河南地区正常人腰椎前后位和侧位及侧位中部区域骨密度的检测分析

目的 了解河南正常人群腰椎前后位、腰椎侧位及腰椎侧位椎体中部区域骨密度数据，为该部位骨质疏松的诊断提供正常参考值。方法 应用Hologic公司生产的4500W型双能X线骨密度仪，对河南地区居住10年以上1141名正常人作了腰椎前后位骨密度检测；960名正常人作了腰椎侧位骨密度检测，其中714人作了腰椎体侧位椎体中部区域骨密度分析。结果 腰椎前后位骨密度女性组于30－39岁达峰值；男性组于40－49岁达峰值。腰椎侧位和侧位区域骨密度不管男组和女组，均在30－39岁达峰值，峰值后随年龄增长骨密度逐渐降低；各年龄段腰椎侧位和侧位区域骨密度值男性均高于女性。结论 检测结果为该地区诊断腰椎前后位、腰椎侧位和侧位区域骨质疏松提供了正常参照值。     

腰椎侧位骨密度测量在骨质疏松症诊断中的应用

目的　为了探讨腰椎前后位、腰椎侧位测量图象的分析方法 ,以便寻找更敏感的测量部位 ,为本地区骨质疏松症的研究提供有益的参考数据。方法　本研究应用法国DMS公司生产的Challanger双能X线骨密度仪 ,对大连地区 80 1名正常人的腰椎骨密度进行了测定。在图象分析上我们探讨了腰椎侧位图象的分析方法 ,即在ROI(regionsofinterest)的划定上 ,采用了腰椎侧位全椎体和腰椎侧位中间区两种划定方法 ,侧位中间区ROI大小规定为椎体扫描图象长宽各 1 /2所围的区域。结果　男性腰椎骨峰值年龄在 2 0～ 2 9岁 ;女性腰椎骨峰值年龄在 30～ 39。无论男性还是女性 ,腰椎骨量随年龄增长而丢失增加 ,腰椎各部位骨量累计丢失率顺序为 :腰椎侧位中间区 >腰椎侧位全椎体>腰椎前后位 ,腰椎侧位中间区最敏感。结论　男性腰椎各部位骨峰值年龄在 2 0～ 2 9岁 ;女性腰椎部位骨峰值年龄在 30～ 39。腰椎侧位BMD能更敏感地反映腰椎松质骨骨量的变化 ,以侧位中间区最敏感 ,侧位测量优于前后位测量     

河南地区正常人四肢、骨盆双能X线骨密度的检测分析

为了解我国河南地区正常人骨密度的数据,作者应用美国 Ｈｏｌｏｇｉｃ 生产的双能 Ｘ 线４５００ Ｗ型骨密度仪,对４１７例正常人进行了全身和腰椎正、侧位（包括侧位区域值）检测,现就四肢和骨盆骨密度的测试结果加以分析。结果显示男性和女性均在３０～３９岁达峰值,峰值后随年龄增长骨密度均逐渐降低,但女性下降幅度明显高于男性;不管任何年龄段女性骨密度均小于男性;左上肢骨密度小于右上肢;而双下肢骨密度无显著差异。本组检测为该地区骨质疏松症的群体防治提供了有益的参考数据     

双能X线吸收法腰椎侧位骨密度测定的临床研究

目的评价双能X线吸收法测定腰椎骨密度时侧位的临床价值。方法178例女性患者(按年龄分组)接受腰椎后前位和侧位骨密度测定,以BMD表示骨密度值,以T值为标准判断骨量正常、骨量减少和骨质疏松,评价腰椎后前位与侧位T值对骨量减少程度的判断和骨质疏松诊断的差别。结果①各年龄组患者腰椎后前位BMD值均高于侧位值;②各年龄组患者腰椎后前位及侧位T值对骨量减少程度的判断有显著性差别;③当大于50岁时,腰椎后前位及侧位T值对骨质疏松诊断有显著性差别。结论腰椎侧位对女性患者骨量减少程度的判断和骨质疏松的诊断(>50岁)都有一定临床价值。     

