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1.
与时俱进开拓创新努力推动中国接骨学不断发展   总被引:5,自引:2,他引:5       下载免费PDF全文
通过系统复习了AO、BO、CO三个学派的发展历程及其特点 ,从中不难发现AO和CO (即中国接骨学 )虽然都在 195 8年同步发展 ,四十多年来都在发展中不断创新不停地自我改进而日臻完善。但客观公正的现实是中国接骨学CO ,还远未做强做大 ,尤其近年来不论在基础理论还是临床研究与应用方面都呈现不同程度的滑坡萎缩 ,形势严峻令人堪忧。究其原因除体制等因素外 ,应该承认AO、BO的研制开发 ,推广经营全方位一气呵成已成规模 ,对我国骨科发展走势也颇具影响 ,越来越为人们所接受和欢迎。我们自身还有诸多消极因素也束约了CO的开拓…  相似文献   

2.
<正>中国接骨学(Chinese Osteosynthesis,CO)一词源于尚天裕教授主编的《中国接骨学》[1]。CO学派是在继承传统中医骨伤理论、技法的基础上融合现代医学、生物力学等的发展成果,也是我们今天创新发展的源泉[2]。  相似文献   

3.
中国接骨学的走势和前景   总被引:6,自引:3,他引:6       下载免费PDF全文
金鸿宾 《中国骨伤》2005,18(2):65-66
20世纪50年代,中国与欧洲的一些骨科医师几乎在同时分别向骨折治疗发起了挑战。虽然不同国度,社会及政治背景各异,但面临的共同问题是对当时或说是对传统的骨折治疗方法及其效果不满意。不论医师还是忠者都痛感骨折治疗周期太长,方法单调,就是骨折愈合后又往往遭遇到骨质疏松、关节僵硬、肌肉萎缩等所谓的“骨折病”。为了改变这种状况,  相似文献   

4.
中国接骨学,即中西医结合治疗骨折,它是以小夹板固定为特点,以手法闭合复位和功能锻炼为主要内容的一种治疗骨折的方法。中国接骨学从产生发展至今已有近半个世纪,其理论和技术均已获得长足的进展。随着现代科学技术的不断进步,如何加快中国接骨学理论和技术的创新,仍是摆在中国骨伤科医务工作者面前艰巨而又紧迫的任务。  相似文献   

5.
目的:回顾性分析中国接骨学(Chinese osteosynthesis,CO)理念指导下改良Uhl技术治疗Colles骨折的优势。方法:回顾性研究2016年1月至2021年6月采用改良Uhl闭合穿针技术治疗Colles骨折358例,符合条件的纳入120例,按照手术方法不同分为两组:闭合穿针组和切开复位组。闭合穿针组68例,采用CO接骨理念指导下改良Uhl闭合复位经皮穿针技术;切开复位组52例,采用切开复位钢板内固定技术。术后6个月比较两组腕关节改良的Sarmiento影像学评分、Gartland-Werley腕关节评分及手术时间、住院时间、治疗费用。结果:两组患者均获得6个月以上随访。两组在Sarmiento影像学评分、Gartland-Werley腕关节评分方面比较,差异无统计学意义(P>0.05)。闭合穿针组手术时间(35.88±14.11) min、住院时间(9.78±2.48) d、治疗费用(16 074.91±1 964.48)元,与切开复位组手术时间(65.48±14.26) min、住院时间(15.88±2.00) d、治疗费用(20 451.27±1 760.2...  相似文献   

6.
目的:评价中国接骨学(Chinese Osteosynthesis,CO)理论指导下按照三踝骨折独立分型揭示骨折移位规律指导手法复位,并配合外固定踝架治疗三踝骨折临床疗效。方法:回顾性分析2010年12月至2021年12月收治的118例三踝骨折患者的病例资料,其中53例采用手法复位配合外固定踝架穿针固定治疗(观察组),65例采用切开复位钢板螺钉内固定治疗(对照组)。比较两组患者在手术时间、住院天数、患肢非负重时间、骨折临床愈合时间、并发症发生率、术前及术后1个月疼痛视觉模拟评分(visual analogue scale,VAS)、术前及术后1年美国足与踝关节协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足评分之间的差异。结果:所有患者获得随访,时间14~70(35.28±14.66)个月。两组患者在手术时间、住院天数、患肢非负重时间、术后1个月VAS及骨折临床愈合时间方面比较,差异有统计学意义(P<0.05),术后1个月观察组VAS低于对照组(t=3.343,P=0.001),观察组手术时间明显短于对照组(t=9....  相似文献   

