The treatment of peritrochanteric fractures in elderly patients with osteoporosis due to the diYculty of obtaining and maintaining stable Wxation. Although many implants have been developed to solve this problem, the choice of implant has been controversial. We present 71 consecutive peritrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA). The average age of the patients was 80.75 § 6.42 (71-96) years. The fractures were closely reduced and Wxed with PFNA. All of the fractures healed in an average of 14 weeks. The mean operation time was 44.68 § 8.44 (30-73) minutes, and the mean blood loss was 126.77 § 49.04 (50-300) ml. One patient was reoperated because of a poor blade position. In three patients, a lateral cortex fracture was observed, and, in one patient, a greater trochanter fracture was observed. At the time of the Wnal follow-up, 78.7% of the patients returned to their pre-injury activity levels. PFNA might be one treatment choice to solve the mechanical problems associated with these fractures because of its improved Wxation strength, simpler technique, shorter operation time and reduced blood loss.
PVNS is a disease with a high risk of recurrence. No individual or combined treatment method can offer a definitive solution. Open or arthroscopic radical synovectomy is still considered as the gold standard. If necessary, adjuvant intraarticular or extraarticular radiotherapy can be added to the treatment.
Objectives. To investigate insulin-like growth factor I (IGF-1) levels in response to hyperbaric oxygen therapy (HBOT) for diabetic foot ulcers and to determine whether IGF-1 is a predictive indicator of wound healing in patients with diabetic foot ulcers. Design and Methods. We treated 48 consecutive patients with diabetic foot ulcers with HBOT. Alterations of IGF-1 levels in patients whose wound healed with HBOT were compared with those in patients who did not benefit from HBOT. Results. There was no significant difference in initial IGF-1 levels between the two groups (P = 0.399). The mean IGF-1 level increased with HBOT (P < 0.05). In the healed group, the mean IGF-1 increase and the final values were significantly higher (P < 0.05). In the nonhealed group, the mean IGF-1 increase was minus and the final values were not significantly different (P < 0.05). The increase in IGF-1 level with HBOT was significantly higher in the healed group (P < 0.001). Conclusions. IGF-1 increased significantly in the healed group. We believe that HBOT is effective in the treatment of diabetic foot ulcers, with an elevation of IGF-1. This alteration seems to be a predictive factor for wound healing in diabetic foot ulcers treated with HBOT.
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