氟骨症肘关节尺神经损害及畸形矫治的研究

目的 研究氟中毒对尺神经的损害及肘关节畸形矫治。方法 (1)流行病学调查；(2)手术矫治；(3）建立动物模型。结果 氟骨症患尺神经损害与非病区比较差异有显性(P＜0．01)。病人活体尺神经外膜明显增粗增厚、水肿。大鼠尺神经超微结构有明显病理改变。结论 高氟可直接损害尺神经组织，肘关节畸形矫治能改善运动功能。     

急诊创伤骨科患者术后疼痛的影响因素及个体化护理效果

目的:改进骨科创伤患者的护理方法,减轻患者术后疼痛。方法:将140例骨科患者分为观察组和对照组,观察组进行个体化护理,对照组采用常规护理,比较两组术后疼痛程度及缓解过程。结果:术后第1天起至术后第4天,观察组患者VAS评分显著低于对照组患者(P<0.05;P<0.01)。结论:对于骨科患者进行个体化护理,能够减轻术后疼痛程度。     

骨科创伤患者术后下肢深静脉血栓的因素与临床治疗

目的 探讨骨科创伤患者术后形成下肢深静脉血栓（DTV）的影响因素及临床治疗.方法 选取云南省第二人民医院急创伤中心2010年3月～2013年3月收治的下肢骨折创伤患者50例,术后发生DTV者25例为DVT组;术后未发生DVT者25例为对照组.记录所有患者的自身病因及手术相关因素以比较这些因素对DVT形成的影响.比较DTV组采用机械辅助药物治疗与综合手术治疗的效果.结果 ①DTV组患者中有高血压、糖尿病、血栓史的比例明显高于对照组,差异有统计学意义（P＜0.05）;而两组吸烟酗酒的比例比较,差异无统计学意义（P＞0.05）.②DTV组患者手术时间[（3.98 ±0.28） min]及制动时间[（8.21±1.36）min]明显长于对照组[（2.34±0.35）、（4.67±0.89）min],差异有统计学意义（P＜0.05）.③DTV组患者中机械配合药物的治疗综合效果为63.7％（7/11）,低于综合手术治疗的85.7％ （12/14）,差异有统计学意义（P＜0.05）.结论 骨科创伤患者术后形成下肢DVT的原因不仅与手术操作等外在因素有关,还跟自身带有的一些高血压、糖尿病等内在因素有关,因此需要综合治疗才能达到最佳效果.     

Surgical Technique: Medial Column Arthrodesis in Rigid Spastic Planovalgus Feet

Background  

Treatment of spastic planovalgus feet is challenging, especially in patients with severe and rigid deformities. The available techniques do provide some correction but not at the site of the deformity and sometimes the correction is lost over time. We describe a new surgical approach at the site of the deformity.     

What to Disclose? Revisiting Informed Consent

Background  

The requirement of obtaining informed consent before medical procedures is well established. With patients having greater access to information through information technology and owing to other factors, disclosure that goes beyond the traditional elements of the risks, benefits, and alternatives to an intervention is demanded from physicians.     

Better Walking Performance in Older Children With Cerebral Palsy

Background  

Children with cerebral palsy (CP) often walk with a slower speed and a higher energy cost. Their walking performance and choice of mobility method may vary in different environments. Independent mobility is important for activity and participation.     

Medical Malpractice Reform: The Role of Alternative Dispute Resolution

Background  

Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena.     

Medical Liability of the Physician in Training

Background  

Lawsuits alleging medical negligence by postgraduate physicians in training (residents) arise from treatment received by aggrieved patients at teaching hospitals. A threshold question in determining liability is whether or not the standard of care has been violated. Courts have questioned whether the proper standard governing resident physician conduct should be that of a reasonably competent generalist physician, that of a specialty physician, or whether the standard should be some subjective determination that addresses the resident level of training.     

Assessment Tools and Classification Systems Used For the Upper Extremity in Children With Cerebral Palsy

Background  

Clinicians interested in assessment and outcome measurement of upper extremity (UE) function and performance in children with cerebral palsy (CP) must choose from a wide range of tools.     

Local recurrence has only a small effect on survival in high-risk extremity osteosarcoma

Background  

Tumor enlargement after chemotherapy is considered one of the high-risk factors for local recurrence and survival in osteosarcoma. We hypothesized patients with this risk factor will have similar survival regardless of the development of local recurrence.