尺骨鹰嘴骨折皮质骨加压螺钉固定的实验研究及临床应用

比较尺骨鹰嘴骨折加压螺钉与常用的4种内固定的强度,为临床选择内固定方法提供实验依据。用22具新鲜尸体肘关节做成横型、斜形和粉碎形鹰嘴骨折模型。用5种内固定后置于MD—10E万能电子力学试验机上,测定骨折处的位移与压力的关系;结果:钢丝内固定强度最小,钩钢板最大。髓内加压螺钉固定欠可靠。横形骨折皮质骨加压螺钉与张力带钢丝比较,统计学上无显著差异(P〉0.05),斜形骨折皮质骨加压螺丝钉强于张力带钢丝(P〈0.01)。粉碎形骨折使用钩钢板尤佳(P〈0.01)。临床应用24例中,22例平均随访14个月。骨折全部愈合,优良率达90.91％;认为皮质骨加压螺丝钉治疗横、斜形尺骨鹰嘴骨折,创伤小,操作简便,固定确切,是一种安全可靠的方法。     

克氏针张力带钢丝治疗关节内骨折

张力带钢丝内固定术 ,是近年来ＡＯ学派推荐的一种新技术 ,其优点是术后不需外固定 ,可早期功能锻炼 ,骨折愈合与功能康复同步进行 ,疗效满意。 1990～ 1999年作者等采用克氏针张力带钢丝内固定治疗关节内骨折 40例 ,疗效满意。1　临床资料1.1　一般资料　　本组 40例 ,男 2 6例 ,女 14例 ,平均年龄 41(18～ 70 )岁。尺骨鹰嘴骨折 2 4例 ,其中横形骨折 15例 ,短斜形骨折 5例 ,粉碎性骨折 4例 (并肘关节脱位 2例 )。髌骨骨折 16例 ,其中横形骨折 10例 ,下极骨折 4例 ,粉碎性骨折 2例 ,均为新鲜骨折 ,且有不同程度移位。本组病例均采用克氏针…     

克氏针“8”字张力带钢丝结合环形钢丝内固定治疗髌骨粉碎性骨折

目的探讨采用克氏针"8"字张力带钢丝结合环形钢丝内固定治疗髌骨粉碎性骨折的临床疗效。方法对38例髌骨粉碎骨折采用克氏针"8"字张力带钢丝结合环形钢丝内固定。结果本组随访6~12个月,平均9个月,骨折均愈合,疗效评定结果:优31例,良5例,可2例,优良率95%。结论采用克氏针"8"字张力带钢丝结合环形钢丝内固定治疗髌骨粉碎性骨折,疗效好,安全可靠。     

拉力螺丝钉张力带固定治疗尺骨鹰嘴骨折

尺骨鹰嘴骨折的手术治疗方法较多,有螺丝钉内固定、钩形钢板,加压髓内钉、克氏针张力带、钢丝固定等。各种治疗效果报道不一。我们根据尺骨鹰嘴的解剖特点,以及拉力螺丝钉的功能。采用拉力螺丝钉张力带治疗尺骨鹰嘴骨折１６例,取得较好疗效,现报告如下。１临床资料１...     

双皮质法张力带固定治疗尺骨鹰嘴骨折

尺骨鹰嘴骨折是较常见的关节内骨折,治疗目标要求尽量解剖复位和早期功能锻炼,因此对大多数尺骨鹰嘴骨折均主张手术治疗.常见的内固定方法是用克氏针或螺钉穿过尺骨近端一侧皮质插入髓腔内加钢丝作张力带固定[1-3].     

尺骨鹰嘴骨折克氏针钢丝张力带固定术后鹰嘴骨折块吸收1例

1病例资料 患者,女,37岁,2008年7月3日因摔倒致右肘部疼痛畸形30min就诊。查体：右肘部肿胀、畸形,右肘关节活动受限。X线摄片示右尺骨鹰嘴粉碎性骨折,Mayo分型2型。入院后完善术前检查,行骨折切开复位克氏针张力带内固定术。术中取肘后正中切口,逐层进入,显露骨折,将粉碎骨折复位后,自尺骨鹰嘴部平行钻入克氏针2枚,子钢丝行“8”字绕扎加压固定（图1）。     

平面三角针治疗尺骨鹰嘴骨折的生物力学研究

克氏针制成平面三角针治疗尺骨鹰嘴骨折１８例取得良好效果，为了其与其它常用方法进行比较，选用相同材料制成了６４个鹰嘴骨折模型，分别采平面三角针，张力带，螺丝钉、“８”字钢丝固定，经生物力学试验表明，平面三角针抗张力及抗剪力最强，符合生物力学优势，应是首选方法。     