7.
现代骨伤科学发展的新路向──评尚天裕教授主编《中国接骨学》中国中医研究院基础理论研究所(100700)孟庆云,李石土在医学史上,骨伤科曾是最早的带头学科。远古时代,人类和自然斗争以及部落间的战争频繁,创伤是最多见又最危及人类生命的疾患,使得骨伤科很早...  相似文献   

8.
[目的]任何一种理论的更替都需要经过实践的检验,在骨外科发展的今天,西方骨折内固定体系日趋完善,但是其弊端也随之被提出.中医骨伤科学经过几千年的积累与沉淀,虽历经曲折,但光芒尽显,天津著名西医骨科学者,虚心学习中医应用西医研究方法,结合临床实践,总结出骨伤科学愈合新理论-中医接骨学理论,即CO理论"Chinese Osteosynthesis",本文就AO理论"Assoniation for the Study of Problem of Internal Fixation"与CO理论作一回归与分析,从而为骨折愈合内固定提供新的理论研究基础.  相似文献   

9.
目的总结应用记忆合金接骨器治疗胸骨骨折的经验。方法回顾性分析2009年1月至2012年6月收治的10例胸骨骨折患者的临床资料,其中男6例,女4例;年龄40~65岁。结果 10例患者住院时间14~30 d。1例患者因重度复合伤术后给予呼吸机辅助呼吸,其余9例术后即拔除气管内插管。所有患者术后胸痛明显缓解,呼吸改善,术后2周复查胸部X线片骨折断端无移位,无纵隔脏器损伤、纵隔感染、切口感染等发生,均痊愈出院。所有患者术后3个月复查,1例患者有轻度胸痛不适,其余患者无胸痛不适。所有患者影像学检查提示骨折对位良好,胸骨骨折均临床愈合无骨不愈合发生,接骨器无脱落松动现象。结论采用记忆合金接骨器治疗胸骨骨折,操作简单,固定稳定,并发症少,是治疗胸骨骨折的理想方法。  相似文献   

10.
天鹅记忆接骨器对长骨干骨折愈合的影响   总被引:13,自引:0,他引:13  
目的 探讨天鹅记忆接骨器(swan-like memory compressive connector,SMC)对实验性长骨干骨折愈合过程中骨力学性能、形态结构和微循环的影响。方法 56只新西兰大白兔行双侧肱骨干截骨后,随机选取一侧用SMC固定,取侧用四孔加压接骨板(dynamic compressive plate,DCP)固定。分别于术后2、4、8、12、16、20周取材,行应力遮挡试验、CT扫描和水平扭转力学测定,观察两组内固定对骨结构和力学性能的影响。另外于骨膜愈合情况。结果 各时相SMC时间延长而加重;SMC组皮质骨厚度和密度保持正常。术后4周开始,SMC组的扭转刚度大于DCP组。SMC组对骨血供的损伤较DCP组轻,从术后3d至术后4周,两组同骨外板血流量的差异均有显著性。SMC组骨外板血供术后4周即恢复正常,而DCP组8周才恢复正常。从内固定后即刻开始,SMC组髓内血流量始终大于DCP组。SMC组骨愈合速度比DCP组快,且骨折愈合局部无骨痂,也无骨质疏松。结论 SMC与DCP相比,具有材料和几何构型上的优势,对固定段骨干几乎不产生应力遮挡;且对骨折局部血供的损伤轻,有利于骨血供恢复。何构型上的优势,对固定段骨干几乎不产生应力遮挡;且对骨折局部血供的损伤轻,有利于骨血供恢复。  相似文献   

11.
Summary Since 1979, we have fixed certain fractures of the calcaneus with a GECO plate. This is a thin 0.5 mm multi-hole plate. Its value is to provide a support for the screw heads, when the lateral cortex of the calcaneus is fragmented. This is frequently the case, due to sinking of the talus which pushes out the lateral cortex which is broken in several places like an egg shell. The medial cortex on the contrary, more solid, is intact or crossed by a single fracture line. Therefore, while the transverse screws have a good hold in the medial cortex, they do not hold anything laterally, without a wide support, or a plate placed either horizontally, or perpendicular to the talus in the same direction as the trabeculae.The GECO plate fixes the plate's three trabecular beams with screws at the top of a triangle that will keep its shape, avoiding any secondary deformation of the calcaneus.193 talar fractures have been fixed with the GECO plate from May 1979 to December 1994. Out of 102 cases reviewed, after 8 months, we found 18 with normal talar movement, 17 partially diminished, 36 greatly diminished, and 31 completely stiff. Our global functional result is within the average of that of the SOFCOT symposium in 1988. Over half our cases are satisfactory: complaining at the most from pain when walking on uneven ground and of difficulties on tiptoe. 4/10 are fair, with pain after one hour walking and an inability to get on tiptoe, as well as a diminution of physical activity, 6.6% are poor.Communication presented at the S.O.T.EST-Meeting in Paris, June 9,1995  相似文献   

