To analyze the treatment of elderly femoral intertrochanteric fracture (EFIF) using InterTan intramedullary nail (InterTanIN) and proximal femoral nail antirotation (PFNA). A total of 75 patients suffering from EFIF receiving intramedullary fixation were retrospectively collected. According to intramedullary fixation methods, the patients were separated into InterTanIN group and PFNA group. Parameters including the surgery time, blood loss, number of X-ray fluoroscopy, hospital stays, bone-healing time, postoperative Harris hip score (HIS) (1 month, 3 months, 6 months, and 12 months), and complications were collected and analyzed. The results showed surgery time, blood loss, and number of X-ray fluoroscopy in InterTanIN group were higher than those in PFNA group ( P < 0.05 ). The mean hospital stay in the InterTanIN group was comparable to that in the PFNA group ( P > 0.05 ). There was no significant difference in bone-healing time between the InterTanIN group and PFNA group ( P > 0.05 ). The postoperative HIS of InterTanIN group was statistically better than PFNA group at the 3rd month and the 6th month ( P < 0.05 ). With the extension of recovery time, the gap between the two groups gradually narrowed. The postoperative implant displacement happened more often in the PFNA group than in the InterTanIN group. EFIF treated with InterTanIN or PFNA could achieve good long-term efficacy. Although InterTanIN has the disadvantages of increased operative time, blood loss, and radiation exposure compared to PFNA, the postoperative hip function recovery of InterTanIN seems to be more reliable and stable than PFNA.

BACKGROUND: Femoral neck fractures often occur in the elderly, which usually results in hip pain. OBJECTIVE: The purpose of this study was to evaluate the difference in the treatment of Pauwels type III femoral neck fractures with medial femoral support plate combined with cannulated screws and cannulated screws alone. METHODS: PubMed, ScienceDirect, China Academic Journals Full-text Database (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), Embase and Cochrane Library were used to collect clinical controlled trials of the medial femoral support plate combined with hollow screw internal fixation and simple hollow screw internal fixation for Pauwels type III femoral neck fracture. RESULTS: Seven articles (n= 409 cases) were evaluated for quality and included in this meta-analysis. Four hundred and nine patients with Pauwels type III femoral neck fractures were included: 202 in the experimental group and 207 in the control group. The results showed that, compared with simple hollow screw internal fixation, the medial femoral support plate combined with hollow screw internal fixation has a longer operation time (MD= 23.05, 95% CI= 13.86–32.24), and more intraoperative blood loss (MD= 91.55, 95% CI= 50.72–132.39), shorter healing time (MD=-1.48, 95% CI (-1.71, -1.26)), lower incidence of complications (RR= 0.34, 95% CI= 0.19–0.61), lower VAS score (MD=-1.28, 95% CI (-1.83, -0.72)), and higher Harris score (MD= 8.49, 95% CI (4.15, 12.83)). CONCLUSION: Medial femoral plate combined with cannulated screw for Pauwels type III femoral neck fracture can shorten healing time, reduce postoperative complications, and improve the postoperative Harris score.

Bone tendon junction injury is hard to cure because of its special anatomical structure, and the treatment applied for bone‐tendon junction injury cannot result in the perfect vascular regeneration and restoration of the fibrocartilage zone. In this article, we aim to explore the effect of caveolin‐1 as a slow‐release material on bone‐tendon junction healing. Seventy‐two New Zealand rabbits were randomly selected and assigned into the experimental, sham‐operated and control groups (n = 24). Caveolin‐1 microspheres and microcapsule were developed as drug delivery system. At the 4th, 8th, and 12th weeks after surgery, quadriceps muscle patella‐patellar tendon (QMPPT) was obtained from each rabbit to observe the tendon‐to‐bone tunnel healing, and X‐ray examination, histological examination and biomechanical testing were applied for evaluating new bone formation. As the X‐ray showed, caveolin‐1 increased the new bone area at each time point. At the 4th and 8th weeks after surgery, the rabbit treated with caveolin‐1 slow release material showed repair of fibrocartilage. According to the biomechanical results, the cross‐sectional area, breaking load and ultimate tensile strength were increased along with time. At the same time point, caveolin‐1 increased the ultimate tensile strength. Our study demonstrates that caveolin‐1 as a slow‐release material could accelerate bone‐tendon junction healing by promoting the formation of the transition zone.