手法复位夹板固定治疗Colles骨折78例

我院自2006年2月至2010年7月收治Colles骨折（伸直型桡骨远端骨折）78例,采用“拧毛巾”法手法复位,纸夹板和木夹板联合固定,取得满意效果,报告如下。     

手法复位石膏外固定治疗Barton骨折

Barton骨折是桡骨远端背侧、掌侧缘骨折,合并腕的半脱位,是一种较少见的关节内骨折。自1998年以来对21例Barton骨折患者采用闭合手法整复、石膏夹板外固定治疗,经随访观察,疗效满意。     

分次手法复位加自制小夹板外固定治疗胫骨干骨折

目的：探讨分次手法复位加小夹板外固定治疗胫骨干骨折的方法及疗效。方法：回顾分析收治的22例闭合性胫骨骨折患者,男14例,女6例;年龄6～54岁,平均33岁;单纯胫骨干骨折15例,胫腓骨双骨折7例;胫骨上段骨折3例,中段骨折4例,下段骨折15例。骨折类型：斜形8例,螺旋形5例,粉碎性4例,横形5例。全部采用分次手法复位小夹板外固定治疗。结果：全部患者经3～15个月,平均6个月随访,骨折畸形愈合1例,骨延迟愈合1例,骨不连1例。依据王旭东疗效评定标准,优18例,良3例,差1例。结论：在传统手法复位小夹板外固定的基础上,给予分次手法矫正以稳定骨折端,防止骨折再移位是治疗闭合性胫骨骨折最可靠的方法之一,具有操作简单、固定可靠、对关节功能影响小、骨折愈合快、并发症发生率低的优点。     

手法折骨复位夹板固定治疗陈旧性Barton骨折6例

自1995—2001年，我们采用重新折骨、闭合复位、夹板固定的方法治疗陈旧性Barton骨折6例(骨折块小于关节面1／2，大于1／2者不属此讨论范围)，现总结报告如下。     

手法复位夹板固定治疗肱骨髁上骨折196例

肱骨髁上骨折是儿童常见的骨关节损伤,因肘关节的特殊解剖结构特征,使骨折的固定相对困难,易遗留肘内翻畸形、肘关节伸屈功能障碍及Volkmanns肌挛缩等。自1998年7月至2006年7月共收治196例肱骨髁上骨折,经临床治疗,效果满意,现就治疗情况及结果分析报告如下。     

手法复位小夹板外固定结合微动理念锻炼治疗肱骨干骨折

目的 :探讨正骨手法复位小夹板外固定结合微动理念锻炼治疗肱骨干骨折的临床疗效。方法 :自2011年3月至2014年2月,采用手法复位小夹板外固定治疗肱骨干骨折患者64例,男28例,女36例;年龄22~67岁,平均38.1岁。按AO/OTA分型:A1型10例,A2型12例,A3型11例;B1型10例,B2型12例,B3型7例;C1型2例,C2型1例,C3型1例。整复后配合微动理念早期功能锻炼。患者均不合并其他部位骨折和血管神经损伤,均无严重内科疾病。随访观察患者骨折愈合及肩肘关节功能恢复情况,并评定疗效。结果:所有患者获随访,时间10~12个月,平均10.3个月。2例复位后3个月少量骨痂生长,改为手术治疗;2例复位后出现桡神经症状,改为手术治疗,其他患者骨性愈合时间8~12周,平均10.2周,骨折达到骨性愈合后,按照Constant-Murley肩关节功能评分评定疗效,平均(93.5±3.2)分,优29例,良29例,可6例,优良率90.3%;按照Mayo肘关节功能评分标准(MEPS),平均(93.7±4.2)分,优35例,良23例,可6例,优良率91.9%。结论 :正骨手法复位小夹板外固定结合微动理念锻炼治疗肱骨干骨折,具有其相应的科学基础和实用价值,整复效果好,费用低廉,能够有效减少并发症,促进患者功能康复。     

闭合手法复位治疗Barton骨折27例

Barton骨折是指通过桡骨远端部分关节面的边缘骨折,且腕关节伴随楔形骨块向掌侧或背侧产生脱位或者半脱位,称为掌侧或背侧Barton骨折。我院自1999-2005年共收治该类骨折27例,采用闭合手法复位结合石膏托外固定,25例闭合复位成功,经随访疗效满意,现报告如下。1临床资料本组27例,均为新鲜骨折,均在受伤后1~2d就诊,男16例,女11例;年龄18~62岁;掌侧型20例,背侧型7例;伴下尺桡关节分离3例,伴尺骨茎突骨折7例。2治疗方法所有患者均采用臂丛神经阻滞麻醉,患者平卧于手术床上,术者位于患侧,双手握住腕关节远端,一助手握住前臂中段部分适当牵引,待腕…     

