Efficient Lead Removal by Assembly of Bio-Derived Ellagate Framework, Which Enables Electrocatalytic Reduction of CO2 to Formate.

Lead (Pb) poisoning and CO2-induced global warming represent two exemplary environmental and energy issues threatening humanity. Various biomass-derived materials are reported to take up Pb and convert CO2 electrochemically into low-valent carbon species, but these works address the problems separately rather than settle the issues simultaneously. In this work, cheap, natural ellagic acid (EA) extracted from common plants is adopted to assemble a stable metal-organic framework (MOF), EA-Pb, by effective capture of Pb2+ ions in an aqueous medium (removal rate close to 99%). EA-Pb represents the first structurally well-defined Pb-based MOF showing selective electrocatalytic CO2-to-HCOO- conversion with Faradaic efficiency (FE) of 95.37% at -1.08 V versus RHE. The catalytic mechanism is studied by 13CO2 labeling, in situ diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS), and theoretical calculation. The use of EA-Pb as an electrocatalyst for CO2 reduction represents a 2-in-1 solution of converting detrimental wastes (Pb2+) as well as natural resources (EA) into wealth (electrocatalytic EA-Pb) for addressing the global warming issue.

Impaction Bone Grafting Combined with Titanium Mesh for Acetabular Bone Defects Reconstruction in Total Hip Arthroplasty Revision: A Retrospective and Mini-Review Study.

OBJECTIVE: To investigate the application of impaction bone grafting (IBG) combined with Ti-alloy mesh for acetabular bone defect reconstruction in total hip arthroplasty (THA) revision and follow up the clinical outcomes and imaging findings. METHODS: The clinical and imaging data of patients who were admitted to our hospital from January 2000 to December 2020 and underwent acetabular bone defects reconstruction using IBG combined with titanium mesh were retrospectively analyzed. Preoperative and post-revision Oxford and Harris scores, and post-revision complications were evaluated. Radiographs were used to determine center of rotation (COR) of the hip joint, transparency line, bone graft fusion, and bone mineral density (BMD) around the hip joint. RESULTS: Significant improvement was observed in both Oxford and Harris scores (P < 0.05). The radiographs taken at the last follow-up examination showed no significant differences in the acetabulum COR, offsets, inclination angle, mean ratio of vertical value, and BMD analysis between the post-revision side and contralateral side (P > 0.05). The follow-up data showed restoration of the mesh implant and graft bone fusion. CONCLUSIONS: The application of IBG combined with titanium-alloy mesh in revision THA patients with acetabular defects was found to provide satisfactory outcomes. However, large-scale studies are still needed to further elucidate the long-term outcomes.

Structure, Luminescent Sensing and Proton Conduction of a Boiling-Water-Stable Zn(II) Metal-Organic Framework.

A novel Zn(II) metal-organic framework [Zn4O(C30H12F4O4S8)3]n, namely ZnBPD-4F4TS, has been constructed from a fluoro- and thiophenethio-functionalized ligand 2,2',5,5'-tetrafluoro-3,3',6,6'-tetrakis(2-thiophenethio)-4,4'-biphenyl dicarboxylic acid (H2BPD-4F4TS). ZnBPD-4F4TS shows a broad green emission around 520 nm in solid state luminescence, with a Commission International De L'Eclairage (CIE) coordinate at x = 0.264, y = 0.403. Since d10-configured Zn(II) is electrochemically inert, its photoluminescence is likely ascribed to ligand-based luminescence which originates from the well-conjugated system of phenyl and thiophenethio moieties. Its luminescent intensities diminish to different extents when exposed to various metal ions, indicating its potential as an optical sensor for detecting metal ion species. Furthermore, ZnBPD-4F4TS and its NH4Br-loaded composite, NH4Br@ZnBPD-4F4TS, were used for proton conduction measurements in different relative humidity (RH) levels and temperatures. Original ZnBPD-4F4TS shows a low proton conductivity of 9.47 × 10-10 S cm-1 while NH4Br@ZnBPD-4F4TS shows a more than 25,000-fold enhanced value of 2.38 × 10-5 S cm-1 at 40 °C and 90% RH. Both of the proton transport processes in ZnBPD-4F4TS and NH4Br@ZnBPD-4F4TS belong to the Grotthuss mechanism with Ea = 0.40 and 0.32 eV, respectively.

