Tạp chí Y Dược học Quân sự

TACTICAL COMBAT CASUALTY CARE TRAINING AT FIELD SURGERY CENTER, VIETNAM MILITARY MEDICAL UNIVERSITY

Le Viet Anh

In modern conflicts, the pattern of casualties and the combat environment have undergone fundamental changes. Epidemiological studies of war trauma indicate that about 90% of fatalities occur pre-hospital. Tactical Combat Casualty Care (TCCC) has become the gold standard of world military medicine, replacing traditional emergency models that are not suitable for the combat environment. This paper provides an overview of the necessity of TCCC training in modern military medicine, the main contents of TCCC its core curriculum, the initial implementation model of TCCC training at the Vietnam Military Medical University (VMMU); thereby, making a number of proposals to improve the efficiency and expand the TCCC training model.

LINEAR REGRESSION MODEL FOR ESTIMATING PERCENT BODY FAT IN YOUNG ADULT MEDICAL STUDENTS: FINDINGS FROM A CROSS-SECTIONAL STUDY

Pham Duc Minh, Nguyen Thi Bon

Objectives: To identify factors associated with percent body fat (PBF) and to develop a predictive model in healthy young adult medical students. Methods: A cross-sectional study was conducted among 76 medical students aged 22 - 24 years. Body composition was assessed using multi-frequency bioelectrical impedance analysis (BIA). Dietary intake was collected using three non-consecutive 24-hour dietary recalls, and physical activity was assessed using the International Physical Activity Questionnaire - Short Form (IPAQ-SF) with total activity expressed as MET-min/week. Block-wise multivariable linear regression was applied to determine independent predictors of PBF. Results: PBF was correlated positively with fat mass and visceral fat area, and negatively with skeletal muscle mass, skeletal muscle index, and phase angle. In the final multivariable model, sex, height, waist-to-hip ratio (WHR), lipid intake (g/kg/day), and physical activity (MET-min/week) were independently associated with PBF. The model equation was: PBF (%) = 53.80 - 7.02 x sex (male = 1) - 0.2 x height (cm) + 18.24 x WHR - 5.53 x lipid intake (g/kg/day) - 0.001 x physical activity (MET-min/week). Conclusion: In young adult medical students, a simple linear model incorporating WHR, sex, height, lipid intake, and physical activity may help estimate PBF and support screening of adiposity patterns in similar student populations. Given the cross-sectional, single-center design, self-reported measures, and lack of validation, larger multicenter studies are needed.

PREVALENCE OF SEGMENTAL CHROMOSOMAL ABNORMALITY IN BLASTOCYSTS DETECTED BY NEXT-GENERATION SEQUENCING

Nguyen Thi Lien Huong, Tran Mai Huong

Objectives: To investigate the incidence and distribution of segmental chromosomal abnormalities in human blastocysts analyzed by next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidy (PGT-A). Methods:A retrospective study was conducted on 994 PGT-A cycles from 859 infertile couples from January 2023 to May 2024. A total of 3,449 trophectoderm-biopsied blastocysts were analyzed using NGS. Segmental chromosomal abnormalities were classified as pure segmental aneuploidy (SA), mosaic SA, complex aneuploidy, and combined mosaicism. Results: Segmental chromosomal abnormalities were detected in 17.3% of blastocysts, including 8.3% with mosaic SA and 3.8% with pure SA. Complex aneuploidy and combined mosaicism accounted for 2.4% and 2.7%, respectively. Segmental chromosomal abnormalities were unevenly distributed across chromosomes, occurring more frequently in larger chromosomes. Segmental losses were more common than gains (56.4% vs. 43.6%). Conclusion: Segmental chromosomal abnormalities are frequently observed in human blastocysts analyzed by NGS-based PGT-A in Vietnam and show a heterogeneous distribution across chromosomes, with segmental losses occurring more often than gains.