手法整复硬纸夹板外固定治疗跟骨骨折60例

【摘要】目的：探讨跟骨骨折手法复位的治疗效果。方法：2009年1月至2012年6月治疗SandesI-Ⅳ型跟骨骨折患者53例（60足）;男45例,女8例;年龄18～65岁,平均（33．5±1．54）岁;病程0．5h～7d。采用手法复位,并以硬纸夹板外固定。治疗前患足肿痛、活动受限明显,部分患足外观宽扁畸形,影像学检查见跟骨骨皮质连续性中断。治疗后采用Creighton-Nebraska跟骨骨折评价标准进行疗效评价。结果：所有患者治疗后12个月随访,按照Creighton-Ne-braska跟骨骨折评价标准评定疗效结果,优13足,良34足,可11足,差2足。结论：SandesI-Ⅳ型跟骨骨折手法治疗临床疗效佳,手法复位既简便又经济,可最大限度恢复跟骨功能,减少并发症,利于足踝功能尽早康复。     

手法整复小夹板外固定治疗桡骨远端骨折的临床观察

<正>桡骨远端骨折系临床常见的损伤,多因跌倒后手部触地所致,成年人及老年人多表现为粉碎性骨折,在儿童则表现为桡骨远端骨骺分离或不完全骨折。常表现有明显的移位及短缩畸形,其中向背侧移位的为伸直型、向掌侧移位的为屈曲型。在临床上采用传统的整复手法和小夹板加压垫外固定     

手法整复小夹板固定治疗闭合性胫骨骨折

胫骨骨折临床上较常见,好发于胫骨中下1/3部位,上1/3比较少,有时可合并腓骨骨折。可发生于任何年龄,多见于儿童和青壮年。在暴力的作用下常合并有软组织损伤。目前随着西医骨科内固定的普及,很多医院都选择了手术内固定,放弃了手法整复术以及外固定术。自1996年1月至2006年12月,采用手法整复小夹板外固定术,配合踝关节皮牵引中立位固定术治疗闭合性胫骨骨折104例,疗效满意,现总结报告如下。     

Supracondylar humerus fractures in children treated with closed reduction and percutaneous pinning

Supracondylar fractures of the humerus in children are important for frequency and type of associated serious complications. The management of this kind of fractures is still controversial (Skaggs et al. in J Bone Joint Surg Am 86:702–707, 2004; Kalllio et al. in J Pediatr Orthop 12:11–15, 1992). We are going to present our experience in the treatment of supracondylar humeral fracture in children. In the Orthopedic Department of Pisa, we treated 150 cases from 1989 to 2006. We are used to perform, emergency or within 12 h, reduction and two lateral-entry percutaneous pins fixation. The mean age was 7.5 years. We checked 125 cases, because we excluded all the cases with follow up less then 5 years. The mean follow up was 8.2 years. We used Gartland classification modified by Wilkins. We evaluated 125 cases by using the Flynn classification: 100 % of patients did not have impairment of the elbow joint mobility. We had seven valgus deviation, one of which was more then 10°. We also had 17 varus deviations, 11 of which were not over 8° and only 2 of them were 15°. The average value of the joint Baumann angle was calculated as great as 16°. The obtained results were classified as very good 80 %, good 11 %, sufficiently good 6 %, and bad 3 %. In our experience, all the fractures type II and III by Gartland have to be treated within 12 h, with closed reduction and stabilization with lateral-entry K-wire technique. The conservative treatment by cast is indicated only in type I fracture. The trans olecranic treatment is not realizable, for the stiffness which can occur, for the risk of iatrogenic ulnar nerve lesion, and for long-time hospitalization. The open reduction remains the first choice treatment for exposed or nonreducible fractures, and in cases of vascular injury.     

