[Clinical effect of allogeneic peroneal bone marrow support combined with plate fixation for the treatment of Neer type â £ proximal humeral fractures].

OBJECTIVE: To explore clinical effect of allogeneic peroneal bone marrow support combined with plate internal fixation in treating Neer type Ⅳproximal humeral fractures. METHODS: From December 2017 to December 2020,12 patients with Neer type Ⅳ proximal humeral fractures were treated with allogeneic peroneal bone marrow support combined with plate internal fixation,including 7 males and 5 females,aged from 56 to 78 years old;the time from injury to operation ranged from 1 to7 days. Operative time,fracture healing time and complications during follow-up were observed,and clinical efficacy was evaluated by Constant-Murley score at the latest follow-up. RESULTS: All patients were obtained follow up for 20 to 29 months. All patients got bone healing and incisicons were healed at stageⅠ,operative time ranged from 95 to 138 min,blood loss ranged from 210 to 275 ml,fracture healing time ranged from 14 to 18 weeks. Two patients occurred postoperative shoulder stiffness and recovered after 2 weeks of passive exercise. There were no complications such as infection,poor wound healing,and failure (fracture and loosening) of internal fixators occurred. Constant-Murley shoulder function score ranged from 69 to 89 at the latest follow up,2 patients got excellent results,9 good and 1 fair. CONCLUSION: The application of allogeneic fibular bone marrow placement could provide effective support for medial humerus,which is conducive to assisting reduction of fracture end,reducing occurrence of internal fixation failure caused by collapse of humerus head and screw perforation,and significantly improving function of shoulder joint.

[Application of greater trochanteric slide osteotomy in total hip arthroplasty for stiff hip].

OBJECTIVE: To study the effect of greater trochanteric slide osteotomy(GTSO) in total hip arthroplasty (THA) for the treatment of stiff hip, as well as the potential complications. METHODS: There were 12 cases enrolled in the study from April 2010 to December 2014, including 9 males and 3 females. The mean age was 49.9 years old (ranged, 37 to 62 years old). The clinical result was evaluated according to the Harris evaluation system, and the radiological evaluations included the healing of the osteotomy, the stability of the prosthesis, and occurrence of heterotopic ossification (HA). RESULTS: The mean follow-up period was 17.3 months (ranged, 15 to 22 months). The mean postoperative Harris score was 88.00±6.11, which was significantly higher than the preoperative mean score which was 43.96±8.46(t=-18.34, P=0.00). All the osteotomy site abtained good healing without prosthesis loosening or HA. There was 1 patient with infection and 1 patient with pain in greater trochanter. CONCLUSIONS: GTSO is an effective exposure technique in THA for stiff hip, and no marked complication associated with the osteotomy is found in the study.