AO钢板内固定治疗跟骨骨折

目的 探讨复杂跟骨骨折治疗方法及AO钢板内固定价值.方法 应用AO钢板治疗累及距下关节的跟骨骨折24例,术中注意关节面复位和Bohler角的恢复.结果 24例病人经12～24个月随访,按照Fernandez评定标准:24例跟骨SandersⅡ-Ⅳ型骨折病人有18足评为优良.结论 距下关节面的复位和Bohler角的恢复,牢固的内固定和术后足够长时间的负重限制是成功的关键.     

关节镜辅助下钢板内固定治疗关节内跟骨骨折

[目的]探讨分析关节镜辅助下钢板内固定治疗关节内跟骨骨折的方法和疗效;[方法]对78位患者，86例累及关节面的跟骨骨折在关节镜辅助下行切开复位钢板内固定术，术后平均随访18个月（12～30个月），通过比较术前术后X线片和踝足功能的AOFAS评分对治疗效果作分析评价．[结果]86例关节内跟骨骨折术后X线示复位满意．与术前存在显著性差异（P〈0．01），AOFAS评分优良率91．86％．[结论]对于关节内跟骨骨折，采用关节镜辅助钢板内固定更加接近解剖复位，足部功能恢复满意且并发症少     

Indications and limitations of locked plating

The goal of fracture fixation is to achieve bone healing and restore the function of the injured limb in the shortest possible time without compromising safety. Newer technologies such as the locking compression plate (LCP) and its derivatives are valuable additions to the orthopaedic traumatologist's armamentarium. As with any emerging technology, the indications will be extended until a threshold is reached and the limitations of the technology are seen. It is vital that surgeons involved in fracture care are aware of when locked plating is superior to other methods and also when they should use another treatment modality.This paper reviews the use of locked plating as a fixation method. Five topics covered in this review are: a historical perspective on locked plating, general indications, specific modes and techniques, patterns of failure, and an anatomical overview of current indications for locked plating.     

有限内固定结合外固定支架治疗胫骨远端骨折

目的探讨有限内固定结合Hybrid外固定支架治疗胫骨远端骨折的疗效。方法从2003年1月～2005年7月,使用Hybird外固定支架治疗胫骨远端骨折21例,按AO分类:A1型4例;A2型5例;A3型4例;C1型2例;C2型3例;C3型3例,其中开放性骨折8例,手术采用有限切开,骨片钉固定,Hybrid外固定支架不跨踝关节固定。结果术后21例均获随访,平均随访时间12.3个月,骨折平均愈合时间7.6个月。功能评定采用Bone的踝关节活动度进行评价,优良率达76%。结论Hybrid外固定支架设计合理并能维持骨干的轴线,骨片钉能很好的固定骨折块,同时避免了软组织的并发症,可使踝关节早期活动,防止踝关节僵硬,因而是治疗胫骨远端骨折有效的方法之一。     

桡骨远端关节内骨折外固定器治疗的相关机制和原则探讨

目的 分析和探讨桡骨远端关节内骨折外固定器治疗的相关机制和原则.方法 笔者采用Orthofix外固定器和国产组合式外固定器治疗桡骨远端关节内骨折45例46肢,以齐藤英彦法对资料完整的37例38肢病例进行分型,分析其影像学表现、损伤和治疗相关机制以及特点.结果 各型复位方向和外固定腕关节位置均与致伤暴力方向相反.骨折愈合时间平均为43 d(37～62 d),平均随访时间14个月(3～56个月),按Dienst标准评估腕关节功能及疗效:优21例22肢,良10例10肢,可6例6肢.结论 闭合复位外固定能很好地解决桡骨远端关节内骨折的治疗问题,特别适用于粉碎型关节内骨折.其治疗原则是复位方向及腕关节外固定位置与损伤机制、移位情形相反,个别骨折块辅以切开复位时须强调有限切开,必须重视部分病例伴有的同侧桡骨中远段骨折和同侧尺骨远段骨折的处理.     

Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures

Abstract Surgical treatment of proximal humeral fractures still remains a challenge. This is primarily due to the fact that sufficient implant fixation in humeral head fractures is often not achieved due to substantial bone tissue loss with increasing age. In the last few years the locking plates and locking nails have been introduced into clinical practice with varying results. The biomechanical studies have focused on locking plate osteosynthesis as well. The following paper focuses on bone quality, biomechanical studies and biology of proper osteosynthesis and reviews the most recent literature.     

颈椎后路螺钉-钛棒(板)内固定技术:初步临床报告

目的 报告利用螺钉-钛棒（板）固定技术治疗各种原因引起的颈椎不稳的初步临床结果。方法 作者1年来行颈椎后路螺钉-钛棒（板）技术内固定9例，其中齿突样骨引起的C1～C2不稳2例，手术后进行性颈椎后凸2例，颈椎管狭窄2例，C3-C4滑脱1例，C6～C7外伤滑脱2例。分别采用C1侧块、C2椎弓根螺钉、C3～C5侧块螺钉、C2-T2椎弓根螺钉植入技术，然后连接钛棒或钛板完成固定。9例病人共植入螺钉59枚。结果 所有病人在1周内带外支架进行活动，除1例因拒绝治疗死亡外，其余病人在1个月及1年后复查均未见内固定物移位。结论 颈椎后路螺钉-钛棒（板）固定为安全可靠的技术，可以术后即刻获得牢固内固定，为下一步治疗创造有利条件。     

管碟法测定Nisin效价

对管碟法测定Nisin效价的条件进行了研究,考察了几个参数的影响,得出了Nisin测定的最佳条件:90mm培养皿中培养基加量为15mL,Na2HPO4·12H2O质量浓度1g/dL,菌悬液浓度109CFU/mL,琼脂质量浓度1g/dL,培养基pH值7.0,牛津杯中样品加液量100μL.在此条件下,Nisin效价在5～100IU/mL,其对数值与抑菌圈直径有较好的线性关系.     

Correction of camptodactyly with an external fixator

Camptodactyly is a flexion deformity of the proximal interphalangeal joint. Because of unsatisfactory results, treatment is not recommended for mild deformities, and in severe deformities surgery has been disappointing. A specially designed external fixator providing gradual distraction was used in a severe case. With this mildly aggressive method, an acceptable result was obtained. Received: 5 June 1997/Accepted: 2 February 1998