锁定加压接骨板治疗肱骨近端Neer四部分骨折

[目的]总结肱骨近端锁定加压接骨板(locking proximal humerus plate,LPHP)治疗肱骨近端Neer四部分骨折的临床疗效.[方法]根据Neer分型:四部分骨折21例.经肩关节前侧“7”字人路,采用LPHP固定、部分植入诱导入工骨.[结果]21例均获得13 ～22个月(平均17个月)随访.骨折均愈合,无内固定松动或断裂,无肱骨头坏死及畸形愈合.按Neer肩关节功能评分标准:优8例,良10例,可3例.[结论]LPHP治疗肱骨近端Neer四部分骨折具有固定牢靠、并发症少、疗效满意,是一种较好的固定肱骨近端骨折的内置物.     

锁定接骨板治疗肱骨近端骨折的临床疗效

目的探讨肱骨近端锁定接骨板(LPHP)治疗肱骨近端NeerⅡ、Ⅲ、Ⅳ型骨折的疗效。方法对36例肱骨近端骨折患者经肩关节前侧"7"字形切口入路,采用LPHP固定,部分植入同种异体骨。结果 36例均获得随访,时间6~18个月,骨折均愈合。无内固定松动、断裂及肱骨头缺血坏死。根据Neer肩关节评分:优8例,良20例,可8例,优良率78%。结论 LPHP治疗肱骨近端骨折固定牢固,并发症较少,疗效较满意。     

锁定钢板在肱骨近端骨折治疗中的应用（附21例报告）

[目的]探讨应用肱骨近端锁定钢板治疗肱骨近端骨折的疗效.[方法]2004年4月-2008年8月使用肱骨近端锁定钢板治疗肱骨近端骨折21例,年龄35～78岁;平均51岁.骨折按Neer分型:2部分骨折7例,3部分骨折12例,4部分骨折2例,均予肱骨近端锁定钢板内固定.[结果]21例均获随访,随诊6～24月,平均14个月.均获骨性愈合,平均愈合时间4.3个月.肩关节功能按Neer疗效评分系统评定,优14例,良5例,可2例,优良率90.5%.[结论]锁定加压钢板治疗肱骨近端骨折疗效满意,是目前治疗肱骨近端骨折较理想的内固定方法.只要重视肩袖损伤的修复,术后能早期进行功能锻炼,功能恢复良好.     

肱骨近端锁定加压钢板治疗肱骨近端骨折的疗效

[目的]观察、评价肱骨近端锁定加压钢板(locking proximal humeral plate,LPHP)治疗复杂性老年肱骨近端骨折的疗效.[方法]回顾性分析2009年12月～2011年12月41例老年肱骨近端二部分以上骨折采用骨折切开复位结合锁定钢板内固定治疗的疗效,其中男13例,女28例,年龄49 ～ 82岁(平均67.5岁).按Neer分类法:2部分骨折12例,3部分骨折22例,4部分骨折7例.[结果]41例均获随访,随访时间8～ 28个月(平均14个月),骨折均得到了愈合,随访肩关节功能按Neer功能评分标准,优13例,良21例,可4例,差3例,优良率达82.9％.有1例发生肱骨头缺血坏死,2例发生肩峰撞击综合征.[结论]锁定钢板针治疗老年性肱骨近端骨折固定可靠,并发症少,骨折愈合良好,便于早期功能锻炼,是一种有效的治疗方法.     

肱骨近端锁定接骨板治疗肱骨近端骨折的临床分析及手术技巧

目的总结和评价应用肱骨近端锁定接骨板(lockingproximalhumeralplate,LPHP)治疗肱骨近端骨折的初步临床疗效和手术技巧。方法2002年12月至2005年1月,应用AO/ASIF的LPHP治疗132例肱骨近端骨折患者,其中男性57例,女性75例;年龄18~79岁,平均58.7岁。根据Neer分类:二部分骨折74例,三部分骨折47例,四部分骨折11例。结果132例患者随访时间为3~28个月,平均15.6个月。均达到骨性愈合,平均愈合时间为9.2周。根据Neer评分,优良率为82.31%。有2例患者LPHP固定失败。结论LPHP具有固定稳定,血运破坏少等优点,在正确掌握手术技巧的前提下,是治疗肱骨近端骨折的较好方法。     

