合并内眦赘皮的重睑术

目的：寻求一种简单有效的内眦赘皮手术治疗方法。方法：通过观察内眦部解剖的特点了解内眦赘皮的形成原因，设计出将内眦部眼轮匝肌和内眦韧带的修复固定，同时一次完成内此成形及重险术。结果：72例不同类型的内眦赘皮，Ⅱ级和Ⅲ级23例，术后经过3－12月随访手术切口产痕3月后逐步软化，有2例肤色较深的患者内眦部切口瘢痕到6月后才不大明显，余效果满意。结论：该方法操作容易，术后外形满意，内眦形态好，瘢痕不明显，患者易于接受。     

Effect of autocontrol micromotion intramedullary interlocking nail on fracture healing： an experimental study

Objective: To investigate the effect of autocontrol micromotion locking nail ( AMLN ) on experimental fracture healing and its mechanism. Methods: 16 goats undergoing both sides of transverse osteotomy of the femoral shafts were fixed intramedullary with AMLN and Gross-Kempf (GK) nail, respectively. The follow-up time was 7, 14, 28 and 56 days. Roentgenographic, biomechanical, histological, scanning electromicroscopic and biochemical analyses were done. Results: (1) The strength of anticompression, antiflexion and antitorsion in the fractural end in the AMLN-fixed group was higher than that of GK nail-fixed group; whereas, the rate of stress shelter in the fractured end decreased significantly (P<0.01). (2) The content of the total collagen, insoluble collagen, calcium and phosphate in the AMLN-fixed group was higher than that in the GK nail-fixed group (P<0.05). (3) Histological observation and quantitative analysis of calluses revealed that AMLN could promote the growth of bridge calluses and periosteum calluses. Hence the facture healing and remolding process achieved early, which was much better than traditional GK nail fixation. (P<0.05). (4) 7-14 days postoperation, the calluses of AMLN-fixed group was flourish and camellarly arranged and the collagen fibril formed constantly in the absorption lacuna of bone trabecula. 28-56 days postoperation, the collagen fibril was flourish around the absorption lacuna and was parallel to the bone's longitudinal axis. Active bony absorption and formation were seen, so was remolding and rebuilding. Haversian system was intact and the bony structural net was very tenacious because of the deposition of calcium salt. None of the above findings was observed in the GK nailfixed group. Conclusions: The design of AMLN accords well with the plastic fixation theory. As the geometry ametabolic system constituted by the intramedullary fixation instruments and the proximal and distal end of the fracture is very firm and stable, the disturbance to the physical stress distributed in the fractural end is light. The generation and conduct of the intermittent physical stress between the fractural parts could reach the balance between stress conduct and stress protection. The feature that the healing and remolding take place at the same time speeds up the fractural healing process.     

自控微动带锁髓内钉内固定对骨折愈合影响的X线平片及微血管造影观察

目的 :探讨自控微动带锁髓内钉 (AMLN )固定对骨折愈合的影响及机制。方法 :对 12只山羊两侧股骨干横断截骨 ,分别采用AMLN和GK钉固定 ,术后 7、 14、 2 8、 5 6d分批处死 ,行X线平片、微血管造影及皮质骨的血流量变化检测。结果 :AMLN固定组 ,骨痂早期数量多 ,密度高连续无中断 ,中、后期骨痂质量好 ,成熟程度高 ,骨折边愈合边改建边塑形 ,与此功能相适应 ,皮质骨骨痂内血管丰富 ,5 6d后血管基本恢复正常 ,血管均匀且扩张消失。GK钉固定组 ,骨痂数量少 ,密度低不连续有中断现象 ,骨痂内血管管径细 ,排列紊乱 ,吻合程度比较差。血液流量前者明显优于后者 ,14d后两者相差 43 % (P <0 .0 5 )。结论 :AMLN内固定所建立的有间歇性动应力刺激与传导的生物力学环境 ,使皮质骨骨痂内血管形成及血运丰富 ,骨痂的形成和强度提高 ,加快了骨质重建的速度。     

