Abstract:
PURPOSE:To compare the short-term ambulatory function of elderly patients after fixation of unstable intertrochanteric fractures with either the AO-ASIF proximal femoral nail anti-rotation (PFNA) device or the dynamic hip screw (DHS). METHODS:63 patients aged 60 years or older underwent fixation for unstable intertrochanteric fractures (AO types A2 and A3) using the PFNA (n=25) or DHS (n=38). The decision for the type of implant used was based on the lead surgeon's preference, according to perceived fracture stability and clinical experience. In patients having PFNA fixation, weight bearing ambulation and rehabilitation was commenced on day 2. The extent of weight bearing was decided by the lead surgeon based on the stability of the fracture. In patients having DHS fixation, non-weight bearing and ambulation with a walking aid was commenced on day 2. Ambulatory function before injury and after surgery was measured using the Parker Mobility Score (PMS). The 2 groups were compared in terms of the PMS, ambulatory independence, and environmental mobility. RESULTS:Respectively in PFNA and DHS patients, 32% and 13% (p=0.035) were ambulant with a walking frame at discharge; the remainder were wheelchair bound. Patients treated with PFNA had significantly higher median PMS at 6 months (4 vs. 2, p=0.002), median ambulatory independence score at 6 months (4 vs. 3, p=0.004) and at 12 months (5 vs. 4, p=0.001), and median environmental mobility score at 6 months (2 vs. 1, p=0.007). They also had significantly higher percentage of patients able to ambulate outdoor and in community at 6 months (64% vs. 29%, p=0.02) and able to walk independently or with a walking aid at 12 months (96% vs. 69%, p=0.01). There were 3 complications. Two patients treated with PFNA had blade cut-out, owing to poor fracture reduction. One patient treated with DHS had screw cut-out and subsequently developed avascular necrosis of the femoral head. CONCLUSION:Unstable intertrochanteric fractures in elderly patients with good pre-fracture ambulatory function stabilised with the PFNA resulted in better short-term ambulatory function.
journal_name
J Orthop Surg (Hong Kong)journal_title
Journal of orthopaedic surgery (Hong Kong)authors
Chua IT,Rajamoney GN,Kwek EBdoi
10.1177/230949901302100309subject
Has Abstractpub_date
2013-12-01 00:00:00pages
308-12issue
3eissn
1022-5536issn
2309-4990journal_volume
21pub_type
杂志文章abstract:PURPOSE:This study aimed to use MRI to evaluate the fibula and talus position difference in functional and mechanical ankle stability patients. METHODS:61 and 68 patients with functional and mechanical instability, and 60 healthy volunteers were involved. Based on the axial MRI images, the rotation of the talus was id...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499020984575
更新日期:2021-01-01 00:00:00
abstract:PURPOSE:The objective of this study was to improve the three-dimensional (3D) understanding of optimal lateral cortical hinge in medial open-wedge high tibial osteotomy (MOWHTO) via a computational cadaveric simulation of actual size. METHODS:The computed tomography data of 117 adult cadavers were imported into Mimics...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499020959172
更新日期:2020-09-01 00:00:00
abstract:PURPOSE:To compare stability and subsidence associated with 3 types of cervical spine stabilisation. METHODS:The C3 to C4 vertebrae of 28 Polish pigs were used. Pigs with intact vertebrae (group 1) underwent standard anterior cervical discectomy (group 2), followed by stabilisation using a cage alone (group 3), a cage...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900801600103
更新日期:2008-04-01 00:00:00
abstract::Intramedullary devices have been developed to reduce the problems associated with Kirschner (K)-wire fixation in proximal interphalangeal joint (PIPJ) arthrodesis. The purpose of this systematic review is to compare the surgical outcomes of K-wires versus novel internal fixation devices in PIPJ arthrodesis in claw/ham...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499020911168
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:To assess the clinical results of pelvic reconstruction using a saddle prosthesis following limb salvage operation for periacetabular tumour. METHODS:12 patients with sarcoma and 4 with metastasis involving the pelvis were treated using the saddle prosthesis between 1995 and 2003 inclusive. Wide pelvic resecti...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900601400210
更新日期:2006-08-01 00:00:00
abstract:PURPOSE:This study compared the results of a culture method using sonication with those yielded by the conventional culture method, for patients with infected total knee arthroplasty (TKA). We also evaluated the usefulness of sonication for the identification of pathogens in infected TKA cases. METHODS:Isolates were c...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499019832417
更新日期:2019-01-01 00:00:00
