Comparative Analysis Between DHS Internal Fixation And Artificial Femoral Head Replacement To Treat Intertrochanteric Fracture Of Femur Of The Elderly

Clinical partObjective: To discuss the shot-term clinical effect on the treatment of intertrochanteric fracture in the elderly by DHS internal fixation or artificial femoral head replacement. Data and method: 60 cases of intertrochanteric fracture were selected from January 2007 to December 2008 in Shandong University of TCM Affiliated Hospital. And these cases had been divided into two groups: 30 cases treated with DHS internal fixation (DHS group) and the other cases treated with artificial femoral head replacement (AFHR group). There were 24 men and 36 women ranged from 67 to 97 years old. Mean age was 79.32±5.68. Post-operative complications and hip function at the time of pre-injury (instead of by the contralateral), one month after surgery and six months after surgery were recorded and scored by Harris Score to carry out statistical analysis. Result: Follow-up period was 6 to 13 months. Post-operative complications occurred in three cases in DHS group and one case in AFHR group. And post-operative complications related to prolonged bed rest did not happen in AFHR group. Comparing the Harris score between two groups, there was no significant difference at the time of pre-injury; there was a statistical difference at one month after hip surgery, that functional recovery of AFHR group was better than that of DHS group; there was no statistical difference at six months after surgery, indicating that functional recovery of AFHR group was close to that of DHS group. Conclusion: For the intertrochanter fracture of the elderly, shot-term treatment effect of artificial femoral head replacement was more effective than the DHS internal fixation. Experiment partObjective: To discuss the influence of rat BMSCs (Bone Marrow Stromal Cells) proliferation by the different concentrations extraction of rhizoma drynariae. Data and method: The BMSCs of two months old wistar rats were inoculated in the cells of 96-well cell culture plates and 6-well cell culture plates. The culture mediums of high-dose (the concentration of the drynariae extraction is 0.02g/ml), middle-dose (0.002g/ml) and low-dose (0.0002g/ml), the conditioned culture medium (dexamethasone 10mol/L,β-glycerophosphate 10mmol/L and Vit C 50ug/ml) and the standard culture medium (low glucose DMEM) were used to continuous culture BMSCs for 5 days. Observed OD492 value of one 96-well cell culture plate by MTT method, Giemsa staining of one 6-well cell culture plate and took photos of the cells stained by HE every day. OD values and the mitotic index were imported into Excel to be drawn the graphs. The data were analyzed by SPSS 13.0 statistical software. Results: Growth curvature: high OD value occurred by rhizoma drynariae sediments in the cells of high-dose group. The trend of the growth curv over time of high-dose group cells was lower. Compared with the standard group, OD492 values of middle-dose group was higher at the second day, the third day and the fourth day (P<0.01); OD492 value of low-dose group was higher in the second day and the third day (P<0.01); OD492 values of the conditioned group was no significant difference (P>0.05). Mitotic index: Compared with the standard group, mitotic index of high-dose group was lower and BMSCs in the cell division stage were less; BMSCs of middle-dose group and low-dose group in the division stage were more and mitotic index was higher; the mitotic index of the conditioned group was no significant difference (P>0.05). Conclusion: The rhizoma drynariae culture medium of high-dose (0.02g/ml) inhibited the proliferation of BMSCs. The rhizoma drynariae culture medium of middle-dose (0.002g/ml) and low-dose (0.0002g/ml) promoted the proliferation of BMSCs.