Linker Deficiency, Aromatic Ring Fusion, and Electrocatalysis in a Porous Ni8-Pyrazolate Network.

The cruciform linker molecule here features two designer functions: the pyrazole donors for framework construction, and the vicinal alkynyl units for benzannulation to form nanographene units into the Ni8-pyrazolate scaffold. Unlike the full 12 connections of the Ni8(OH)4(H2O)2 clusters in other Ni8-pyrazolate networks, significant linker deficiency was observed here, leaving about half of the Ni(II) sites capped by acetate ligands, which can be potentially removed to open the metal sites for reactivity. The crystalline Ni8-pyrazolate scaffold also retains the crystalline order even after thermal treatments (up to 300 °C) that served to partially graphitize the neighboring alkyne units. The resultant nanographene components enhance the electroactive properties of the porous hosts, achieving hydrogen evolution reaction (HER) activity that rivals that of topical nickel/palladium-enabled materials.

Conjugated crosslinks boost the conductivity and stability of a single crystalline metal-organic framework.

A linker molecule with four pendant thiophene functions was crystallized with Zr(iv) ions to form a semiconductive porous coordination solid (1.1 × 10-5 S cm-1). Oxidative treatment with FeCl3 guests then coupled the thiophene units to form conjugated bridges as covalent crosslinks. The resulting hybrid of a metal-organic framework and conjugated polymer featured robust crystalline order that withstood long-term air exposure and broad pH (from 0 to 12) conditions. Moreover, the homocoupled thiophene units, conjugated through sulfide links (-S-) with the linker backbone, afforded higher electronic conductivity (e.g., >2.2 × 10-3 S cm-1), which is characteristic of conductive polymer prototypes of polythiophene and polyphenylene sulfide. The crosslinked solid also exhibited proton conductivity that could be increased broadly upon H2SO4 treatment (e.g., from 5.0 × 10-7 to 1.6 × 10-3 S cm-1).

Effect of 3 different anticoagulants on hidden blood loss during total hip arthroplasty after tranexamic acid.

Comparison of different anticoagulants in blood management and complications with tranexamic acid (TXA) in total hip arthroplasty (THA) is unclear. Our aim was to compare the efficacy and safety among receiving nadroparin calcium, enoxaparin sodium or rivaroxaban after TXA in THA.150 patients undergoing primary unilateral THA were received 15 mg/kg intravenous TXA (IV-TXA) before skin incision, followed by 1 of nadroparin calcium (Group A), enoxaparin sodium (Group B), or rivaroxaban (Group C) randomly during hospitalization. The primary outcome was hidden blood loss (HBL). Other outcomes such as the maximum hemoglobin (Hb) drop, total blood loss (TBL), the volume of drainage, transfusion rate, length of hospital stay (LOS), and complications were also compared.There were no statistically significant differences in HBL, the maximum hemoglobin (Hb) drop, transfusion rate, and complications among 3 groups. LOS was significantly higher for patients in Group B than Group A (P = .026). Neither deep venous thrombosis (DVT) nor pulmonary embolism (PE) occurred in any group.There were no differences in efficacy and safety in patients undergoing THA receiving nadroparin calcium, enoxaparin sodium, or rivaroxaban after anti-fibrinolysis with TXA.

A Bumper Crop of Boiling-Water-Stable Metal-Organic Frameworks from Controlled Linker Sulfuration.

The series of highly stable porous solids here feature systematic, regiospecific sulfur substitutions on the organic linkers for versatile functions. One major surprise lies in the controllable sequential reactions between sodium thiomethoxide (NaSMe) and octafluorobiphenyl-4,4'-dicarboxylic acid (H2bpdc-8F; this was readily made without precious metal catalysts). Namely, 3, 4, 6, and 8 methylthio-substitutions can be respectively achieved with regiospecificity (i.e., to produce the four molecules H2bpdc-3S5F, H2bpdc-4S4F, H2bpdc-6S2F, H2bpdc-8MS). A second surprise lies in their persistent formation of the UiO-67-type net with Zr(IV) ions, e.g., even in the case of the fully sulfurated H2bpdc-8MS. In addition to the remarkable breadth of functional control, all the Zr(IV)-based crystalline solids here are stable in boiling water (e.g., for 24 h) and in air as solventless, activated porous solids. Moreover, the thioether groups allow for convenient H2O2 oxidation to fine-tune the hydrophilicity and luminescence properties and improve proton conductivity.

