Joint Replacement in Femoral Neck Fractures

Abstract

Results of joint replacement in femoral neck fractures have been analyzed. During the period from 1994 to 2003 total hip replacement was performed to 399 patients with subcapital fractures including 372 patients in whom the operation was performed as a primary intervention. From 2002 to 2004 the total number of 290 hemiarthroplasty operations with use of module native implant was performed in 286 patients aged 76-101 years. In total joint replacement group intrahospital lethality made up 2% due to the following causes: pulmonary thrombembolia - 3 cases, acute cardiac insufficiency - 1 case, deep decubitus ulcers resulting in sepsis - 2 cases, polyorganic insufficiency on the background of severe concomitant pathology - 1 case. In the early postoperative period the following complications were noted: implant dislocation (5.2% of cases), intraoperative femoral fracture (3.5%). Infectious complications developed in 2 patients and in both cases removal of the implant was required. With mean-term follow-up native implants showed mean-term survival of 92-94% in 272 patients. Mean evaluation by Harris was the following: biometric «Sinko» and «ESI» implants - 83.1 points, PF «Sinko» implants - 89.3 points, combination of «Mathys» friction pair with native femoral component - 91.2 points. «Mathys» implants showed 94.6 points. Results of ЯРТЕЗ joint replacement were evaluated during the period from 1 to 3 years in 183 patients. Intrahospital lethality made up 1.8%. Excellent and good results were achieved in 53.7% of patients. Revision was required in 1.5% of cases. As concluded total hip replacement in femoral neck fracture was the effective treatment technique. It was reasonable both cement and cementless fixation with various implants for the optimum choice of implant in every specific patient. Use of modern module implants enabled to expand the indications for application of arthroplasty in elderly patients.

The Enlightenment as determinant of accounting change: The case of royal estate bookkeeping during the reign of Catherine II

“…Researchers distinguish certain specific features in the perception of Enlightenment ideas in Russia. There is extensive literature on the subject both in English (d’Encausse, 2002; Madariaga, 1981; Rancel, 1975; Wirtschafter, 2009, and others) and in Russian (Gribovskiy, 1864; Klyuchevskiy, 1910; Pisarkova, 2007; Sereda, 2004; Solovyev, 1879, and others).…”

“…The new idea of the Enlightenment and the traditional Russian autocracy combined in the notion of the enlightened monarch. Historians differ in their interpretation of the reasons behind Catherine’s ambition to present herself as an enlightened monarch : her personal characteristics (high intelligence, curiosity) (Gribovskiy, 1864; Klyuchevskiy, 1910); the influence of her supporters N. Panin, I. Betskoy and E. Dashkova (Rancel, 1975); the questionable way of her coming to power (d’Encausse, 2002; Madariaga, 1981; Solovyev, 1879); and popularity of European ideas (Bartlett, 1979; Kahan, 1966). The analysis of these reasons is outside the scope of our study.…”

“…Reforms in governmental institutions began to develop actively after the succession to the throne of Catherine II (Klyuchevskiy, 1910; Solovyev, 1879). Having ascended to the Russian throne, Catherine II became the ruler of a country in which the laws did not recognise the civil freedom and equality of citizens.…”

“…At the beginning of her reign, Catherine II demonstrated a new style of government putting the issue to a broad public debate before adopting a state decision. The main political problem that hampered the development of the country was the need for emancipation of peasants from serfdom (Klyuchevskiy, 1910; Solovyev, 1879). Catherine II motivated the Free Economic Society to hold a competition for the best project to free the serfs (Belyavsky, 1960).…”