12.
目的 评价经皮微创钢板接骨术治疗胫骨骨折的临床疗效。方法 运用此技术治疗胫骨骨折54例。于胫骨内侧建立皮下隧道,经此隧道将钢板穿置在胫骨内侧骨膜上,骨折间接复位,低密度螺钉予以固定。结果 全部病例获随访,时间12~26个月,平均18个月,骨折愈合时间10~16周,平均12周,无骨折延迟愈合及不愈合,无感染及内固定失败等并发症。结论 微创经皮钢板接骨术符合生物学固定原则,有利于骨折的愈合。  相似文献   

13.
Magu NK  Singh R  Mittal R  Garg R  Wokhlu A  Sharma AK 《Injury》2005,36(1):110-122
Fifty-three adults sustaining intracapsular femoral neck fractures (subcapital 38 and transcervical 15) with osteoporosis were treated primarily by osteosynthesis with valgus intertrochanteric osteotomy. Final evaluation was done in 50 patients (1 patient died and 2 lost to follow up, were not considered). Union was achieved in 47 (94%) patients in an average period of 12.2 weeks (range 10-18 weeks) with 100% union at osteotomy site. An axial collapse between 2 and 14 mm was observed in 74% of patients at the fracture site. Average neck shaft angle achieved was 141 degrees . Retroversion of the femoral head was seen in 28% of patients postoperatively, but none demonstrated a further posterior tilt of proximal femoral fragment, thus preventing implant cut through. One of the four patients with avascular necrosis of the femoral head exhibited late segmental collapse between 98 and 171 weeks. Final results were excellent to good in 76% of patients (average hip score 92), fair in 18% (average Harris hip score 73) and poor in 6% (average Harris hip score 30). Deep infection in 2%, superficial infection in 4%, implant penetration into the joint in 4%, limb length discrepancy in 6% and external rotation in 68% were other complications. Primary osteosynthesis with valgus intertrochanteric osteotomy is a dependable procedure to provide stable fixation in fresh fractures of the neck of femur with osteoporosis. The potential benefit of retaining a viable biologic joint justifies the usefulness of this procedure.  相似文献   

14.
This report presents the long-term effect of plate osteosynthesis to repair a right forearm fracture in an 11-year old patient, who 6 years later requested removal of her plates because of the pain she was experiencing in the area. The 17 year-old female had developed simple bone cysts around the implanted plates for her radius and ulnar fracture. Circulatory disturbances might have a role in the development of the simple bone cysts in this case.  相似文献   

15.
Abstract In a retrospective study we analyzed the functional and radiological outcome of 30 proximal humeral fractures, treated by PHILOS-plate, a fixed-angle device. Two of them were characterized as type Neer III, 14 as type Neer IV, 5 as type Neer V and 9 as type Neer VI. There were 2 2-part, 16 3-part and 12 4-part fractures. According to the constant-score, the normalized constant-score and the UCLA-score, good to excellent results were obtained in 66.7, 76.7 and 76.7%. Twenty-six (86.7%) patients had no or mild pain. Active forward flexion and active abduction over 90° was possible in 26 (86.7%) cases. Four (13.3%) patients developed partial avascular necrosis. Screw perforation was seen in 3 (10%) cases, delayed union in 1 (3.3%) case, malunion in 1 case and a loosening of plate and screws in another one. A secondary varus displacement of 5°–35° with a mean of 7° was found in 19 (63.3%) cases. The average time to union was 75 days. Fixation with PHILOS-plate is an adequate treatment for displaced 2- to 4-part fractures. Even in dislocated or 4-part fractures or in patients over 65 years good to excellent results were seen in the majority of cases.  相似文献   

16.
微创经皮锁定加压钢板内固定治疗胫骨远端骨折   总被引:13,自引:1,他引:13  
目的探讨微创经皮锁定加压钢板内固定治疗胫骨远端骨折的效果。方法自2003年6月~2005年5月微创经皮锁定加压钢板内固定治疗胫骨远端骨折56例。按AO分类标准:A型20例,B型19例,C型17例。结果48例获得随访,平均11个月(8~21个月)。X线片显示骨折全部一期愈合,平均愈合时间为13周,均无感染、骨不连、钢板松动等并发症。按照Mazur踝关节功能评分:优38例,良6例,可4例,优良率为91.7%。结论微创经皮锁定加压钢板内固定治疗胫骨远端骨折符合生物力学固定(BO)原则,内固定牢靠,有利于骨折的愈合及软组织的修复。  相似文献   

17.