abstract::Osteoarthritis (OA) is an extremely common form of chronic joint disease which can affect the knees and other joints of older adults, leading to debilitating disability in the knee and consequent reduction in quality of life. Intra-articular platelet-rich plasma (PRP) or hyaluronic acid (HA) injections are effective f...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章,meta分析,评审
doi:10.1177/2309499019887660
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Management of longitudinal forearm instability remains challenging. Chronic forearm stability may be overcome by reconstruction of the interosseous ligament (IOL). Despite the bands of the IOL being inseparable, studies of the IOL have focused on the central band (CB), but have neglected the proximal (PB) an...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499020973481
更新日期:2020-09-01 00:00:00
abstract::An unusual case of avulsion fracture of the tibial tuberosity with underlying angiomatosis in a middle-aged man is described, with particular emphasis on the successful use of bisphosphonate in its treatment and the value of serial dual energy X-ray absorptiometry in its subsequent disease monitoring. This case illust...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900301100119
更新日期:2003-06-01 00:00:00
abstract:INTRODUCTION:The aim is to analyze the functional outcomes of patients of giant cell tumor (GCT) of distal radius treated with ulnar translocation and wrist arthrodesis. METHODS:Study included 25 patients of aggressive GCT of distal radius, resected and reconstructed using ulnar translocation and wrist arthrodesis. Th...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499016684972
更新日期:2017-01-01 00:00:00
abstract:AIM:To determine whether a mechanical, high-frequency vibration device (Tenease™) can improve pain and function for the treatment of tennis elbow (TE), compared with standard treatment. METHODS:Adults presenting to an elbow clinic with a clinical diagnosis of TE were randomized to standard treatment with physiotherapy...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章,随机对照试验
doi:10.1177/2309499018792744
更新日期:2018-05-01 00:00:00
abstract::Tophaceous pseudogout in the knee joint is rare. We report an 82-year-old man who presented with a one-year history of pain and swelling of the right knee joint. Treatment with non-steroidal anti-inflammatory drugs and aspiration of the joint effusion had not been effective. The mass continued to enlarge, and the pati...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949901001800127
更新日期:2010-04-01 00:00:00
abstract:PURPOSE:To assess the clinical outcome of unreamed intramedullary interlocking nailing in open fractures of tibia, and to evaluate the incidence of complications in these open fractures as a result of the unreamed intramedullary nailing. METHODS:Between June 1999 and May 2000, a total of 60 cases of open tibial shaft ...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900401200215
更新日期:2004-12-01 00:00:00
abstract::Elderly people with osteoarthritis of the knee and postpartum women are at risk of insufficiency fractures of the proximal fibular or tibia. We report on an 82-year-old woman with valgus osteoarthritis of the knee who developed insufficiency fractures of the right proximal fibula and then the right proximal tibia. She...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949901302100126
更新日期:2013-04-01 00:00:00
abstract::Tears of the triangular fibrocartilage complex (TFCC) often lead to chronic wrist pain. The commonly used 2-needle outside-in and inside-out suturing techniques require an extra incision to tie the sutures subcutaneously. We use a practical and cost-effective arthroscopic technique for treatment of peripheral Palmer t...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900901700224
更新日期:2009-08-01 00:00:00
abstract:PURPOSE:To assess distance changes between the femoral and tibial attachment points of 3 different anterior cruciate ligament (ACL) tunnel entry positions throughout the range of knee motion in cadaveric knees. METHODS:The ACLs of 11 fresh-frozen cadaveric knees (from 6 men and 5 women) were removed using radiofrequen...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949901402200310
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Various radiographic measurements that describe humeral head coverage by the acromion and the effect on rotator cuff pathology have been reported. This study aimed to describe and validate a new radiographic measurement, the acromiohumeral centre edge angle (ACEA). METHODS:We compared the ACEA on computed t...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499017727950
更新日期:2017-09-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the implication of gait speed, which is a prerequisite for the diagnosis of sarcopenia in older patients with lumbar spinal stenosis (LSS). METHODS:This study was conducted in a total of 235 patients with LSS who underwent surgical treatment. The state of sarcopenia an...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499020918422
更新日期:2020-01-01 00:00:00
