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1.
目的:通过对成人股骨远端解剖学参数测量及股骨骨髓腔观测,为扁弧形长针的设计及治疗股骨远端骨折提供形态学基础.方法:选用成人干燥股骨60根,平均分为2组,一组测量股骨长度、内外侧髁、内外上髁等有关数据,另一组测量股骨的密质厚度、髓腔内径及髓腔狭窄区、最远端断面皮质骨侧缘切线与中轴线所形成的夹角,并对测量结果进行统计分析.结果:股骨内侧髁宽度为(47.41±3.44)mm;股骨外侧髁宽度为(33.77±4.79)mm;股骨髁干角96.32°±2.30°;远端松质骨的长度为(50.00±7.90)mm;股骨干长度为(382±8.00)mm.成人股骨髓腔形态复杂,近远端呈漏斗状,而中间非松质骨部呈类柱体,中上段1/3部位最为狭窄,远端呈冠状面宽,而非松质骨部呈矢状面宽,且股骨髓腔具有一向前弧度.结论:股骨远端解剖学参数和股骨髓腔形态特点为扁弧形长针的设计研制和临床应用提供了解剖学依据;扁弧形长针其形态结构特点与髓腔顺应性好,可有效抗分离移位、抗旋转,操作简单,成本低廉,是治疗股骨远端骨折的有效内固定器械之一.  相似文献   

2.
目的:比较弹力内锁髓内钉与交锁钉固定股骨中下段骨折的生物力学性能.方法:用8根新鲜成人股骨标本,制成股骨中下2/5骨折模型,分别用弹力内锁髓内钉、国产交锁髓内钉、梅花钉和钢板内固定,对内固定后的标本进抗扭转测试,用spss统计软件对实验数据进行分析.结果:弹力内锁钉在5 Nm扭矩下抗旋转刚度接近交锁髓内钉.结论:弹力内锁钉在冶疗股骨中下段骨折中固定可靠,符合生物力学要求.该器械结构合理,简单实用,有一定的临床价值.  相似文献   

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胫骨骨髓腔的X线解剖及临床意义   总被引:3,自引:1,他引:2  
目的研究胫骨骨髓腔解剖特征,为临床应用提供形态学基础。方法25根成人胫骨标本摄取正侧位X线平片,并定义一系列测量参数进行测量。结果胫骨骨髓腔平均全长为(29.4±1.9)cm;髓腔狭段长度为(6.5±1.2)cm,上下开口指数分别为10.0±2.9和8.5±2.6;胫骨骨髓腔中心线向后的弧度平均为2.6°±1.4°。结论①髓内钉固定应限于胫骨狭点附近占胫骨骨髓腔全长1/5~2/5范围内的骨折;②交锁钉一期动态固定的骨折范围应限于胫骨狭段范围的骨折;③胫骨下段骨折适合逆向穿钉固定;④胫骨骨髓腔的弧度变化应成为髓内钉设计的考虑因素。  相似文献   

4.
山羊股骨解剖学观测及其骨缺损模型的建立   总被引:1,自引:0,他引:1  
目的:为骨组织工程的研究提供理想的动物模型。方法:选取20~25kg重的青山羊后肢6个,观察股骨和肱骨外形,并测量股骨长度、前曲度、髓腔近、中、远端直径。根据所得参数,研制股骨交锁髓内钉固定系统,并在8只山羊股骨上制备长2cm段状缺损模型。结果:山羊股骨外形与人相似,稍前曲。股骨长(15.1±0.86)cm;前曲度为(9±1.26)°,髓腔近、中、远端直径分别为(12.6±0.36)mm、(12.3±0.05)mm、(12.5±0.31)mm,其差异无统计意义;自行研制的交锁髓内钉长12cm,直径9mm,用于骨缺损动物模型的内固定,无一例出现断钉和内固定失效,术后24周骨缺损段仍被纤维组织充填,无骨性连接。结论:山羊股骨适于制备骨缺损和交锁髓内钉固定模型,其2cm段状骨缺损模型是研究组织工程骨较为理想的动物模型。  相似文献   

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目的 研究成人肱骨骨髓腔的解剖特征 ,为临床应用提供解剖学基础。方祛  4 0根成人肱骨标本矢状切开 ,观察髓腔形态 ,并测量一些数值。结果 髓腔似漏斗状 ;肱骨髓腔平均长 (2 7 6 4± 1 4 8)cm ;狭窄处位于髓腔中点下 10cm处。结论 行肱骨内固定时 ,应考虑肱骨髓腔长度、狭窄部和髓腔弧度 ,以免造成新的损伤。  相似文献   

