肘管综合症的神经电生理分析

目的：研究肘管综合症患者尺神经功能状态。方法：对确诊肘管综合症的患者进行尺神经运动、感觉神经传导检测，并对尺神经所支配的肌肉进行 EMG 检测。结果：50例患者尺神经传导（NCV）异常率达到94％，肌肉 EMG 总的异常率达到75％。结论：肌电图检测是判断肘管综合症患者尺神经功能状态的有效检查方法[1]。     

老年人桡骨远端C型骨折的手术治疗与非手术治疗的疗效对比

目的：探讨老年人桡骨远端C型骨折的手术治疗与非手术治疗的疗效差异，评价两种方法的优缺点。方法回顾性分析2009-12—2011-12收治的老年桡骨远端C型骨折68例，按照治疗方法分为A组(手术组)及B组(非手术组)，统计分析两组患者的临床资料。结果 A组33例， B组35例，平均随访21.5个月。两组患者的年龄、骨折类型均无差异(P＞0.05)；术后影像学指标A组优于B组，骨折愈合时间B组优于A组，治疗成本A组大于B组(P＜0.05)；Cooney评分早期A组优于B组，1年后两组无差异，两组的并发症无差异(P＞0.05)。结论老年人桡骨远端C型骨折手术治疗较非手术治疗可获得更好的复位及早期功能，但远期功能恢复无差异。     

足球致伸直型桡骨下端骨骺分离2例

桡骨下端骨折一般多见于成年及老年伤员，青少年少见，如遭受同样暴力，可发生桡骨下端骨骺分离，一般为跌伤所致，其他原因引起的骨折并不多见。我院于2001年、2005年分别门诊收治2例桡骨下端骨骺分离（伸直型）患者，均为足球外力所致，致伤暴力少见，报道如下。     

上肢

12例开放性腋动脉损伤的诊治；肩胛骨骨折的外科治疗方法探讨；锁骨钩状钢板在锁骨远端骨折和Tossy Ⅲ型肩锁关节脱位中的临床应用；钛弹力钉治疗儿童尺桡骨下1／3双骨折；经后方劈肱三头肌入路治疗肱骨干中下段骨折；Herbert螺钉治疗桡骨头骨折及文献复习；尺桡骨中段旋转截骨术治疗先天性上尺桡关节融合及并发症探讨；自增强可吸收内固定治疗儿童肘部骨折；Colles骨折合并尺骨向背侧脱位下尺桡关节损伤的临床观察     

折顶回旋法整复新鲜移位型科雷氏骨折

笔者自１９９０年８月～１９９６年５月采用折顶回旋法整复新鲜科雷氏骨折１２０例，取得良好的效果，现报告如下。临床资料１．一般资料：本组１２０例中男５２例，女６８例；年龄１５～８４岁，左侧４５例，右侧７５例；均为一周内的新鲜骨折，未合并其它损伤。２．整复方法：患者取坐位或卧位，部分患者配合臂丛神经阻滞麻醉。患者肩关节稍外展，屈肘９０°位，前臂旋前位，令一助手双手握持患者前臂近端，术者双手握住患腕，双拇指扶住移位的挠骨远端背侧，与助手作持续对抗牵引，力量逐渐加大，时间约２～３分钟，此时一般可听到骨擦音…     

Treatment of dislocation of distal radioulnar articulation by reconstruction of ulnar collateral ligament from pediculated partial ulnar flexor tendon of wrist

Background:Auricular pseudocyst,which is also calles serous perichondritis of thd auricle,is and aseptic local serous inflammatory mass in the perichondrium of the auricle.The cause is unknown,.It is difficult to the cured with a chronic course,and might transform into suppurative perichondritis because of incorrect treatment such as repeated puncture,and even necrosis occurs,resulting in deformation of the external ear.Objective:To study the therapeutic effect of magnetic application.Unit:Jianping County Hospital.Subjects:42 patients were included in this study,including 31 males,11 females aging 10 to 56 years,with unilateral attack in 38 cases,bilateral attack in 4 cases.No obvious cause was found in all of the cases.Local prominences occurred suddenly mostly at the navicular fossa,less at the triangular fossa,least in the cavity of concha.The site is felt hot and swelling with slight tenderness.The locus ranges from 0.5 cm to 1.5cm in diameter.The disease course ranges between 3 and 30 days.Interention:The intracapsular fluid was withdrawn out from the locus in all the pwatients.Two magnetic pieces of 100-170mT in intensity were chosen and fixed on both sides of the locus by wadhesive plaster with the S and N poles opposited.The magnetic pieces of the Npole were applied 24 hours a day.But the S pole should be taken off at night and 5-10 minutes every 1-2 hours in daytime.The application method must be clearly taught to the patients to avoid local ischemic change because of persistent pressure.The poles of the magnetic pieces should also be told to the pwatients lest the pwatients fixed the magnetic pieces in a contrary way.The treatment courese was 1 week but 2 weeks in patients wih larger loci.Result:All the patients were cured with no local induration,thickness,deformation,or dispigmenttation.No recurrence occurred after 3 months of telephone following up.Conclusion:The treatment of magnetic application is easily performed,safe,reliable,cheap and free of side effects with significant therapeutic effect.     

杠杆复位法治疗儿童桡骨远端畸愈性骺离骨折

自2000年至2005年,作者用杠杆复位法治疗儿童桡骨远端畸形愈合性骺离骨折36例,全部治愈,报告如下。1临床资料本组36例,皆为男性,年龄最小8岁,最大14岁,全部为伸直型。单侧30例,双侧6例。受伤至就诊时间最短10 d,最长16 d,均为二次就诊,经历过不当治疗而延误者。骨折远端都有不同程度的背桡侧移位。2治疗方法选用坚固木桌一张,自制长30cm,宽15cm,厚3cm的棉垫,按照患肢前臂放置的方位,棉垫与木桌前内侧缘平齐,向外后顺势铺平。患者取坐位,将患侧前臂放置在棉垫上,背侧朝上,掌侧桡骨远端超出桌沿3 cm。用药棉叠制一长6 cm,宽3 cm,厚1cm的压垫,…     

儿童"浮肘"损伤15例治疗体会

目的：为了提高对儿童“浮肘”损伤(肱骨髁上骨折伴同侧尺桡骨远端骨折)的认识，并有助于在临床中选择适当的治疗方法。方法：对15例儿童“浮肘”损伤的3种治疗方法进行了较为详细的总结。结果：发现尺骨鹰嘴牵引加手法复位、小夹板固定治疗方法对预防和减小后期肘内翻发生的几率和程度，以及肘、腕关节功能的恢复有着较好的效果。     

尺神经损伤术后34例随访分析

采用显微外科技术治疗单纯尺神经损伤64例,随访2年以上者34例,优良率达79.4%。作者认为,早期进行准确的神经修复是提高神经恢复优良率的关键。并尽可能同时修复合并的肌腱与尺动脉损伤。畸形严重者宜行相应的功能重建术。     

牵引式夹板治疗Barton骨折43例

我院自2002年3月至2008年1月采用牵引式夹板治疗Barton骨折43例，取得较好疗效，现报告如下。