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41.
髋臼内壁内移截骨全髋置换治疗成人髋臼发育不良的有限元分析及临床意义 总被引:5,自引:2,他引:3
目的 通过计算机辅助设计有限元分析,找寻髋臼内壁截骨的合适内移范围,为临床工作提供理论依据.方法 利用SolidWorks 2005软件,建立髋臼发育不良骨盆的三维模型,模拟髋臼内壁内移截骨术式,使髋臼内壁骨从未完全陷入盆腔内保持2 mm骨性接触处开始,逐渐内移至完全陷入盆腔内7 mm处,每隔1 mm为1个实验组,分成10个实验组.每组髋臼人为划成4个象限,分别对各组假体臼-骨界面间进行计算机模拟对比力学实验分析,测量出髋臼假体-骨界面间的Mises应力及剪切应力值,找寻出应力分布较为均匀的实验组.结果 Mises应力及剪切应力均有1个象限内的值较大,通过2次统计学分析计算,得出实验结果.结论 当髋臼内壁内移至未完全陷入盆腔内1 mm处到完全陷入盆腔内1 mm处的范围内,髋臼假体-骨界面间的应力分布均匀,最佳位置在完全陷入盆腔内1 mm处. 相似文献
42.
Rehan Gul Eric Masterson 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2005,15(2):101-104
We present our experience over 6 years with the use of uncemented total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH) with a mean follow-up of 3 years. In a 6-year period, 26 THAs were performed in 19 patients with Hartofilakidis grades 2 and 3 dislocation of the hips. Out of 19 patients, seven had bilateral dislocations. Uncemented acetabular and femoral components were used in all patients. Patients with a minimum follow-up of 1 year were included in the study. The average age at the time of surgery was 38 (range 20–69) years. Approaches used include trochanteric osteotomy in 14 (54%) patients and a lateral approach in 12 (46%) patients. In addition, subtrochanteric osteotomy was performed in four (15%) patients. A Mallory-head femoral stem was used in 15 (58%) patients; a DDH femoral stem was in nine (35%), and the S-ROM femoral prosthesis in two (8%). A Mallory head acetabular shell was used in all cases, a 22.2-mm chrome cobalt head was used in 18 (69%), and a 28-mm chrome cobalt head was used in eight (31%). The average follow-up was 3 (range 1–6) years. The Harris hip score (HHS) improved in the cohort from a mean preoperative score of 51 to a mean postoperative score of 86 (p<0.05). The mean preoperative SF36v2 score was 42 compared to postoperatively of 67(p<0.05). The complication rate was 11% with nonunion of a subtrochanteric osteotomy in one patient, dislocation in one, and trochanteric bursitis due to fracture of Dall-Miles cables in one. THA for DDH is a technically demanding procedure. This short-term follow-up of THA for DDH using uncemented implants is encouraging for arthrosis secondary to DDH. It provides better function compared to arthrodesis or excision arthroplasty, especially in young individuals. A long-term follow-up is required in order to establish the role of this management strategy. 相似文献
43.
Abstract: A pulsatile impeller assist heart and a total heart were tested as a chronic left ventricular assist device in 5 calves and an acute biventricular assist device in 4 pigs respectively, to evaluate their blood compatibility. During the left ventricular assist experiments, the indicators for hemolysis, thrombogenesis, renal dysfunction, and hepatic dysfunction were measured preoperatively, at the beginning of the pumping, 6 h postoperatively, and every following day. The results demonstrated that the impeller assist heart causes no severe blood damage nor organ dysfunction in the experiments lasting up to 11 days. In biventricular assist experiments, the number of red blood cells, white blood cells, platelets, and the he-matocrit, hemoglobin, free hemoglobin, and lactate dehy-drogenase levels were tested preoperatively at the beginning of the pumping and every 2 h postoperatively. The data remained in acceptable ranges during experiments lasting 6 h. It is confirmed that the authors' impeller assist heart and total heart have the advantages of simplicity, implantability, and pulsatility with good blood compatibility. 相似文献
44.
本文报告了4例涉及椎体及其后部结构的全椎骨肿瘤的外科治疗,介绍了全椎骨切除术的手术方法及手术注意事项。手术采用后路附件切除,上下椎体Steffee钢板内固定,前路椎体切除自体髂骨植骨融合,初步效果满意。本手术难度大、出血多、危险性高,术中采用控制性低血压,以减少出血。 相似文献
45.
46.
完全性肺静脉异位引流的手术治疗经验 总被引:15,自引:1,他引:14
为评估影响完全性肺静脉异位引流(TAPVD)手术纠治的因素,本组纳入了28例在中度低温体外循环和15例在深低温停循环下手术纠治者。结果手术死亡4例,死亡率9.3%。随访32例,2例肺静脉回流梗阻分别于术后5个月和2年3个月死亡。结论认为,TAPVD必须早期手术防止肺血管阻塞性病变;术后定期随访;改进手术方法,防止心房内补片粘连所致肺静脉回流梗阻。 相似文献
47.
48.
目的探讨人参总皂甙(GS)对不完全性脑缺血及再灌注不同时间后海马CA1区一氧化氮合酶(NOS)的影响及对神经元的保护作用.方法用双侧颈总动脉夹闭加放血的方法制成大鼠不完性脑缺血及再灌注模型,以还原烟酰胺腺嘌呤二核苷酸脱氢酶(NADPH-d)组织化学方法观察缺血及再灌注后海马CA1区NOS阳性神经元变化及GS对其的影响.结果单纯缺血组海马CA1区在缺血30min时NOS阳性细胞数最高(44.5±7.42),为假手术组2倍,再灌注2h、12h、24h、3d后逐渐下降,5d时恢复正常水平(21.12±3.50),缺血再灌注3d、5d时出现神经细胞损伤.GS能抑制缺血30min及再灌注各时程中NOS阳性神经元数量变化,并能预防缺血再灌注后迟发的神经元损害.结论GS对大鼠不完全性脑缺血及再灌注不同时程后海马CA1区NOS的异常表达有抑制作用,对神经元的保护作用. 相似文献
49.
50.
U. Böhling H. Schamberger U. Grittner J. Scholz 《Journal of orthopaedics and traumatology》2005,6(2):69-75
Abstract The objective of the study was to evaluate the precision, concordance, practicability and the early clinical outcome of the use of a computerised navigation system in a comparative study with a group of 100 patients. Two groups of 50 patients each underwent implantation of a bicondylar knee prosthesis either by means of the freehand navigation system or by means of technical instrumentation. We found that the computerised navigation system provided a higher precision than the technically instrumented implantation: 94% of the prostheses implanted with the navigation system have an alignment within a range of -3° to 3° on of the Mikulicz line. Only 46% of the patients operated by means of the technical instrumentation reached this aspired result. Furthermore, the navigation system showed smaller ranges in the deviation of the aspired alignment. The radiological and computer-modeled alignment values differed both pre- and postoperatively, but to a larger extent before surgery. The varus or valgus deviations of the axis were more distinct radiologically under the weight of the patient’s body than in the computer model. The clinical outcome examined by the use of the HSS score after a mean followup of 7 months is good in both groups, and without significant differences. On average, the duration of surgery was 13 minutes longer in the computerised navigation group. We conclude that the benefit of the computerised navigation system is represented by the high improvement of precision. Achieving early clinical results identical to those in the technical instrumentation group, we expect a reduction of aseptic loosening in the computerised navigation group. 相似文献