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BACKGROUND Intertrochanteric femur fractures are typically treated with proximal femoral nails. There are two varieties of proximal femoral nails in our study: PFNA2, which has a single proximal blade, and normal PFN, which has two proximal screws. AIM Our study compares functional results and implant-related problems in individuals treated for proximal femur fracture using PFNA2 nails versus conventional PFN nails. MATERIAL AND METHODS After obtaining ethical clearance from Institutional ethical committee, this prospective study was conducted in the Department of Orthopaedics in Sri Madhusudhan Sai Institute of Medical Sciences and Research from Nov 2022 to Nov 2023. A series of 50 cases were included in the study. After obtaining prior informed and written consent from the patients. Fracture diagnosis confirmed by clinical examination and radiography. Pre-anaesthetic evaluation done as per protocols. 25 Patients underwent PFN nailing and 25 Patients underwent PFN- A2 nailing. Post operatively follow up was done until 6 months to assess various outcomes namely fracture healing, incidence of post-operative complications, rehabilitation and functional outcome. RESULTS Implant A2-PFN nails has better results than implant standard PFN nail in terms of operative time, operative blood-loss and functional outcome. CONCLUSION We concluded from the study that, in comparison to standard PFN nails, PFNA2 nails minimises surgical time, blood loss, and radiation exposure. When compared to standard PFN nail, PFNA2 nails offers substantially superior functional outcomes and a greater union rate. PFNA2-treated patients are able to bear weight quickly. PFNA2 does not cause too many implant-related issues including screw backing out and cut-through of screws in the femoral head (also known as the z-effect and reverse z-effect). Consequently, we draw the conclusion that PFNA2 nails are better than standard PFN nails. [ABSTRACT FROM AUTHOR]

BACKGROUND: Stage III Kümmell’s disease is characterized by a high degree of vertebral compression and posterior wall defects. Most of the patients are elderly people with severe osteoporosis and various medical diseases. Clinically, some surgical methods are often at high risk and are controversial. OBJECTIVE: To investigate the clinical efficacy of screw placement combined with transpedicular impaction bone grafting in the treatment of stage III Kümmell’s disease. METHODS: The clinical data of injured vertebral screw placement combined with transpedicular impaction bone grafting in treatment of stage III Kummell’s disease from May 2016 to August 2021 were retrospectively analyzed. Visual analog scale score, Oswestry disability index, anterior vertebral heights, kyphotic Cobb angle and American Spinal Injury Association (ASIA) impairment scale were used to evaluate the effects of surgery. The operation time, intraoperative blood loss and complications were recorded. CT scans were used to evaluate the healing of injured vertebrae at the final follow-up visit. RESULTS AND CONCLUSION: (1) A total of 26 patients were included, with 7 males and 19 females, at the age range of 62-81 years [mean (69.7±4.8) years]. The follow-up time was 18-60 months [mean (35.1±8.9) months]. The average operative duration was 133.5 minutes (100-165 minutes), and the average intraoperative blood loss was 285.3 mL (210-350 mL). (2) Visual analog scale and Oswestry disability index scores 1 week after surgery were significantly lower than those before surgery. (3) At 1 week after surgery, the anterior vertebral height corrections and the Cobb angle were (9.0±0.7) mm and (16.2±1.0)°, respectively. During the follow-up period, the loss of vertebral height and kyphosis correction were (5.1±0.3) mm and (8.0±0.4)°, respectively. (4) 14 patients (54%) had ASIA grade D before operation, which recovered to grade E at the last follow-up. CT scan showed that all patients achieved good osseous union. (5) Complications occurred in seven patients (27%), including hypostatic pneumonia in two cases, postoperative superficial wound tissue liquefaction in two cases, and adjacent vertebral compression fractures in three cases. (6) It is concluded that screw placement of the injured vertebra combined with transpedicular impaction bone grafting can rapidly rebuild spinal stability, effectively relieve pain and improve neurological function in the treatment of stage III Kümmell’s disease. This technique is an effective and relatively minimally invasive surgical option. [ABSTRACT FROM AUTHOR]

The Asian and Latin America Fracture Observational Study (ALAFOS) is a prospective, observational, single-arm study conducted in 20 countries across Asia, Latin America and the Middle East. ALAFOS evaluated new clinical vertebral and non-vertebral fragility fractures in relation to time on teriparatide, in postmenopausal women with osteoporosis in real-life clinical practice. Clinical fragility fractures, back pain, and health-related quality of life (HRQoL) were recorded in 6-month intervals for ≤ 24 months during teriparatide treatment and up to 12-months post-treatment. Data were analysed with piecewise exponential regression with inverse probability weighting for time to event outcomes and mixed-model repeated measures for back pain and HRQoL. 3054 postmenopausal women started teriparatide and attended ≥ one follow-up visit (mean [SD] age 72.5 [10.4] years). The median (95% CI) time to treatment discontinuation was 22.0 months (21.2, 22.8). During the treatment period, 111 patients (3.6%) sustained 126 clinical fractures (2.98 fractures/100 patient-years). Rates of new clinical fragility fractures were significantly decreased during the > 6–12, > 12–18, and > 18–24-month periods, as compared with the first 6 months of treatment (hazard ratio [HR] 0.57; 95% CI 0.37, 0.88; p = 0.012; HR 0.35; 95% CI 0.19, 0.62; p < 0.001; HR 0.43; 95% CI 0.23, 0.83; p = 0.011; respectively). Patients also reported an improvement in back pain and HRQoL (p < 0.001). These results provide data on the real-world effectiveness of teriparatide in the ALAFOS regions and are consistent with other studies showing reduction of fractures after 6 months of teriparatide treatment. These results should be interpreted in the context of the noncontrolled design of this observational study. [ABSTRACT FROM AUTHOR]

Biodegradable magnesium has regained great attention due to its ability to temporarily offer mechanical strength and degrade completely once the injured pathological tissue is healed. A few clinical applications of Mg-based implants were reported in the last century. However, the knowledge and experience is being gained continuously by studying the host response and degradation behavior of Mg implant in animal models and clinical trials. This led to the development of commercial products emerging from Europe and Asia very recently. The potential of Mg implants in repairing fractures at upper and lower limb of large, small animal models and humans is compared and discussed in detail. In addition the possible future Mg implants that might treat problems concerning to urology and gynecology are reviewed. [ABSTRACT FROM AUTHOR]