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成人股骨骨髓腔影像解剖学及临床意义   总被引:8,自引:2,他引:6  
目的 :为研制新型股骨髓内固定器提供解剖学依据。方法 :将 60支成人股骨干燥标本 ,拍摄标准的X线正侧位片 ,观察髓腔的形态 ,测量皮质骨的厚度 ,髓腔的横状径 ,矢状径 ,髓腔的轴线在不同节段与皮质骨内侧缘的切线形成的夹角等。结果 :正位片示髓腔呈“哑铃状” ,自上而下 ,横状径由大 (2 0 .0±0 .3 )mm变小 (11.1± 2 .4)mm ,再由小 (11.1± 2 .4)mm变最大 (3 2 .6± 5 .2 )mm。狭窄段横状径的直方图呈正态分布 ,均数为 (10 .7± 2 .0 )mm。侧位片示髓腔中上段的轴线与中下段的轴线所形成夹角为 (172 .2±2 .2 )° ,其夹角顶端距小转子下缘的实际长度为 (12 .8± 3 .0 )cm。结论 :①髓内钉不适合股骨中下段骨折的髓内固定。②组合式分叉防旋转的髓内钉适合股骨中下段的解剖学特点和力学要求。③顺行击钉 10~ 15cm处时 ,忌用暴力 ,减慢进入速度。  相似文献   

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本文测量了30块成人股骨的长度,骨髓腔长度及内径。骨髓腔的长度为28.86±2.79cm,其最狭窄部位在股骨中段,最小径为9.86±1.20mm。股骨长度与骨髓腔长度明显相关(P(0.001),回归方程为Y=-4.0543+0.8516X,为骨外科髓内钉术提供应用解剖学数据。  相似文献   

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肱骨髓腔的形态学参数测量及临床意义   总被引:4,自引:0,他引:4  
目的 :为髓内钉的研制提供解剖学依据。方法 :分别以防腐湿肱骨 ,新鲜肱骨和干肱骨为材料 ,用牙托树脂灌铸成型后测量其内径 ;用螺旋CT测量活体肱骨髓腔内径 ,所有数据进行统计处理 ,观察各组数据的相关性关系。结果 :肱骨髓腔在中上 2 /3接近不规则圆柱体 ,自中下 1/3开始在矢状面上有一向前为 (8.8± 0 .3 )°的弧度。在桡神经沟部位的单侧骨密质最厚 (6.0± 1.5 )mm。髓腔最狭窄的部位在肱骨中下 1/3左右 ,其冠状径、矢状径在 7~ 8mm左右。分组统计结果证明 ,防腐湿肱骨的形态与新鲜肱骨无差别 ,干肱骨的形态与其他组差别显著 ,CT实测结果在大部分平面上与防腐湿肱骨及新鲜肱骨的结果无显著差别 ,与干肱骨组差别显著。结论 :肱骨髓内形状大体上接近于不规则圆柱体。  相似文献   

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目的探讨髓腔延长顺行交锁髓内钉治疗股骨远端骨折的临床疗效。方法:(1)107例成人股骨X线正、侧位片观测髓腔形态结构特点;(2)在X线片上测量估算髓内钉可达到股骨远端的最远距离,复位骨折,术中X线临测扩髓延长股骨远端髓腔至关节面上10~15mm,采用髓腔延长顺行交锁髓内钉治疗股骨远端骨折12例,2例不稳定骨折髓内钉同定后均加用小钢板单侧骨皮质螺钉同定。结果:12例骨折均达解剖复位或接近解剖复位,全部愈合。结论:髓腔延长顺行交锁髓内钉治疗股骨远端骨折具有创伤小,基本不损伤膝关节,术中出血少,稳定性好,膝关节功能恢复良好,骨折愈合率高等优点,值得临床推广和应用。  相似文献   

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背景:髓外固定系统包括动力髋螺钉常用于治疗股骨转子间骨折;但在不稳定性股骨转子间骨折的患者中,髓外固定系统往往会导致骨折固定失败。髓内固定系统包括股骨近端抗旋髓内钉和联合加压交锁髓内钉系统广泛用于治疗不稳定性股骨转子间骨折。目的:比较髓外固定系统包括动力髋螺钉,股骨近端抗旋髓内钉和联合加压交锁髓内钉系统治疗股骨转子间骨折的疗效。方法:检索万方数据库、Pub Med、Embase、Medline和Cochrone library从1990年1月到2014年11月的文献。对髓外固定系统包括动力髋螺钉,股骨近端抗旋髓内钉和联合加压交锁髓内钉系统的相关文献进行筛选。结果与结论:通过对346篇文献进行筛选,共有13篇文献符合标准,其中共纳入1 271例不同类型的股骨转子间骨折患者。与髓外固定系统包括动力髋螺钉组相比,股骨近端抗旋髓内钉组和联合加压交锁髓内钉系统组患者手术时间更短,且出血量更少,但3种固定方法患者康复时间和愈后Harris评分差异无显著性意义。此外,股骨近端抗旋髓内钉和联合加压交锁髓内钉系统的疗效相似。提示与髓外固定系统包括动力髋螺钉相比,股骨近端抗旋髓内钉和联合加压交锁髓内钉系统虽可优化手术过程,但不能提升术后恢复效果。  相似文献   

