AO微型钢板与交叉克氏针治疗掌、指骨骨折的疗效对比

目的评价AO微型钢板和克氏针治疗掌、指骨骨折的疗效。方法共评价68例88处掌、指骨骨折病例，分为AO微型钢板组（26例37处）及交叉克氏针组（42例5l处），随访3～12个月（平均5．3个月）。以TAFS评分为评价标准。结果所有病例均达骨性愈合。AO微型钢板组TAFS评分中，优良率为78．4％；而交叉克氏针组为54．9％。两者的TAFS功能评分结果差异有统计学意义（x^2=5．179，P〈0．05），前者明显优于后者。AO微型钢板组延迟愈合率为2．70％；交叉克氏针组为7．84％，前者优于后者。AO微型钢板组平均骨折愈合时间为4．5周，交叉克氏针组为7．6周，两者结果差异有统计学意义（t=2．964，P〈0．05），前者病例骨折愈合时间明显短于后者。两者术后感染率相似。结论AO微型钢板治疗掌、指骨骨折在术后关节功能恢复情况、骨折延迟愈合率及骨折愈合时间、并发症发生等指标上明显优于交叉克氏针固定，但在术后感染率上无明显差异。     

广东汉族指节纹研究

目的了解汉族指节纹的形态特点。方法粉笔—碳素墨水—透明胶带法采集指节纹,放大镜下鉴定纹型,调查分析了17～21岁广东地区420例(男210人,女210人)汉族的指节纹。结果汉族指节纹以钩型(39.98%)最多;其次是弓型(20.97%)和直线型(15.07%)。分析了纹型在各指分布特点,比较了不同民族和不同人种间的差异,并对差异的可能原因进行了讨论。结论指节纹是皮纹学的有效参数,对深入进行体质人类学和医学遗传学研究有重要意义。     

Clinical and radiological findings in Schinzel–Giedion syndrome

The absence of a definitive genetic test for the autosomal recessive condition Schinzel–Giedion syndrome is a significant handicap to the recognition of this disorder. Radiological features have been an important aspect of many of the published cases. In a series of six cases, we now establish a consistency among many of the radiological features in affected cases which will be an important diagnostic aid in identifying future cases. This is confirmed by reference to an extensive review of previously published instances of the syndrome. Moreover, the clinical data, including previously unpublished photographs, which we detail from our patients will assist in enhanced diagnosis in the future.     

Age and menopause-related changes in phalangeal bone density of Japanese women, measured by a digital image processing method

The bone density (BD), phalangeal index (PLI), and metacarpal index (MCI) of the proximal phalangeal and metacarpal bones of the index finger of the nondominant hand were measured, using a digital image processing (DIP) method, in a total of 345 normal Japanese women. In this study, two different locations were measured and the BD, PLI, and MCI decreased significantly after the age of 50 years (P < 0.01 vs values for women in their third decade). The BD, PLI, and MCI of the proximal phalangeal and metacarpal bones showed a significant decrease in postmenopausal groups compared with the pre-menopause group (P < 0.01), which indicated that not only trabecular bone but also cortical bone had an accelerative bone loss in the postmenopausal women. The BD in proximal phalangeal and metacarpal bones decreased by 0.69% and 0.74% / per year, respectively, and there were no significant differences between these annual decreases. The BD of proximal phalangeal bone had a good correlation with that of the metacarpal bone (r = 0.77; P < 0.01), which suggested that the measurement of proximal phalangeal BD was as useful as the measurement of metacarpal BD in screening for osteoporosis (coefficient of variation; CV, 0.64%). The data suggest that DIP has a potential application in screening for osteoporosis. Received: October 20, 1999 / Accepted: March 29, 2000     

微型钢板治疗掌指骨骨折疗效分析

目的:分析微型钢板治疗掌、指骨骨折的疗效,评价其临床应用价值。方法:采用微型钢板治疗掌、指骨骨折98例125处。结果:患者均获随访,随访时间12～18个月,平均14个月。骨折愈合时间8～16周,平均12周。伤指外观无明显成角及旋转畸形。无骨不连及畸形愈合。86例患者为优良,优良率为87.4%。结论:微型钢板固定掌、指骨骨折适应证广泛,骨折复位满意,固定牢靠,能促进早期进行功能锻炼,利于手部功能的恢复,是治疗掌骨骨折理想的方法。     

Reconstruction of distal phalangeal injuries with the reverse homodigital island flap

Reconstruction of extensive distal phalangeal defects with exposure of tendon, bone, or joint can be particularly a difficult problem. For assessment of the value of the reverse homodigital island flap patients with distal phalangeal avulsion and crush injuries who were treated from January 2005 to April 2006 were analysed retrospectively. Main outcome measurements included flap survival rate, sensory restoration, occurrence of cold intolerance, length of occupational disability, and joint mobility. Eleven patients were included in the study. Only one patient suffered from venous congestion with partial flap necrosis, requiring debridement with subsequent skin grafting. The minimum follow-up was 6 months. The static 2-point discrimination had a mean value of 9 mm. None of our patients complained of cold intolerance or residual joint contracture. All patients returned to full occupational activity within an average time period of 4.5 weeks. In conclusion, the reverse homodigital island flap is an excellent option for 1-stage reconstruction of distal phalangeal defects.     

单枚克氏针髓内穿梭法闭合复位内固定治疗儿童Ⅱ型指骨颈骨折

目的 探讨采用闭合复位单枚克氏针髓内穿梭法内固定治疗儿童Ⅱ型指骨颈骨折的临床疗效与优势.方法 以上海交通大学医学院附属上海儿童医学中心骨科2017年1月至2019年1月收治的13例采用闭合复位单枚克氏针髓内穿梭法内固定手术治疗的儿童Al-QattanⅡ型指骨颈骨折患儿为研究对象,手术指征为:骨折线位于指骨颈、伴远端骨折...