Background

Relatively few studies have addressed plate osteosynthesis for open proximal tibial fractures by now. The purpose of this study was to assess the results of minimally invasive plate osteosynthesis (MIPO) for open fractures of the proximal tibia.

Methods

Thirty-four patients with an open proximal tibial fracture were treated by MIPO. Thirty of these, who followed for over 1 year, constituted the subject of this retrospective study. According to the AO Foundation and Orthopaedic Trauma Association (AO-OTA) classification, there were 3 patients of type 41-C, 6 of type 42-A, 8 of type 42-B, and 13 of type 42-C. In terms of the Gustilo and Anderson''s open fracture grading system, 11 patients were of grade I, 6 were of grade II, and 13 were of grade III (III-A, 6; III-B, 6; III-C, 1). After thorough debridement and wound cleansing, when necessary, a soft tissue flap was placed. Primary MIPO (simultaneous plate fixation with soft tissue procedures) was performed in 18 patients, and staged MIPO (temporary external fixation followed by soft tissue procedures and subsequent conversion to plate fixation after soft tissue healing) was performed in 12 patients. Results were assessed according to the achievement and time to union, complications (including infections), and function of the knee joint using Knee Society scores. Statistical analysis was performed to identify factors influencing results.

Results

Primary union was achieved by 24 of the 30 study subjects. Early bone grafting was performed in 6 cases with a massive initial bone defect expected to result in non-union. No patient had malalignment greater than 10°. The mean Knee Society score was 88.7 at final follow-up visits, 23 patients achieved an excellent result, and 7 a good result. There were 3 superficial and 5 deep infections, but none required early implant removal. Functional results were similar for primary and staged MIPO (p = 0.113). Fracture pattern (p = 0.089) and open fracture grade (p = 0.079) were not found to influence the results.

Conclusions

If soft tissue coverage is adequately performed, MIPO could be regarded as an acceptable method for the treatment of open proximal tibial fracture.  相似文献   

18.
目的胫骨远端骨折是一种比较常见的高能量骨折,我们采用外固定支架临时复位,经皮钢板内固定治疗胫骨远端骨折,并评价其疗效。方法以2004年10月至2005年4月来我院治疗胫骨远端骨折的患者为研究对象,开放性胫骨远端骨折不在本次的研究范围之内。所有患者入院后均行择期手术,手术时先利用外固定支架复位,维持下肢力线,后通过内踝远端小切口逆行将钢板插入皮下,进行固定。关闭切口后去除外固定支架。术后要求患者早期负重锻炼。结果平均手术时间74.9min,其中外支架固定时间10.6min。钢板平均9.4孔;使用螺钉7.8枚。住院平均时间7.5d。所有患者均未出现切口感染及皮肤坏死。本组患者的随访时间为8~24个月,平均15.4个月。在32例骨折中.24例(75%)6月内骨折愈合,平均愈合时间4.7个月。5例(15.6%)骨延迟愈合,平均愈合时间为8.6个月。3例(9.4%)出现骨不连,其中2例通过髂骨植骨在植骨后6个月骨折愈合,1例未愈。8例患者出现踝关节活动受限:8例患者诉小腿前内侧钢板放置处疼痛不适。结论结合外固定支架经皮钢板固定是一种治疗胫骨远端骨折的有效且可靠的方法。  相似文献   

19.
唐佩福 《中国骨伤》2015,28(2):97-100
锁骨骨折是最常见骨折之一,占所有骨折的2.6%~12%[1-2]。在成年人,2%~5%的骨折累及锁骨,而在儿童,这一比例高达10%~15%[3-5]。在锁骨骨折中,中段骨折占所有骨折的80%[2,6-7],而内1/3、外1/3分别占锁骨骨折的5%和15%[8-11]。锁骨内1/3对深层的臂丛神经、锁骨下静脉、液静脉、肺尖部等重要器官起到保护作用,该部位骨折可合并臂丛神经损伤等严重并发症。1锁骨骨折分型目前已有很多分型方法用于描述锁骨骨折[2-3,11-13],  相似文献   

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