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61.
62.
Anterior Cruciate Ligament Reconstruction:
State of the Art 总被引:2,自引:0,他引:2
Abstract The rupture of the Anterior cruciate ligament (ACL)
belongs to the most common ligament injuries of the
human knee joint. ACL rupture results in an increased
anterior translation and internal rotation of the tibia.
Untreated knee instability causes a disintegration of
the roll and sliding movement and a high incidence of
secondary meniscus and chondral damages with consecutive
or advanced arthritic changes.
For deciding on a conservative or operative therapy, it is
necessary to develop a high-risk profile. Elderly, inactive
patients without instability symptoms can be treated
conservatively; younger, active people and complex
ligament injuries should receive an ACL replacement.
The goal is to eliminate instability by maintaining the
physiological kinematics of the knee.
Anterior cruciate ligament may be reconstructed
arthroscopically assisted by autologous tendons. Predominantly,
hamstring- and bone-patellar-tendon
grafts are used. No significant differences in knee laxity,
clinically and functionally, were observed between
both grafts. Various reconstruction techniques, single-
or double-bundle techniques, were described. Successful
replacement depends on a correct tunnel placement
and reconstruction of the physiological band
tension, a sufficient mechanical stability of fixation, an
impingement-free range of motion and an adequate
rehabilitation.
A high degree of patient satisfaction in clinical and
functional outcome could be evaluated. 相似文献
63.
本文通过免疫荧光(IF)和电镜(EM)技术对新疆出血热(XHF)及流行性出血热(EHF)病毒的生物学特性在Vero E_6及LLC-MK_2两株传代细胞上进行了比较。两种病毒感染两株细胞后免疫荧光染色有两种不同的荧光形态特征,两种病毒对细胞的敏感性明显不同,XHF病毒在LLC-MK_2细胞上感染后6~8天可出现明显的细胞病变,而EHF病毒感染此细胞后则不引起病变。电镜观察到两种病毒在LLC-MK_2细胞中都能形成与布尼病毒相似的形态特征。 相似文献
64.
优选前后精子顶体酶活性与IVF受精率相关性的研究 总被引:1,自引:0,他引:1
目的探讨优选处理前和处理后精子顶体酶活性的变化,及与体外受精(IVF)受精率的相关性。方法采用分光光度比色法,对接受IVF治疗的53例不育夫妇男方精液,分别测定优选处理前和处理后精子顶体酶活性,分析其与IVF受精率的相关性。结果优选处理后精子顶体酶活性与优选前比较有显著性差异(P<0.05);达到常规IVF标准并选择常规IVF治疗者,优选后的精子顶体酶活性与IVF受精率有相关性,精子顶体酶活性降低与IVF受精率降低有关。结论精子顶体酶活性与IVF受精率有相关性,并且通过精子顶体酶活性可以预测IVF受精率。 相似文献
65.
目的 探讨经尿道切除技术(TUR)治疗下尿路疾病的适应证、操作方法、术中术后处理及并发症预防的要点。方法 应用经尿道汽化电切术(TURVP)和双极等离子汽化电切术(TUPKVP),分别以5%葡萄糖液和生理盐水作冲洗介质,选择性耻骨上膀胱造瘘,持续低压灌洗,术后气囊导尿管留置5~7天拔管,自行排尿。结果 经尿道前列腺双极等离子汽化电切术7例,经尿道前列腺汽化电切术58例,合计前列腺手术65例;腺性膀胱炎汽化电切术43例;膀胱肿瘤汽化电切术15例;后尿道狭窄等离子汽化电切术3例;精阜腺瘤汽化电切术2例。全部病例均一次手术完成,有效率(126/128)98.4%。无膀胱穿孔、电切综合征、大出血、真性尿失禁发生。前列腺术后尿道狭窄、排尿困难再次手术者2例,占3.08%,排尿疼痛、不适感6例,占9.23%,逆行射精4例,占6.15%。结论 TUR技术是一种微创、安全、迅速、有效、恢复快、并发症较少的腔内泌尿外科治疗方法,特别适用于下尿路疾病的手术;术中持续低压灌注对确保切割视野清晰、预防并发症至关重要。 相似文献
66.
结核分枝杆菌分子生物学检测方法新进展 总被引:2,自引:0,他引:2
应用分子生物学技术检测结核分枝杆菌,克服了传统检测方法的诸多不足,能够对难以培养、生长缓慢的结核分枝杆菌进行更加敏感、特异、准确、快速的鉴定和药物敏感性评价。本文概述了目前国内外几种结核分枝杆菌分子生物学检测方法的原理、应用现状及评价。 相似文献
67.