肱骨近端复杂骨折临床治疗分析

目的探讨肱骨近端锁定钢板治疗肱骨近端复杂骨折的疗效。方法应用肱骨近端锁定钢板(LPHP)治疗肱骨近端复杂骨折33例,其中3部分骨折25例,4部分骨折8例。结果本组33例患者均获得平均12个月的随访(8～18个月)。全部骨折均骨性愈合,平均愈合时间13周(10～18周)。无1例发生内固定松动、断裂。肩关节功能按照Neer评分标准评定,优良率84.85%。结论 LPHP治疗肱骨近端复杂骨折固定可靠,骨折愈合率高,可行早期功能锻炼,功能恢复良好。     

锁定钢板内固定治疗肱骨近端粉碎性骨折

目的探讨锁定钢板(LPHP)内固定治疗肱骨近端粉碎性骨折的临床疗效。方法自2010-03—2012-09应用LPHP内固定治疗肱骨近端粉碎性骨折28例。骨折按Neer分型,Ⅲ型骨折21例,Ⅳ型骨折7例;合并肩关节脱位2例。结果 28例随访8~36个月,平均20个月。肩关节功能按Neer评定标准:优15例,良10例,可3例。结论 LPHP内固定治疗肱骨近端粉碎性骨折微创、固定可靠、可早期功能锻炼、骨折愈合率高、并发症少、疗效满意,尤其适用于骨质疏松的中老年患者。     

小切口锁定加压钢板治疗老年人肱骨近端骨折

目的 探讨应用微创经皮钢板接骨术(MIPPO)、肱骨近端锁定加压钢板(LPHP)治疗肱骨近端骨折的疗效及特点.方法 2006年4月至2009年5月共收治33例闭合性肱骨近端骨折患者,男12例,女21例;年龄66 ～82岁,平均71.2岁;左侧13例,右侧20例.骨折按Neer分型:二部分骨折9例,三部分骨折13例,四部分骨折11例.患者术后3d开始行肩关节功能锻炼,行X线检查及肩关节旋转等活动度检查. 结果 所有患者术后获1～24个月(平均6.5个月)随访.骨折均获愈合,愈合时间为8～14周,平均10.2周;无骨不连、内固定松脱及感染等并发症发生.Neer肩关节功能评分平均为87.6分. 结论 应用MIPPO技术及LPHP治疗肱骨近端骨折具有创伤小、固定可靠、功能恢复好的优点,是治疗老年人肱骨近端骨折的有效方法.     

中西医结合治疗肱骨近端骨折畸形愈合

[目的]探讨中西医结合治疗肱骨近端骨折畸形愈合的临床疗效。[方法]29例肱骨近端骨折畸形愈合，其中男24例，女5例。患者平均年龄41．6岁（21—53岁）。按Neer分类法，2部分骨折20例，3部分骨折9例。所有患者均采用中西医结合治疗并作功能锻炼，采用切开复位、LPHP内固定治疗，术后使用传统中药外洗。[结果]29例均获得随诊，X线片观察骨折愈合时间9．6周（8—12周）。按照Neer评分标准，功能优23例，良4例，中2例，优良率为93．1％。[结论]对于肱骨近端骨折畸形愈合，使用LPHP具有微创、固定可靠、并发症少、骨折愈合率高等优点：中药外洗促进肩关节功能的恢复．中西医结合治疗是恢复息肩关节功能的有效方法。     

锁定加压钢板治疗肱骨近端骨折

目的 探讨肱骨近端锁定加压钢板(LPHP)治疗肱骨近端骨折的疗效.方法 对2005年2月至2009年6月经肩关节前外侧入路应用LPHP治疗且获得完整随访的52例肱骨近端骨折患者资料进行回顾性分析,其中男21例,女31例;年龄26～86岁,平均53.2岁.骨折按Neer分型:二部分骨折8例,三部分骨折30例,四部分骨折14例.其中合并骨质疏松13例,23例因骨缺损术中以自体骨或其他骨替代物植骨.结果 52例患者获6～50个月(平均18个月)随访,骨折均获愈合,愈合时间10～16周.按Neer肩关节功能评分标准:优33例,良10例,可9例,优良率为82.7%.结论 应用LPHP治疗肱骨近端骨折具有手术方法简单、微创固定可靠、并发症少、骨折愈合率高、肩关节功能恢复好等特点,是一种理想的治疗方法,尤其适用于骨质疏松患者.     