Conductive Metal-Organic Frameworks: Mechanisms, Design Strategies and Recent Advances.

Metal-organic frameworks (MOFs), constructed from metal ions and organic ligands through coordination assembly, exhibit considerable conductivity, which originates from the ionic or electronic transport pathway between the host architecture and guest species. In recent decades, the study of conductive MOFs has accelerated deservedly due to their importance in the electronic information industry. In this review, we first briefly describe the different mechanisms of ionic and electronic conduction. The design strategies of constructing intrinsic and doping MOFs are then summarized and generalized into three major categories (host-based-, guest-based- and host-guest-related systems) in terms of promoting conductive performance. In the next section we provide an overview of recent progress in research on conductive MOFs, providing details according to the various carriers of transporting electrons, protons and other ions. We conclude with a discussion on the practicability and emerging applications of conductive MOFs and a section on the existing challenges and development prospects. Conduction mechanisms, design strategies, recent progresses and emerging applications of conductive MOFs.

An air-stable anionic two-dimensional semiconducting metal-thiolate network and its exfoliation into ultrathin few-layer nanosheets.

The black, small-bandgap semiconducting framework Eu-dfdmat features extensive Eu3+-sulfur bridges from the linear linker 2,5-difluoro-3,6-dimercaptoterephthalate (dfdmt). Each Eu center is chelated to four dfdmt linkers to form an anionic coordination sphere involving four carboxyl O and four mercapto S centers (EuO4S4), wherein the charge buildup can be alleviated by the electron-withdrawing fluoro groups. The extensive metal-linker bonding, together with a trace of Eu2+ species, appears to boost electronic interaction in the 2D net, generating a small band gap of 1.31 eV (946 nm), albeit a modest conductivity (e.g., 10-6 S m-1). The crystals also exhibit persistent EPR signals indicative of organic radicals (g = 2.002). The Eu-dfdmt solid are stable in air and can be exfoliated into ultrathin nanosheets (ca. 5 nm; 6-8 layers).

Best bone of acetabulum for cup component placement in Crowe types I to III dysplastic hips: a computer simulation study.

BACKGROUND: During cup implantation, vertical height of the cup center (V-HCC) should be precisely controlled to achieve sufficient bone-cup coverage (BCC). Our study aimed to investigate the acetabular bone stock and the quantitative relationship between V-HCC and BCC in Crowe types I to III hips. METHODS: From November 2013 to March 2016, pelvic models of 51 patients (61 hips) with hip dysplasia were retrospectively reconstructed using a computer software. Acetabular height and doom thickness were measured on the mid-acetabular coronal cross section. V-HCC was defined as the vertical distance of cup rotational center to the interteardrop line (ITL). In the cup implantation simulation, the cup was placed at the initial preset position, with a V-HCC of 15 mm, and moved proximally by 3-mm increments. At each level, the BCC was automatically calculated by computer. Analysis of variance and Kruskal-Wallis test were used to compare the differences between groups. RESULTS: There were no significant between-group differences in maximum thickness of the acetabular doom; however, peak bone stock values were obtained at heights of 41.63 ±â€Š5.14 mm (Crowe type I), 47.58 ±â€Š4.10 mm (Crowe type II), and 55.78 ±â€Š3.64 mm (Crowe type III) above the ITL. At 15 mm of V-HCC, median BCC was 78% (75-83%) (Crowe type I), 74% (66-71%) (Crowe type II), and 61% (57-68%) (Crowe type III). To achieve 80% of the BCC, the median V-HCC was 16.27 (15.00-16.93) mm, 18.19 (15.01-21.53) mm, and 24.13 (21.02-28.70) mm for Crowe types I, II, and III hips, respectively. CONCLUSION: During acetabular reconstruction, slightly superior placement with V-HCC <25 mm retained sufficient bone coverage in Crowe I to III hips.

