ObjectiveTo design an auto-compressive and anti-circumrotate intramedullary nail( ACACIN) and to evaluate the preliminary clinical efficacy on fixing adult femur fracture. Methods From January 1998 to June 2001, 23 patientswith femur fracture were stabilized with auto-compressive and anti-circumrotateintramedullary nail. 2-4 elastic blocks were installed into the proximal and distal different distance of quincunx nail to defend circumrotate and axis compress. Results Fracture healing were obtained in all 23 patients treated with auto-compresseiveand anti-circumrotate intramedullary nail, the time of fracture healing was 6-13 weeks in 21 cases and 15-22 weeks in 2 cases of old fracture. There was no complication related to infection, nail break, abnormal union and joint ankylosis. The results were excellent in 19 cases, good in 3 cases, and moderate in 1 case according Kolmert’s criterion for function ; the effective rate was 95.7%. Conclusion Auto-compressive and anti-circumrotate intramedullary nail has a suitable radian for adult femur, can afford stable fixation, anti-circumrotate andaxis compress.
Objective To investigate the effectiveness on the re-fracture of the femur with occult infection by using non-contact locking plate which was placed under the deep fascia. Methods Clinical data of 12 cases of occult infective re-fracture after femoral fracture operation were retrospectively analysed between January 2010 and December 2014. There were 8 males and 4 females with an age of 28-69 years (mean, 42.8 years). Femur re-fractured in 5 cases after 3 days to 4 weeks (mean, 10.6 days) of removal of internal fixation, including 4 cases of plate fixation and 1 case of intramedullary nail fixation; femur in 7 cases re-fractured because of breakage of internal fixator after 7-16 months (mean, 9.3 months) of internal fixation, including 5 cases of plate fixation and 2 cases of intramedullary nail fixation. The tissues near the fracture were collected for bacteria culturing and pathological examining. All the patients were treated by debriding the site of the fracture, bridging with the non-contact locking plate, and transplanting with granulated cancellous bone autograft. Intravenous infusion of antibiotics were used for 2-3 weeks after operation and oral administration for 4 weeks. The X-ray films were taken regularly and the function of the knees were evaluated by the Hospital for Special Surgery (HSS) score system. Results The results of bacteria culturing were positive in 8 patients and negative in 4 patients, and the pathological results of all the patients were confirmed to be chronic bone infection. All the fractures healed with no signs of exudation and ulceration of the incisions. The 12 patients were followed up 18-36 months (mean, 29.6 months). The fracture healed well and no re-fracture occurred. The fracture healing time was 14-22 weeks (mean, 18 weeks). At last follow-up, the function of the knee joint was excellent in 9 cases and good in 3 cases according to HSS score system. Conclusion The treatment of re-fractures after femur fracture operation needs to determine whether there is an occult infection, and non-contact locking plate placed under the deep fascia is an effective way for the re-fracture.
ObjectiveTo analyze the changing trends in disease burden of femoral fractures in China from 1990 to 2021, evaluate the impacts of age, period, and cohort effects, and project the age-standardized prevalence rate and age-standardized incidence rates of femoral fractures from 2022 to 2036. MethodsUtilizing open data from the 2021 Global Burden of Disease (GBD) study, this research characterized the disease burden of femoral fractures in China between 1990 and 2021, including trends in incidence, prevalence, and years lived with disability (YLDs). Age-standardized rates were calculated, and Joinpoint regression models were employed to estimate annual percentage changes (APC) and average annual percentage changes (AAPC). An age-period-cohort (APC) model was applied to quantify the effects of age, period, and birth cohort on disease burden. A Bayesian age-period-cohort (BAPC) model was further utilized to project age-standardized prevalence rates and age-standardized incidence rates from 2022 to 2036, with stratified analyses by age, sex, and time period. ResultsFrom 1990 to 2021, age-standardized prevalence (AAPC=0.138 5%), incidence (AAPC=0.294 2%), and YLD rates (AAPC=0.128 3%) exhibited sustained upward trends. Unintentional injuries constituted the predominant etiology of femoral fractures, followed by transport accidents and interpersonal violence/self-harm. In 2021, disease burden escalated with advancing age, with females over 60 years demonstrating significantly higher burdens than males. Age effect coefficients showed a monotonic increase, period effects displayed a U-shaped trajectory (decline followed by rebound), and cohort effects exhibited an inverted U-shaped pattern (rise then decline). Projections indicated continued growth in age-standardized prevalence rates and age-standardized incidence rates through 2036. ConclusionAs the population aging intensifies in China, the disease burden of femoral fractures in our country remains extremely severe. Among them, the elderly female group has become the key focus for prevention and control due to the high prevalence of osteoporosis.
Objective To evaluate the results of the treatmenton femoral fractures with inverse limited marrow cavity rasping intramedullary interlocking nail . Methods From Jun. 1999 to Sep. 2003, 74 patients with femoralfractures were treated by intramedullary interlocking nail (inverse limited marrow cavity rasping) .There were 62 males and 12 females. Among them, 5 caseswere type 32A1, 7 cases were type 32A2, 12 cases were type 32A3, 35 cases were type 32B2, and 15 cases were type 32C2. Results Seventyfour patients were followed up for 13 to 29 months(15.4 months in average). Thetime for fracture union ranged from 3 to 5 months(3.8 months in average). The overall rate of excellence was 98.7% by Wuyuesong grading. There was 1 case of non-union, 1 case of delayed infection, and 2 cases of bent screw. Conclusion The treatment on femoral fractures with inverse limited marrow cavity rasping intramedullary interlocking nail is easy to operate and has minimum impairment to local circulation. It also promotes the healing and early function.