共查询到20条相似文献,搜索用时 31 毫秒
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患者,男,69岁,2 d前从约2 m高处坠落,左足着地后出现左下肢畸形、肿胀,于2019年4月26日入我院治疗。判断患者生命体征平稳后,摄左胫腓骨DR片显示左Pilon骨折及左跟骨骨折(图1A);CT检查显示骨折类型为左Pilon骨折,AO分型C2型,左跟骨骨折SandersⅣ型(图1B)。入院后给予左距骨骨牵引以保持左下肢稳定及力线,同时积极给予脱水消肿。13 d后肿胀消退及左下肢力线、皮肤软组织条件等均良好,行左Pilon骨折及左跟骨骨折切开复位内固定术。术后摄左踝关节DR片复查显示骨折对位对线良好,内固定在位(图1C)。出院后患者定期门诊复查,行临床及影像学评估。术后2个月,患者左下肢无负重、后部分负重到完全负重。术后3个月骨折愈合尚可,AOFAS踝-后足功能评分85分,患者的踝关节运动功能基本正常。 相似文献
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《Injury》2017,48(2):399-405
AimsThis purpose of this meta analysis was to investigate and quantify the relative risk of hip fracture in patients who have sustained a wrist fracture.MethodStudies were identified by searching Medline, Embase, Cochrane CENTRAL database and CINAHL from their inception to August 2015. Studies reporting confirmed hip fracture following wrist fracture were included.Data extraction was carried out using a modified Cochrane data collection form by two reviewers independently. Quality assessment was carried out using a modified Coleman score and the Newcastle Ottawa scale for cohort studies. An assessment of bias was performed for each study using a modified Cochrane Risk of Bias tool.A pooled relative risk(RR) was estimated with 95% CI from the RR/HRs and CIs reported in the studies.Results12 studies were included in the final meta-analysis (4 male, 8 female only). Relative risk of hip fracture following wrist fracture for women was 1.43 (CI 1.27 to 1.60). In men it was not significantly increased (RR 2.11, 95% CI: 0.93–4.85). Heterogeneity was low (I squared 0%) for both groups so a fixed effects model was used.ConclusionRisk of a subsequent hip fracture is increased for women who suffer a wrist fracture (RR 1.43).Resources and preventative measures should be targeted towards these high risk patients to prevent the catastrophic event of a hip fracture.This meta analysis confirms and quantifies the increased relative risk of hip fracture after wrist fracture in women. 相似文献
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Ruedi-Allgower Ⅲ型Pilon骨折的治疗 总被引:1,自引:1,他引:0
目的总结Ruedi-AllgowerⅢ型Pilon骨折的治疗思路和手术方法的选择。方法对29例Ruedi-All-gowerⅢ型Pilon骨折的患者,根据软组织损伤程度及骨折的不同形态分别采用钢板内固定(26例)、螺钉结合外固定支架固定(3例),合并的腓骨骨折均使用1/3管型钢板固定。结果所有患者均获得随访,时间8-36个月。根据Teeny踝关节评分标准:优9例,良12例,可5例,差3例。结论正确评估局部皮肤和软组织损伤及骨折形态,是掌握手术时机和选择正确治疗方法、获取满意疗效的基础。 相似文献
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不同固定方法治疗老年股骨转子间骨折 总被引:16,自引:2,他引:14
目的 探讨不同固定方法早期手术治疗老年股骨转子间骨折的疗效。方法 早期采用不同固定方法治疗老年股骨转子间各型骨折150例,早期锻炼,延迟负重。结果 随访140例(93.3%)。随访时间6~36个月,平均20个月。围手术期无严重并发症发生,切口无感染,骨折均愈合,骨愈合时间3~8个月,平均4.5个月。按黄公怡功能标准评定:优128例(91.4%),良9例(6.4%),可3例(2.2%)。结论 根据老年患者状况和转子间骨折类型选择不同固定方法,早期手术,合理锻炼,可有效减少各种并发症,降低病残率。 相似文献
