暂时性异位断足寄养再回植术

目的：报道2例采用暂时性异位寄养再植技术，挽救无一期再植条件的新足及在特殊条件下的断足再植方法，方法，对无一期再植条件的2例断足，采用暂时异位寄养的方法，分别植于健侧小腿下段，分别利用胫后动脉和大隐静脉作为受区血管，维持断足存活，待全身状态平稳和离断肢体近端条件允许时，再将断足自寄养部位二期回植于原来的解剖位置。结果：2例断足完体成活。经4－6个月随访，受伤的下肢恢复正常长度，足底感受恢复，能下地行走。结论：暂时性异位寄养再植技术为挽救特殊条件下的离断肢体提供了一种新的选择，特殊条件下的断足和小腿下段的离断是暂时性异位寄养断肢再植术的理想病例。     

Baumann角测定在儿童肱骨髁上骨折的应用

肱骨髁上骨折系指肱骨远端内外骨髁上方2～3cm骨折。是儿童骨折中比较常见的疾病。而肘内翻畸形也称“枪托（Gunstock）畸形”．是其最常发生的远期并发症．献报道其平均发生率为30％．高达57％。自2001年5月至2005年5月共收治儿童肱骨髁上骨折96例．应用Baumann角（简称B角）与提携角（简称C角）的负相关性进行临床指导．取得一定的临床疗效。现总结如下。     

应用电刺激结合康复训练治疗足内翻、下垂临床观察

在脑卒中恢复期患者的康复训练中，常因患侧下肢痉挛、足下垂、足内翻等畸形，影响患者的进一步康复。我科运用电脑中频治疗仪作用于偏瘫下肢局部，增加其拮抗肌力量，同时结合偏瘫康复训练对上述患者进行治疗，取得了良好的疗效。     

综合治疗糖尿病足40例临床观察

目的探讨综合治疗糖尿病足的疗效。方法对40例糖尿病足采用中西医、内外科相结合的综合治疗,总结其疗效,并对不同级别糖尿病足疗效进行分析。结果40例糖尿病足经综合治疗后,治愈率42.5％,总有效率70％,级别越低,治愈率、总有效率越高。结论综合治疗疗效显著,对糖尿病足应做到早发现、早诊断、早治疗。     

小腿外侧皮瓣顺行及逆行转位的经验与教训

1984年以来,我院应用腓动脉为血管蒂的小腿外侧皮瓣顺行或逆行转位修复小腿及足部皮肤缺损共8例,成功7例,失败1例。现将经验教训介绍如下。     

复杂中足损伤的临床治疗

Objective To evaluate the features and key points of clinical treatment of the complex midfoot injury retrospectively.Methods Twenty-two cases of complex midfoot injury were admitted to our hospital from June 2003 to June 2008, including 8 cases of open fracture and 5 cases of complicated soft tissue defects.Thirteen were emergency cases and the other 9 chronic ones were referred from other hospitals.In the emergency cases, only 1 underwent arthrodesis of the navicular and middle and lateral cuneiform and the others had reduction and internal fixation.In the referred cases, 2 received talar-navicular arthrodesis, 3 Lisfranc arthrndesis (accompanied by distal hallux amputation in 1), 1 navicular-cuneiform arthrudesis and 1 Chopart arthrndesis, 1 medial column amputation and 1 lateral column reconstruction.In the cases of soft tissue defects, 4 underwent free serratus anterior transfer, and 1 had transfer of distally-based sural fas-eio-cutaneous flap.The American Orthopaedic Foot & Ankle Society (AOFAS) scoring was used to evaluate the results.Results All the patients were followed up for 5 to 44 (average, 17.5) months.The main sequelae of the emergency cases were pain after long time waking, which was relieved following local injection of steroid and NIADs in 2 cases.Of the referred cases, pain and fatigue after walking were reported in 2, callus and pain under the 4th and 5th metatarsal heads in 2, and the whole foot rigidity and atrophy of the intrinsic muscle with severe pain while walking in 1.The case of medial column amputation developed medial arch collapse and valgus of hind foot.The mean AOFAS score for the emergency cases was 80.3± 8.7 and for the chronic ones was 60.1±16.3.Conclusion For complex midfoot injury, good results can only be obtained by early operation, anatomic reduction and stable fixation on the basis of enough understanding of the functional anatomy and traumatic pathology.     

吃药您喝足水了吗

张大爷患有多种慢性病，经常需要服用药物进行治疗，有时，他图省事，将药片放在口中后，不喝水或仅喝一口水，用力一咽，算是服完了药。其实，这种服药方式是不可取的。     

小儿肱骨髁上骨折治疗的探讨(附94例分析)

对94例小儿肱骨髁上骨折分别给予石膏托固定、手法复位加石膏托固定、皮牵引后手法复位加石膏托固定和手术切开复位加克氏针内固定加石膏托固定治疗,随访61例,总优良率为62.30％;发生肘内翻20例,占32.79％。本文对治疗方法的选择和肘内翻的发生原因及预防进行了讨论。     

小腿后部巨大腓动脉逆行皮瓣修复足部皮肤软组织缺损

目的 探讨小腿后部巨大腓动脉逆行皮瓣在修复足部、足远侧半大面积皮肤缺损的应用效果.方法 应用小腿后部巨大腓动脉逆行皮瓣修复11例含一个或多个跖趾关节外露的、足部大面积皮肤缺损.皮瓣设计:上界超过腓骨头平面.外侧界达腓骨前缘前2 cm,内侧界达腓肠肌内侧缘,下界达内外踝连线,以外踝上1 cm为旋转点.手术要点:解剖皮瓣时应将腓动脉在外踝上11～13 cm和5～7 cm两个肌皮支和(或)皮支带入,并包含腓肠神经、小隐静脉在内的3 cm宽筋膜蒂.结果 本组11例中10例皮瓣全部成活,1例皮瓣边缘1 cm宽区域坏死,经换药处理后愈合.结论 应用小腿后部巨大腓动脉逆行皮瓣修复足部大面积皮肤缺损,尤其是含足远侧半的皮肤缺损,皮瓣成活率高,对肢体供血影响小,血管蒂恒定,解剖容易,易于推广.     

足细胞骨架相关蛋白研究进展

近年来的研究表明足细胞在多种肾小球疾病的发生和发展过程中起着关键作用.在人类及动物模型的肾小球疾病如微小病变、局灶节段硬化、膜性肾病、糖尿病肾病和狼疮肾炎中都发现有足细胞损伤,主要表现为裂孔膜和细胞骨架的异常.