低切迹钢板与克氏针张力带治疗尺骨鹰嘴骨折的比较

[目的]探讨低切迹钢板和克氏针张力带钢丝内固定治疗尺骨鹰嘴骨折的临床疗效。[方法] 2012年01月～2015年12月,52例尺骨鹰嘴骨折患者被随机分为两组,其中低切迹钢板内固定26例,克氏针张力带钢丝内固定26例。采用VAS疼痛评分评定疼痛程度,采用Mayo肘关节评分评估功能情况~([4]),评估记录肘关节活动度。[结果]两组患者均顺利手术,无血管、神经损伤等严重并发症。52例均获得随访,随访时间12～24个月,平均(18.71±4.59)个月。随访过程中,低切迹钢板组的并发症发生率略低于克氏针张力带组,但差异无统计学意义(P0.05)。末次随访时,低切迹钢板组的VAS评分、Mayo评分及肘关节活动功能略优于克氏针张力带组,但差异无统计学意义(P0.05)。[结论]对于尺骨鹰嘴骨折,低切迹钢板和克氏针张力带钢丝内固定治疗均能取得良好的临床疗效。     

分叉克氏针治疗尺骨鹰嘴骨折

尺骨鹰嘴骨折是临床上较常见的骨折之一，治疗方法较多，其中应用最普遍的是张力带钢丝固定。但尺骨鹰嘴粉碎性骨折及小块撕脱骨折仍较难处理，为此我们自行改制了一种分叉克氏针，从2003年4月～2006年5月，应用该种克氏针治疗尺骨鹰嘴骨折30例，取得了较好的疗效。本文介绍了分叉克氏针的治疗方法，并与张力带钢丝治疗方法进行比较，旨在评价其疗效。     

环形钢丝加张力带钢丝内固定治疗尺骨鹰嘴骨折

1996年4月—2004年10月，我科采用环形钢丝加张力带钢丝内固定治疗尺骨鹰嘴骨折26例，取得了良好的效果。1．一般资料：本组26例，男19例，女7例；年龄18～60岁，平均39岁。跌伤15例，车祸11例。其中尺骨鹰嘴横行骨折11例，粉碎性骨折5例，“T”形骨折6例，斜形骨折4例，骨折均有分离移位。受伤至手术时间为3h～4d。     

"Free" and "exchangeable" or "trapped" and "non-exchangeable" water in cartilage

We repeated some of our own previous experiments, as well as some of Torzilli's recent experiments (11) on which he bases his conclusions relating to a nonexchangeable "trapped water" in cartilage. We are unable to confirm Torzilli's findings. We observed partition coefficients for 3H.HO very close to unity. That both the extrafibrillar and most of the intrafibrillar water is freely exchangeable and behaves as available water towards small solutes has been independently shown (3) for other collagenous tissues. All the different permutations of partition experiments have yielded results that are fully consistent with our original picture of the very major fraction of cartilage water being free.     

Spatiotemporal analysis of auditory "what" and "where" working memory

Goal-directed attention to sound identity (what) and sound location (where) has been associated with increased neural activity in ventral and dorsal brain regions, respectively. In order to ascertain when such segregation occurs, we measured event-related potentials during an n-back (n = 1, 2) working memory task for sound identity or location, where stimuli selected randomly from 3 semantic categories (human, animal, music) were presented at 3 possible virtual locations. Accuracy and reaction times were comparable in both "what" and "where" tasks, albeit worse for the 2-back than for the 1-back condition. The partial least squares analysis of scalp-recorded and source waveform data revealed domain-specific activity beginning at about 200-ms poststimulus onset, which was best expressed as changes in source activity near Heschl's gyrus, and in central medial, occipital medial, right frontal and right parietal cortex. The effect of working memory load emerged at about 400-ms poststimulus and was expressed maximally over frontocentral scalp region and in sources located in the right temporal, frontal and parietal cortices. The results show that for identical sounds, top-down effects on processing "what" and "where" information is observable at about 200 ms after sound onset and involves a widely distributed neural network.     

"Empty wall" and "vertical strut" signs of ACL insufficiency

We report our observation on the "empty wall" and "vertical strut" signs of anterior cruciate ligament (ACL) insufficiency. ACL tears most commonly occur in the midsubstance; arthroscopic evaluation of patients with these tears often reveals minimal evidence of previous ACL tissue along the intercondylar wall, thus giving the appearance of an "empty wall." In proximal ACL tears, the long remnant of ACL tissue may adhere to adjacent PCL tissue. Arthroscopically, one may see this vertically oriented strut of tissue, which to the casual arthroscopist may mimic a normal-appearing ACL except for orientation and tension. In addition, the "empty wall" sign will be noted because the lateral intercondylar wall becomes easily visible following ACL injury. In two separate prospective studies of 84 such patients, the combined incidence of the empty wall sign was 82%, and the incidence of the vertical strut sign was 50%. These findings should be sought for meticulously at the time of arthroscopic evaluation. The vertical strut should not be misinterpreted as an aberrantly oriented ACL or partial ACL tear.