CORRELATION OF SERUM ANTI-MULLERIAN HORMONE LEVELS WITH MATURE OOCYTE COUNT AND BLASTOCYST FORMATION IN IN VITRO FERTILIZATION CYCLES

Do Ngoc Lan, Trinh The Son, Doan Thi Hang, Nguyen Minh Phuong

Objectives: To evaluate the correlation between serum anti-Mullerian hormone (AMH) levels and the total number of oocytes, the proportion of mature oocytes, and the proportion of good-quality blastocysts. Methods: A retrospective observational study was conducted on 435 women (18 - 45 years of age) undergoing in vitro fertilization (IVF) at the Military Institute of Clinical Embryology and Histology from June 2023 to December 2024. Patients were divided into four groups: Women < 35 years old with low AMH (< 1.2 ng/mL, n = 60) and normal AMH (≥ 1.2 ng/mL, n = 119), and women ≥ 35 years old with low AMH (n = 96) and normal AMH (n = 160). Results: The antral follicles count (AFC) was significantly higher in the normal AMH group compared to the low AMH group (16.33 ± 6.24 vs. 8.83 ± 4.26, p < 0.001) among women < 35 years, and (12.92 ± 6.29 vs. 7.26 ± 3.46, p < 0.001) among women ≥ 35 years. The median number of mature oocytes (MII) was higher in the normal AMH group (8 vs. 4 oocytes) in women < 35 years, and (6 vs. 3 oocytes) in women ≥ 35 years. The median number of usable blastocysts differed significantly (p < 0.001) between low and normal AMH groups: 2 vs. 4 blastocysts in women < 35 years, and 1 vs. 3 blastocysts in women ≥ 35 years. However, the proportions of mature oocytes and blastocyst formation showed no significant differences across the groups. Conclusion: Serum AMH levels were positively correlated with the number of mature oocytes and usable blastocysts, but were not significantly associated with oocyte or blastocyst quality in IVF cycles.

TEMPORAL CHANGES IN LEFT ATRIAL FUNCTION AND LEFT ATRIOVENTRICULAR COUPLING ASSESSED BY 2D SPECKLE-TRACKING AND 3D ECHOCARDIOGRAPHY FOLLOWING PERCUTANEOUS CORONARY INTERVENTION IN ACUTE MYOCARDIAL INFARCTION

Le Thi Ngoc Han, Tran Duc Hung, Luong Cong Thuc

Objectives: To assess temporal changes in left atrial (LA) function and left atrioventricular coupling (LAC) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) using advanced echocardiographic techniques. Methods: A prospective, descriptive, longitudinal, controlled study was conducted on 120 patients with AMI undergoing PCI and 50 control subjects without coronary artery disease, matched for age, sex, and cardiovascular risk factors. Echocardiography was performed to assess LA strain and left atrioventricular coupling index (LACI) in both groups, with the AMI group undergoing assessment at baseline (within 24 hours of admission), 7 days, 1 month, 3 months, 6 months, 9 months, and 12 months post-PCI. Results: Compared with controls, AMI patients showed impaired LA function, including lower LAEF (54.6% vs. 64.4%), LASr (28.9% vs. 44.3%), LAScd (14.2% vs. 21.9%), LASct (14.9% vs. 22.3%), all p < 0.001, while LACI was higher (19.2% vs. 15.1%; p < 0.001). Following PCI, LACI improved by 7 days (19.2% vs. 17.6%; p = 0.027), LAEF improved by 1 month (58.5% vs. 54.6%; p = 0.001), and LA strain improved by 3 months: LASr (38.7% vs. 28.9%), LAScd (17.9% vs. 14.2%), and LASct (20.8% vs. 14.9%), all p < 0.001. These trends continued up to 12 months post-PCI, with ongoing improvements in LACI (p = 0.006), LAEF (p = 0.003), and LA strain (p < 0.001). Conclusion: Patients with AMI had impaired LA function and LAC, which gradually improved following PCI. Serial assessment of LA strain and LACI provides valuable insight into cardiac recovery and risk stratification after AMI.

