Zhuozhou Municipal Hospital

Zhuozhou, China

Zhuozhou Municipal Hospital

Zhuozhou, China
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Zhao Z.-J.,Zhuozhou Municipal Hospital | Xu H.-S.,Zhuozhou Municipal Hospital | Meng W.-M.,Zhuozhou Municipal Hospital | Zhang X.-W.,Zhuozhou Municipal Hospital | Zhang L.,Zhuozhou Municipal Hospital
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: Good rotational location for femoral prosthesis is a key in total knee replacement, which is strongly associated with joint function after replacement. Each anatomical parameter of femoral condyle is also very important. To familiar with each data can do reasonably ostectomy and select axis, can avoid poor location of prosthesis-induced joint dysfunction after total knee replacement. OBJECTIVE: To observe the anatomical structure of femoral condyle specimens, and measure the angle between anatomical parameter and the axis. METHODS: A total of 40 femoral bone specimens were fixed on the frame. Morphological changes in the medial epicondyle and the lateral epicondyle were observed. Femoral condyle parameters, including length and width, were measured. Kirschner wire was used between the medial epicondyle and the lateral epicondyle using a targeting device. After ostectomy, four axial lines were measured with a conimeter, including surgical epicondylar axis, clinical epicondylar axis, posterior condylar line and anterior-posterior axis. RESULTS AND CONCLUSION: The depression of medial epicondyle appeared relatively low, accounting for 25% of the total number of all specimens; the height of the femoral condyle did not have significant difference compared with westerners, but width was smaller compared with westerners. Thus, the surgeons should be fully aware of the width of femoral condyle in operative procedures. The appearance of depression of medial epicondyle was not frequent, so posterior condylar angle of epicondylar axis was only fit for some persons. However, anterior-posterior axis was easily to be located. The angle between two axes and posterior condylar line was stable, and variability was small. Thus, the anterior-posterior axis can be used as a reliable label for rotational position of femoral prosthesis.


Xu H.-S.,Zhuozhou Municipal Hospital | Zhao Z.-J.,Zhuozhou Municipal Hospital | Meng W.-M.,Zhuozhou Municipal Hospital | Zhang L.,Zhuozhou Municipal Hospital | Zhang X.-W.,Zhuozhou Municipal Hospital
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: The good rotational alignment of femoral prosthesis was very important in total knee arthroplasty. The research has shown that the posterior condylar angle was important to determine the alignment. The posterior condylar angle is the angle between the posterior condylar axis and the femoral epicondylar axis. MRI can clearly show the condylar cartilage, the projections of lateral epicondyle and the medial epicondyle depression, thus ensuring accuracy of measurement data. OBJECTIVE: To measure the posterior condylar angle of knee joint in the northern part of Baoding City in China, and to provide image evidence for identifying the rotational alignment of femoral prosthesis during total knee arthroplasty. METHODS: The knee was extended on a neutral position when MRI machine was applied to scan knee joint. The scanning plane was perpendicular to the mechanical axis of the knee. The best T1 axial plane of the knee was chosen, and two observers analyzed images independently. Existence rate of femoral medial epicondyle was observed using Bravo viewer 6.0 imaging software. The posterior condylar angle between posterior condylar axis and the femoral condyle axis was measured. RESULTS AND CONCLUSION: The posterior condylar angle was (2.73±1.28)° in males and (2.35±1.37)° in females on average, which did not show significant difference. The results showed that the MRI had great superiority in measuring the posterior condylar angle. The variability of the epicondylar axis was small in total knee arthroplasty. Posterior condylar angle can be referenced to position femoral prosthesis and to avoid the complications after knee replacement.


Meng W.-M.,Zhuozhou Municipal Hospital | Li Y.-M.,Zhuozhou Municipal Hospital | Xu H.-S.,Zhuozhou Municipal Hospital | Fu W.-J.,Zhuozhou Municipal Hospital | Zhao Z.-J.,Zhuozhou Municipal Hospital
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: The classification and treatment of subtrochanteric fracture experienced a long process of development. Surgical treatment was currently used popularly, including extramedullary and intramedullary fixation. It should be selected according to the type of fracture and clinical practice, and it is inconclusive in the clinic. OBJECTIVE: To summarize the study and present application of intramedullary and extramedullary fixation in the subtrochanteric fracture in recent years. METHODS: The first author researched two books, and retrieved PubMed, Wanfang Database, and Chinese Journal Full-text Database for articles about clinical trials on fixation for subtrochanteric fractures, and the safety and efficacy of fixation for subtrochanteric fractures published until March 2014. A total of 42 clinical studies on type, intramedullary and extramedullary fixations were selected. RESULTS AND CONCLUSION: With the progress of fixation methods of subtrochanteric fracture, there was a great progress in improving the rate of fracture healing and reducing hip malunion, and limited mobility. Whether extramedullary fixation, intramedullary fixation or arthroplasty, clinical reports have achieved satisfactory results at present. The intramedullary fixation was still dominated among various therapeutic methods. However, the type of fracture, age and osteoporosis fractures were different in patients. There was no uniform standard of the specific choice of surgical approach, which still should be further studied. Authors believed that when fracture line was below the lesser trochanter, interlocking intramedullary nail could be used. High subtrochanteric fracture could utilize proximal femoral nail anti-rotation. However, if the medullary cavity was narrow, the fracture was involved in the greater trochanter or piriformis fossa area, locking proximal femoral plate or less invasive stabilization system could be employed. No matter intramedullary or extramedullary fixation, minimal invasion and biological fixation were the present trend of development. The new minimally invasive techniques and internal fixation are still the goal. Although intramedullary fixation has advantages, but cannot completely replace the current extramedullary fixation. It is important to have a perfect surgery plan, standardized surgical approach and long-term postoperative follow-up, in order to achieve better clinical outcomes. © 2014 Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.

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