腋下型肱骨头脱位伴臂丛受压急诊治疗5例

腋下型肱骨头脱位在临床上较为少见,作者在临床中遇到5例报告如下.……     

手法整复塑形夹板固定配合跟骨牵引治疗胫骨平台骨折

胫骨平台骨折为临床常见的关节内骨折，多见于高能量创伤，治疗较棘手，并发症多。从1995-2002年，我们采用手法整复超膝关节塑形夹板固定配合跟骨牵引治疗胫骨平台骨折69例，术后辅以积极的功能锻炼，获得较满意的疗效，现总结如下。     

伸直位整复纸夹板外固定治疗第5掌骨颈骨折

自1998至2006年,采用我院传统的伸直位手法整复,纸夹板结合厚棉压垫、厚棉衬垫外固定治疗第5掌骨颈骨折30例,疗效满意,现总结报告如下。     

手法治疗非牵拉力致桡骨小头半脱位22例

自2005年6月-2006年3月,急诊收治小儿桡骨小头半脱位126例,其中22例为非牵拉力致桡骨小头半脱位,采用手法治疗疗效满意,现报告如下。1临床资料本组22例,男14例,女8例;年龄6个月～8岁,其中1～4岁17例;左侧12例,右侧10例。受伤原因:跌伤15例,压伤5例,甩手伤1例,其他1例。伤后至治     

手牵膝顶法治疗肩关节前脱位

外伤性肩关节前脱位临床上较为多见，复位方法亦很多。自2000年3月，在传统手法整复基础上，采用手牵膝顶法治疗肩关节前脱位47例，效果满意，报告如下。临床资料本组47例，男31例，女16例；年龄21～68岁，平均35岁；跌伤25例，殴伤12例，投掷伤6例，车祸伤4例。就诊时间伤后30min-5d；左侧20例，右侧27例；喙突下脱位25例，盂下脱位17例，锁骨下脱位5例，     

手法复位石膏外固定治疗Barton骨折

Barton骨折是桡骨远端背侧、掌侧缘骨折,合并腕的半脱位,是一种较少见的关节内骨折。自1998年以来对21例Barton骨折患者采用闭合手法整复、石膏夹板外固定治疗,经随访观察,疗效满意。     

腰椎间盘突出症患者腰腿痛的血循环障碍因素与推拿手法的促循环作用机制

推拿手法长期以来被广泛用于腰椎间盘突出症的治疗．但其疗效机制却不甚明了。腰椎间盘突出症最具特征性的临床症状是不同程度的腰腿痛，其发病机制主要是机械压迫、无菌性炎症刺激以及循环与营养障碍等因素导致受累神经根传导功能的障碍，其中血循环与营养障碍是腰腿痛发病的重要环节。手法治疗对患者腰腿痛的缓解与消除作用应与改善患者的血循环和营养障碍有直接或间接的关系。     

Spinal manipulation results in immediate H-reflex changes in patients with unilateral disc herniation

The aim of this clinical investigation was to determine whether the abnormal H-reflex complex present in patients with S 1 nerve root compression due to lumbosacral disc herniation is improved by single-session lumbar manipulation. Twenty-four patients with unilateral disc herniation at the L5-S1 level underwent spinal H-reflex electro-physiological evaluation. This was carried out before and after single-session lumbar manipulation in the side-lying position. Eligibility criteria for inclusion in the study were: predominant sciatica, no motor or sphincteric involvement, unilateral disc herniation at the L5-S1 level on CT or MR imaging, age between 20 and 50 years. H-reflex responses were recorded bilaterally from the gastrosoleous muscle following stimulation of tibial sensory fibers in the popliteal fossa. H-reflex amplitude in millivolts (HRA) and H-reflex latency in milliseconds (HR-L) were measured from the spinal reflex response. Pre- and post-manipulation measurements were compared between the affected side and the healthy side. Statistical evaluation was performed by the Wilcoxon matched-pairs test (SPSS). Thirteen patients displayed abnormal H-reflex parameters prior to lumbar manipulation, indicating an S1 nerve root lesion. The mean amplitude was found to be significantly lower on the side of disc herniation than on the normal, healthy side (P = 0.0037). Following manipulation, the abnormal HR-A increased significantly on the affected side while the normal HR-A on the healthy side remained unchanged (P = 0.0045). There was a significant difference between latencies on the affected side and those on the healthy side (P = 0.003). Following manipulation there was a trend toward decreased HR-L. However, this trend did not reach statistical significance (P = 0.3877). Eight patients displayed no H-reflex abnormalities before or after manipulation. Their respective HR-A and HR-L values did not change significantly following manipulation. Three additional patients were excluded due to technical difficulties in achieving manipulation or measuring spinal reflex. These observations may lend physiological support for the clinical effects of manipulative therapy in patients with degenerative disc disease.Presented in part at EURO SPINE, Zurich, 18 October 1996, the International Conference on Spinal Manipulation, Bournemouth, 19 October 1996, and the North American Spine Society Annual Meeting, Vancouver, 25 October 1996     

肩关节脱位手法整复的流派及发展动态

肩关节脱位指的是肩肱（或称盂肱）关节脱位，临床上十分常见，肩关节脱位通常采取手法整复，疗效确切，手法整复研究也较多，笔者参阅有关文献资料，结合自己的临床体会，对国内肩关节脱位的手法整复流派和发展动态做一整理，与同仁共飨。