CHARACTERISTICS OF MUSCULOSKELETAL DISORDERS AMONG PEACEKEEPING FORCES AT VIETNAM’S LEVEL-2 FIELD HOSPITAL IN SOUTH SUDAN

Hoang The Hung, Phung Cong Manh, Nguyen Thai Hoanh, Le Viet Anh

Objectives: To describe the characteristics of musculoskeletal disorders (MSDs) among peacekeeping forces in the Unity Sector of the United Nations Mission in South Sudan (UNMISS). Methods: A retrospective, descriptive study was conducted on 1,638 patients who presented to Vietnam’s Level-2 Field Hospital (VNL2H) in South Sudan and were diagnosed with MSDs from 2020 to 2024. Study variables included age, unit, diagnosis (classified according to ICD-10), anatomical site of injury, and surgical intervention. Results: Between January 1, 2020 and December 31, 2024, VNL2H managed 7,077 patients, of whom 1,638 (23.2%) presented with MSDs. Diseases of the musculoskeletal system and connective tissue represented 63.6% of cases, with dorsopathies accounting for 33.0%. Injuries accounted for 36.4%, of which soft tissue trauma represented 26.4%. Joint disorders and soft tissue injuries were most prevalent among the Ghanaian Force Police Unit (GHANAFPU), whereas dorsopathies, soft tissue trauma, wounds, fractures, and animal bites were more common among the UNMISS Assistance Force (AssUNMISS). Conclusion: MSDs were common among peacekeeping forces in the Unity Sector of UNMISS. Arthropathies and dorsopathieswere the most prevalent among musculoskeletal conditions, while soft tissue trauma was the most frequent type of injury.

FACTORS ASSOCIATED WITH CHRONIC PAIN CHARACTERISTICS ASSESSED USING THE McGILL PAIN QUESTIONNAIRE IN MAINTENANCE HEMODIALYSIS PATIENTS AT MILITARY HOSPITAL 103

Pham Quoc Toan, Hoang Trung Vinh, Nguyen Van Tu, Nguyen Thi Thu Ha

Objectives:To evaluate the association between chronic pain characteristics assessed using the McGill Pain Questionnaire and selected clinical and laboratory parameters in maintenance hemodialysis (MHD) patients.Methods:A cross-sectional descriptive study was conducted on 131 patients with end-stage renal disease (ESRD) undergoing MHD at Military Hospital 103 from May 2024 to May 2025.Results:Chronic pain was highly prevalent among MHD patients, with a rate of 83.97%. Sex significantly influenced the total sensory-affective pain rating index (PRI-T), with higher scores observed in female patients (p = 0.02). Duration of hemodialysis was strongly associated with pain severity (p = 0.002), with total pain scores increasing with longer dialysis duration, particularly in patients undergoing MHD for more than 7 years. Longer duration of chronic pain was associated with higher total pain scores (p = 0.019). Age at pain onset also affected pain intensity, with patients experiencing pain onset at an older age more likely to report moderate to severe pain (p = 0.037).Conclusion:Chronic pain is highly prevalent in MHD patients and is associated with sex, hemodialysis duration, chronic pain duration, and age at pain onset. The McGill Pain Questionnaire is a useful tool for assessing pain severity and characteristics in this population.

ASSESSMENT OF THE QUALITY OF LIFE AND RELATED FACTORS IN HEAD AND NECK CANCER PATIENTS UNDERGOING RADIOTHERAPY AT THE ONCOLOGY CENTER, MILITARY HOSPITAL 103