Talar neck fractures treated with closed reduction and percutaneous screw fixation:a case series

Talus fractures are relatively rare injuries, accounting for approximately 3% of all foot fractures. Fractures of the talar neck account for almost 50% of all talus fractures. Diagnosis and treatment of these fractures play an important role in patients' outcomes. Treatment of talar neck fractures has slowly evolved from closed treatment to open reduction and internal fixation. Treatment of type I and type II talar neck fractures is debated in the orthopedic community. Choosing which treatment to perform depends on injury severity, associated injuries, and surgeon experience and preference. In this article, we report on our retrospective review of all talar neck fractures treated with closed reduction and percutaneous fixation between 1996 and 2001 at the Pennsylvania State University Milton S. Hershey Medical Center.     

闭合复位LISS钢板治疗胫骨近端多段骨折的临床疗效

目的：通过应用闭合复位AO微创内固定系统（LISS）治疗胫骨近端多段骨折,探讨闭合复位LISS固定对该类骨折复位及愈合的影响。方法：2003年7月至2007年12月,采用闭合复位LISS钢板治疗胫骨近端多段骨折19例,男14例,女5例;年龄21—49岁,平均39．2岁;直接暴力致伤15例,间接暴力致伤4例。致伤原因：交通伤14例,高处坠落伤3例,摔伤2例。于术后随访观察患肢功能恢复情况,及摄X线片显示骨痂生成和骨折愈合情况。结果：患者均获随访,时间8-21个月,平均12．2个月。无固定丢失和骨折不愈合,无钢板和螺钉变形,无软组织感染。膝关节功能按Merchan等评分标准评定,优14例,良3例,可2例。结论：采用闭合复位LISS钢板治疗胫骨近端多段骨折,是一种有效的内固定方法,具有稳定固定、愈合率高、创伤低等优点。     

Displaced femoral neck fractures in young adults treated with closed reduction and internal fixation

This article describes the effect of closed reduction and internal fixation with 3 different screw configurations for acute completely displaced femoral neck fractures in young adults. From 2001 to 2006, 136 patients (age range, 20-50 years) who had acute unilaterally completely displaced femoral neck fractures were evaluated retrospectively. All fractures were managed with closed reduction and internal fixation with 3 cannulated screws. The follow-up period was 55 months on average (range, 36-90 months). One hundred twenty-two patients were available for final evaluation of union condition and late complication. Twenty-three patients (18.9%) had nonunion, 15 (12.3%) had fixation failure, and 21 (17.2%) had avascular necrosis of the femoral head. The average duration from injury to surgery was 18.4 hours in the union group and 23.3 hours in the nonunion group, with no statistical significance (P=.196). The average duration from injury to surgery was 17.3 hours in the avascular necrosis of the femoral head group and 22.3 hours in the non-avascular necrosis of the femoral head group, with no statistical significance (P=.155). Vertical- and separated-type screw configurations resulted in a significantly higher nonunion rate (P=.001 and P=.0017, respectively) than parallel configuration. The complication rate in treating completely displaced femoral neck fractures with internal fixation in young adults is high, and screw configuration may further affect results.     

跟骨牵引+手法复位小夹板固定治疗胫腓骨闭合骨折

2010年3月～2012年1月,我科采用跟骨牵引+手法复位和小夹板外固定治疗51例胫腓骨闭合骨折,临床疗效满意,报道如下. 1材料与方法 1.1病例资料本组51例,男36例,女15例,年龄7～55(31.6±2.4)岁.胫腓骨中上1/3段骨折16例,下1/3段骨折35例.胫腓骨干双骨折28例,单纯胫骨骨折16例,单纯腓骨骨折7例.粉碎骨折12例,螺旋形骨折8例,斜形骨折10例,横断或锯齿状骨折21例.     

π型锁定加压接骨板治疗Barton骨折

目的 探讨切开复位π型锁定加压接骨板(π-LCP)内固定治疗Barton骨折的效果. 方法 2006年1月至2007年1月,对21例Barton骨折患者采用背侧入路切开复位π-LCP内固定进行治疗.其中14例植骨,6例辅以石膏托保护. 结果术后所有患者获得6～18个月(平均10个月)随访,所有骨折均愈合.患者手术前、后在掌倾角、尺偏角、桡骨远端相对长度方而差异有统计学意义(P<0.05).随访时患侧腕关节在背伸、掌屈、桡偏等方面与健侧比较差异无统计学意义(P>0.05);尺偏角小于健侧,差异有统计学意义(t=2.548,P<0.05).用改良的Gartland和werkey评分系统评估腕关节功能:优15例,良4例,中2例,优良率为90.5%. 结论背侧入路切开复位π-LCP内固定是治疗Barton骨折的有效方法.