股骨干骨折合并同侧股骨颈骨折的临床诊治分析

目的 探讨股骨干骨折合并股骨颈骨折漏诊的原因及最佳诊治方法。方法 对18例该种骨折的诊疗方法和效果进行回顾分析。按股骨颈骨折的确诊时间分为A组(伤后3周内)，B组(伤后3周以上)。结果 A组疗效优于B组。结论 及时诊断，科学的治疗可取得良好的效果。     

新骨生胶囊治疗股骨头坏死的药理研究

目的探讨中药新骨生胶囊治疗无菌性股骨头坏死的机理。方法采用口服维甲酸致小鼠和大鼠骨质变性模型。 30只昆明小鼠分为 3组 ,未服药者作为正常组 ( 10只 ) ,模型组 ( 10只 )和治疗组 ( 10只 )均服维甲酸 ,治疗组同时服新骨生胶囊 ,观察时间为 3周。 18只Wistar大鼠分为 3组 ,未服药者为正常组 ( 6只 ) ,模型组 ( 6只 )和治疗组 ( 6只 )切除睾丸 ,并服维甲酸 ,治疗组同时服新骨生胶囊 ,观察 5周。观察小鼠自发活动变化 ,用双能X线检测大鼠的骨密度 ,并用HE染色观察病理改变。结果小鼠模型自发运动 (横向和纵向 )明显减少 (P <0 .0 1) ;模型大鼠平均骨密度、股骨重量及重量系数明显低于正常组 (P <0 .0 1)。病理切片可见股骨头关节软骨表层有缺损、骨化线紊乱、骨小梁变细 ,出现死骨。经新骨生胶囊治疗 5周后 ,治疗组与正常组相比未见显著性差异。结论新骨生胶囊具有促进骨质修复的作用     

关节镜下紧缩术治疗重度膝内侧副韧带断裂

目的 探讨关节镜下紧缩术治疗重度膝内侧副韧带断裂,并评价其临床治疗效果。方法 关节镜下探查12例膝内侧副韧带及其他主要结构的损伤,对Ⅲ度膝内侧副韧带体部断裂进行紧缩术。结果 12例患者平均随访6~30个月,Lysholm评分由术前40.0分提高到80.6分,所有患者屈膝30°外翻应力试验阴性,应力下摄X线片示双膝内侧关节间隙差异从术前9.5 mm减少至3.3 mm。结论早期关节镜下重度膝内侧副韧带断裂紧缩术,具有损伤小、早期恢复膝关节稳定性的优点。     

经股动脉插管行选择性脑血管造影

我科１９８９年８月～１９９３年１月经股动脉插管行选择性脑血管造影８２例，所摄颅内血管像均可满足临床诊断要求。介绍导管的选用、置管的具体操作，金属导丝的应用及其注意事项，提出导管意外的处理。讨论并发症的可能原因和处理。     

Effect of Guchi Gao on HGF and PDL in periodontal tissue cells

The effects of eight herbs of Guchi Gao on periodontal tissue cells were investigated. The results show that Herba Dendrobii, Radix Ophiopogonis, and two other herbs can significantly promote attachment of human gingival fibroblasts (HGF) and periodontal ligament cells (PDL) and enhance the proliferation of the latter. This may account for the effect of Guchi Gao and suggests a potential treatment for periodontitis in the future.     

髂胫束包裹碳纤维重建膝交叉韧带

我院从1982年～1992年应用髂胫束包裹碳纤维作膝交叉韧带重建18例,术后观察半年～9年,平均3.4年。随访1年以上的15例,优12例,良2例,可1例,优良率为93.3％。文中详述了手术方法并对髂胫束包裹碳纤维的优点作了讨论。     

