Objective To compare the clinical therapeutic effect of transverse cancellous lag screw (TCLS) fixations and ordinary cannulated screw (OCS) fixations for vertical femoral neck fractures. Methods A total of 62 eligible patients with an average age of 56.2 years (range, 19–45 years; 40 male and 22 female) with Pauwels’ type III femoral neck fractures were recruited in our study from January 2016 to December 2017. Among the patients, 30 underwent TCLS fixation (TCLS group), and the others were treated with OCS fixation (OCS group). The baseline data, perioperative outcomes (operative time, intra‐operative blood loss, reduction quality, and hospital time), postoperative outcomes evaluated by a variety of scales including visual analogue scale (VAS) score, EuroQol five dimensions questionnaire (EQ‐5D) and Harris hip scores (HHS), and complications (nonunion, femoral head necrosis, femoral neck shortening, and failure of fixation) of the two groups were recorded to compare at 12‐month follow‐up. Results The mean follow‐up time of included patients was 13.4 ± 1.6 months in the TCLS group and 13.7 ± 0.9 months in the OCS group. There was no statistically significant difference in the baseline data as well as perioperative outcomes, including operative time, intra‐operative blood loss, the hemoglobin difference before and after treatment, quality of reduction, and hospital time between two groups. Likewise, the VAS score, the EQ‐5D score, and complications rates including nonunion and femoral head necrosis had no distinct difference in two groups. However, HHS in the TCLS group were superior to those in the OCS group at 12‐month follow‐up, and the femoral neck shortening rate was prominently reduced in the TCLS group when compared with the OCS group. Conclusions Treating vertical femoral neck fractures with the TCLS technique could significantly improve hip functional recovery and reduce the postoperative femoral neck shortening rate. The present study provides novel insight for the treatment of vertical femoral neck fractures.

Objective To compare the effectiveness of a six‐month home‐based telerehabilitation based on the Internet‐based rehabilitation management system coupled with conventional outpatient care in elderly patients with hip fractures following total hip replacement (THR). Methods Elderly patients (aged over 65 years) with first hip fractures who underwent THR between March 2018 and September 2018 in Tianjin Hospital were enrolled in this study. Patients were divided into two groups: telerehabilitation group (n = 43) and telephone group (n = 42). A Internet‐based telerehabilitation management system was established and applied on patients in the telerehabilitation group. For patients in the telephone group, the rehabilitation intervention was administered through conventional outpatient care (telephone along with outpatient follow‐up). Data from the Harris hip scale (HHS), functional independence measure (FIM), self‐rating anxiety scale (SAS), and postoperative complications at 1, 3, and 6 months after surgery were collected and compared between the two groups. Results A total of 85 elderly patients completed the 6‐month follow‐up assessment. Results showed that the HHS score was significantly higher in the telerehabilitation group than in the telephone group at 1 month (66.35 ± 4.63 vs 63.48 ± 4.49), 3 months (76.33 ± 4.52 vs 71.81 ± 3.84), and 6 months (84.23 ± 3.13 vs 77.29 ± 4.95) after surgery (P < 0.001). The FIM score was significantly higher in the telerehabilitation group than in the telephone group at 1 month (89.00 ± 5.63 vs 73.35 ± 8.70), 3 months (100.16 ± 4.56 vs 92.81 ± 5.17), and 6 months (111.70 ± 3.13 vs 98.64 ± 5.12) after surgery (P < 0.001). The SAS score was significantly lower in the telerehabilitation group than in the telephone group at 1 month (42.40 ± 3.07 vs 46.21 ± 3.53), 3 months (36.77 ± 2.26 vs 40.24 ± 1.66), and 6 months (29.26 ± 1.63 vs 33.81 ± 2.62) after surgery (P < 0.001). The overall complication rate was significantly lower in the telerehabilitation group than in the telephone group (14% vs 40.5%) (P < 0.05). Conclusion Internet‐based rehabilitation management system can not only promote the physical rehabilitation of patients, but also play a positive role in psychological rehabilitation and the prevention of complications, which provides new ideas and methods for clinical rehabilitation.

The topical administration of TXA in THA carried similar hemostasis effects compared with intravenous use without an increased risk of thrombotic complications. No other adverse effect was identified. Topical TXA application was a simple, safe, effective and cost-effective adjunct for blood management following primary THA. For patients with a high risk of thromboembolic events, there may be benefits with topical administration.

The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed. A 3D printing pelvic model was established using CT digital imaging and communications in medicine (DICOM) data preoperatively, with which surgical procedures were simulated in preoperative surgery to confirm the sequence of the reduction and fixation as well as the position and length of the implants. Open reduction with internal fixation (ORIF) of the acetabular fracture using modified ilioinguinal and Kocher-Langenbeck approaches was performed 25 days after injury. Plates that had been pre-bent in the preoperative surgery were positioned and screws were tightened in the directions determined in the preoperative planning following satisfactory reduction. The duration of the operation was 170 min and blood loss was 900 mL. Postoperative X-rays showed that anatomical reduction of the acetabulum was achieved and the hip joint was congruous. The position and length of the implants were not different when compared with those in preoperative surgery on 3D printing models. We believe that preoperative surgery using 3D printing models is beneficial for confirming the reduction and fixation sequence, determining the reduction quality, shortening the operative time, minimizing preoperative difficulties, and predicting the prognosis for complicated fractures of acetabulam.

These findings suggested that g.23276 G>A genotypes in the OPG gene were associated with spine BMD in Chinese postmenopausal women. The A-allele was associated with lower BMD and an increased risk for osteoporosis.