牙体牙弓颌骨阻力中心及其临床意义

牙体、牙弓及颌骨的阻力中心在正畸矫治力系统中具有重要的意义,也是正畸学领域争论较多的一个问题。Dermaut等研究表明,当力作用于物体阻力中心时,物体将发生平动,否则将发生平动和转动的复合运动。目前,国内外多数学者认为牙体、牙弓及颌骨存在阻力中心,但其位置存在争议。本文就牙体、牙弓及颌骨的阻力中心及其临床意义作一综述。     

Hazards and complications of endoscopic transurethral ureterolithotripsy and lithoextraction and means of prevention

Complications related to ureterolithotomy and ultrasonic ureterolithotripsy performed under the control of visual endoscope were analyzed in 86 ureterolithiasis patients, methods of their prevention discussed. All the aforementioned complications were distributed into three groups: inapplicability of surgery due to anatomic and functional defects of lower and upper urinary tracts, intraoperative, and postoperative complications. The commonest ones were ureteral abruption and perforation, acute pyelonephritis, temporary vesicoureteral reflux. Their control measures were considered as relative methods of treatment: immediate surgical intervention in case of ureteral abruption, renal catheterization in patients with insignificant ureteral perforation or acute pyelonephritis. Adequate ureteroscopy, careful consideration of pro- and contraindications, catheterization of renal pelvis and urinary bladder performed within 2-3 days after the surgery and adequate antibacterial therapy are the most decisive steps in the control of aforementioned complications.     

Characterisation and differentiation of chondroblastomas and chondromyxoidfibromas - presence and expression of collagen types I and II

AIM: Chondroblastomas and chondromyxoidfiibromas are rare benign skeletal neoplasms with reported overlapping histology. Aim of this study was to analyse the biochemical composition of the matrix of these tumour entities in order to further characterise the cellular phenotypes of these neoplasms using typical cell biological marker genes. METHODS: The matrix compositions of chondroblastomas and chondromyxoidfibromas were analyzed by HE-histology, histochemistry, and immunolocalization techniques. Cellular gene expression patterns were detected by mRNA in situ hybridization. RESULTS: Chondroblastomas are rich in collagen type I and show foci of an osteoid-like matrix, whereas collagen type II as a typical marker of chondrocytic differentiation was not detected in any of the specimens. Chondromyxoidfiibromas had foci of chondroid appearance with chondroblastic cellular differentiation characterised by collagen type II expression. CONCLUSION: These results characterise chondroblastomas and chondromyxoidfiibromas as skeletal neoplasms that have a different biology and which can be distinguished by matrix protein expression products: collagen type II, the typical marker of chondroblast differentiation, could only be detected in chondromyxoidfibromas, but not in chondroblastomas. Thus, both neoplasms are clearly different on the cell biological level.     

Histochemical and contractile properties of striated muscles of urethra and levator ani of dogs and sheep

AIMS: To understand their possible importance in long- and short-term control of continence, some properties of the striated muscles of the urethra and pelvic floor (levator ani) of dogs and sheep were investigated, especially fiber types and contractile characteristics. MATERIALS AND METHODS: Striated muscles of urethra and levator ani of 29 male and 6 female dogs and 11 male and 6 female sheep were removed and cut into strips. Some strips were frozen and stained for ATPase at pH 9.4 and 4.3 for fiber typing; others were set up in an organ bath to study contractile responses to nerve stimulation. RESULTS: All muscles contained both type I (slow) and type II fibers, ranging from 97% type II in female greyhound urethra to 60% in female sheep levator ani. For each muscle, there were fewer type II muscles in sheep than in dog. The diameters of the urethral fibers were about 60% of the levator ani in dogs and 34% in sheep. Contraction of the urethral muscle was faster than for levator ani and declined to about 80% of the peak, 500 msec after the beginning of stimulation at 20 Hz. The levator ani contraction rose to a steady level as long as stimulation continued. CONCLUSIONS: Both the levator ani and urethral striated muscles contain slow and fast fiber types. The levator ani muscles are capable of sustained contraction with rapid onset which will produce long-term closure of the urethra. The circular urethral muscle contraction was faster but less well maintained.