无锡地区正常人群QCT法测定腰椎骨密度分析

目的了解无锡地区腰椎骨密度变化特点。方法采用QCT法测量626例正常人腰椎骨密度值,按5岁一个年龄组分性别进行统计学分析。结果男、女腰椎骨密度峰值均在26~30岁年龄组。男性峰值为133.42±12.69mg/cm3,女性峰值为136.88±10.69mg/cm3;50岁之前骨密度值女性高于同年龄组男性,而50岁之后女性低于男性。结论掌握了无锡地区正常人各年龄组腰椎骨密度正常数据及变化特征,为无锡地区腰椎骨密度正常值的建立和骨质疏松研究积累资料。     

合肥地区1162例正常人群骨密度的分析研究

目的 了解合肥地区正常人群骨密度的变化规律和骨质疏松的患病率.方法 采用美国Lunar公司的双能x线骨密度仪对合肥地区1162名20～91岁居民进行腰椎2～4、股骨近端和前臂的骨密度测量.结果 男性腰椎骨密度峰值在30～34岁,女性腰椎骨密度峰值在25～29岁;男性股骨近端骨密度峰值在20～24岁,女性股骨近端骨密度峰值在25～29岁;男性前臂骨密度峰值在30～34岁,女性前臂骨密度峰值在35～39岁.峰值后随年龄增长而骨密度下降,女性在50～59岁出现明显加速,男性没有出现加速下降现象.合肥地区50岁以上男性骨质疏松的患病率为25.8%,女性骨质疏松的患病率为54.1%.两者之间差异有非常显著性(P<0.01).结论 合肥地区正常人群骨密度随年龄增长而降低,骨质疏松的患病率也随之增加,骨质疏松的患病率女性高于男性.     

双能X线骨密度仪测定成都市城区771例健康人骨密度结果分析

目的观察成都市城区健康人群骨密度变化规律,建立该型骨密度仪成都地区骨密度正常值,为骨质疏松诊断、防治提供参考依据。方法①采用EXPERT-XL双能X线骨密度仪(美国 LUNAR公司生产)测定成都市城区健康体检者771例,其中男性300例,女性471例,测量部位包括腰椎1～4和髋部;②按年龄、性别分别输入数据,以10岁为一年龄组,分别计算各组骨密度值,结果以x-±s表示。结果男性腰椎及股骨近端骨密度峰值出现在30～39岁,女性腰椎及股骨近端骨密度峰值出现在20～29岁,随着年龄增加,骨密度逐渐降低,男性在70岁后腰椎骨密度有反弹,而女性在50～59岁间骨密度下降迅速。结论本组健康人群骨密度数据将为成都地区骨质疏松诊断、防治提供参考依据;分析男性腰椎骨密度时应结合股骨近端骨密度;女性50岁后应注意预防、治疗骨质疏松,男性骨质疏松不容忽视。     

绝经后女性腰椎骨密度正侧位测量的比较

目的 骨质疏松症是全世界最流行的疾病之一,以老年人和绝经后妇女患此病者居多,其中由于女性绝经后雌激素缺乏造成骨质疏松症的患者日益增加.骨质疏松症是一种常见的多因素疾病,是"骨质减少"的疾病,除了骨质异常减少外,骨内微小架构变得更细.通过绝经后女性腰椎前后位骨密度测量与腰椎侧位骨密度测量的分析比较,探索更适宜的骨密度测量方法.方法 选择绝经后女性健康查体40例,年龄在48-68 岁之间,绝境年限最短1年,最长21年.采用美国HOLOGIC公司生产的DISCOVERY-W型双能X线骨密度测量仪测量,研究对象2-4腰椎前后位,2-4腰椎侧位.结果 ①腰椎侧位BMD的统计学意义明显小于腰椎前后位BMD统计学意义.②腰椎侧位T值的统计学意义明显大于腰椎前后位T值统计学意义.结论 绝经后女性腰椎侧位骨密度测量与前后位有显著性差异,其统计数字能反应骨量的变化.其中侧位T值均数为-2.865,前后位均数为-0.613,侧位T值远远大于前后位T值.对于腰椎BMD值,前后位的均数为0.91175,侧位均数为0.67230,前后位数值高于侧位.     

