记忆合金锁骨环抱式接骨板治疗锁骨粉碎骨折18例疗效分析

目的利用记忆合金环抱器治疗锁骨中1/3粉碎骨折。方法新鲜锁骨中1／3粉碎骨折18例。均利用记忆合金环抱器行内固定。结果所有患者经3—23月,平均8个月随访,骨折愈合时间6-10周,平均7．3周,总优良率95％。结论记忆合金环抱器是治疗锁骨中1／3粉碎骨折较理想的方法。     

负压封闭引流技术致伤口出血2例

近年来,负压封闭引流技术(vacuum sealing drainage,VSD)在创伤骨科的应用越来越广泛,但其相关并发症报道却极少.2011年9月-2011年12月,我科有2例应用VSD的患者发生伤口出血并发症,现报告如下.     

骨疏康治疗骨质疏松性脊椎压缩性骨折64例临床观察

目的 观察中药骨疏康在骨质疏松性脊椎压缩骨折治疗中的作用。方法 对94例临床诊断为骨质疏松性脊椎压缩骨折患者进行随机对照单盲研究。其中治疗组64例,服用骨疏康颗粒和钙制剂加维生素D;对照组30例服用钙制剂和维生素D治疗,持续6个月。治疗结束时进行疗效评价。疗效以腰背痛消失情况和躯体活动是否受限,以及下地活动时间、行走距离为判断指标。结果 治疗组64例中,显效51例(79.7％),有效11例(17.2％),无效2例(3.1％);对照组30例中,显效19例(63.3％),有效10例(33.3％),无效1例(3.3％)。经统计学处理,两组显效率差异显著(P<0.05),治疗组优于对照组。结论骨疏康可以有效治疗骨质疏松性脊椎压缩骨折引起的疼痛,加快骨折愈合。     

中药电熨治疗膝关节滑膜炎34例疗效观察

中药电熨治疗膝关节滑膜炎３４例疗效观察河北医学院第三医院（石家庄０５００５１）薄丽亚，吴春生滑膜炎是由于急、慢性损伤所引起的滑膜水肿、充血、增厚、滑液增多、囊壁增厚等一系列变化的疾病。该病多发生于磨擦频繁或压力较大的关节，尤以膝关节为多见，表现为关节...     

腰椎管狭窄症的疗效评价问题

腰椎管狭窄症的疗效评价问题腰椎管狭窄症是中老年人腰腿痛的重要原因之一，其治疗效果既往各位专家报告相差悬殊，无法横向评定其疗效，目前国内尚无统一的疗效评价标准。作者认为：疗效评价应向客观量化，以临床症状体征为主，与影像学检查、电生理检查相接合的目标发展...     

应用胫骨Ⅰ期短缩加Ⅱ期延长治疗严重胫骨开放性骨折

目的 评价应用胫骨Ⅰ期短缩加Ⅱ期延长的方法治疗严重胫骨开放性骨折的临床效果.方法 自2006年5月至2009年8月应用胫骨Ⅰ期短缩加Ⅱ期延长治疗5例严重胫骨开放骨折患者,均为男性;年龄23～41岁,平均35岁.清创和胫骨短缩后用单边外固定支架临时固定,血管损伤者行动脉吻合.1例伤口Ⅰ期闭合,2例经植皮后愈合,2例分别通过腓肠神经营养支筋膜瓣和交腿皮瓣闭合伤口.伤口愈合后从胫骨近端做截骨,应用Ilizarov架行胫骨延长,恢复小腿的长度.胫骨短缩3～5 cm,平均4.2 cm.结果 所有患者术后获18～24个月(平均20个月)随访.患者骨折短缩处伤口均获愈合,无一例发生感染.全部患者骨折均获愈合,愈合时间为6～12.5个月,平均9.6个月,平均愈合指数1.7个月/cm,患肢长度均恢复,与健侧无差别.按Paley功能评价标准:优3例,良1例,可1例.结论 应用胫骨Ⅰ期短缩加Ⅱ期延长治疗严重胫骨开放性骨折,具有安全可靠、简化治疗过程及减少皮瓣应用等优点,是一种较好的方法.

Abstract：

Objective To evaluate clinical results of primary shortening plus secondary lengthening of the tibia for sever tibial fractures. Methods From May 2006 to August 2009, 5 men with severe open tibial fracture were treated with primary shortening plus secondary lengthening of the tibia in our center. They were aged from 23 to 41 years (average, 35 years) . Four cases were Gustilo type MB and one was Gustilo type M C. The primary procedure included debridement, shortening of the tibia and temporary fixation with a unilateral external fixator, and arterial anastomosis in cases of vessel injury. The wounds healed primarily in one case, after skin graft in 2 cases, and after flap transplantation in 2 cases. After wound healing, secondary lengthening of the tibia was performed following osteotomy of the proximal tibia with an Ilizarov fixator to restore the length of the injured leg. The average shortening was 4. 2 cm (range, 3 to 5 cm). Results The average follow-up period was 20 months (range, 18 to 24 months). All the wounds were healed without signs of osteomyelitis. All the fractures united. The mean bone healing time was 9. 6 months (range, 6 to 12. 5 months) . The average healing index was 1. 7 months/cm. A normal length was restored in all the affected lower limbs. By Paley functional assessment system, 3 cases were excellent, one was good and one was fair. Conclusion Primary shortening plus secondary lengthening of the tibia is a reliable and successful method for sever tibial fractures, because it can simplify management and minimize the need for flap coverage.     

微创治疗单纯性大隐静脉曲张80例报告

目的探讨微创治疗单纯性大隐静脉曲张的可行性及临床效果。方法80例患者采用小切口行高位结扎,应用剥脱器抽剥大隐静脉主干,同时带入输血管,将40℃热生理盐水注入抽剥腔,小腿部曲张静脉采用点式剥脱术。结果80例病人术后均恢复良好。术后无出血、皮下血肿、淤血麻木等并发症发生。术后平均住院时间3.6天。随访3月至4年,无复发病例。结论微创治疗单纯性大隐静脉曲张,创伤小,恢复快,操作简便,疗效确切,值得临床推广应用。