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Four patients with displaced fractures of the capitellum (capitulum humeri) were treated by open reduction and internal fixation using Herbert screws. The mean follow-up was 16 months (range from 12 to 21 months). All fractures united without evidence of avascular necrosis. Postoperatively, the range of motion was excellent, except in one patient who had a comminuted open fracture and other injuries. Three cadaveric dissections demonstrated that the Herbert screw could be inserted without detaching the lateral collateral ligament. The Herbert screw is useful in treating displaced capitellar fractures since the jig maintains the reduction and the screw, compressing the fracture site, is buried beneath the articular cartilage and does not have to be removed. 相似文献
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Robin R. Richards MD FRCS C.Bruce Paitich MD Robert S. Bell MD FRCS 《The Journal of hand surgery》1990,15(6):885-887
A case of an isolated, displaced fracture of the capitate is described. This rare carpal injury was treated by internal fixation with two Herbert screws. The fracture united and the patient achieved an excellent range of wrist motion. The Herbert screw is useful in the treatment of displaced fractures of the capitate since the screw maintains reduction, compresses the fracture site, and allows early wrist motion. 相似文献
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Sano S Rokkaku T Saito S Tokunaga S Abe Y Moriya H 《Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]》2005,14(3):307-311
From 1993 to 2003, 6 patients with displaced fractures of the humeral capitellum were treated by open reduction and internal fixation of the capitellar fragments with Herbert bone screws. By use of the criteria of Grantham et al, there were 2 type II-A fractures, 1 type II-B fracture, 1 type II-C fracture, and 2 type III-A fractures. A lateral approach was used in 4 patients and a posterior approach with olecranon osteotomy in 2. The elbows were immobilized postoperatively for 4 to 28 days (mean, 13.5 days). We evaluated the range of motion, stability, and pain using the criteria of Grantham et al. The follow-up period ranged from 2.5 to 9.3 years (mean, 5.6 years). All patients had a stable, pain-free elbow with good range of motion at follow-up. All fractures healed, and there was no evidence of avascular necrosis or degenerative change. 相似文献
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枢椎泪滴样骨折以枢椎椎体前下缘冠状面大小不等的分离骨折块为特点[1,2],主要是由颈椎过伸性损伤所致,在颈椎损伤中比较少见,目前国内外对其治疗方式的选择仍不统一.2008年1月~2011年12月我院脊柱外科共收治枢椎泪滴样骨折患者5例,均行Herbert螺钉前路内固定术,报告如下.
临床资料5例患者中男4例,女1例,年龄27~63岁,平均42岁.3例为车祸伤,2例为高处坠落伤,受伤时均为前额着地.患者均有颈后部不适及颈椎活动受限,查体均有前额或眼部皮肤挫伤或裂伤,颈后部有压痛,均不伴脊髓神经损伤表现.颈椎X线片示枢椎前下缘三角形游离骨折块,移位明显,伴有少许翻转(图1);MRI检查未见明显脊髓受压,C2/3椎间盘未见损伤、破裂,前纵韧带未见明显损伤(图2).入院后均给予颅骨牵引,牵引重量根据患者体重而定,为2~4kg,根据骨折块移位的方向和枢椎椎体移位的方向相应采取屈曲位或过伸位牵引,牵引4~7d后复查颈椎X线片骨折均未复位,改行手术治疗. 相似文献
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Internal fixation of radial neck fracture in a fracture dislocation of the elbow. A case report. 总被引:2,自引:0,他引:2
N A Ebraheim M C Skie J Zeiss S R Saddemi W T Jackson 《Clinical orthopaedics and related research》1992,(276):187-191
A 27-year-old manual laborer presented with dislocation of the right elbow, complete separation of the radial head at the neck level, and avulsion of the coronoid process. Closed reduction of the elbow resulted in ulnohumeral instability. As an alternative to silastic implant, the radial head was reduced, internally fixed, and used as a spacer to restore elbow stability. The radial head fracture healed with no sequelae. At two years follow-up examination, the patient had a stable elbow with nearly full range of motion. 相似文献
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目的运用微型钢板螺钉治疗桡骨头粉碎性骨折以改善肘关节功能。方法21例闭合性桡骨头粉碎性骨折,按Morrey改良Mason分型,Ⅲ型骨折15例,Ⅳ型骨析6例,其中4例涉及桡骨颈,合并肱骨内髁骨折6例,尺骨喙突骨折3例,均采用AO微型钢板螺钉进行固定。术后1~3天开始功能锻炼。结果所有病例关节面均获得满意复位。随访9~45个月,平均18.3个月,根据Mackay和Carn疗效评定,优15例、良4例、差2例,优良率98.9%。结论微型钢板螺钉内固定治疗桡骨头粉碎性骨折是一种有效的方法。 相似文献
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Herbert螺钉治疗关节内骨折回顾性分析 总被引:5,自引:0,他引:5
[目的]回顾性分析Herbert螺钉治疗关节内骨折,评价其临床长期疗效.[方法]1991年3月-2006年3月,应用Herbert螺钉治疗不同部位关节内骨折,有效长期随访55例,其中腕舟骨骨折组19例,桡骨头骨折组25例,股骨头骨折组11例.[结果]平均随访5年11个月(1~13年),3组分别按改良Mayo法、改良Cassebaum法及Tompson-Epstein法评定,优良率分别为94.7%、96%、72.7%.[结论]Herbert螺钉能提供牢固的内固定,长期随访稳定,是关节内骨折较理想的内固定材料. 相似文献