Acidity and Cd2+ fluorescent sensing and selective CO2 adsorption by a water-stable Eu-MOF.

A new Eu-MOF was designed from an amino-functionalized ligand and Eu(iii) ions under solvothermal conditions. It is a highly porous, water-stable, and luminescent material, exhibiting pH sensing in the acidic range of pH = 7-3 with selective detection for Cd2+ by an enhanced fluorescence of ∼23-fold against a series of metal ions. Gas adsorption performance shows that Eu-MOF exhibits a high CO2/N2 (15/85) selectivity of 109.4 at 273 K and 1 atm. This performance was superior to that of most reported Ln-MOFs owing to its appropriate pore size, dipole-dipole interaction and donor-acceptor Lewis affinities.

Semiconductive Amine-Functionalized Co(II)-MOF for Visible-Light-Driven Hydrogen Evolution and CO2 Reduction.

A Co-MOF, [Co3(HL)2·4DMF·4H2O] was simply synthesized through a one-pot solvothermal method. With the semiconductor nature, its band gap was determined to be 2.95 eV by the Kubelka-Munk method. It is the first trinuclear Co-MOF employed for photocatalytic hydrogen evolution and CO2 reduction with cobalt-oxygen clusters as catalytic nodes. Hydrogen evolution experiments indicated the activity was related to the photosensitizer, TEOA, solvents, and size of catalyst. After optimization, the best activity of H2 production was 1102 µmol/(g h) when catalyst was ground and then soaked in photosensitizer solution before photoreaction. To display the integrated design of Co-MOF, we used no additional photosensitizer and cocatalyst in the CO2 reduction system. When -NH2 was used for light absorption and a Co-O cluster was used as catalyst, Co-MOF exhibited an activity of 456.0 µmol/(g h). The photocatalytic mechanisms for hydrogen evolution and CO2 reduction were also proposed.

Single-Phase White-Light-Emitting and Photoluminescent Color-Tuning Coordination Assemblies.

Metal-organic complexes assembled from coordinative interactions are known to be able to display a wide range of photoluminescent behaviors benefiting from an extensive number of metal ions, organic linkers, and inclusion guests, depending on the multifaceted nature of their chemical structures and photophysical properties. In the past two decades, the white-light-emitting (WLE) and photoluminescent color-tuning (PLCT) materials based on the single-phase metal-organic coordination assemblies have merited particular attention and gained substantial advances. In this review, we give an overview of recent progress in this field, placing emphasis on the WLE and PLCT properties realized in the single-phase materials, which covers the origin, generation, and manipulation of different types of photoluminescence (PL) derived from ligand-centered (LC), metal/cluster-centered (MC or CC), excimer/exciplex-based (EX), metal-to-ligand or ligand-to-metal charge-transfer-based (MLCT or LMCT), or guest-included emissions. The coordination assemblies in this topic can be generally classified into three categories [(1) mono/homometallic coordination assemblies based on main group (s,p-block), transition (d-block), or lanthanide (f-block) metal centers, (2) s/p-f-, d-f-, or f-f-type heterometallic coordination assemblies, and (3) guest-included coordination assemblies] for which WLE and PLCT properties can be achieved by virtue of either a wide-band/overlapped emission covering the whole visible spectrum from a single emitting center or a combination of complementary color emissions from multiple emitting centers/origins. Some state-of-the-art assembly methods and successful design models relevant to the above three categories are elaborated to demonstrate how to achieve efficient and controllable white-light emission in a single-phase material through a tunable PL approach. Potential applications in the fields of lighting and displaying, sensing and detecting, and barcoding and patterning are surveyed, and at the end, possible prospects and challenges for future development along this line are proposed.

Tailoring exciton and excimer emission in an exfoliated ultrathin 2D metal-organic framework.

