关节镜下同种异体肌腱移植修复膝交叉韧带早期排斥反应的观察

目的 了解关节镜下同种异体肌腱移植修复膝交叉韧带术后早期排斥反应的发生情况.方法 对关节镜下行同种异体肌腱移植修复膝交叉韧带的17例患者(异体肌腱移植组)的临床资料进行分析,以同期29例自体肌腱移植患者(自体肌腱移植组)作为对照,比较两组术后早期体温、关节疼痛、肿胀积液及外周血白细胞计数的差异.结果 异体肌腱移植组手术...     

神经松解减压术治疗上肢神经损伤

目的 :报告采用神经松解压术治疗上肢神经损伤的效果。方法 :采用显微外科技术对 6例 48条上肢神经分别行神经外膜松解、外膜加束膜松解及神经前置治疗。结果 :48条神经中疗效优的 18条 ,良 2 4条 ,可 5条 ,差 1条 ,总优良率 87.5 %。结论 :对上肢神经损伤患者 ,应尽早选用神经探查松解减压术 ,可望获得满意效果。     

脊髓造影对腰骶神经根管狭窄的诊断意义

本文报告23例退行性腰骶神经根管狭窄的病例，应用脊髓造影作定位诊断。本组23例腰椎CT均无发现明显椎间盘突出和中央椎管狭窄。行脊髓造影检查显示不同程度腰骶神经根受压，受累节段的神经根管狭窄程度经手术证实。造影与手术发现的符合率为％％％。结论：脊髓造影可显示腰骶神经根在整个神经根管的形态特点，是对腰骶神经根管狭窄有效而经济的诊断方法。     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

导航下与传统方法应用动力髋螺钉治疗老年股骨转子间骨折的疗效比较

Objective To compare the navigational and traditional dynamic hip screw (DHS) fix-ations in the treatment of intertrochanteric fractures in elderly patients. Methods A retrospective study was conducted to analyze the elderly patients with intertrochanterie fracture who had been treated in our de-partment from April 2005 to April 2007 and whose clinical data were complete. Enrolled in the present study were 25 cases that had received navigational DHS fixation and 31 cases who had received traditional DHS fixation. In navigational group, there were 10 males and 15 females, with an average age of 82. 1 years. They were 14 eases of Evans type Ⅰ and 11 Evans type Ⅱ. In traditional group, there were 12 males and 19 fe-males, with an average age of 82. 8 years. They were 16 cases of Evans type Ⅰ and 15 Evans type Ⅱ. The 2 groups were compared in incision length, operation time, bleeding volume, X-ray exposure time, bed-ridden time, medical and implant complications, and one-year functional recovery. Results In navigational group, 23 patients were followed for 11 to 20 (average, 14) months and 2 were lost. In traditional group, 30 patients were followed up for 14 to 23 (average, 18) months and 1 died from cardiovascular disease within 1 year. Compared with traditional group, navigational group had a smaller incision, less blood loss, shorter bed-ridden time and less X-ray exposure time, a higher rate of fracture healing at 3 months, with statistically significant differences (P <0.05). The Harris hip function scores at postoperative 1 year were of no significant difference between the 2 groups (P > 0.05) . In navigational group there were 3 medical and 1 implant complications. In traditional group there were 9 medical and 5 implant complications. There was no significant difference between the 2 groups (P > 0.05). Conclusion In the treatment of intertrochanteric fractures for the elderly patients, the navigational DHS fixation is superior to traditional DHS fixation due to its ad-vantages of smaller incision, less blood loss, shorter bed-ridden time, faster fracture healing and betterfunctional recovery.     

锁定加压钢板在上肢长管骨干骺端粉碎性骨折中的初步应用

目的 探讨锁定加压钢板治疗上肢长管骨干骺端粉碎性骨折的效果。方法 自2002年3月至2003年9月，选用锁定加压钢板治疗上肢长管骨干骺端粉碎性骨折35例。按AO骨折分型，其中11C3型7例，21B3型6例，23A3型2例，23C2型12例，23C3型8例。结果术后随访3—20个月，平均8个月。35例伤口均I期愈合，无感染。术后3～4周开始见骨痂生长，骨折临床愈合期为6～10周，骨折愈合率100％。功能评定：肩关节按Constant等标准，肘关节按Mayo标准，腕关节按NYOH标准，优20例，良11例，可3例，差1例，优良率为88％。结论锁定加压钢板具有钉-板角度稳定性强和对骨膜血供损伤小的生物学固定优点，根据骨折情况可以选择加压机制、内支架机制或两种混合的机制固定骨折。     

骶管硬膜外蛛网膜囊肿的临床特点及治疗(附7例报告)

目的：探讨骶管硬膜外蛛网膜囊肿的临床特点及治疗方法。方法：本组7例，男2例，女5例，年龄28－76岁，平均44．2岁，病变全部位于S1、S2节段。临床特点：腰骶部钝痛，下肢痛与体位改变有关，膀胱功能障碍。X线检查：7例中骶骨骨质侵蚀4例，有腰骶部先天畸形2例，MRI检查：硬膜囊末端均为梭型的囊性肿物。治疗：全部采取手术摘除。结果：7例中6例得到随访5月－5年，平均3．8年，全部病人腰骶部症状缓解。结论：骶管硬膜外蛛网膜囊肿临床上少见，容易误诊，其诊断靠病史、体征及影像学检查，其治疗则采用手术摘除，疗效满意。     

AO锁定加压接骨板微创手术治疗胫骨远端粉碎性骨折

目的 探讨AO锁定加压接骨板有限切口手术治疗胫骨远端粉碎性骨折的疗效。 方法 32例胫骨远端粉碎性骨折（AO/AFIF分类 A2型8例,A3型15例,B2型2例,C1型5例,C2型2例）,采用有限切口手术复位AO锁定加压接骨板内固定治疗。 结果 28例获得随访,平均15月,骨折均获得愈合。临床愈合时间3 ~ 6个月,无出现骨筋膜综合症,无骨折畸形愈合或接骨板折弯或断裂等并发症。93%患者获得正常活动,关节功能恢复满意。 结论 AO锁定加压接骨板设计合理,固定效果良好,结合有限切口技术对骨折进行内固定符合生物学内固定要求,疗效优良。     

手术治疗外旋型三踝骨折21例

目的总结治疗外旋型三踝骨折的手术方法和治疗效果。方法21例外旋型三踝骨折患者,手术入路选用内、外侧2个切口,应用1/3管钢板和螺钉对外踝、后踝、内踝以及不稳定的下胫腓关节进行内固定治疗,采用Baird的踝关节功能评定标准对术后疗效进行评定与分析。结果21例患者中有19例获得了随访,平均随访时间11个月,骨折均愈合。优14例,良4例,可1例。本组病例术后未发生感染、骨不连、骨折畸形愈合等并发症。结论手术治疗外旋型三踝骨折可取得满意的骨折复位和临床疗效。     

锁定加压钢板治疗桡骨远端粉碎性骨折37例

目的：探讨应用锁定加压钢板（locking compression plate，LCP）治疗桡骨远端骨折的临床效果。方法：回顾性分析2002年6月至2006年2月使用LCP内固定术治疗的37例桡骨远端粉碎性骨折患者的临床资料。结果：经过平均8．5个月的随访，优31例，良4例，差2例，优良率为95％。结论：早期切开复位LCP内固定是治疗桡骨远端粉碎性骨折的理想方法。