锁定加压钢板及解剖钢板治疗高能量胫骨远端骨折的对比研究

目的 对比锁定加压钢板(1ocking compression plate,LCP)及普通解剖钢板治疗高能量胫骨远端骨折的临床疗效.方法 2003年5月-2009年5月,采用LCP及解剖钢板治疗入选的高能量胫骨远端骨折42例.解剖钢板组24例,男16例,女8例;年龄20～54岁,平均39岁.按AO分型:A型13例,B型5例,C型6例.LCP组18例,男15例,女3例;年龄25～55岁,平均40岁.按AO分型:A型11例,B型3例,C型4例.比较两组的手术时间、出血量、透视次数、骨折愈合时间、踝关节功能及并发症,参照Mazur标准评价踝关节功能.结果 LCP组平均随访11.6个月,解剖钢板组平均随访14.2个月,均显示骨折愈合.解剖钢板组植骨比例多于LCP组.CP组透视次数L多于解剖钢板组.LCP组手术时间、手术切口、出血量、放射学愈合时间及术后并发症发生总数优于解剖钢板组.结论 LCP及解剖钢板治疗高能量胫骨远端骨折均可取得满意效果,但LCP具有创伤小、骨折愈合快、并发症少等优点,体现了生物学固定的优点,是治疗高能量胫骨远端骨折的有效方法.

Abstract：

Objective To compare the clinic effect of the locking compression plate (LCP) fixation and the anatomical plate in treatment of high-energy distal tibial fractures. Methods The study involved 42 patients with high-energy distal tibial fractures treated between May 2003 and May 2009. The anatomical plate group included 24 patients ( 16 males and 8 females, at average age of 39 years), of whom there were 13 patients with type A fractures, five with type B and six with type C according to the AO/ASIF classification. The LCP group included 18 patients ( 15 males and 3 females, at average age of 40 years), of whom there were 11 patients with type A fractures, three with type B and four with type C according to the AO/ASIF classification. All the patients were followed up for 8-17 months. Their functional and radiographic outcomes were collected. The operation time, intra-operative blood loss, X-ray exposure, bone healing time, post-operative complications and therapeutic effects were compared between both groups. Mazur's criteria was used to evaluate the function of the ankle. Results The LCP group was followed up for average 11.6 months and the anatomical plate group for average 14.2 months, which showed fracture healing in all the patients. The bone graft in the anatomical plate group was used more frequently than the LCP group, while the X-ray exposure in the LCP group was much more than that in the anatomical plate group. The operation time, incision size, blood loss, postoperative complications and radiographic bone healing time in the LCP group were significantly less than those in the anatomical plate group. Conclusions Both the LCP and anatomical plate are effective methods for the high energy distal tibial fractures. LCP has advantages of less trauma, quick fracture healing and less complications, is consistent with the biomechanics of internal fixation and hence is an ideal method for the treatment of the high-energy tibial fractures.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

桡骨小头骨折的治疗

Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.     

AO解剖型胫骨髓内钉微创治疗胫骨远端骨折

目的初步探讨国际内固定研究学会(AO)新型解剖型胫骨交锁髓内钉(ETN)微创治疗胫骨远端干骺端骨折的临床疗效。方法对我院2007年11月~2009年11月ETN在透视下闭合复位微创内固定治疗18例距关节面50mm以内的胫骨远端干骺端骨折临床资料进行回顾性分析。结果本组随访时间5~22个月,平均12个月。骨折愈合时间平均为4.5个月(3~6个月),无感染、无断钉、无畸形愈合和骨不连等并发症。最终结果评分采用Johner-W ruhs评分标准,结果:优17例,良1例;优良率100%。结论 ETN治疗胫骨远端干骺端骨折具有设计合理、操作简单、固定可靠、手术创伤小、并发症少等优点,是治疗胫骨远端干骺端骨折的一种安全、有效的方法。     

