[Impact of hip fracture on coagulation function in elderly patients].

OBJECTIVE: To investigate the impact of hip fracture on coagulation function in elderly patients. METHODS: In our study, 127 elderly patients with hip fracture were diagnosed and admitted to Peking University People's Hospital from January 2011 to March 2012. Specimens of their venous blood were obtained before and after the surgery, and measured for fibrinogen (FIB) and D-dimer. Also, we analyzed their age, type of fracture, fracture time, and concomitant diseases. RESULTS: The FIB level of the patients (127 cases) before surgery was (3.91 ± 1.06) g/L, and 42.52% (54/127) patients' FIB was higher than normal. After the surgery, 28 patients underwent FIB test [(4.21 ± 1.24) g/L], which was higher than the FIB value before surgery, but was not statistically significant. Before surgery, 15 patients underwent D-dimer test [(2 059.5 ± 1 948.0) µg/L]. After the surgery, 26 patients underwent D-dimer test [(2 574.9 ± 1 702.4) µg/L].The two values were significantly higher than normal (P<0.05). The elevated value of FIB had no relationship with age, diabetes, cardiovascular or cerebrovascular diseases. Before surgery, 45.83% (22/48) of the intertrochanteric fracture patients had abnormal FIB, and 40.50% (32/79) of the patients with femoral neck fracture had abnormal FIB, but they were not statistically significant. Grouped according to the fracture time, when fracture time was longer than 96 h, the ratio of abnormal FIB was 26.7%, lower than those of other groups, and the difference was statistically significant (P<0.05). CONCLUSION: The hip fracture in elderly patients has a direct impact on coagulation system, and FIB and D-dimer have significantly changed. According to the variation of FIB after fracture,we speculate that fracture surgery after 96 h may affect the coagulation system at the lowest level.

[Analysis of clinical outcomes of carpal tunnel syndrome combined with cervical nerve root compression].

OBJECTIVE: To analyze the clinical curative effect of carpal tunnel syndrome (CTS) combined with cervical nerve root compression and to explore the differences between CTS combined with cervical nerve root compression and simple CTS in the clinical manifestations, diagnosis and treatment. METHODS: From February 2004 to October 2010, 93 cases (120 sides) were selected among the patients (21 males and 72 females) adopted to our department and primarily diagnosed as CTS, of whom 29 had cervical nerve root compression. Neurolysis of peripheral nerve was conducted in the 93 cases, and the mean follow-up period was 16 months. RESULTS: The results of the improvements of symptoms and signs after operation were evaluated by the British Medical Research Council (BMRC). According to the BMRC scores, we divided the patients into three stages: excellent, good and none. In the 93 patients, 29 were with visible nerve root compression in radiograph or magnetic resonance imaging, in whom the excellent rate was 86.21%, and the good rate 13.79%, meanwhile in the patients without nerve root compression, the excellent rate was 90.63% and the good rate 9.37%. CONCLUSION: In the case of CTS combined with cervical nerve root compression, our findings are as follows: Firstly, neurolysis of peripheral nerve has an accurate curative effect; Secondly, neurolysis of peripheral nerve may decline the symptoms of nerve root compression; Thirdly, patients with nerve root compression are obviously more common in men, therefore, we should pay attention to the double crash when it comes to the male patient.