In cases of displaced greater tuberosity fractures, treatments by arthroscopic-assisted reduction and percutaneous screw fixation have been reported. However, in cases in which there is a comminuted fracture or a minimally displaced fracture combined with concomitant lesions such as rotator cuff tear or labral pathology, it is difficult to reduce the fracture and to treat other pathologies by use of a percutaneous screw. Recently, many surgeons have used the double-row repair method in rotator cuff repair, which provides a tendon-bone interface better suited for biologic healing and restoring normal anatomy. In accordance with this method, we used the arthroscopic technique of double-row suture anchor fixation for a minimally displaced greater tuberosity fracture without additional incision. Initially, debridement was performed on the fracture surface by use of a shaver, and the medial-row anchor was inserted through the anterior portal or the intact cuff. Two lateral-row anchors were inserted just anterior and posterior to the lower margin of the fractured fragment under C-arm guidance. The medial-row sutures and lateral-row sutures were then placed. Arthroscopic double-row suture anchor fixation of a displaced greater tuberosity fracture restores the original footprint of the rotator cuff and normal tendon-bone interface of the displaced greater tuberosity fracture. 相似文献
68.
C. Faldini M. Manca S. Pagkrati D. Leonetti M. Nanni G. Grandi M. Romagnoli M. Himmelmann 《Journal of orthopaedics and traumatology》2005,6(4):188-193
Abstract Complex tibial plateau fractures are a challenge in trauma surgery. In these fractures it is necessary to anatomically reduce
the articular part of the fracture and to obtain stable fixation. The aim of this study is to review the results of a surgical
technique consisting of fluoroscopic closed reduction and combined percutaneous internal and external fixation. Thirty-two
complex tibial plateau fractures in 32 patients were included. Twenty-one fractures were closed, 4 were open Gustilo grade
I, 3 were Gustilo grade II and 4 were Gustilo grade III. The mean age was 37.8 years (range 21–64 years). Surgery was performed
with patients in transcalcaneal traction and the knee flexed at 30° was used. Through a 1-cm incision centred over the tibial
metaphysis of the tibia, a 3.2-mm hole was drilled in the antero-medial tibial aspect. The tibial plateau fracture fragments
were elevated using either 1 or 2 curved Kirschner wires under fluoroscopy to control the reduction. Then the fragments were
fixed with 2 cannulated AO screws inserted through small incisions into the medial aspect of the tibial plateau. Knee rehabilitation
started postoperatively. Weight bearing started after 8–12 weeks depending upon the radiographic appearance. All external
fixators were removed in outpatient facilities. All patients were clinically and radiographically evaluated at a mean follow-up
of 48 months (range 38–57 months). Clinical results were evaluated according to the Knee Society clinical score. Average healing
time was 24 weeks (range 18–29 weeks). In 1 patient a non-union occurred. This patient was treated with open reduction and
plate fixation. In 2 patients a varus knee deformity occurred and a surgical correction was performed. There were no surgical
complications. Mean knee range of motion was 105° (range 75–125°) and mean Knee Society clinical score was 89. Twenty-five
results were scored as excellent, 4 good, 2 fair and 1 poor. Using this technique there is limited soft tissue damage and
virtually no periosteum damage to the fracture fragments. However anatomical reconstruction of the joint can be obtained.
Furthermore knee rehabilitation can be started immediately after surgery. We think that these factors were responsible for
the optimal clinical long-term results. 相似文献
69.
目的介绍一种较新的矫治鹰钩鼻鼻尖畸形的手术方法。方法自1995年2月至2005年5月,采用埋没导引缝合技术对18例鹰钩鼻鼻尖畸形患者进行手术矫治,术后结合鼻管支撑的鼻孔悬吊法外固定7~10d。结果术后经14个月至3年的随访,18例患者的鼻尖外形良好,形态满意。其中1例患者因鼻腔内悬吊线穿透引起轻度炎症,术后3周剪除缝线,5d自愈。结论采用埋没导引缝合的手术方法对鹰钩鼻鼻尖畸形患者进行矫治,并结合缝合、悬吊和固定,获得了良好的术后效果。此方法是一种较理想的手术方法,值得推广应用。 相似文献
70.
关节镜下应用“微骨折”方法修复关节软骨缺损 总被引:3,自引:3,他引:0
目的:探讨关节镜下应用“微骨折”技术对膝关节全层关节软骨缺损修复的效果。方法:对68例全层关节软骨缺损患者进行随机分组:实验组(35例),男17例,女18例,平均年龄35.1岁,采用关节清理后应用“微骨折”技术进行处理,即利用骨刀设计的特性和适度的锤击力量造成软骨下的骨组织微小骨折,刺激软骨生长。对照组(33例),男17例,女16例,平均年龄31.6岁,仅作关节清理术。结果:术后随访6~18个月,平均8.6个月,按Lysholm评分标准,实验组明显优于对照组(P<0.01)。结论:关节镜下应用“微骨折”技术能够显著减轻关节疼痛,增加关节活动度,改善关节功能,是一种简单有效的修复全层关节软骨缺损方法。 相似文献