胫骨Pilon骨折的外科治疗策略

目的 探讨胫骨Pilon骨折的外科治疗策略. 方法随访我院2005年5月-2008年3月治疗的47例Pilon骨折患者,其中男37例,女10例;年龄23～63岁,平均42.6岁.本组共47例51侧胫骨.致伤原因:交通伤34侧,坠落伤12侧,重物砸伤5侧.开放性骨折7侧,闭合性骨折44侧.根据Ruedi-Allgower分型标准:Ⅰ型6侧,Ⅱ型28侧,Ⅲ型17侧.软组织损伤根据Tscherne-Gotzen分度:开放性骨折1度2侧,2度3侧,3度2侧;闭合性损伤0度2侧,1度27侧,2度15侧.出于对内固定具体的选用,又将胫骨远端分为三柱:前外侧、前内侧及后侧柱.胫骨骨折采用Depuy的"T"形钢板18侧,AO三叶草钢板10侧,短"T"形钢板2侧,锁定钢板2侧,Link的前外侧解剖钢板4侧,Orthofix超踝关节外固定支架合并有限内固定15侧. 结果随访时间为12～44个月,平均23.2个月.踝关节功能按Mazur评分标准:优29侧,良13侧,可7例,差2侧,优良率为82%. 结论根据Ruedi-Allgower分型和软组织Tscherne-Gotzen分度选择手术时机和治疗方案,根据骨折累及胫骨远端三柱的情况选择合适的内固定,术后并发症少,可取得良好、满意的临床疗效.     

有限切开复位结合前外侧L形锁定加压接骨板内固定治疗胫骨远端干骺端骨折

目的探讨胫骨远端干骺端骨折应用有限切开复位结合前外侧L形锁定加压接骨板(locking compression plate,LCP)内固定治疗的临床疗效。方法 2011年6月~2013年1月共收治15例胫骨远端干骺端骨折患者。骨折按照国际内固定研究协会(AO/ASIF)分型:43A2型3例,43A3型10例,43B1型2例,均合并腓骨下端骨折;胫骨远端干骺端骨折线距踝关节面1.6~4.5cm,平均2.8cm;闭合性骨折8例,开放性骨折7例(GustiloⅠ型2例,Ⅱ型3例,ⅢA型2例)。GustiloⅢA型2例急诊行清创、腓骨内固定及外固定支架固定,余患者术前行跟骨骨牵引。运用有限切开复位结合前外侧L形LCP内固定治疗,术中酌情植骨,术后早期功能锻炼。结果所有患者术后获12~18个月(平均16个月)随访,术后2例切口表皮坏死,经换药处理后愈合,余切口均一期愈合。骨折于术后16~24周(平均20周)获骨性愈合。末次随访时根据美国骨科协会足踝外科分会(American Orthopedic Foot Ankle Society,AOFAS)评分标准:评分为73~95分,平均89.5分,其中优10例,良3例,可2例,优良率86.7%。随访期间无感染、骨不连及内固定松动断裂等并发症发生。结论采用有限切开复位结合前外侧L形LCP内固定治疗胫骨远端干骺端骨折,术中利用微创置板技术,并酌情植骨,术后早期功能锻炼,可获得良好疗效。     

关节镜辅助下手术治疗胫骨平台骨折56例

目的观察膝关节镜辅助下微创经皮螺钉内固定术治疗胫骨平台骨折的临床疗效。方法自2007年1月～2011年1月采用膝关节镜辅助下微创经皮螺钉内固定术治疗56例胫骨平台骨折。其中男性39例,女性17例;年龄16～67岁,平均35岁;闭合性骨折46例,开放性骨折10例;按Schazker分型:Ⅰ型13例,Ⅱ型24例,Ⅲ型19例。结果 56例患者随访6～54个月,平均34个月。术后膝关节功能评价参照Rasmussen评分标准,疗效优35例,良18例,中3例;总优良率94.6%。结论关节镜辅助下微创治疗胫骨平台骨折(SchazkerⅠ型、Ⅱ型、Ⅲ型),具有创伤小、复位准确、关节功能恢复良好、并发症少等优点,是一种治疗胫骨平台骨折较理想的方法。     

应用微创经皮钢板固定技术结合解剖钢板治疗胫骨远端粉碎性骨折

目的探讨应用微创经皮钢板固定法（MIPPO）结合解剖钢板治疗胫骨远端粉碎性骨折的临床效果。方法对25例胫骨远端粉碎性骨折采用胫骨远端解剖钢板应用微创经皮钢板固定技术（MIPPO）治疗。骨折分型按AO分型A型14例,B型2例,C型9例。结果本组病例随访5～25个月,平均14个月,伤口全部愈合,其中2例延迟愈合,皆为糖尿病患者。X线片示骨痂出现时间12周,无短缩以及旋转畸形,外观无明显畸形,膝踝关节功能正常。按Johner-Wruhs胫骨骨折疗效评定标准,优19例,良4例,中2例;优良率为92％。结论MIPPO技术结合解剖钢板治疗胫骨远端粉碎性骨折具有优势,降低了手术损伤,提高治疗成功率,有利于患者肢体功能的恢复。     