abstract::We conducted a study on dried cadaveric pelvic bones to determine the relation between acetabular diameter and thickness of the acetabular wall. The acetabulum was divided into four quadrants: antero-superior, postero-superior, postero-inferior, and antero-inferior. The diameters of the acetabulum were measured for 15...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900201000108
更新日期:2002-06-01 00:00:00
abstract::Diabetic muscle infarction of the peroneus brevis is a rare complication of diabetes mellitus. It often presents with an acute leg pain without any obvious signs. Due to poor awareness of this condition, it is often misdiagnosed and results in anxiety of the patient and unnecessary investigations. It is ominous as it ...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900501300319
更新日期:2005-12-01 00:00:00
abstract:PURPOSE:To evaluate understanding of the fundamental concepts of informed consent by the public and patients. METHODS:Questionnaires were distributed to any persons (aged more than 16 years) attending the Palmerston North Hospital (excluding in-patients). The first 1000 completed questionnaires were analysed using the...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900801600202
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:This study evaluated the efficacy of surgery for femoral neck fractures in children after a 24-h delay and the factors affecting the risk of complications. METHODS:The study included 16 children who underwent surgery after the first 24 h for femoral neck fractures. According to Delbet's classification, there...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499019889682
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:To review the outcome of retrograde locked nailing for aseptic supracondylar femoral nonunions following failed locked plating. METHODS:Records of 20 men and 4 women aged 20 to 57 (mean, 39) years who underwent retrograde locked intramedullary nailing for aseptic supracondylar femoral nonunion following failed...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949901502300207
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:To evaluate the intra- and inter-observer reproducibility of the Gartland radiographic classification for supracondylar humeral fractures in children. METHODS:Anteroposterior and lateral radiographs of 50 supracondylar humeral fractures in children were graded on 2 separate occasions by 4 orthopaedic surgeons ...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900701500104
更新日期:2007-04-01 00:00:00
abstract:PURPOSE:In this study, we asked the question of whether non-invasive (NI) extendible bone tumour implants are as reliable and reduce infection when compared with patients who received a minimally invasive (MI) extendible implant. METHODS:Forty-two NI extendible bone tumour implants were investigated at a mean follow-u...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499019833403
更新日期:2019-01-01 00:00:00
abstract:PURPOSE:This study is performed to identify risk factors for delirium in osteoporotic hip fractures and to evaluate the hospitalization cost and clinical outcomes of delirium in osteoporotic hip. METHODS:A total of 221 patients with osteoporotic hip fractures were assessed for eligibility between 2010 and 2014. Among ...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499017739485
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Cementless femoral reconstruction is challenging in hip dysplasia due to deformity of the proximal femur causing insufficient stem fixation and/or inadequate neck anteversion. Strategies to address these problems include the use of a modular stem or a distal fixation stem, but both stems have some characteri...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499020956742
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Metaphyseal sleeves have been used as metaphyseal filling implants to address bone loss during revision total knee replacements (TKRs). This study aims to compare the 2-year clinical and radiological outcomes of constraint implant with bone defect and constraint implant without or minimal bone defect in revi...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499020926313
更新日期:2020-01-01 00:00:00
abstract::PURPOSE. To investigate consultant surgeons' knowledge about the costs of implants for various joint surgeries. METHODS. Questionnaires were distributed to consultant orthopaedic surgeons at 2 hospitals. Respondents were asked to estimate the implant costs of any brand for low-demand and high-demand total hip replacem...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949901402200222
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:This study aimed to present the change in humeral retroversion (HR) angle (HRA) that occurs in childhood and young adulthood and the potential developmental difference that is observed in wrestlers. METHODS:HRA of dominant and non-dominant shoulders (DSHRA and NDSHRA, respectively) were measured using ultrason...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499020985149
更新日期:2021-01-01 00:00:00