Ho Viet Hoanh, Vu Anh Hai, Tran Dinh Thiet, Le Van Dinh

Objectives: To assess the quality of life (QoL) in head and neck cancer (HNC) patients undergoing radiotherapy and to identify factors influencing their QoL during treatment at the Oncology Center, Military Hospital 103. Methods: A prospective longitudinal study was conducted on 52 HNC patients undergoing radiotherapy from September 2022 to September 2025. The EORTC QLQ-C30 and QLQ-H&N35 questionnaires were administered at three timepoints: Before, during (mid-treatment), and at the end of treatment. Data were analyzed using the Friedman test. Results: Before treatment, the mean global QoL score was 77.5. Emotional functioning (78.3), insomnia (31.3), and sexual functioning (26.4) were the most affected domains. During treatment, functional scales (physical, role, social) declined significantly (p < 0.05) with no subsequent improvement. Symptom scores for pain, swallowing, social eating, dry mouth, sticky saliva, and coughing progressively worsened at both mid-treatment and end-of-treatment timepoints (p < 0.05). Patients with earlier disease stage (I - II vs. III - IV), better performance status (PS 0 vs. 1), and those receiving radiotherapy alone (vs. combined chemoradiotherapy) reported significantly better QoL throughout the treatment course (p < 0.05). Conclusion: Radiotherapy significantly impairs the QoL of HNC patients, affecting multiple functional and symptom domains. Poorer QoL is associated with advanced disease, lower performance status, and combined chemoradiotherapy. These findings underscore the need for integrated psychological support and proactive symptom management to improve patient outcomes.

FRAILTY AND ASSOCIATED FACTORS AMONG OLDER ADULTS HOSPITALIZED WITH SEVERE COMMUNITY-ACQUIRED PNEUMONIA

Vu Thu Huong, Nguyen Xuan Thanh Dat

Objectives: To determine the prevalence of frailty and its associated factors among older adults hospitalized with community-acquired pneumonia (CAP). Methods: A cross-sectional study was conducted among 117 older adults admitted with pneumonia. Baseline characteristics, comorbidities, and functional status were collected. Frailty was assessed using the Clinical Frailty Scale (CFS) and categorized into frail vs. non-frail. Results: Patients had a mean age of 79.5 ± 10.9 years, and 42.7% were female. Hypertension (67.5%), diabetes (28.2%), and heart failure (21.4%) were the most common comorbidities; 40.2% had ≥ 2 comorbidities. Frailty was highly prevalent, affecting 88.0% of participants. In logistic regression, female sex was an independent predictor of frailty (OR = 3.31; 95%CI: 1.13 - 9.64; p = 0.029). Conclusion: Frailty was highly prevalent and was independently associated with female sex among older adults hospitalized with CAP.

STUDY ON URIC ACID LEVELS AND RELATED FACTORS IN HEMODIALYSIS PATIENTS AT MILITARY HOSPITAL 103

Nguyen Thi Thu Ha, Mixay Latsavong, Bui Van Manh, Le Viet Thang

Objectives:To investigate uric acid (UA) levels and their association with certain clinical and paraclinical characteristics in patients undergoing maintenance hemodialysis (MHD).Methods:A cross-sectional descriptive study was conducted on 69 patients with end-stage chronic kidney disease (ESRD) receiving MHD at the Nephrology and Hemodialysis Department, Military Hospital 103, from December 2023 to March 2025.Results:The mean UA level was 464.09 ± 122.26 μmol/L. The prevalence of hyperuricemia among the study population was 69.57%. UA levels were significantly associated (p < 0.05) and moderately positively correlated with carotid intima-media thickness (CIMT) (r = 0.448; p = 0.0001) and blood creatinine levels (r = 0.305; p = 0.011). No significant association was found between UA levels and age, sex, body mass index (BMI), causes of chronic kidney disease (CKD), duration of MHD, residual urine output, or dyslipidemia (p > 0.05). Multivariate analysis showed that low BMI, high hemoglobin levels, and blood creatinine levels were independent risk factors for hyperuricemia, with ORs of 0.78, 1.05, and 1.00, respectively (p < 0.05). Conclusion:Patients undergoing MHD have elevated UA levels due to reduced renal clearance. Elevated UA levels are associated with increased CIMT and a higher risk of cardiovascular complications. Ensuring adequate nutrition and adherence to sufficient dialysis sessions may help control UA levels within normal limits, reduce CIMT, lower cardiovascular risk, decrease mortality, and improve treatment outcomes.