加压交锁髓内钉治疗下肢长骨干骨折不愈合及延迟愈合

目的 分析下肢长骨干骨折不愈合及延迟愈合的原因,评价加压交锁髓内钉治疗下肢长骨干骨折不愈合及延迟愈合的效果. 方法 1998年2月-2006年12月,对21例股骨和胫骨干骨折不愈合及延迟愈合者采用加压交锁髓内钉治疗.其中股骨13例,胫骨8例,3例未植骨,仅扩髓加压,5例同时行膝关节松解. 结果 随访11.4～36个月,平均13.6个月,全部患者均骨性愈合,平均愈合时间8.7个月,无畸形、感染及再骨折出现.采用Klemm分级标准,优19例,良2例. 结论 下肢长骨干骨折不愈合及延迟愈合主要原因是手术适应证选择不当,手术内固定使用不当,断端血运和骨折愈合生物环境破坏.加压交锁髓内钉治疗下肢长骨干骨折不愈合及延迟愈合具有固定可靠,便于膝、踝早期功能活动,肢体可早期负重等优点.手术应用联合骨移植,扩髓及膝关节松解,可促进骨愈合,改善膝关节功能.     

膝内外侧双切口双钢板内固定治疗复杂胫骨平台骨折的效果分析

目的分析膝内外侧双切口双钢板内固定手术方法对复杂胫骨平台骨折的治疗效果。方法选取2013年7月~2015年2月收治的86例复杂胫骨平台骨折手术患者,随机分为两组,对照组43例采用膝前正中直切口双钢板固定术,观察组43例采用膝内外侧双切口双钢板内固定术,分析并比较两组的治疗效果。结果观察组手术时间及手术费用均高于对照组,差异有统计学意义(P0.05);观察组手术出血量与对照组差异无统计意义(P0.05);观察组住院时间、开始负重时间及骨折愈合时间均少于对照组,差异有统计学意义(P0.05);术后1年观察组胫骨平台内翻角、后倾角明显小于对照组,差异有统计学意义(P0.05);观察组术后6个月及术后1年膝关节HSS评分、Rasmussen评分均优于对照组,差异有统计学意义(P0.05)。结论膝内外侧双切口双钢板内固定治疗复杂胫骨平台骨折,虽增加了手术时间及费用,但能减少住院时间,加快骨折愈合,恢复原有解剖结构,使患者获得更好的膝关节功能,值得参考。在实际应用中,还应根据患者情况合理选择。     

胫骨下端螺旋形接骨板治疗肱骨近端延及中段的骨折

目的 探讨应用胫骨下段螺旋形接骨板治疗成年人肱骨近端延及中段骨折的固定技术并评价其临床效果.方法 选择2004年5月-2009年2月应用胫骨下段螺旋形接骨板治疗成年人肱骨近端延及中段骨折并获得随访的患者共15例,其中男10例,女5例;年龄19～65岁(平均38岁),总结其手术方法并对其肩关节功能进行评价.结果 15例患者随访7～24个月,平均13个月.结果 显示全部患者均骨性愈合,平均愈合时间4.7个月,未见内固定物松动或断裂.参照Neer肩关节功能评价标准:优7例,良好6例,优良率为87%.结论 应用胫骨螺旋形接骨板固定技术治疗成年人肱骨近端延及中段的骨折简单有效,创伤小.     

关节镜下PDS线交叉缝合固定治疗胫骨髁间棘骨折

目的 探讨关节镜下复位、聚对二氧杂环己酮(PDS)线缝合固定治疗胫骨髁间棘骨折的临床疗效.方法 对32例采用关节镜下PDS线交叉缝合固定治疗的胫骨髁间棘骨折患者临床资料进行回顾性分析.按Meyers-McKeever-Zaricznyj骨折分型:Ⅱ型5例,Ⅲ型15例,Ⅳ型12例.结果 平均随访17.1个月,所有患者膝关...