Two-dimensional (2D) metal-organic frameworks have exhibited a range of fascinating attributes, of interest to numerous fields. Here, a calcium-based metal-organic framework with a 2D layered structure has been designed. Dual emissions relating to intralayer excimers and interlayer trapped excitons are produced, showing excitation-dependent shifting tendency, characteristic of a low dimensional semiconductor nature. Furthermore, the layer stacking by weak van der Waals forces among dynamically coordinated DMF molecules enables exfoliation and morphology transformation, which can be achieved by ultrasound in different ratios of DMF/H2O solvents, or grinding under appropriate humidity conditions, leading to nano samples including ultrathin nanosheets with single or few coordination layers. The cutting down of layer numbers engenders suppression of interlayer exciton-related emission, resulting in modulation of the overall emitting color and optical memory states. This provides a rare prototypical model with switchable dual-channel emissions based on 2D-MOFs, in which the interlayer excitation channel can be reversibly tuned on/off by top-down exfoliation and morphology transformation.

MicroRNA-193b-3p regulates matrix metalloproteinase 19 expression in interleukin-1ß-induced human chondrocytes.

Micro(mi)RNAs are small, non-coding RNA molecules known to play a significant role in osteoarthritis (OA) initiation and development, and similar to matrix metalloproteinases (MMPs), they participate in cartilage degeneration and cleave multiple extracellular matrices. The aim of this study was to determine whether the expression of MMP-19 in interleukin (IL)-1ß-induced human chondrocytes is directly regulated by miR-193b-3p. Expression levels of miR-193b-3p and MMP-19 in normal and osteoarthritis (OA) human cartilage, and interleukin-1 ß (IL-1ß)-induced human chondrocytes were determined by real-time polymerase chain reaction. Additionally, expression level of MMP-19 in IL-1ß-induced human chondrocytes was estimated by Western blotting and immunohistochemistry analyses. The effect of miR-193b-3p on MMP-19 expression was evaluated using transient transfection of normal human chondrocytes with miR-193b-3p mimic or its antisense inhibitor (miR-193b-3p inhibitor), and siMMP-19. The putative binding site of miR-193b-3p in the 3'-untranslated region (UTR) of MMP-19 mRNA was validated by luciferase reporter assay. miR-193b-3p expression was reduced in OA cartilage compared to that in normal chondrocytes, while the opposite was observed for MMP-19. Upregulation of MMP-19 expression was correlated with downregulation of miR-193b-3p in IL-1ß-stimulated normal chondrocytes. Increase in miR-193b-3p levels was associated with silencing of MMP-19. Overexpression of miR-193b-3p suppressed the activity of the reporter construct containing the 3'-UTR of human MMP-19 mRNA and inhibited the IL-1ß-induced expression of MMP-19 and iNOS in chondrocytes, while treatment with miR-193b-3p inhibitor enhanced MMP-19 expression. MiR-193b-3p is an important regulator of MMP-19 in human chondrocytes and may relieve the inflammatory response in OA.

Better Prognosis of Senile Patients with Intertrochanteric Femoral Fracture by Treatment with Open Reduction Internal Fixation than by Hip Arthroplasty.

PURPOSE: To compare the postoperative survival and mortality rates in intertrochanteric femoral fracture (IFF) patients who underwent either open reduction internal fixation (ORIF) or hip arthroplasty. METHODS: Clinical data from senior patients who had IFF and underwent ORIF or hip arthroplasty were analyzed retrospectively. Survival curves were compared between groups with Kaplan-Meier method and log-rank test. Significant independent prognostic factors were identified by Cox multivariate regression analysis. RESULTS: All patients recovered fully post-surgery. Although 31 patients died during the follow-up period (ORIF, mean 45.4 months; arthroplasty, mean 51.6 months), mortality rate did not differ significantly between the groups. The 1-yr and 2-yr survival rate estimates for the ORIF group were 92.2%, and 86%, respectively; they were 85% and 74% for the arthroplasty group. Average survival lengths for ORIF and arthroplasty groups were 88 and 67 months, respectively. The effect of surgical approaches on survival differed significantly (log-rank test c2 = 6.402, p = 0.011). Multivariate Cox regression model indicated that surgical choice (p = 0.036) was a significant independent risk factor for the prognosis of senile IFF, even with adjustment for age (p = 0.002). CONCLUSION: The overall postoperative prognosis was superior in senile IFF patients treated with ORIF.

