胫骨骨条植骨结合多根克氏针内固定治疗股骨颈骨折

从1985年起,应用胫骨骨条植骨结合多根克氏针内固定治疗股骨颈骨折21例,经随访7个月—48个月,优17例、良3例、差1例。通过临床观察,用自体胫骨骨条植骨提供活的骨细胞及诱导成骨,能促进加速骨折愈合。本手术方法简单、安全     

右膝髌骨滑膜肉瘤1例报告

滑膜肉瘤是一种常见的恶性软组织肿瘤,多发于大关节滑膜,在髌骨较少见,且易与其他骨肿瘤混淆。我院1984年5月收治右膝骨髌滑膜肉瘤一例,现报告于下: 患者女性,28岁,两年前,偶尔发现右膝髌前压痛,但无红肿,亦无其他不适。在外诊断为“纤维织炎”,并给予强地松龙局部注射,注射后髌前压痛不但未缓解,局部反而出现隆起硬块,触痛明显,但对行走无明显影响,故未作特殊处理。以后包块逐渐增大,来我院门诊,经摄片诊断,以膝骨肚瘤收入住院。 查体:全身检查无特殊。骨科所见,右膝髌前     

小腿外侧皮瓣顺行及逆行转位的经验与教训

1984年以来,我院应用腓动脉为血管蒂的小腿外侧皮瓣顺行或逆行转位修复小腿及足部皮肤缺损共8例,成功7例,失败1例。现将经验教训介绍如下。     

髌前8字钢丝结合环形钢丝固定治疗髌骨骨折

髌骨骨折比较常见,手术固定方法也较多,但往往引起不同程度的膝关节僵硬。自1990年以来,我们采用髌前“8”字钢丝结合环形钢丝固定治疗髌骨骨折27例,术后不需外固定,能早期进行功能锻炼、效果满意。现介绍如下:     

小腿外侧皮瓣顺行及逆行转位的经验与教训

小腿及足部皮肤缺失,可致慢性溃疡,骨质外露,骨折不愈合,甚至恶性变。自1984年来我院应用以小腿次要动脉—腓动脉为血管蒂的小腿外侧皮瓣行顺行或逆行转位修复小腿及足部皮肤缺损共8例。男6例,女2例。年龄最小14岁,最大54岁。7例为外伤所致开放性骨折、感染,骨质外露,1例为慢性骨髓炎恶变。2例为小腿皮肤缺损行顺行腓动     

Repair of flexor tendon defects of rabbit with tissue engineering method

OBJECTIVE: To repair rabbit tendon defects with tissue engineering method. METHODS: The third passage of fetal skin fibroblast cells was labeled with 5-bromo-2' deoxyuridine (Brdu) and then seeded on human amnion extracellular matrix (HA-ECM). Using 1 cm-long-Achilles tendon defects as repairing models in the experimental group, tendon defects were core bridged with polydioxanone (PDS) and then capsulated with the complex of fibroblasts-HA-ECM. In the control group I, defective tendons were sutured with PDS following the former procedure and capsulated with HA-ECM (without fibroblasts). In the control group II, only PDS was applied to connect the defective tendons. Gross examination, light microscopy, scanning electronmicroscopy and biomechanical measurement of the repaired tendons were respectively performed at postoperative 1, 2, 3 month as well as immunohistochemical examination. RESULTS: The optimal cell concentration for seeding fibroblasts was 3.5 x 10(6) cells/ml. Cells grew well and radiated or paralleled on HA-ECM. Immunohistochemistry showed that the labeled seed fibroblasts played an important role in tendonization. The results of light microscopy, electron microscopy, and biomechanical assessment suggested that the rate and quality of tendonization in the experimental group was superior to those of the control group I and II. The tensile strength in the experimental group was the greatest, the next was in the control group I, and the worst in the control group II (P<0.05). CONCLUSIONS: HA-ECM is the excellent carrier for fibroblasts. Fibroblasts-HA-ECM complex has the capability to repair tendon defect and to tendonize with rapid rate and good performance three months after operation. Its tensile strength is 81.8% of that of normal tendon.     

扇形足治疗的探讨

作者提出了扇形足的定义。对足的解剖重点叙述了跖横韧带的问题。本组３例，采用竹排样的肌腱固定１．２．３．４．５跖骨颈，加上改良的ＭｃＢｒｉｄｅ手术，重建了横弓，使前足宽度变窄，１．２．３．４．５跖骨之间的夹角缩小，同时矫正了外翻及小趾内收畸形。随访１８个月～３２个月，扇形足得到矫正，效果满意。     

游离背阔肌移植术

背阔肌具有优越的神经血管蒂,无论作为带蒂移植或游离移植都较理想。但利用游离背阔肌移植代替其他肌肉功能尚未见报导。我院自1980年起,用游离背阔肌移植治疗前臂伸肌缺失及股四头肌麻痹共4例,取得一定效果,报道如下。病历摘要例1 夏某某,男,30岁。诊断为右前臂伸肌群外伤性缺失,右腕下垂畸形。于1980年7月4日行右背阔肌游离移植术,术中切下带有6×20平方厘米皮瓣的背阔肌,移植于右前臂代替伸腕伸指诸肌,将背阔肌之止点扁腱固定于肱骨外上髁,其另一端与伸指总腱残端缝合固定。将供应背阔肌之肩胛下     

自制L形双翼钉在骨科手术内固定中的应用

本文总结我科1981年以来，用V形髓内钉改制成的一种L形双翼钉，用于四肢长骨靠近关节部位骨折，或上述部位先天及后天性畸形矫正术后的内固定。17例共22处，经临床观察及随访，病人可早期关节活动。除1例由于当时手术技术原因，病人过早地负重活动，而出现L形双翼钉松动外，其余尚未出现内固定物的松动和变形，效果满意。     

脊髓灰质炎后遗臀肌麻痹和髋部畸形的治疗

脊髓前角灰质炎后遗下肢肌肉麻痹很常见,可引起髋、膝、踝及足部的各种畸形及功能障碍,其中臀肌麻痹、髋关节畸形、连枷髋等对整个下肢功能影响尤为严重。因此在治疗时,除了解决膝、踝、足等处的各种问题外,正确处理髋部是改善下肢功能的关键之一。我院自1972年1月至1982年1月收