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Introduction and importanceAs the population grows older, femoral neck fracture is becoming one of the prevalent cases in orthopedics, although this fracture can also happen in younger individuals following high energy traumas. Fixation with cancellous lag screws is one treatment option for femoral neck fractures, especially for young adults and relatively active older patients.Case presentationIn this case report, we describe a 52-year-old man referred with the formation of enterocutaneous fistula (ECF) in the surgery place for fixation of a femoral neck fracture 30 years prior to presentation.Clinical discussionInterpretation of CT scan images as well as findings of the performed laparotomy suggested that fixation procedure with screws was probably the main culprit for penetration of ileum. Subsequently, the removal of screws enabled the fistula to reach the surface of skin, which presented with fecal drainage. To eliminate fistula, we performed right hemicolectomy and ileocolic anastomosis for the case.ConclusionSince management of ECF remains among the most challenging problems for surgeons, this unique case report indicates the possibility for formation of such fistula following a fixation procedure in the hip joint area, even after thirty years and stresses on taking measures in order to prevent fistula formation caused by the prevalent procedures performed on the hip joint. 相似文献
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A Kreicbergs 《Acta orthopaedica Scandinavica》1983,54(5):739-742
The present report describes an unusual complication after surgical treatment of a femoral fracture. Metal particles, produced by mechanical damage to an intramedullary rod by the insertion of screws perpendicular to the rod, were found to have initiated a tumor-like change in the soft tissues 4 years after removal of the metal implants. Conventional X-ray, angiography and CT-scan showed adjacent to the healed fracture a large tumor mass, which was interpreted as a soft tissue sarcoma. However, histopathological assessment revealed extensive necrotic changes around scattered metal particles in the biceps femoris muscle, which may be assumed to have been induced either chemically or bacterially. 相似文献
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目的探讨闭合复位Herbert螺钉内固定治疗跟骨骨折的疗效。方法采用闭合复位Herbert螺钉内固定治疗20例跟骨骨折患者。结果患者均获得随访,时间6~12个月。患者骨折均愈合,无伤口并发症。跟骨Bhler角由术前5.2°±3.7°恢复至末次随访时的20.4°±2.8°,差异有统计学意义(t=-17.16,P0.01);Gissane角由术前92.9°±4.8°恢复至末次随访时的122.5°±4.4°,差异有统计学意义(t=-10.84,P0.01)。Maryland足部评分:优10例,良8例,可2例。结论闭合复位Herbert螺钉内固定治疗SandersⅡ型跟骨骨折和跟骨结节横形骨折临床效果满意。 相似文献
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Introduction
Hoffa fractures are uni- or bicondylar fractures of the distal femur in a coronal tangential plane. 相似文献16.
A 20-year-old patient was seen with an unstable, infected, open fracture of the distal phalanx of the long finger of the right dominant hand. The patient was treated by removal of the nail, debridement of the fracture site, and stabilization of the fracture with a Herbert screw. The Herbert screw compressed the fracture site and allowed early active motion of the distal inter-phalangeal (DIP) joint. The wound healed without incident, and the fracture was radiographically united 6 weeks after the procedure. The Herbert screw is useful in the treatment of unstable fractures of the distal phalanx, since the screw maintains reduction, compresses the fracture site, and allows early active motion of the DIP joint. 相似文献
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Yip DK 《Journal of orthopaedic trauma》2002,16(7):529; author reply 529
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Current methods of fixation of femoral osteochondritic fragments do not provide rigid enough stabilization to allow early postoperative motion. We describe a technique using Herbert screws in a patient to secure a large unstable medial condylar fragment. A second procedure for removal of the screws was not required, and the patient had an excellent clinical result. The Herbert differential pitch bone screw is able to provide compressive fixation, allow early motion, and minimize the potential for complications. 相似文献