An injectable, biodegradable calcium phosphate cement containing poly lactic-co-glycolic acid as a bone substitute in ex vivo human vertebral compression fracture and rabbit bone defect models.

Purpose/Aim of the study: To evaluate the biomechanical characteristics and biocompatibility of an injectable, biodegradable calcium phosphate cement (CPC) containing poly lactic-co-glycolic acid (PLGA). MATERIALS AND METHODS: A vertebral compression fracture model was established using 20 human cadaveric vertebrae (T11-L3) divided into CPC/PLGA composite versus PMMA groups for biomechanical testing. In addition, 35 New Zealand rabbits were used to evaluate biodegradability and osteoconductive properties of CPC/PLGA using a bone defect model. In vitro cytotoxicity was evaluated by culturing with L929 cells. RESULTS: The CPC/PLGA composite effectively restored vertebral biomechanical properties. Compared with controls, the maximum load and compression strength of the CPC/PLGA group were lower, and stiffness was lower after kyphoplasty (all p <.05). Degradation was much slower in the control CPC compared with CPC/PLGA group. The bone tissue percentage in the CPC/PLGA group (44.9 ± 23.7%) was significantly higher compared with control CPC group (25.7 ± 10.9%) (p <.05). The viability of cells cultured on CPC/PLGA was greater than 70% compared with the blanks. CONCLUSIONS: Our biodegradable CPC/PLGA composite showed good biomechanical properties, cytocompatibility, and osteoconductivity and may represent an ideal bone substitute for future applications.

Radiographic Measurement of Femoral Lateral Bowing and Distal Femoral Condyle Resection Thickness: Variances and Effects on Total Knee Arthroplasty Planning.

BACKGROUND: Accurate evaluation of the plain radiography of lower limb is critical for preoperative planning of total knee arthroplasty (TKA). We aimed to investigate the effect of femoral lateral bowing and rotation on the radiographic measurements of distal femoral condyle resection thickness (DRT) and the distal femoral resection valgus angle (FVA). METHODS: We analyzed 246 three-dimensional femoral models generated from computed tomography images of 123 patients, acquiring projected contours in seven positions - 20° and 10° internal rotation; 0° rotation; 10°, 20°, 30°, and 40° external rotation - for each model. Medial and lateral condyle DRTs, femoral shaft lateral bowing angle (FBA), and distal FVA were determined for each position. Linear mixed effect model was used to determine the effect of degree of femur rotation on repeated measurements of DRT or FVA. RESULTS: FBA significantly affected the FVA and DRT (Pearson's R = 0.767 and -0.408, respectively; P < 0.000). Samples were divided into three groups according to the FBA measured in neutral position: FBA <0°: DRT 3.75 ± 1.30 mm, FVA 4.53° ± 1.27°; FBA >0° but <3°: DRT 3.39 ± 1.31 mm, FVA 5.92° ± 1.31°; FBA >3°: DRT 2.22 ± 1.31 mm, FVA 7.37° ± 1.31°. From simulated 20° internal rotation to 40° external rotation in each femoral model, the average variation ranges of radiographically measured DRT, FVA, and FBA were 0.50 ± 0.28 mm, 2.93° ± 0.96°, and 10.33° ± 1.90°, respectively, with no significant differences among the FBA groups. The degree of femoral rotation significantly affected the FVA (F = 62.148, P < 0.000), whereas there was no effect on condyle resection thickness (F = 0.4705, P = 0.494). CONCLUSIONS: Axial femoral rotation has less effect on radiographic measurements of differences in the DRT than on those of the distal FVA.

Preoperative Measurement of Tibial Resection in Total Knee Arthroplasty Improves Accuracy of Postoperative Limb Alignment Restoration.

