锁骨钩板配合锚钉固定治疗肩锁关节脱位的临床分析

目的介绍肩锁关节脱位合并喙锁韧带撕裂,行关节复位、韧带重建的新方法。方法 2008年1月~2012年5月采用锁骨钩板加带线锚钉治疗30位肩锁关节脱位患者,男25例,女5例,平均27.8岁,按Rockwood分型:Ⅲ型3例,Ⅳ型11例,Ⅴ型16例,术后采用Constant-Murley评分评价术后肩关节功能。结果用该方法治疗30例患者获得全程随访,平均随访时间28个月(25~48月)。根据Constant-Murley评分平均89.1分(82~97分),均能达到肩锁关节复位和恢复患者肩关节较好功能的目的。结论该手术方法的设计,符合生物力学的要求,操作简单,复位作用良好,能早期恢复肩关节的运动功能,值得推广应用。     

股骨近端骨折内固定失败后全髋关节置换术：50例囊内骨折和囊外骨折分析

目的：回顾性分析股骨近端骨折内固定失败后全髋关节置换的疗效,比较股骨近端囊内骨折和囊外骨折内固定失败后髋关节置换两种类型的技术、临床结果、并发症。方法：将2013年6月—2018年6月50例股骨近端骨折内固定失败后全髋关节置换术患者纳入研究,全髋关节置换术均Ⅰ期完成。术后定期随访。结果：囊内骨折组平均手术时间（72.4±14.3） min,平均出血量（322.6±135.2） mL,均少于囊外骨折组平均手术时间（81.3±17.6） min和平均出血量（543.4±108.3） mL,两组有显著性差异。平均随访38个月,囊内骨折组Harris评分（85.5±16.2）,高于囊外骨折组评分（73.4±13.1;P=0.01）。结论：股骨近端骨折内固定失败后全髋关节置换术比常规髋关节置换术有更多并发症,与囊内骨折相比,囊外骨折组手术时间更长,出血、并发症更多,假体生存率相对更低。     

浮肩损伤植入物固定方案选择与骨折移位的关系

BACKGROUND: There are more literature reports about the floating shoulder injury in recent years, but there still have obvious controversies about the treatment of the floating shoulder injury. Whether choose the conservative treatment or operative treatment is an important issue in face of every clinician. OBJECTIVE: To review the clinical features and present treatment situation of the floating shoulder injury. METHODS: A computer-based online search was performed in the PubMed and the China National Knowledge Infrastructure database for the clinical research papers on the treatment methods of the floating shoulder injury from January 1975 to August 2015. The key words were floating shoulder injury, diagnose, treatment method. The articles published earlier and repetitive researches were excluded. Finally, 33 articles were included for further analysis. RESULTS AND CONCLUSION: (1) Floating shoulder injury is a kind of severe shoulder injury which is caused by high energy and violence. It is often complicated with severe systemic injury, which should be paid more attention in clinic. (2) The treatment of floating shoulder injury has been controversial, and there is no standard treatment guideline. Conservative treatment and operative treatment can get good outcomes. There are less reports about conservative treatment of the floating shoulder injury in recent years. The outcome of operative treatment may better than conservative treatment. (3) Conservative or simple clavicle fixation can be used for fractures without displacement or with small displacement. Obviously displaced fractures can be treated with simple clavicle fixation or double fixation of clavicle and scapula, which may have good repair effects.       

内、外侧双钢板治疗股骨远端粉碎性骨折的临床效果

目的:探讨应用内、外侧双钢板治疗股骨远端粉碎性骨折的临床疗效。方法:回顾性分析我院自2010年8月-2014年4月在临床中应用切开复位结合股骨髁内、外侧双钢板治疗股骨远端粉碎性骨折21例,闭合性骨折18例,开放性骨折3例,开放性骨折经过一期清创缝合使其转变为闭合性骨折。按Müller分型:A2型6例,A3型4例,C1型2例,C2型4例,C3型5例。结果:术后患者平均随访5-20个月,所有患者均达到骨性愈合。采用Lysholms评分评价膝关节功能,优14例,良4例,可2例,差1例。术后有1例患者出现切口局部脂肪液化坏死,通过换药愈合,其他患者均未出现感染、切口皮肤坏死、深静脉血栓等并发症,无围手术期及随访期内死亡。结论:应用内、外侧双钢板治疗股骨远端粉碎性骨折(Müller分型A2、A3、C2、C3型)是一种有效的方法。