大连地区1112名正常人群骨密度测定结果分析

目的：为了了解大连地区正常人群骨密度的水平和特点，以便为本地区骨质疏松症的研究提供有益的参考数据。方法：本研究应用法国DMS公司生产的Challanger双能X线骨密度仪，对大连地区1112名正常人的腰椎和股骨近端骨密度进行了测定。结果：男性各部位骨峰值年龄在20－29岁；女性Ward氏区骨峰值年龄在20－29岁，其他部位骨峰值年龄在30－39岁。女性腰椎前后位、骨股近端峰值骨量大于男性相应部位的峰值骨量，腰椎各部位BMD与股骨近端BMD存在相关性（P＜0．05）。结论：男性各部位骨峰值年龄在20－29岁；女性Ward氏区骨峰值年龄在20－29岁，其他部位骨峰值年龄在30－39岁。女性腰椎前后位、股骨近端峰值骨量大于男性相应部位的峰值骨量，有显差异（P＜0．05）。采椎各部位BMD与股骨近端BMD存在相关性（P＜0．05）。但r值在0．1－0．3之间，两个部位的测量不能相互替代。     

大庆地区1096例汉族人群骨密度调查及骨质疏松发生率分析

目的 调查大庆市1096例健康汉族人群骨密度,了解该地区健康人群骨量峰值、骨密度变化的规律及骨质疏松发生率。方法 采用美国GE公司生产的Luner Prodigy Advance型骨密度仪,检测受试者腰椎和股骨颈骨密度（BMD）。将1096例检测结果按不同性别每5岁为1年龄组,应用SPSS19.0软件统计分析骨密度测量指标及骨质疏松（OP）发生率。结果 大庆市汉族男、女性人群腰椎骨密度峰值分别为1.197±0.203、1.192±0.145,股骨颈骨密度峰值分别为0.977±0.157、0.918±0.128。其峰值骨量年龄男性为45～49岁,50岁以后开始缓慢下降。其峰值骨量年龄女性为40～49岁,50岁以后开始缓慢下降。50～54岁年龄段男性骨质疏松症发生率为5.56%,女性为5.67%;55～59岁年龄段男性骨质疏松症发生率为7.32%,女性为11.51%;60～64岁年龄段男性骨质疏松症发生率为15.15%,女性为28.28%;65～69岁年龄段男性骨质疏松发生率为26.67%,女性为29.41%;70～74岁年龄段男性骨质疏松发生率为25.00%,女性为44.44%;75～79岁年龄段男性骨质疏松发生率为36.36%,女性为77.78%;80岁以上男性骨质疏松发生率为66.67%,女性为83.33%。结论 大庆市汉族人群不同年龄及同年龄组两性之间比较骨密度测定值差异显著（P<0.01）。55岁以后各年龄段女性骨质疏松发生率明显高于男性（P<0.01）。本研究报告的骨密度峰值大于沈阳地区,与合肥地区相近,略低于贵阳地区。OP发生率与合肥地区比较相近,略低于沈阳地区。     

外眦锚着术及进展

目的介绍下睑美容与重建有关的外眦锚着术(外眦成形术和外眦固定术)的方法和近年来的进展情况。方法应用计算机检索PUBMED的相关文章,并限定文章语言种类为英语。结果共收集127篇相关文献,其中25篇符合标准,纳入本文参考文献。结论外眦锚着术是预防和治疗不同原因引起的下睑错位和轻、中、重度下睑退缩的有效方法,能确保眼睑闭合、保持合适的睑裂形状。该方法即能达到美容外观,又能恢复眼睑功能,并发症少,效果满意。     