BACKGROUND: Accuracy of implant placement in total knee arthroplasty (TKA) is crucial. Traditional extramedullary alignment instruments are fairly effective for achieving the desired mean tibial component coronal alignment. We modified the traditional tibial plateau resection technique and evaluated its effect on alignment restoration. METHODS: Two hundred and eighty-two primary TKAs in our hospital between January 2013 and December 2014 were enrolled in this retrospective study. Group A consisted of 128 primary TKAs performed by one senior surgeon. Preoperative measurement of the tibial resection was conducted on radiographs, and the measured thicknesses of the lateral and medial plateau resection were used to place the tibial alignment guide. Group B consisted of 154 primary TKAs performed by the other senior surgeon, using a traditional tibial plateau resection technique. In all patients, an extramedullary guide was used for tibial resection, and preoperative and postoperative full-leg standing radiographs were used to assess the hip-knee-ankle angle (HKA), femoral component alignment angle (FA), and tibial component alignment angle (TA). A deviation ≥3° was considered unsatisfactory. Data were analyzed by unpaired Student's t-test. RESULTS: The mean postoperative HKA and TA angles were significantly different between Groups A and B (178.2 ± 3.2° vs. 177.0 ± 3.0°, t = 2.54, P = 0.01; 89.3 ± 1.8° vs. 88.3 ± 2.0°, t = 3.75, P = 0.00, respectively). The mean postoperative FA was 88.9 ± 2.5° in Group A and 88.9 ± 2.6° in Group B, and no significant difference was detected (t = 0.10, P = 0.92). There were 90 (70.3%) limbs with restoration of the mechanical axis to within 3° of neutral alignment and 38 (29.7%) outliers (>3° deviation) in Group A, whereas there were 89 (57.8%) limbs with restoration of the mechanical axis to within 3° of neutral alignment and 65 (42.2%) outliers (>3° deviation) in Group B. The severity of the preoperative alignment deformity was a strong predictor for postoperative alignment. CONCLUSIONS: Using conventional surgical instruments, preoperative measurement of resection thickness of the tibial plateau on radiographs could improve the accuracy of conventional surgical techniques.

[Comparison of the prognosis of intertrochanteric fracture with different surgical methods in elderly: a retrospective survival analysis].

OBJECTIVE: To determine the difference of post-operative mortality between ORIF (open reduction internal fixation) and hip replacement for the treatment of intertrochanteric fracture in elderly by using survival analysis. METHODS: The clinical data of 110 patients above 60 years old who underwent surgical treatment (ORIF or hip replacement) for the intertrochanteric fracture between April 2003 and May 2013 were retrospectively analyzed. Among the patients, 83 cases were treated with ORIF (ORIF group), there were 32 males and 51 females, aged from 61.44 to 98.75 years old with an average of (78.52 ± 7.98) years old; and 27 cases were treated with hip replacement (arthroplasty group), there were 8 males and 19 females, aged from 71.82 to 96.54 years old with an average of (79.99 ± 6.11) years old. A survival analysis was performed on the clinical data by using SPSS 110 software. The survival rate of 1-year,2-year, 5-year and the mean survival time for the total patients, the mortality rate of 1-year, 2-year in each group, the survival rate of 1-year, 2-year and mean survival time and survival curve in each group were included. RESULTS: All wounds achieved primary healing and no deaths were found in stay hospital. All patients were followed up from 1 to 125 months with an average of (46.93 ± 29.53) months. Among all 110 cases, 31 were dead and 79 survived. The survival rate of 1-year, 2-year and 5-year was (90.7 ± 2.8)%, (82.5 ± 3.9)% and (57.6 ± 6.5)%, respectively,while the ensemble mean survival time was (84.137 ± 5.902) months. The mortality rate of 1-year, 2-year in ORIF group was 7.2% and 12.0%, respectively; and in arthroplasty group, there was 14.8% and 25.9%, respectively. There was no significant difference in mortality rate of 1-year and 2-year between two groups. According to the survival analysis of the ORIF group, the survival rate of 1-year, 2-year was (92.6 ± 2.9)%, and (85.8 ± 4.3)%, respectively, and the mean survival time was (87.508 ± 6.063) months. In arthroplasty group, the survival rate of 1-year, 2-year was (85.2 ± 6.8)% and (73.9 ± 8.5)%,and the mean survival time was (67.294 ± 11.180) months. There was significant difference in mean survival time between two groups (P < 0.05). CONCLUSION: ORIF can achieve a better postoperative survival compare with hip replacement in treating intertrochanteric fracture in elderly.