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Hoffa fracture associated with ipsilateral femoral shaft fracture is very rare.Three cases of this rare type of injury were retrospectively reviewed.The sites of femoral shaft fractures and Hoffa fractures were documented.All femoral shaft fractures were managed with internal fixation.The rate of misdiagnosis for the Hoffa fractures was documented.Functions of the affected knees were evaluated according to the modified Hospital for Special Surgery (HSS) scores at two years follow-up.Femoral fractures were either transverse or composite in all three cases.Ipsilateral Hoffa fractures occurred at medial condyle in two cases,and lateral condyle in one case.Only one Hoffa fracture was identified preoperatively.All the femoral shaft fractures healed uneventfully.In the patient whose Hoffa fracture was correctly diagnosed,the modified HSS score was 94.In another patient,whose Hoffa fracture was treated by a second operation,the modified HSS score was 93.And in the third case,who refused additional operation for the Hoffa fracture,the modified HSS score was only 70.Conclusively femoral shaft fracture can be associated with ipsilateral Hoffa fracture,especially in motorcycle accident.This type of injury is very rare and misdiagnosis is common. 相似文献
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2003年6月~2006年8月,我科采用从腓骨小头处顺行进针治疗腓骨中上段骨折25例,取得满意效果. 相似文献
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肱骨髁上骨折的治疗方法及疗效分析 总被引:2,自引:1,他引:1
目的 探讨肱骨髁上骨折的治疗方法和疗效。方法手术治疗肱骨髁上骨折43例。肱骨远端Y型钢板固定6例,双张力带固定17例,单张力带固定20例。结果所有患者均获得随访,时间6—28(18.2±3.4)个月,肘关节功能按Morrey评定标准进行评定:优34例,良7例,差2例。结论肱骨髁上骨折应采用Y型板双张力带进行双柱固定,而双克氏针张力带内固定手术操作简单,时间短,出血少,固定可靠,如掌握恰当的适应证,其疗效与Y型板固定相近。 相似文献
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目的;探讨适合老年人股骨干骨折的手术治疗方法。方法:68例老年人股骨干骨折随机分成3组:髓内钉固定组,加压钢板固定组和外固定支架固定组,临床观察结合,X线片评定骨折愈合,延迟愈合,不愈合作为判断13组临床疗效的标准。结果:髓内钉组的骨折愈合率明显高于其他两组,外固定支架组的骨折延迟愈合率高于其他两组,加压钢板组的骨折不愈合率高于其他两组(P<0.05)。结论:髓内钉内固定治疗老年人股骨干骨折的临床疗效优于加压钢板和外固定支架。 相似文献
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胫骨平台骨折的分级与治疗方法选择 总被引:21,自引:6,他引:15
目的 探讨胫骨平台骨折手术治疗的适应证。方法 对93例治疗后随访2年以上的胫骨平台骨折患者进行回顾性分析。结果 治疗前影像学评级为Ⅰ级者共5例,均采用非手术治疗,优良率为5/5;评级为Ⅱ级者共55例,其中25例采用非手术治疗,优良率为22/25,另外30例采用手术治疗,优良率为28/30;评级为Ⅲ级者共33例,其中2例采用非手术治疗,疗效均差,另外31例采用手术治疗,优良率为23/31。治疗后影像学评级为I级者62例,优良率为62/62;Ⅱ级者28例,优良率为16/28;Ⅲ级者3例,疗效均差。结论 对影像学评级为Ⅰ级者,采用非手术治疗;对影像学评级为Ⅱ级者,根据患者的身体情况可考虑手术治疗;对影像学评级为Ⅲ级伴有韧带断裂、半月板损伤的病例均应手术治疗。螺旋CT三维成像检查及影像学评级对术前治疗方法的选择及术后疗效的评估有重要意义。 相似文献
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肱骨干投弹骨折的分型及意义 总被引:2,自引:0,他引:2
目的 探讨投弹所致肱骨干螺旋骨折的类型及其生物力学意义。方法 分析 4 6例肱骨干投弹骨折X线片 ,测量骨折部位、长度、斜面角度和骨折的螺旋弧度等形态指标。结果 4 6例肱骨干螺旋骨折均发生于中下段 ,远近段骨折线具有对称性。骨折长度均在 30mm以上 ,以 5 1~ 90mm最多 ,共 31例 (6 7 4 % )。骨折斜面角度均≤ 4 5°,其中 4 0°~ 4 5°者 4 2例 (91 3% )。骨折螺旋角度在 2 85°~ 32 6°,平均 30 5 5°(0 85个圆周 )。 4例在骨折端内侧有一螺旋蝶形骨片。结论 肱骨干投弹骨折按形态特征分为 3种类型 ,即短螺旋、长螺旋和粉碎螺旋 ,主要发生于上臂加速期 ,由扭转暴力和纵轴压缩力引起。 相似文献