A CLINICAL CASE REPORT: SMALL BOWEL OBSTRUCTION DUE TO PHARMACOBEZOAR

Truong Minh Thuong, Tran Quyet Thang, Le Van Lam

Small bowel obstruction (SBO) caused by aggregated medications is an extremely rare condition and can be easily overlooked due to its nonspecific clinical presentation. We report a case of a 65-year-old female patient admitted with fever and abdominal pain in the periumbilical and suprapubic region. The patient had a history of gastric ulcer and had been taking oral Maalox at a dose of two tablets per day for seven days prior to admission, swallowing the tablets whole without chewing. Laboratory tests revealed leukocytosis, an increased neutrophil count, and elevated C-reactive protein levels. Contrast-enhanced computed tomography of the abdomen demonstrated multiple disc-like, flat, high-density structures within the ileal lumen, associated with bowel wall thickening, mesenteric oedema, and mild dilatation of adjacent small bowel loops, suggesting pharmacobezoar-induced ileitis with early SBO. After failure of conservative treatment, the patient underwent surgery, which revealed multiple medication tablets impacted in the ileum, causing inflammation, oedema, luminal narrowing, and intestinal obstruction. Histopathological examination showed necrotising intestinal inflammation. This case highlights the important role of computed tomography in identifying rare causes of SBO and guiding timely management.

COMPARISON OF 1 MG/L VERSUS 2 MG/L ADRENALINE IN TUMESCENT SOLUTION: HEMODYNAMIC EFFECTS AND CARDIOVASCULAR EVENTS DURING LIPOSUCTION - A RANDOMIZED CONTROLLED TRIAL

Vo Van Hien, Tran Phi Hung

Objectives: To compare the hemodynamic changes and cardiovascular adverse events associated with two adrenaline concentrations (1 mg/L vs. 2 mg/L) in tumescent solution for patients undergoing liposuction under general anesthesia. Methods: A randomized clinical trial was conducted at Le Huu Trac National Burn Hospital (Hanoi, Vietnam) from January to August 2025. 132 ASA I - II patients undergoing elective liposuction were randomly assigned to receive tumescent solution containing either 1 mg/L (group 1, n = 66) or 2 mg/L (group 2, n = 66) adrenaline with lidocaine. Primary outcomes were changes in heart rate (HR) and mean arterial pressure (MAP) recorded at baseline, 30, 60, 90 minutes, and procedure end. Secondary outcomes included the incidence of tachycardia, hypertension, and surgeon satisfaction scores. Results: Baseline characteristics were comparable between groups. Group 2 demonstrated significantly higher HR and MAP at all post-infiltration timepoints compared to group 1 (p < 0.05). Tachycardia incidence was markedly higher in group 2 than in group 1 (31.82% vs 10.61%, p < 0.05), consistent with a higher rate of hypertension (22.73% vs 6.06%, p < 0.05). Despite pronounced hemodynamic differences, surgeon satisfaction scores remained comparable between groups (p > 0.05). Conclusion: Increasing adrenaline concentration from 1 mg/L to 2 mg/L in tumescent solution is associated with a significantly higher risk of cardiovascular instability without improving surgical outcomes. These findings support the use of 1 mg/L adrenaline as the optimal concentration for tumescent anesthesia in liposuction under general anesthesia.

INTRACRANIAL PROGRESSION-FREE SURVIVAL AND PROGNOSTIC FACTORS OF BRAIN METASTASES FROM NON-SMALL CELL LUNG CANCER TREATED WITH GAMMA KNIFE RADIOSURGERY AND TYROSINE KINASE INHIBITORS

