Warping of cross sections in the torsion of long bones with internal fracture fixation plates

Torsion of noncircular beams results in warping of each cross section. When noncircular cross sections are constrained to remain plane, the resulting shear stress distribution is different from what Saint Venant torsion (with warping) would predict. This has practical implications to the stress analysis of plated long bones subjected to torsional loadings. Analyses in which warping is not allowed predict incorrect stress fields in the plate and bone and overpredict the amount of stress shielding associated with fracture plate fixation.     

双头加压螺纹钉贴股骨距内固定治疗股骨颈骨折

在Ｘ光电视下采用双头加压螺纹钉贴股骨距内固定治疗新鲜股骨颈骨折４２例，随访平均２．５年，其中１６例随访３年以上，骨折愈合率９５．２％，骨折不愈合并股骨头缺血性坏死率４．７６％。认为加压螺纹钉贴股骨距内固定可使钉的受力由较大剪应力变为较大轴向力承受，减少骨折处的剪应力，并加压于骨折端能促进骨折愈合。具有操作简单、进钉准确、创伤小、固定牢靠、并发症少等优点。     

改良哈氏棒治疗胸腰段脊柱不稳定骨折

本文报告了作者研制的改良哈氏棒治疗胸腰段脊柱不稳定骨折的临床效果。１９９１年１月～１９９４年１０月，治疗２６例，伤椎椎体前缘高度从４１．９１％，恢复至９５．５７％，椎体后缘高度从８１．０３％恢复至１００％，后凸畸形（Ｃｏｂｂ氏法）从２６°恢复至５°，有５例恢复前凸８°～１０°，神经功能恢复１．８级（Ｆｒａｎｋｅｌ分级）。作者认为回复生理前凸的纵轴上纵向撑开力，更有助于胸腰段脊柱骨折的解剖复位。     

带旋髂深血管蒂髂骨瓣移植与加压螺钉治疗青壮年股骨颈骨折

本文报告了自１９８５年￣１９９５年间采用带旋髂深血管蒂髂骨瓣移植与加压螺纹钉内固定治疗青壮年囊内型股骨颈骨折２６例。随访时间平均５年５个月。结果，２６例骨折痊愈，骨折愈合率为１００％。骨折愈合时间平均４个月。仅１例骨折愈后后股骨头发生缺血坏死。股骨头缺血坏死率为４％。     

股骨颈骨折粗细双螺钉内固定生物力学研究

股骨颈骨折内固定方法繁多。本文采用一粗一细加压螺纹钉，采用先进电阻应变仪方法，对股骨颈的应力分布规律在中立、外展、内收不同位置上施加50kg荷载压力．通过电阻应变计测定一耗一细两钉所承受拉、压应力优于其它内固定形式。     

胸腰椎稳定性重建方法的改进

为了改进胸腰椎脱位的治疗方法，更好地重建脊柱稳定性，设计了一种新的脊柱固定器械，由滚花钉及连接板构成，并通过椎弓根进行的一种脊柱后路短节段固定方法，脊柱固定范围限制在两个椎体间。１９８９年～１９９５年，临床应用这种新器械矫正胸腰椎脱位１２例，经１～４年随访，畸形矫正满意，固定牢固。结果表明：该器械具有手术方法简单、固定牢固和手术创伤小等优点。认为，该项技术适用于胸腰椎稳定性的重建。     

组合式外固定器最佳拆除 时间及有关问题探讨

作者１９９２年６月－１９９４年１２月，用组合式外固定器治疗胫腓骨骨折２４例，治疗过程中应用Ｂ超直方图检测骨愈合，为固定器高速及拆除提供量化指标。固定后６周，Ｂ超直方图值达到健侧５０％－６０％，拆除外固定更换夹板或行走石膏，为骨愈合创造较好力学环境，骨折在１０－１４周愈合，比通常认为需要３－５月更短。     

张力带固定与钢丝环扎治疗髌骨骨折疗效分析

使用张力带固定、钢丝环扎与丝线环扎治疗髌骨骨折共６５例，平均优良率９１．５２％，但优级疗效者张力带组是８０％，钢丝及丝线环扎组分别是５６％及５６．５％。张力带内固定术后不需石膏外固定，利于膝关节早期功能锻炼与康复，疗效明显优于其它两种疗效（ｐ＜０．０５），但术中操作要求准确细致。与钢丝环扎相比，丝线环扎荷包缝合具有可避免取出内固定的第二次手术的优点，两组疗效相似。     

The use of frame fixation in the management of open distal extensor mechanism avulsion fracture in a dislocated knee

An avulsion fracture of the tibial tubercle is a common injury in traffic accident. If the fracture is closed, then a comparatively good prognosis can be expected through reinforcement of the bone via osteosynthesis and the use of artificial ligaments. In this case, an open wound was observed in the tibial tubercle, and the wound was so polluted that the healing process was significantly delayed. It was therefore difficult to provide simultaneous surgical treatment and so three operations were required to perform the reconstruction of the extensor mechanism. The reconstruction of extensor mechanism and the frame fixation between the patella and tibia was performed. Six months after the injury, the patient was able to walk without aid, had a range of movement from 5°to 130°, and did not show any indications of ADL disorder. Using this method of frame fixation between the patella and tibia proved to be an effective technique for the reconstruction of the open knee extension mechanism injury.     

有限内固定结合石膏外固定治疗桡骨远端粉碎性骨折

1996年8月—2000年12月，我院采用有限内固定结合石膏外固定治疗桡骨远端粉碎性骨折36例，经随访观察，效果满意，现总结报告如下。