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BACKGROUND: Early childhood fevers appear to protect against later allergies and asthma. What is not known is the time in which fevers exert this effect and whether the degree of temperature increase is important. OBJECTIVE: We sought to examine the relationship between the time and degree of early fevers and later allergies and asthma. METHODS: Eight hundred thirty-five children from southeast Michigan were enrolled at birth. Clinic records from their first 2 years were abstracted for episodes of fever. At age 6 to 7 years, children underwent allergy testing. We examined fevers occurring within 6-month intervals in the first 2 years of life and outcomes at age 6 to 7 years. The primary outcome measures were allergic sensitization, asthma, asthma with allergic sensitization, and asthma without allergic sensitization. RESULTS: In the unadjusted analysis each episode of fever between 7 and 12 months of age was associated with a lower odds of allergic sensitization (odds ratio [OR], 0.71; 95% CI, 0.54-0.93) and asthma with allergic sensitization (OR, 0.43; 95% CI, 0.21-0.90) at age 6 to 7 years. Likewise, every 1 degrees C increase in the maximum temperature between 7 and 12 months was associated with a lower odds of allergic sensitization (OR, 0.77; 95% CI, 0.61-0.96) and asthma with allergic sensitization (OR, 0.62; 95% CI, 0.40-0.94). After adjusting for potential confounders, each episode of fever between 7 and 12 months was associated with a lower likelihood of asthma with allergic sensitization (adjusted OR, 0.33; 95% CI, 0.11-0.94) at age 6 to 7 years. CONCLUSIONS: Both the timing and intensity of childhood fevers appear to be important factors in the development of allergies and asthma.  相似文献   

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In this study, we examined external and "alien" reinforcement (ER and AR. respectively) as a factor in social learning, and studied the combined effects of culture and reinforcement mode. A female (Experiment 1) and a male (Experiment 2) experimenters conducted experimental sessions. Both men and women, who grew up in the same culture as the experimenter, participated and performed the experimental task. A three-way interaction effect of experimenter gender, culture, and reinforcement mode was found on task performance. And the effect was more pronounced for a Japanese experimenter. A female and a male experimenters conducted Experiments 3 and 4, respectively; however participants this time were men and women who grew up in different cultures than the experimenter. Results indicated that the pattern of the subject gender and reinforcement mode interaction effect, when the experimenter was Japanese with American subjects, was exactly opposite to that when the experimenter was American. These experiments showed that AR was as effective for social learning as ER, and that the cultural backgrounds of experimenter and subject influenced AR and ER effectiveness.  相似文献   

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1. Rates of oxygen uptake and of anaerobic glycolysis were estimated in slices from the renal cortex and medulla (a) of adult rats and guinea-pigs, (b) of new-born (1-, 5- and 21-day-old) rats and of guinea-pigs of 1, 12, 21, 24 and 120 hr age.2. In the adult rat, Q(O2) values for the cortex were 12.55 +/- 0.20 (22) and for the medulla: 8.56 +/- 0.17 (22) mul./hr.mg dry weight, while in the new-born rat (24 hr old) they were 10.99 +/- 0.46 (12) and 9.33 +/- 0.18 (9) mul./hr.mg dry weight respectively.3. Values for Q(CO2) (N2) (anaerobic glycolysis) in the 14 hr old new-born rat were in the renal cortex 9.65 +/- 0.35 (5) and in the medulla 7.39 +/- 0.43 (5) mul./hr.mg dry weight; while in the adult they were 2.25 +/- 0.08 (16) and 5.76 +/- 0.14 (16) mul./hr.mg dry weight, respectively.4. In the adult guinea-pig values for Q(CO2) (N2) were of the same order as in the adult rat, though the rate of O(2) uptake was for the cortex 8.12 +/- 0.22 (12) and for the medulla 5.02 +/- 0.23 (11) mul./hr.mg dry weight.5. Though the Q(O2) values in the renal cortex and medulla were smaller in the 1 hr old new-born guinea-pig, they were already increasing in the 12 hr old neonate.6. The results are discussed in the light of enzyme changes occurring during the process of maturation of the nephron as indicated by histochemical observations.  相似文献   

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