Tran Duc Linh, Nguyen Duc Lien, Nguyen Van Ba

Objectives: To investigate intracranial progression-free survival (iPFS) and its associated prognostic factors in patients with brain metastases (BM) from non-small cell lung cancer (NSCLC) treated with a combination of upfront Gamma Knife radiosurgery and tyrosine kinase inhibitors (TKIs). Methods: A longitudinal observational study was conducted on 74 patients at Vietnam National Cancer Hospital from February 2021 to May 2025. Results: The median iPFS was 22 months (95%CI: 17.45 - 26.55). The iPFS rates at 6, 12, and 24 months were 94.6%, 77.9%, and 40.4%, respectively. Regression analysis revealed that iPFS was not significantly influenced by the number of BM (p = 0.98), total tumor volume (p = 0.51), EGFR mutations (p = 0.26). In contrast, the presence of extracranial metastases (HR: 3.39, 95%CI: 1.31 - 8.74; p = 0.01) and the status of extracranial disease control (HR: 4.52; 95%CI: 2.13 - 9.60, p < 0.01) were identified as two independent prognostic factors for iPFS. Conclusion:In this study, the median iPFS was 22 months for NSCLC patients with BM treated with upfront Gamma Knife and TKIs. The presence of extracranial metastases and poorly controlled extracranial disease were significant predictors of iPFS.

CLINICAL OUTCOMES OF USING PEDICLED LATISSIMUS DORSI MUSCLE FLAPS IN THE TREATMENT OF LARGE CHEST WALL DEFECTS

Objectives:To evaluate the efficacy and safety of the pedicled latissimus dorsi (LD) muscle flaps for the reconstruction of large chest wall defects. Methods: A retrospective and prospective, descriptive, interventional study was conducted on 30 patients with large chest wall defects treated with pedicled LD muscle flaps at Le Huu Trac National Burn Hospital and 108 Military Central Hospital from September 2020 to November 2025. Results:The cohort comprised 30 patients (7 males, 23 females) with a mean age of 55.83 ± 15.18 years. The primary etiologies were radiation-induced sequelae (70.0%) and burns (26.7%). The latissimus dorsi muscle flaps were harvested with mean dimensions of 19.57 ± 4.29cm in length and 10.7 ± 2.82cm in width. Overall flap survival was 96.67% (29/30 flaps); partial necrosis occurred in one case (3.33%). Skin grafts healed successfully on the muscle flap, and primary closure of the donor site was achieved in 100% of cases. At the 6-month follow-up (n = 28), 100% of patients demonstrated preserved shoulder function, favorable scar aesthetics, and high satisfaction with both functional and aesthetic outcomes. Conclusion: The pedicled LD muscle-only flap is a safe and highly effective modality for reconstructing large chest wall defects, providing durable coverage with a 96.67% success rate and ensuring full preservation of shoulder range of motion.

IMPACT OF RESPIRATORY COMPLICATIONS AND ANASTOMOTIC LEAKAGE ON HEALTH-RELATED QUALITY OF LIFE FOLLOWING THORACOSCOPIC ESOPHAGECTOMY

Nguyen Van Tiep, Nguyen Trong Hoe, Nguyen Anh Tuan

Objectives: To evaluate health-related quality of life (QoL) in patients undergoing thoracoscopic esophagectomy (TE) and the impact of respiratory complications and anastomotic leakage on health-related QoL at 3 months postoperatively. Methods: A prospective, descriptive study was conducted on 70 patients with esophageal cancer who underwent TE at Military Hospital 103 and 108 Military Central Hospital between June 2022 and June 2024. QoL was assessed using the European Organisation for Research and Treatment of Cancer QoL Questionnaire - Esophageal Module (EORTC QLQ-OES18) preoperatively and at 1, 3, and 6 months after surgery. Results: The incidences of respiratory complications and anastomotic leakage were 18.6% and 7.1%, respectively. At 3 months postoperatively, patients with respiratory complications had significantly higher scores for cough and esophageal pain compared with those without complications (68.2 vs. 52.1 and 64.1 vs. 51.8, respectively; p < 0.05). Anastomotic leakage was associated with significantly higher dysphagia scores (67.0 vs. 54.3; p = 0.04) and greater eating restrictions (73.1 vs. 53.0; p = 0.001). Overall QoL showed gradual improvement from 3 to 6 months after surgery. Conclusion: Respiratory complications and anastomotic leakage are major determinants of early deterioration in QoL after esophagectomy, particularly affecting cough, esophageal pain, and eating function.

