Baek, S.-H. and S.-Y. Kim (2008). "Cementless Total Hip Arthroplasty with Alumina Bearings in Patients Younger Than Fifty with Femoral Head Osteonecrosis." J Bone Joint Surg Am 90(6): 1314-1320.50岁以下的股骨头坏死患者使用铝球轴承非骨水泥全髋关节成形术

Background: There are conflicting reports with respect to the outcomes of total hip arthroplasties with ceramic bearings in young patients with osteonecrosis of the femoral head.We prospectively investigated the outcomes after cementless total hip arthroplasties with contemporary alumina bearings in patients with osteonecrosis of the femoral head in this age group.

背景：目前有一些关于股骨头坏死的年轻患者使用陶瓷球全髋关节成形术成的预后结果互不一致致的报道。我们前瞻性的调查了在此年龄段的使用现代铝球轴承非骨水泥全髋关节成形术治疗股骨头坏死患者术后的情况。

Methods: We prospectively followed sixty patients (seventy-one hips) with a mean age of 39.1 years for an average of 7.1 years.All procedures were performed at the same institution by one surgeon, and the results were evaluated serially.The clinical evaluations included use of the Harris hip score, and activities of daily living were evaluated with use of the criteria of Johnston et al.

方法：我们前瞻性的追踪调查平均年龄为39.1岁的60位（共71个髋部）的患者，调查的平均时长为7.1年。所有操作都在同一医疗机构由同一个医生完成，并且严谨的评价所获结果。 临床评价使用Harris髋部评分，及日常起居活动则用Johnston等人制定的准则。

Results: The mean Harris hip score was 97.0 points at the time of final follow-up. Thirteen patients (fourteen hips, 20%) reported noise in the hip. Loosening or osteolysis was not observed in any hip, and no prosthesis had been revised. No hip had dislocated, and no ceramic fracture d occurred.

结果：最后随访得到的Harris髋部评分平均分为97.0.   有13名患者（14个髋部，20%）回报存在髋部噪音（嘈杂？）的情况。无松弛及骨质溶解被观察到，并且无假体重置。亦无髋关节脱位及陶瓷断裂发生。

Conclusions: After a minimum of six years of follow-up, this cementless total hip arthroplasty with contemporary alumina bearings was found to be a promising procedure for young, active patients with osteonecrosis of the femoral head. However, we remain concerned about the long-term implications of the noise that was reported in these hips. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
结论：经过短暂的6年跟踪调查发现，使用现代铝轴承的无骨水泥髋关节成形术手术对年轻且活跃的股骨头坏死患者来说是个可靠的方法。尽管如此，我们依在关注被报道的髋部噪音的远期提示意义。

不清楚之处：ceramic bearing 最佳的翻译是什么：陶瓷头？ 陶瓷球轴承？ 陶瓷轴承？

contemporary alumina bearings 是最不清楚的东西。

纪念一下

[b]Complications of Titanium and Stainless Steel Elastic Nail Fixation of Pediatric Femoral Fractures.[/b]
[color=red]钛制及不锈钢弹力髓内钉钉治疗小儿股骨骨折的并发症[/color]

Background: In vitro mechanical studies have demonstrated equal or superior fixation of pediatric femoral fractures with use of titanium elastic nails as compared with stainless steel elastic nails, and the biomechanical properties of titanium are often considered to be superior to those of stainless steel for intramedullary fracture fixation. We are not aware of any clinical studies in the literature that have directly compared stainless steel and titanium elastic nails for the fixation of pediatric femoral fractures. The purpose of the present study was to compare the complications associated with the use of similarly designed titanium and stainless steel elastic nails for the fixation of pediatric femoral fractures.
[color=blue]背景：离体力学研究已经表明对于小儿股骨骨折，与不锈钢弹力髓内钉相比较使用钛弹性髓内钉等效或优于前者，并且钛钉的生物力学特性也常被认为优于不锈钢髓内钉内固定。我们尚未知晓任何关于直接比较使用不锈钢与钛弹性髓内钉行小儿股骨骨折内固定两种方法的临床研究文献。本研究的目的为比较在使用相似设计的钛及不锈钢弹性髓内钉行小儿股骨骨折内固定的手术。[/color]

Methods: A group of fifty-six children with femoral fractures that were treated with titanium elastic nails was compared with another group of forty-eight children with femoral fractures that were treated with stainless steel elastic nails.Both nail types were of similar design, and a similar retrograde insertion technique was used. The groups were compared with regard to complications as well as insertion and extraction time.Major complications were defined as malunion with sagittal angulation of >15{degrees} and coronal angulation of >10{degrees}, nail irritation requiring revision surgery, infection, delayed union, and rod breakage.Minor complications were defined as nail irritation or superficial infection not requiring surgery.
[color=blue]方法：以一组用钛弹性钉治疗的56名股骨骨折儿童与另一组用不锈钢弹性钉治疗的48名儿童相比较。 两种钉为设计相似的类型，以及使用相似的逆行插入术式（方法？）。两组均比较并发症及插入与取出内固定的时间。 主要的并发症被定义为矢状轴成角大于15度及冠状轴成角大于10度的畸形愈合，需要翻修手术的髓内钉激惹，感染，延迟约合，及钉干断裂 。次要并发症为髓内钉激惹或无需手术治疗的浅表创口感染。[/color]

Results: The malunion rate was nearly four times higher in association with the titanium nails (23.2%; thirteen of fifty-six) as compared with the stainless steel nails (6.3%; three of forty-eight) (p = 0.017, chi-square test; odds ratio = 4.535 [95% confidence interval, 1.208 to 17.029]). The rate of major complications was 35.7% (twenty of fifty-six) for titanium nails and 16.7% (eight of forty-eight) for stainless steel nails.The rates of minor complications were similar for the two groups, as were the insertion times and extraction times. The supplier price of one titanium nail ranges from $259 to $328, depending on size, whereas the price of one stainless steel nail would be $78 in current United States dollars.
[color=blue]结果：钛弹性髓内钉钉的畸形愈合率（23.2%；13/56）与不锈钢弹性髓内钉（6.3%；3/48）的相比接近后者之近四倍(p = 0.017, 卡方检验; 比值比= 4.535 [95% 置信区间, 1.208 to 17.029])。钛钉的主要并发症发生率为35.7%（20/56）而不锈钢钉为16.7(8/48)。两组的次要并发症以及插入时间和取出内固定时间都相近。钛钉的供货商报价依其大小型号不同价位从259至328刀不等，而不锈钢钉的价格才78刀。[/color]

Conclusions: Our results indicate that the less expensive stainless steel elastic nails are clinically superior to titanium nails for pediatric femoral fixation primarily because of a much lower rate of malunion.
[color=blue]结论：我们的结果提示了临床上，相对便宜的不锈钢钉以其更低得多的畸形愈合率为主要原因而优于钛钉。[/color]

今天也挺失败的，没有把下载的论文看完，也没有及时的回顾背过的方歌，似乎有网络强迫症了，网络成瘾，上了网就不记得要干什么东西了。

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