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The gamma nail and proximal femoral locking plate (PFLP) are both used for fractures. A controlled study was performed to determine the optimal implant. To assess and analyze the clinical effects of gamma nails and PFLPs for patients with unstable intertrochanteric femoral fractures, specifically with broken lateral walls. Thirty-six patients with unstable intertrochanteric femoral fractures and broken lateral walls were treated with gamma nails or PFLPs and retrospectively studied. The clinical data were compared. Duration of surgery and early full weight-bearing time were significantly longer in the PFLP group compared to the gamma nail group (P < 0.05). However, intraoperative fluoroscopy frequency and total blood loss in the PFLP group were significantly less than those in the gamma nail group (P < 0.05). No significant differences were found in hospitalized days, Parker Palmer mobility scores, Harris hip scores, and complications between the two groups. No difference in hip-functional recovery was found between the gamma nail group and the PFLP group, indicating that both the gamma nail and PFLP were effective for unstable intertrochanteric femoral fractures with a broken lateral wall. However, early weight bearing on the fractures was not encouraged in patients treated with PFLP.

The Value of High Resolution Computed Tomography in the Diagnostics of Small Opacities and Complications of Silicosis in Mine Machinery M a n u f a c t u r i n g W o r k e r s , C o m p a r e d t o Radiography: Jinkai SUN, et al. Division of Pneumoconiosis, School of Public Health, ChinaMedical University, China-The purpose of this study was to assess the value and usefulness of high resolution computed tomography (HRCT) in the diagnostics of small opacities and complications of silicosis in mine machinery manufacturing workers, compared to conventional radiograms. The diagnosis of silicosis is mainly based on the radiological findings of workers exposed to the dust causing lung fibrosis. However, on radiograms many parenchymal structures overlap, which limits the sensitivity and specificity of the method. Difficulties in accurate interpretation of conventional radiograms in silicosis also result from their relatively low resolution. We randomly selected 30 I period silicosis patients from 77 I period silicosis patients working at a mine machinery manufacturing company. Out of 1078 non-silicosis and 162 0 + period silicosis subjects, 30 non-silicosis and 30 0 + period silicosis subjects were randomly selected and matched with the 30 I period silicosis subjects by age (± 3.0 yr) and occupational exposure time (± 2.0 yr). Chest Xrays were taken at maximal inspiration. For the HRCT examination, the GE Somatom plus apparatus was used. Eight, five and six subjects were respectively diagnosed as 0 + , I or I + period silicosis based on HRCT among 90 subjects whose original diagnoses were nonsilicosis, 0 + or I period silicosis based on radiography. The numbers of small opacities in HRCT scans were significantly higher than those seen in radiography in all lung zones (p<0.01). HRCT was more sensitive than radiography in detecting small opacities of midout zones of the lung, but no statistical significance was found between the two methods in the detection of small opacities of lower zones of the lung. A statistically significant increase in the detectability of bulla, emphysema, pleural, mediastinal and hilar changes was observed (p<0.05). HRCT might be more sensitive than radiography in detecting lung parenchymal changes suggestive of silicosis. (J Occup Health 2008; 50: 400-405)

Objective To compare the effects of repairing and not repairing the lateral ulnar collateral ligament (LUCL) when surgically treating elbow varus posteromedial rotatory instability (PMRI). Methods In this retrospective study spanning June 2014 to February 2019, 24 patients with elbow PMRI who were treated surgically were assigned to group RL (Repair LUCL) or group NL (Non‐repair LUCL) depending on whether the LUCL was repaired. Hospitalization time, operation time, intraoperative blood loss, and related complications were reviewed. The elbow range of motion (ROM), the visual analog scale (VAS), the Mayo elbow performance score (MEPS), and the disabilities of the arm, shoulder, and hand (DASH) score were used for functional assessment. Results Among the 24 patients with PMRI, 15 were assigned to group RL and nine were assigned to group NL. The mean blood loss (184.66 ± 20.3 vs 207.33 ± 19.447, P < 0.001), the operation time (98.88 ± 12.693 min vs 184.66 ± 20.3 min, P < 0.001) were significantly lower in group RL compared to group NL. There were no significant differences between the two groups in time until surgery and follow‐up time (6.66 ± 1.838 vs 6.11 ± 1.900 days, 25.53 ± 2.099 vs 26.11 ± 2.891 months, P = 0.577, P = 0.486). All of the patients achieved bone union. The elbow flexion‐extension ROM (122.00° ± 3.162°vs 121.11° ± 3.333° at 12 months, P = 0.520) and pronation‐supination ROM (154.53° ± 3.335° vs 155.55° ± 4.639° at 12 months, P = 0.537). Both groups achieved similar results in MEPS score (90.53 ± 2.695 vs 89.77 ± 3.865, P = 0.578) and DASH (9.77 ± 1.897 vs 9.99 ± 1.550, P = 0.772) score at the final follow‐up. And the MEPS score revealed excellent results (87% in group RL, 89% in group NL).The VAS scores decreased significantly in group RL (from 6.13 ± 0.990 to 1.93 ± 0.593) and group NL (from 5.77 ± 1.481 to 1.88 ± 0.781), and no significant differences in preoperative or final follow‐up were observed between the two groups (P = 0.487, P = 0.876). Complications observed in group NL with one patient occurred cubital tunnel syndrome 3 months after the operation, the patient underwent ulnar nerve simple neurolysis and the symptoms were relieved after 3 weeks. Conclusion For patients with elbow PMRI, satisfactory functional outcomes can be yielded with non‐repair of the LUCL as long as the stable elbow joint is performed during operation.