人工肱骨头置换治疗高龄患者肱骨头颈部骨折疗效观察

目的探讨人工肱骨头置换治疗高龄患者肱骨头颈部粉碎性骨折的可行性及疗效。方法回顾性分析2011年1月～2012年4月收治的17例高龄肱骨头颈部粉碎性骨折患者的临床资料,平均年龄70.4(65～78)岁,其中65～70岁10例,70～75岁5例,75岁以上2例。右侧13例,左侧4例,均行人工肱骨头置换。结果所有患者术后2周伤口拆线,Ⅰ期甲级愈合,无感染病例。术后17例均获得随访,时间6～12个月。17例患者术后6个月恢复生活自理,无假体松动、脱位、伤口感染及慢性疼痛等并发症发生。结论人工肱骨头置换治疗高龄肱骨头颈部粉碎性骨折能较快地恢复患肩功能,提高患者生活质量。     

肿瘤骨转移，能补钙吗

柯大夫：我阿姨患乳腺癌10年,最近一次复查CT提示肿瘤细胞已经转移到骨头了,但她自觉没什么不适,医生说肿瘤细胞侵犯骨头,可能会导致骨头变脆,引起疼痛、骨折等,这种情况下,能不能吃补钙的药物？     

盐酱骨头

杀完年猪,主妇们腌腊肉时发现一个秘密：腊肉的骨头不再坚韧无比,很多骨头用刀可以切开,煮熟之后很容易咬碎,还可以吸食骨头的有效成分。最后明白这是盐的功劳。     

Inadvertent advancement of guide wire across the knee caused by incarcerated bone fragment at the nail tip during femoral nailing

Fracture of femoral shaft in adults is common and mostly managed with intramedullary interlocking nails. Complications during closed intramedullary femoral nailing are uncommon, and mostly of them are caused by technical reasons. We describe a case of closed nailing for a femoral shaft fracture in which a jammed intramedullary guide wire, due to an incarcerated bone fragment at the nail tip, was inadvertently advanced across the knee. Forceful attempt of nail insertion caused this complication, which was probably attributed to nail design.     

微创小切口行股骨头置换治疗高龄股骨颈骨折预后分析

目的分析微创小切口行股骨头置换治疗高龄股骨颈骨折的临床效果。方法随机抽取2009年1月-2012年1月32例高龄老人股骨颈骨折患者,中男女各16例,年龄75—95岁不等,对全部患者进行股骨头置换治疗,统计治疗总有效率。结果32例患者手术均成功进行,经随访,老人患者无脏器损伤、无髋关节脱位、无感染,治疗总有效率为81．25％。结论采用微创小切口行股骨头置换方法,治疗高龄股骨颈骨折,时间短,见效快,能减少老年患者并发症,降低病死率,值得在临床中推广。     

黑骨头抗炎镇痛作用的实验研究

目的:观察黑骨头乙醇提取物的抗炎镇痛作用.方法:采用二甲苯致小鼠耳廓肿胀、醋酸致小鼠腹腔毛细血管通透性增加模型观察黑骨头的抗炎作用;采用热板法、醋酸扭体法观察黑骨头的镇痛作用.结果:黑骨头可有效提高小鼠痛阈值(P＜0.01)和抑制小鼠醋酸扭体反应率(P＜0.05);对二甲苯所致小鼠耳肿胀有显著抑制作用(P＜0.01);对醋酸所致小鼠腹腔毛细血管通透性增加也有抑制作用(P＜0.05).结论:黑骨头具有较好的抗炎、镇痛作用.     

人工肱骨头置换治疗肱骨近端骨肿瘤

目的 探讨肱骨近端骨肿瘤施行瘤段切除、人工肱骨头置换的手术适应证、疗效等.方法 8例肱骨近端骨肿瘤,其中骨巨细胞瘤3例,骨肉瘤3例,软骨肉瘤2例,均采用肩关节前上内侧入路,肱骨干近端切除均包含大、小结节,同时重建了肩外展及内收功能,术后悬吊托板外固定,保持人工肱骨头与肩胛孟较紧密接触,进行早期术后功能锻炼.结果 术后平均随访18个月,无感染、关节松动、关节脱位、假体周围骨折和上肢淋巴及静脉回流障碍等并发症.Neer评分平均为84.3分,>90分2例,80～89分4例,70～79分2例,满意率达100%.结论 人工肱骨头置换治疗肱骨上端骨肿瘤疗效较好,能达到切除肿瘤和保肢目的 .由于随访时间短,长期疗效有待观察.     

Experimental study of natural hydroxyapatite/chitosan composite on reconstructing bone defects

Objective:To study the possibility of natural hydroxyapatite/chitosan composite on repairing bone defects. Methods:We developed a natural hydroxyapatite/chitosan composite that could be molded into any desired shape. The powder component consists of natural hydroxyapatite, which is epurated from bone of pigs. The liquid component consists of malic acid and chitosan. Operations were performed on the left tibias of 15 white rabbits to create two square bone defects. One of the defects was reconstructed with the composite, while the other was not repaired and used as a blank control. Three of the animals were killed at the end of 2 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks respectively and implants were evaluated anatomically and histologically. Results:No apparent rejection reaction was found, except for a mild inflammatory infiltration observed 2 weeks after surgery. Fibrous tissue became thinner 2～8 weeks after surgery and bony connections were detected 12 weeks after surgery. The new bone was the same as the recipient bone by the 16th postoperative week. Conclusion:The hydroxyapatite/chitosan composite has good biocompatibility and osteoconduction. It is a potential repairing material for clinical application.     

肩关节后脱位1例

1 病历摘要患者,男43岁,因车祸致左肩部肿痛、活动受限4小时来诊。查体:左上肢处于伸直、内收、内旋位置,无明显方肩畸形,肩前方塌陷空虚,喙突明显突出,肩后方隆起,肩胛冈下可摸到突出的肱骨头,肩关节周围压痛,患肢无血管神经损伤征象。     

带血管蒂跖骨瓣逆行移位术的应用解剖

目的 为应用带血管蒂跖骨瓣逆行移位修复第二跖骨头缺血性缺血性坏死提供解剖学依据。方法 在３０例经动脉灌注红色乳胶的成人下肢标本和４中足部铸型标本上观测上观测第一、二跖背动脉的起源、走行、分布和吻合情况。结果 第一、二跖骨动脉均有骨膜支供养第一、二跖骨。该两动脉远端分别在第一、二跖蹼缘近侧１．５９±０．２３ｃｍ和１．６４±０．２０ｃｍ处发出趾痛动脉并向跖底发吻合支与第一、二跖底动脉构成恒定吻合。结论