膝关节外侧副韧带断裂——附32例手术病例分析

本文报告了我所自1966—1993年间32例手术治疗的膝外侧副韧带断裂病例。对其受伤项目、受伤机转、复合伤情况及治疗结果加以分析。结果表明:膝关节外侧副韧带损伤为较少见损伤,占膝韧带伤的2.4％,受伤项目以摔跤、柔道、足球、跳远为多见,伸直内翻伤的复合伤发生率明显高于屈曲内翻伤(p=0.02);强调了对复合伤及时、全面诊断与处理的重要性;强调了运动员膝外侧副韧带断裂手术治疗的必要性;并介绍了一种膝外侧副韧带下止点断裂前移固定于胫骨的手术方法。     

滑动加压螺纹钉的力学研究及疗效评价

对滑动加压螺纹钉（Ｒｉｃｈａｒｄｓ钉）进行了力学测试，结果显示，滑动加压螺纹钉的力学性能较可靠。３１例临床资料分析发现，滑动加压螺纹钉的临床效果理想。作者认为，滑动加压螺纹钉有动力性和静力性加压作用，它结构牢固，固定效果可靠，病人可早期下地活动，是当今治疗股骨转子间骨折比较理想的内固定物。其不足之处是无有效的抗旋转作用。     

Tibial tunnel enlargement after anterior cruciate ligament reconstruction by autogenous bone-patellar tendon-bone graft

This retrospective study was designed to evaluate changes in the diameter of the tibial tunnel over time following the reconstruction of the anterior cruciate ligament (ACL) with a bone-patellar tendon-bone autograft in 44 patients. The changes in the geometry of the bone tunnels were measured radiographically during the immediate postoperative period and at time intervals between 3 and 36 months after surgery. The dimensions at 1 year were correlated with the 1-year clinical results. The distance between the sclerotic margins of the tibial tunnel was measured at the distal tunnel exis on the medial tibial cortex, in the middle of the tunnel, and proximally at the level of the joint line. The dimensions were calculated by using a magnification factor determined by reference to the interference screw of known diameter located within the tunnel. The position of the centre of the tibial tunnel with regard to Blumensaat's line was also measured. The average tunnel diameter at the proximal tibial exit increased from 12±1.9 mm (mean ± standard deviation) postoperatively to 14±2.2 mm at 3 months. The average proximal tunnel diameter did not significantly change from 3 months to 2 years, and then decreased to 13±2.4 mm at 3 years. At 1 year, most of the patterns of osteolysis were of the cone type (57%), followed by the cavity type (40%) and line type (3%). The degree of osteolysis was not related to the tibial tunnel position with respect to Blumensaat's line. There was no correlation between the changes in tunnel diameter and either the IKDC score or the residual joint laxity measured by a KT-1000 arthrometer. The aetiology of tunnel enlargement is currently unknown. Possible factors responsible for bone resorption include micromotion of the graft relative to the tunnel wall, leading to an inflammatory response in the tunnel, or stress shielding of the tunnel wall proximal to the interference screw.     

Arthroscopic reconstruction of the anterior cruciate ligament with Leeds-Keio ligament in non-professional athletes

We report our experience using the Leeds-Keio artificial ligament for anterior cruciate ligament (ACL) reconstruction. The study relates the results of the first 40 patients subjected to arthroscopic reconstruction of the ACL with a Leeds-Keio ligament, with a mean follow-up of 73 months. No associated peripheral procedures were carried out on any patient. The average age of the patients at the time of the operation was 31 years (range 26–35 years). The rehabilitation protocol followed by all patients aimed at resumption of sport 4 months after the operation. Clinical assessment included IKDC and the Lysholm scoring scale. The KT-2000 system was used for instrumented evaluation of joint laxity. All patients underwent a radiographic check-up. Clinically there were 55% excellent or good results when using the IKDC scale, while with the Lysholm score, satisfactory results were obtained in 80%. Complete post-traumatic rupture of the ligament was observed in three patients. No patient suffered an episode of either hydrarthrosis or reactive synovitis, which indicates good tolerance to the ligament. The radiographic evaluation of the operated knees showed a close correlation between the appearance of degenerative phenomena and performance of arthroscopic meniscectomy. The results achieved with the Leeds-Keio artificial ligament 5 years after application, although not completely satisfactory and inferior to those obtained with autologous biological ligaments, should be considered an encouragement to promote new efforts in this interesting research field.