EVALUATION OF CLINICAL AND RADIOGRAPHIC CHARACTERISTICS OF COMBINED MAXILLARY AND MANDIBULAR FRACTURES AT MILITARY HOSPITAL 103

Le Ha Khoa, Le Manh Cuong

Objectives:To evaluate the clinical characteristics, radiographic features, and fracture patterns of combined maxillary and mandibular fractures. Methods: A cross-sectional descriptive study was conducted on 30 patients diagnosed with confirmed combined maxillary and mandibular fractures. These patients were treated at the Maxillofacial and Reconstructive Surgery Department, Military Hospital 103, from January 2018 to May 2020. Results: The mean age of patients was 29.16 ± 11.24 years with a male-to-female ratio of 14:1. The primary cause this fracture type was traffic accidents (90.0%). Common clinical presentations included swelling and ecchymosis, and bone discontinuity (100.0%); abnormal jaw mobility (96.7%); malocclusion (93.3%); restricted mouth opening/trismus (90.0%); and maxillofacial deformities (80.0%). 56.7% of cases involved zygomatic complex (ZMC) or unilateral maxillary fractures, while 30.0% were combined with Le Fort I, II, or I + II maxillary fractures. 3.3% exhibited injuries involving Le Fort I + II + III fractures and the remaining 10.0% presented with other varied forms of maxillary fractures. Computed tomography (CT) scans facilitated more accurate and comprehensive detection of maxillofacial injuries compared to conventional radiography. Conclusion: CT provides superior accuracy and comprehensiveness in detecting maxillofacial lesions compared to conventional radiography.

LONG-TERM RESULTS OF HEMIARTHROPLASTY IN THE TREATMENT OF INTERTROCHANTERIC FRACTURE

Dang Hoang Anh, Vu Nhat Dinh, Nguyen Dinh Huan, Hoang The Hung

Objectives: To evaluate the long-term outcomes of patients ≥ 70 years old with intertrochanteric fractures treated with hemiarthroplasty. Methods: A retrospective longitudinal, uncontrolled study was conducted on 40 patients aged > 70 years with intertrochanteric fractures who underwent hemiarthroplasty in the Joint Surgery Department, Trauma and Orthopaedics Center, Military Hospital 103 in 2019 and 2020. Complications, Barthel index (BI), and mortality rate (at 30 days, 1 year, and 5 years after surgery) were recorded. Results: The mean age of patients was 82.0 ± 6.31 years (range: 70 - 93 years). 25% (10/40) of the patients sustained complications. The most common complication was delirium (4/40 of the patients). 38 patients (95%) survived at 1 year postoperatively, and 28 patients (70%) survived at 5 years postoperatively. The mean BI was 90.66 ± 14.76 (range: 35 - 100) at 1 year, and 88.39 ± 16.83 (range: 35 - 100) at 5 years after surgery. Conclusion: Patients ≥ 70 years of age with intertrochanteric fractures who underwent hemiarthroplasty had a BI score of 88.39 ± 16.83 at 5 years postoperative, and a 5-year mortality rate of 30%. Postoperative complications were associated with a higher long-term mortality rate.

SURVIVAL OF PEDICLED PERFORATOR FLAPS IN LOWER-LEG SOFT-TISSUE RECONSTRUCTION: AN ANALYSIS OF INFLUENCING FACTORS

Vu Huu Trung, Ngo Thai Hung, Truong Anh Dung, Nguyen Van Phu, Tran Thi Kim Lien

Objectives: To evaluate the survival of pedicled perforator flaps and analyze related factors, including rotation angle, pedicle diameter, pedicle length, and flap size. Methods:A cross-sectional descriptive study was conducted on 55 patients with lower-leg soft-tissue defects treated with pedicled perforator flaps. The effects of flap rotation angle, pedicle diameter, and pedicle length on flap survival were analyzed. Results:96.4% of flaps survived, achieving effective coverage. Flap width and defect size were significantly associated with flap survival. Pedicle length showed an inverse correlation with flap survival (OR = 0.3). Conclusion: Pedicled perforator flaps represent a reliable option for reconstruction of lower-leg soft-tissue defects. Flap width and defect size are associated with the risk of flap necrosis. A pedicle diameter of ≥ 0.5 mm is safe for flap survival.