自控微动带锁髓内钉内固定对骨折愈合影响的组织学实验研究

目的 :探讨自控微动带锁髓内钉 (AMLN )固定后骨折局部的组织学改变对骨折愈合的影响及机制。方法 :对 1 2只山羊两侧股骨干横断截骨 ,分别采用AMLN和GK钉内固定 ,术后 1、 2、 4、 8周分批处死 ,行组织学观察。结果 :AMLN钉能以微动间歇性应力方式促进骨折愈合 ,骨外膜骨痂、桥梁骨痂能早期加速形成 ,并逐渐连接骨痂、封闭骨痂 ,使皮质骨松化 ,骨小梁坚韧 ,提高了骨的结构力学特性 ,缩短了愈合周期 ,明显优于GK钉固定。骨痂的定量分析表明 ,两者具有显著性差异 (P <0 .0 5)。结论 :AMLN钉内固定所建立的局部有应力、应变产生及轴向应力传导的生物力学环境 ,可以调控成骨细胞与破骨细胞的活性平衡 ,骨折边愈合边改建边塑形 ,增加了骨折愈合的速度和质量     

上下睑松弛垂直提升联合整形术

面部是暴露的 ,且表情丰富 ,因而 ,面部皮肤最易衰老和出现皱纹。皮肤衰老的速度有明显的种族和个体差异 ,黄色人种最早也最明显的衰老部位是上、下睑 ,眼角和额部[1] 。表现为上睑皮肤松弛 ,出现皱纹、眉下垂 ,形成三角眼 ;下睑出现皮肤皱褶、臃肿、袋状畸形 ,呈现老态 ,影响美观。近年来 ,随着人们审美水平的提高 ,上睑松弛和眼袋整形术已越来越受到重视。我们通过上、下睑垂直提升联合术 ,一次性完成眼周整形 ,取得满意的手术效果。现报告如下。1　资料与方法1.1.　一般资料　 1999年 6月— 2 0 0 2年 6月共完成 34例 ,女31例 ,男 3例 ,…     

有限双开窗法治疗腰椎软骨板破裂症

为保留腰椎后部结构的完整性,又能充分显露,彻底减压,采用根据椎板分型,倒U或V型椎板开窗,扩大侧隐窝治疗腰椎软骨板破裂症12例。手术尽可能地保留腰椎全部结构的完整性,可防止术后腰椎不稳,同时使神经根管代偿间隙明显增大,减低了术后DFC连锁变异现象所引起的椎管狭窄。经1～3.5年随访效果满意。并就12例腰椎软骨板破裂症的特点进行了讨论。     

腰椎间孔内口狭窄的有限手术治疗

腰椎间孔内口狭窄是引起腰腿疼痛的病因之一.常用全椎板或半椎板切除减压治疗,生物力学研究表明,该术式容易导致腰椎术后不稳[1],已引起临床充分重视.自1990年2月～2003年2月,我们采用有限开窗腰椎间孔内口扩大成形术治疗该病40例,疗效满意.现总结报告如下.     

膝关节弹响28例关节镜诊治分析

目的探讨关节镜在膝关节弹响诊治中的应用。方法回顾性分析281例存在膝关节弹响症状的膝关节疾病的临床资料,全部病例均施行了膝关节镜手术治疗。分析不同疾病导致膝关节弹响的部位、镜下特点和评价疗效。结果发现半月板损伤占53%,骨性关节炎（OA）占21%、盘状半月板为9%、关节内游离体及滑膜皱襞分别为7%和5%,其他占5%。镜下发现弹响产生的机制各不相同,使临床上弹响的性质、特点不完全一样。结论形成膝关节弹响的病因很多,其中以半月板损伤多见,但必须结合病史及弹响特点,才能更准确地做出诊断。关节镜术是关节内弹响的有效诊治手段。