 84.9 at 1 year postoperatively. Three patients died of unrelated causes (one due to myocardial infarction and the others due to cerebral hemorrhage during at least one-year follow-up). Conclusion: Bipolar hemiarthroplasty with a two-step osteotomy technique for unstable intertrochanteric fractures in the senile patients is a good choice for early ambulation and good hip function. Key words: Hemiarthroplasty; Hip fractures; Os-teotomy

【Abstract】Hip trauma has been a leading cause of death in senile patients for more than a centenary. Although the mortality decreased due to the advanced technique in medication, surgery and nursing, the increasing mortality should not be neglected in elders after orthopedic opera-tion nowadays. Many factors are considered to influence the causes of death after trauma, such as age, gender, per-sonal customs, comorbidities, types of fracture, timing of surgery, procedure, anesthesia, complications, medical treatment, activity of daily living, or even marriage status. This article reviews these causes from the aspects of patient’s own factors, iatrogenic factors, medical treatment and other factors and provides some clues for further clini-cal application according to the recent foreign and domes-tic researches. According to the present research, it is es-sential for surgeons to perform a comprehensive estimation for patients suffering from hip trauma. Key words: Hip fractures; Aged; Cause of death; Review

【Abstract】Objective: To evaluate the role of high risk factors in octogenarians and nonagenarians with hip trauma, which may lead to excessive mortality and morbi- dity postoperatively. Methods: Fifty-four octogenarians and nonagenarians patients were enrolled in the study, receiving surgical repair of hip fracture in our hospital from January 2006 to January 2010. High risk factors were recorded preoperatively in detail. Complications and survival state were followed up by telephone for 2 years postoperatively. All the data were analyzed by Chi-square test with SPSS 13.0. Results: Twenty-six males (48.1%), aged from 80 to 94 years with a mean age of 84.2 years, and twenty-eight females (51.9%), aged from 80 to 95 years with a mean age of 83.4 years, were presented in the cohort study. The hip traumas were caused by daily slight injuries (52 cases) and car accidents (2 cases), respectively. Twenty-eight patients (51.9%) with femoral neck fracture while 26 patients (48.1%) with intertrochanteric fracture were diagnosed through an anterior-posterior pelvic radiophotograph. In this series, 39 patients (72.2%) suffered from one or more comorbidities preoperatively. The morbidity was 48.1% and the major cause was urinary tract infection, while a significant difference was noted between females and males. The mortality was 20.4% with a predominant cause of acute renal failure. Conclusions: The gender should be considered as a critical high risk factor in octogenarians and nonagenarians with hip trauma postoperatively. Females are more likely to suffer complications postoperatively, which is especially obvious in senile patients over 80 years (P

Hip fractures, including femoral neck, intertrochanteric, acetabular, femoral head, and subintertrochanteric fractures, are very common clinically. Among them, femoral neck fracture and intertrochanteric fracture are the most common types of fractures (over 90%).1Comparingwith hip fracture in young patients, there are some special characteristics in senile patients: (1) The patients usually suffer from osteoporosis. (2) They need long-time rehabilitation in bed, whichmay lead to severe complications, such as hypostatic pneumonia, urinary tract infection, pressure ulcer, and deep venous thrombosis of lower limb.(3) Themortality after injury is quite high. Therefore, as a rule, orthopedic surgeons preferably choose surgical means to treat these patients.

Improvement in social media (SM) platforms and their ability to enable small and medium-sized enterprises (SMEs) to reach a large audience has led to changes in how entrepreneurial firms carry out their regular activities. Studies on entrepreneurship and SM adoption are relatively new and fragmented; however, there is scant interest from managers, scholars, and governments for future research work in this area in emerging countries. This study aims to investigate the role of SM adoption and innovation capabilities (IC) in improving SME performance. We employ the resource-based view (RBV) as a basis for the conceptual model and infer relationships between entrepreneurial orientation (EO), SM adoption, IC, and SME performance. A closed-ended questionnaire was administered to collect data through a web-based survey and quantitative analysis was employed to generalise the results. The proposed relationships are tested on a sample of 431 randomly selected SMEs, applying the PLS algorithm, bootstrapping, and blindfolding techniques using SmartPLS 3.0. The findings reveal that SME performance could be improved by EO, SM adoption, and IC. Additionally, SM adoption significantly mediates the EO–SME-performance relationship, and IC moderates the SM-adoption–SME-performance association. This paper also makes several theoretical and practical contributions. [ABSTRACT FROM AUTHOR]