Injury
-
Randomized Controlled Trial
Hip hemiarthroplasty for senile femoral neck fractures: Minimally invasive SuperPath approach versus traditional posterior approach.
The supercapsular percutaneously-assisted total hip (SuperPATH®) approach was created by combining the percutaneous preparation of the acetabulum using the percutaneously-assisted total hip (PATH), femoral reaming, and broaching of superior capsulotomy (SuperCap) approach. This technique reported a low complication rate, excellent gait kinematics, low transfusion rate, a shorter length of hospital stay, and a high proportion of discharge from the hospital. As minimally invasive SuperPath approach is designed for both trauma and end-stage degenerative joint disease, we investigated if this technique and standard surgical tools can replace artificial femoral head in elderly patients with femoral neck fracture. We also tested if it has advantages over the traditional posterior approach. ⋯ SuperPath approach for artificial femoral head replacement can reduce surgical injury due to smaller size of incision and accelerate weight-bearing activities post-operation to treat senile femoral neck fractures compared with traditional posterior approach surgeries.
-
Randomized Controlled Trial
Daily subcutaneous Teriparatide injection increased bone mineral density of newly formed bone after tibia distraction osteogenesis, a randomized study.
Long bone defects are often treated by bone segment transport with the Ilizarov method requiring months spent with fixator mounted until bony consolidation of the newly formed bone. Shortening of consolidation would allow earlier fixator removal and earlier return to work. In pre-clinical studies parathyroid hormone, increased bone mineral density and mechanical properties of regenerate bone formed during distraction osteogenesis. ⋯ After adjustment for a potential phase difference, 8 weeks of Teriparatide treatment led to an additional 0.19 g/cm2 BMD increase (95%-CI:[0.11,0.28], p < 0.001). The ratio of the BMD increase between the two treatments was 0.33/0.14 = 2.43 (CI: [1.21,3.65]). Teriparatide treatment during the consolidation phase of distraction osteogenesis doubled the mineralization rate of the regenerate when compared to no treatment.