骨折面水疱的性质和对伤口愈合的反应

从临床和组织学上研究骨折水疱的性质和对伤口愈合的反应.     

急性颈椎间盘突出合并中央脊髓损伤

目的　报道急性颈椎间盘突出合并中央脊髓损伤并探讨前路减压与融合手术的作用。方法　对 2 4例急性颈椎间盘突出合并中央脊髓损伤患者作回顾性分析 ,所有病例均行前路减压与融合手术 ,随访时间 2～ 7年 ,平均 3年 8个月。并对其椎间盘突出程度及神经功能进行评价。结果　平均ASIA运动评分由 47 79± 19 6 6增至 86 46± 10 2 2 ,患者年龄与恢复率成负相关 (r =- 0 5 93,P <0 0 1) ,但脊髓受压程度与神经功能评分无显著相关性 (P >0 0 5 )。有骨折脱位者术后神经恢复比无骨折脱位者要差 (t=3 342 ,P <0 0 1)。结论　急性颈椎间盘突出是引起中央脊髓损伤的主要原因之一 ,对此类病例应行MRI检查及前路减压融合手术     

脊柱前路手术入路

脊柱外科的手术治疗可经不同的入路来完成 ,而对手术入路的选择常取决于脊柱外科医师的手术技能。脊柱前路手术已作为许多脊柱疾患的常规治疗方法而逐渐普及 ,本文就脊柱前路手术的入路及术中、术后应注意的事项进行介绍。1　枕颈部 (枕骨～颈 3)1 1　经口入路沿咽后壁正中纵行切开 ,即可显露颅底至颈 3椎体 (图 1) ,必要时还可切开悬雍垂及软腭以便向上扩大显露。用刮匙和骨膜剥离器剥离枕骨斜坡、寰椎前弓、齿状突基底部和枢椎椎体前方的软组织 ,用磨钻和咬骨钳仔细切除寰椎前弓的下 1/3～ 2 /3以使齿状突基底部得到满意显露 ,同时还应注…     

胸腰椎爆裂性骨折的生物力学

爆裂性骨折系指脊柱前、中柱在压缩载荷作用下发生的损伤 ,主要特征为椎体前方的楔形压缩 (前柱损伤 )、后方骨皮质的骨折 (中柱损伤 )及椎体后缘骨折片凸入椎管。在所有胸腰椎损伤中 ,以爆裂性骨折最为常见。胸腰椎爆裂性骨折一直是脊柱外科的研究热点之一 ,随着脊柱生物力学研究的进展及脊柱内固定技术的进步 ,对于胸腰椎爆裂性骨折的认识也发生了相应的改变。本文重点对其生物力学研究进展作一回顾。1　定义与分类1 .1　Ｄｅｎｉｓ分类1 96 3年 ,Ｈｏｌｄｓｗｏｒｔｈ首次提出了爆裂性骨折的概念 ,并将其定义为由轴向压缩暴力作用于略微…     

骨微损伤与骨重建

在生理运动范围内,一定量的重复性力学载荷可以引起骨微损伤,甚至发生骨骼的断裂。然而,骨组织可以通过某种的反馈机制进行自我修复和重建,来适应不断变化的力学环境。本文综述了骨微损伤的发生、发展和影响因素,以及与骨重建的关系和相关机制。     

Baumann角的放射学测量及其临床意义

测定了48例2～13岁正常小儿及71例肱骨髁上骨折小儿的Baumann角.结果提示Baumann角与提携角之间存在非常显著的相关性(P<0.01),骨折复位后Baumann角可用来准确地预测提携角,并有效地防止肘内翻畸形的发生.     

Back pain associated with osteoporosis

ＢａｃｋｐａｉｎａｓｓｏｃｉａｔｅｄｗｉｔｈｏｓｔｅｏｐｏｒｏｓｉｓＤａｉＬｉｙａｎｇ（戴力扬）；ＪｉａＬｉａｎｓｈｕｎ（贾连顺）（ＤｅｐａｒｔｍｅｎｔｏｆＯｒｔｈｏｐａｅｄｉｃｓ，ＣｈａｎｇｚｈｅｎｇＨｏｓｐｉｔａｌ，ＳｅｃｏｎｄＭｉｌｉｔａｒｙＭ...     

LUMBAR SPINAL STENOSIS. A REVIEW OF BIOMECHANICAL STUDIES

ObjectS. To investigate the biomechanical aspects of etiology, pathology, clinical manifestation, diagnosis and surgical treatment of the lumbar spinal stenosis. Methods. A series of biomechanical methods, such as three-dimensional finite element models, threedimensional kinematic measurement, cadeveric evaluation, and imaging assessment was applied to correlate lumbar biomechanics and lumber spinal stenosls. Surgery of lumber spinal stenosis has been improved. Results.The stresses significantly concentrate on the posterolateral part of the annulus fibrcsms of disc, the posterior surface of vertebral body, the pedlcle, the interarticularis and the beet joints. This trend is intensified by disc degeneration and lumber backward extension. Posterior elcxnent resection has a definite effect upon the biomechanical behavior of lumbar vertebrae. The improved operations proved satisfactory. Conclusion. Stress concentration in the lumber vertebrae is of importance to the etiology of degenerative lumbar spinal stenosls, and disc degeneratkm is the initial key of this process. Than these will be aggravatnd by backward extension. Functloval radiography and myelography are of assistance to the diagnosis of the lumhar spinal stenosls. For the surgcal treatment of the lumber spinal stenosis, destruction of the posterior element should be avoid as far as possible based upon the thorough decmnpression. Maintaining the lumbar spine in flexion by fusion after decorapression has been proved a useftd method. When developmental spinal stenoals is combined with disc herniation, discectoray through laminotomy is recommend for decompression.