掌浅弓的应用解剖

ObjectiveTo provide anatomical basis for repair of the superficial palmar arch with transplanted superficial vein when the operations of vessel repair and replantation of severed palm are performed.MethodsThe origin and branches of ulnar of superficial palmar arch were observed and measured on 30 cases of hand specimens.ResultsThere were 4 types of branches arising from the ulnar side of superficial palmar arch.If the center of pisiform bone was regarded as point O,the origin of the proper palmar digital artery of little finger as point A,the origin of common palmar digital arteries of the 3rd、2nd、1st fingers were regarded as point B,C,D respectively;then the distance was as followO-A 30.1±5.6 mm;A-B 8.1±4.7 mm;B-C 9.2±6.0 mm;C-D 6.2±3.9 mm.The diameters of the origins of branches followedA1.24±0.34 mm;B1.50±0.34 mm;C1.78±0.42 mm;D1.54±0.38 mm.ConclusionsThe branches of superficial palmar arch on ulnar side are constant.The anatomical data will benefit the repair the repair of superficial palmar arch.     

经宿主携带的指甲重建

指甲重建,报道很少。蔡锦方等1986年报道指(趾)甲皮片游离移植,在10例12个手指施行原位或移位植入缝合均获成功。本文报道经宿主携带的指甲重建及手术方法。     

克氏针结合钢丝法治疗尺骨茎突骨折

目的 探讨尺骨茎突骨折的手术方法 及疗效.方法 2001年8月-2006年6月,对56例(58处)尺骨茎突骨折的患者,采用克氏针结合钢丝法进行内固定治疗.结果 术后随访1.5～18个月,平均7个月.X线片显示骨折均完全骨性愈合,55例无腕部慢性疼痛及活动受限,1例有腕部慢性疼痛.结论 应用克氏针结合钢丝法治疗尺骨茎突骨折是理想的治疗方法 ,尤其对预防尺骨远端疼痛,疗效满意.     

小腿严重开放伤的早期治疗

目的 探讨严重小腿开放伤后软组织损伤的早期重建.方法 近三年来对于44例小腿软组织缺损病人根据不同损伤部位、损伤情况、损伤时间,早期行腓肠肌内侧头转移皮瓣、比目鱼肌皮瓣、背阔肌游离皮瓣覆盖创面.结果 全部随访6～36(15.5±3.6)个月,失败3例,成功率93.4%.结论 强调早期,强调技术和根据不同情况选择不同的肌皮瓣对该损伤的治疗.     

多发性创伤抢救治疗体会（附124例临床分析）

近年来，随着机械工业和交通事业的迅速发展，多发性创伤逐渐上升，已是创伤外科急诊最常见的危重症。多发性创伤多伤情重、变化快、休克多、易漏诊、处理难、并发症多、伤残率高。若掌握不了救治理念和程序，轻重缓急主次不分，把握不了急救手术     

AO微型钉板在指间关节融合术中的临床应用

目的探讨手指间关节融合术方法与疗效。方法采用AO微型钉板进行指间关节融合31例。结果本组获随访3～24个月,9例术后1.5个月达到骨性愈合,20例术后2.5个月达到骨性愈合,2例术后4.5个月达到骨性愈合。伤指术后疗效评定结果:良29例,可2例。结论 AO微型钉板应用于近指间关节融合中,伤指骨质愈合及活动有优势,但对于远指间关节(拇指除外),术后有钉板外露等并发症,手术需慎重。     

显微外科在肘关节成形术中的应用

自1985年至2002年我院采用带血管蒂的前臂筋膜瓣填充肘关节成形术，治疗肘关节强直26例，取得良好效果。     

克氏针夹扣法治疗槌状指骨折

本文介绍７例槌状指骨折采用克氏针夹扣法手术治疗的经验。从受伤到手术时间最长１３个月，最短２８天。随访７～２６个月，平均１４．７个月。７例患者均获良好疗效。Ｘ线片示骨折愈合，指背骨突消失，疼痛缓解；远指间（ＤＩＰ）关节活动范围接近正常。该方法不用克氏针或钢丝穿绕骨折片，不会导致骨折片碎裂，且由于两枚克氏针的夹扣能对骨折面间施加足够的压力，并有利于保护终末腱和骨折片的血运。故我们认为该方法简单、安全。     

尺骨茎突骨折手术与非手术治疗的疗效比较研究

目的 比较尺骨茎突骨折手术治疗与非手术治疗的疗效.方法 尺骨茎突骨折手术治疗组62例(64处),采用克氏针结合钢丝法,术后随访2～18个月,平均8个月;非手术治疗组70例(72处),随访1.5～24个月,平均10个月.采用AO组织的Gartland-Wertey评分方法,根据尺骨茎突骨折愈合情况,对两组病例疗效进行比较.结果 尺骨茎突骨折手术治疗组:优57例,良2例,中2例,差1例,优良率为95.2%;X线片显示术后3个月骨折均达到骨性愈合.尺骨茎突骨折非手术治疗组:优10例,良15例,中18例,差27例,优良率为35.7%;X线片显示伤后1.5个月9例骨折达到骨性愈合,伤后6个月32例骨折畸形愈合,伤后12个月29例尺骨茎突骨折不愈合.两组差异有统计学意义(P＜0.05).结论 尺骨茎突骨折手术治疗在腕关节功能恢复优良率及骨折愈合方面均明显优于非手术治疗.

Abstract：

Objective To compare the clinical outcomes of surgical and non-surgical treatment of ulnar styloid fractures. Methods There were 62 patients (64 sides) that were treated with Kirschner wire and tension band fixation in the surgical group. They were follow-up postoperatively for 2 to 18 months, with an average of 8 months. Seventy patients (72 sides) were non-surgically treated and follow-up for 1.5 to 24 months with an average of 10 months. Gartland and Werley scoring system of the AO Foundation was applied to evaluate the results. Fracture healing was evaluated by X-ray films. Comparison was made between the surgical and nonsurgical groups. Results Results in the surgical group were graded as excellent in 57 cases, good in 2 cases,fair in 2 cases and poor in 1 case. The overall satisfactory rate was 95.2%. X-rays showed that bone union was obtained in all the patients three months after the surgery. Results in the non-surgical group were graded as excellent in 10 cases, good in 15 cases, fair in 18 cases and poor in 27 cases. The overall satisfactory rate was 35.7%. X-rays showed bone union in only 9 cases 1.5 months after the injury, fracture malunion in 32 cases 6 months after the injury, and nonunion in 29 cases even 12 months after the injury. The differences between the two groups were statistically significant. Conclusion From the aspects of wrist function and fracture healing,surgical treatment of ulnar styloid fractures is superior to non-surgical treatment.