外眦锚着术及进展

目的 介绍下睑美容与重建有关的外眦锚着术（外眦成形术和外眦固定术）的方法和近年来的进展情况。方法 应用计算机检索PUBMED的相关文章，并限定文章语言种类为英语。结果 共收集127篇相关文献，其中25篇符合标准，纳入本文参考文献。结论 外眦锚着术是预防和治疗不同原因引起的下睑错位和轻、中、重度下睑退缩的有效方法，能确保眼睑闭合、保持合适的睑裂形状。该方法即能达到美容外观，又能恢复眼睑功能，并发症少，效果满意。     

Grip strength is more sensitive to changes in elbow position than isolated wrist extension strength in patients with lateral elbow tendinopathy

Study DesignThis is an observational study.IntroductionBecause isometric wrist extension minimizes the effects of other muscles, the sensitivity of wrist extension strength testing on patients with lateral elbow tendinopathy (LET) should be evaluated.Purpose of the StudyThe purpose of the study was to compare the effects of the elbow position on wrist extension and grip strength in patients with LET.MethodsPatients were screened for at least 2 of 5 clinical tests for LET. Between-day intraclass correlation coefficients (ICC_{3, 1}) for healthy individuals were examined for both grip and wrist extension strength at 0° and 90°. To compare the effects of elbow position on wrist extension strength to grip strength, a repeated measure analysis of variance was run using 2 within-group factors, test angles (0° and 90°), and the test type (wrist extension and grip).ResultsNineteen patients with LET and twenty-one healthy participants were included. The between-day intrarater reliability for both wrist extension and grip strength was excellent for the healthy subjects across the 0° and 90° positions (ICC > .95). The analysis of variance yielded a significant interaction between the type of test and the angle of testing (P = .00).DiscussionBoth wrist extension strength and grip strength are reliable between-day measures. For patients with LET, there was a significant decrease in grip strength when testing at 0° compared with 90°.ConclusionIn patients with LET, clinicians can expect wrist extension strength at 0° and 90° to be similar. Grip strength testing may be a more relevant clinical test at the initial evaluation.     

Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution

Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF of lateral humeral condyle fractures at a single institution over a period of 13 years. All cases were identified through the trauma register. Case notes and radiographs were retrieved. Fracture classification, mode of fixation, time to union, and final outcomes at the latest follow-up were reviewed. One hundred and five lateral condyle fractures were identified in 76 male and 29 female patients. Average age was 6.2 years. Ninety-two were Milch type II and 13 Milch type I. According to the Jacob’s classification, 38 were type II and 67 type III. All fractures were treated with open reduction and fixation with K-wires. Average time to radiological union was 33 days. Follow-up ranged between 2 and 8 years (average 3.2 years). Radiological hypertrophy of the lateral condyle was present in 45 cases (42 %). Three patients developed a pseudo-cubitus varus deformity. Further four patients developed a true cubitus varus. There was one case of superficial infection of the K-wires and one case of delayed union. At the latest follow-up, 96 % of the patients achieved an excellent final result and 4 % a good final result. Our results demonstrate that fracture union and excellent final outcomes can be expected in all patients using our protocol, whereby all patients with a displaced fracture are managed by ORIF with K-wire fixation, with the wires only being removed after there is evidence of radiological union. Compared to recent reports of closed reduction internal fixation, this series demonstrates good results with no complications directly relating to the open reduction technique. Level of evidence Case series, Level IV.     

外眦锚着术在下睑退缩修复中的应用

目的探讨外眦锚着术在睑袋术后并发下睑退缩修复中的应用，寻找一种理想可靠的修复方法。方法应用外眦锚着术修复下睑退缩126例（207只眼），对其中20例（33只眼）单纯施行经外眦眦固定术，以缩紧外眦腱；35例（57只眼）施行3mm睑板条外眦成形术；26例（45只眼）行经外眦眦固定术，同时行Hamra释放弓状缘和保留眶脂肪的下睑成形术；45例（72只眼）行睑板条技术，同时行Hamra术。结果术后75例（123只眼）得到6～12个月的随访，平均随防时间8个月。除1例（1只眼）较重的下睑退缩矫正不全外，其余美容外观和功能均获得满意效果。没有明显的并发症发生，仅有1例发生轻微的缝线刺激反应，在随访期间恢复正常。结论外眦锚着术在轻到中、重度的下睑退缩修复中是一项有效方法，既能达到改善眼睑外观，又能恢复眼睑功能的目的，并发症少，患者满意。     

