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.
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.
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.
To evaluate the cl inical results of less invasive stabil ization system (LISS) for femur supercondylar and intercondylar fractures. Methods From March 2004 to November 2005, 47 patients with 49 intercondylar and supercondylar fractures were treated. Of all the patients, there were 34 males and 13 females with an average of 39.7 years (range 19-56 years). The locations were left side in 21 cases and right side in 28 cases. Fracture was caused by traffic accident in 31 cases, fall ing in 8 cases, violence in 6 cases and others in 2 cases. Forty-nine fractures included 14 intercondylar fractures, 21supercondylar fractures and 14 intercondylar and supercondylar fractures; 32 closed fractures and 17 open fractures. According to the AO typing, there were 6 type 33-A1, 8 type 33-A2 , 10 type 33-A3, 7 type 33-C1, 3 type 33-C2 and 15 type 33-C3. The disease course was 30 minutes to 6 days. Articular surface reduction was first performed, then the LISS plate was inserted via two incisions and locking screws were used later. Results The average operation time was 126 minutes (range 48-248 minutes). The blood loss was 180 mL(range 60-1 200 mL). The average follow-up time was 18.6 months (range 12-23 months). There were 4 patients with AP angular deformity and 5 patients with lateral angular deformity (range 2-5°). External rotation deformity was presented in 2 patients. There were no plate breakage, screw loosen and fixation failure. Average bone union time was 5.6 months (range 3-8 months) without infection case. Six cases were treated with il iac bone transplantation for delayed union. Conclusion LISS is one kind of effective treatment to femoral intercondylar and supercondylar fractures.