Biomechanics of lateral plate and pedicle screw constructs in lumbar spines instrumented at two levels with laterally placed interbody cages

Background context

The lateral transpsoas approach to interbody fusion is gaining popularity because of its minimally invasive nature and resultant indirect neurologic decompression. The acute biomechanical stability of the lateral approach to interbody fusion is dependent on the type of supplemental internal fixation used. The two-hole lateral plate (LP) has been approved for clinical use for added stabilization after cage instrumentation. However, little biomechanical data exist comparing LP fixation with bilateral pedicle screw and rod (PSR) fixation.

Purpose

To biomechanically compare the acute stabilizing effects of the two-hole LP and bilateral PSR fusion constructs in lumbar spines instrumented with a lateral cage at two contiguous levels.

Study design

Biomechanical laboratory study of human cadaveric lumbar spines.

Methods

Eighteen L1–S1 cadaveric lumbar spines were instrumented with lateral cages at L3–L4 and L4–L5 after intact kinematic analysis. Specimens (n=9 each) were allocated for supplemental instrumentation with either LP or PSR. Intact versus instrumented range of motion was evaluated for all specimens by applying pure moments (±7.5 Nm) in flexion/extension, lateral bending (LB) (left+right), and axial rotation (AR) (left+right). Instrumented spines were later subjected to 500 cycles of loading in all three planes, and interbody cage translations were quantified using a nonradiographic technique.

Results

Lateral plate fixation significantly reduced ROM (p<.05) at both lumbar levels (flexion/extension: 49.5%; LB: 67.3%; AR: 48.2%) relative to the intact condition. Pedicle screw and rod fixation afforded the greatest ROM reductions (p<.05) relative to the intact condition (flexion/extension: 85.6%; LB: 91.4%; AR: 61.1%). On average, the largest interbody cage translations were measured in both fixation groups in the anterior-posterior direction during cyclic AR.

Conclusions

Based on these biomechanical findings, PSR fixation maximizes stability after lateral interbody cage placement. The nonradiographic technique served to quantify migration of implanted hardware and may be implemented as an effective laboratory tool for surgeons and engineers to better understand mechanical behavior of spinal implants.     

Arthroscopic lateral meniscectomy

Surgical Principle Partial or total arthroscopic lateral meniscectomy by triangulation. A special arthroscope is not necessary. Additional instruments are inserted through separate portals. The technique used was originally described by Gillquist [1–4] and modified based on information given by Glinz [5], Holder [6], and Klein and Schulitz [8]. Revised Version from: Operat. Orthop. Traumatol. 1 (1989), 53–61 (German Edition).     

Application of a Ni-Ti arched shape-memory connector in unstable lateral malleolus fractures: A retrospective study

Purpose

To compare the outcomes of the arched shape-memory connector (ASC) only fixation and the lateral one-third tubular plate fixation in managing unstable Type A or B lateral malleolus fractures according to the Weber (AO) classification, and to evaluate the feasibility and reliability of ASC only fixation in treating these fractures.

Proboscis Lateralis of Nose—A Case Report

Lateral proboscis is a rare craniofacial malformation characterized by a rudimentary tubular, nose-like structure located off-center from the vertical midline of the face, and occur in association with a wide spectrum of other anomalies, including heminasal aplasia spectrum,mental retardation, callosal agenesis, heminasal hypoplasia, microphthalmia, and atypical clefting syndrome. Evaluation of a patient should include CT scan examination to look for growth of facial and skull bones. Reconstruction should start at an early age. Proboscis itself is the best option for heminose formation. Cartilaginous or bony support can be planned later in the late teens. Esthetic and psychological problems are often concern of the patient and families. Here we presented a male infant of 2 months with Proboscis Lateralis. There was no e/o cleft lip or cleft palate. Staged repair was done at an early age to avoid anxiety of parents and to allow proportionate growth of nose and face.