成人一侧股骨、胫骨分段延长术

 目的设计股骨胫骨分段延长术治疗严重短肢合并股骨前倾角畸形疑难病例.方法1990年5月～1999年12月用该术式实施的脊髓灰质炎后遗成人严重短肢合并股骨上端畸形12例.结果随访时间最短2 a,最长9 a,平均6 a.12例中胫骨延长从3.5～5.5cm,平均4.4 cm;股骨延长1.6～3.5 cm,平均2.7 cm,股骨胫骨共延长5.1～8.5 cm,平均7.1 cm;前倾角畸形明显改善.结论股骨胫骨分段延长术是治疗严重短肢合并股骨上端畸形的一种有效治疗方法.     

髂骨股骨一次截骨延长术18例报告

我院于1986年6月至1988年8月采用髂骨股骨一次旋转截骨延长治疗髋关节不稳及短肢畸形共26例,随访18例,疗效满意。现介绍如下: 临床资料:本组男11例,女7例,年龄10～20岁,平均16.5岁。患肢短缩3～6cm,平均3.8cm,延长3.0～5.5cm,平均4.1cm。本组18例病人先后都进行了随访,最短6个月,最长16个月,平均为     

髂骨尤文氏肉瘤一例报告

患儿，男，10岁，一月前因头痛、发烧，当时诊为感冒，肌注洁霉素、链霉素治疗不见好转，继而出现跛行，同时发现右臀部隆起、肿痛，故来我院就诊。体检，发育营养可，右臀部后外上1／4区隆起，可触及8cm×8cm大的肿块，质硬，固定，触疼明显．局部皮肤温度不高，不红，表浅静脉无怒张。化验检查，血WBC17．8×10^9/L。     

髂骨巨细胞瘤一例

患者　男 ,2 4岁。因左髂部摔伤疼痛 8小时入院。患者因骑摩托车不慎摔倒 ,伤其左髂骨 ,疼痛剧烈 ,左下肢活动明显受限。体检 :体表无破损 ,被动体位 ,功能受限 ,深压痛及叩击痛。Ｘ线平片示 :左侧髂骨见大片状密度减低区 ,边缘清晰 ,呈网格状 ,其内可见大小不等囊状阴影。左侧髋臼上缘骨折 ,断端明显错位。ＣＴ扫描 :左侧髂骨翼呈膨胀性改变 ,骨皮质变薄呈皂泡样 ,并见骨性分隔及病理性骨折 ,其内可见软组织结构 ,ＣＴ值 16ＨＵ(图 1、2 )。手术所见 :左侧髂骨外侧骨皮质膨大变薄 ,其内骨质破坏 ,见灰红色腐肉样组织。病理诊断 :髂骨巨细胞…     

髂骨骨肉瘤一例

患者 男,17岁。左腰腿疼痛3个月,加重伴行走困难半个月入院。体检：一般情况好,左骶髂关节稍肿胀,压痛明显,但无红、热及浅表静脉曲张。左臀部明显压痛,左小腿肌肉萎缩,外侧感觉障碍。实验室检查：碱性磷酸酶300U／L。     

髂骨骨样骨瘤一例

患者　男 ,33岁。无明显诱因出现左髂部钝痛 10余年 ,呈间歇性发作 ,现发作间歇缩短 ,且频繁 ,口服“芬必得”后症状可缓解。查体 :左髂部压痛 (± ) ,余无阳性体征。实验室检查 :血、尿常规及肝肾功能正常。Ｘ线检查 :左髂骨翼见一片状边缘骨质硬化透光区 ,其内部有密度减低区内有密度增高钙化影 ,其余骨质未见异常。Ｘ线诊断 :左髂骨皮质内脓疡 ,不排除良性骨肿瘤 (图1)。手术所见 :左髂骨内有 0 .9ｃｍ× 3.0ｃｍ× 3.5ｃｍ骨硬化区 ,在其硬化骨内有一 0 .2 5ｃｍ的瘤巢 ,瘤巢内肿瘤组织呈灰白色的肉芽组织样。病理结果 :骨样骨瘤。讨论…     

右髂骨巨大内生软骨瘤一例

病例资料　患者,男,42岁,因右髂骨区间断性疼痛3个月就诊。体格检查:右髂区压痛,余未见明显异常。X线检查:右髂骨可见一巨大囊性占位病变,边界较清楚,内缘可见小的骨脊(图1)。CT检查:右髂骨可见一囊性低密度区,边缘清晰,有轻度硬化。局部边缘可见骨脊(图2 )。病理诊断:右髂骨内生软骨瘤。讨论　内生性软骨瘤是较常见的良性肿瘤,与胚胎性组织残留或异位有关。主要成分有透明软骨,骨化的软骨、黄棕色假囊肿,好发四肢短管状骨,常为单侧性,边缘整齐,呈椭圆型透亮区。肿瘤一般为中心性生长,邻近的骨皮质呈梭形膨胀、变薄,肿瘤的周围有一薄层骨…     

左髂骨硬纤维瘤一例

病例资料患者,男,32岁,因左髋酸痛2个月入院。体检:腹平软,左侧髋部未扪及肿块,左髋关节活动正常。X线平片:左髂骨见一直径约10 cm的囊状膨胀性骨破坏区,境界清楚,边缘呈波浪状, 有窄的硬化带,内部可见粗大的骨嵴将病变区分割成大小不等的多房状(图1)。 CT平扫:左髂骨见膨胀性骨破坏区,CT 值51 HU,境界清楚,内部可见骨嵴,无钙化,骨皮质不连续,病变向周围软组织生长(图2)。MR平扫:T1WI示病变呈均匀较低信号,与邻近肌肉组织信号相近, 境界清楚,边缘硬化带呈低信号,病灶向内侧软组织生长;T2WI压脂图像示病变呈高低混杂信号,中央可见斑片状低信号区(图3、4)。     

髂骨动脉瘤样骨囊肿一例

患者女,29岁。发现右髋部肿物半年入院。患者半年前不慎摔伤致右髋部疼痛,但无明显红肿,可自行站立行走,当时未作特殊处理。自后右髋部肿物日渐增大,遂来院求诊。体检:右髋部红肿,皮温正常,可扪及一约9cm×6cm大小肿块,质硬,边缘清晰,无明显压痛,活动度差。X线检查:骨盆正位片示右侧髂骨外缘一约为8.5cm×7.4cm大小类圆形膨胀性透亮区,病灶周围为清晰的骨性边缘,厚约0.5cm;其内见多发条索状分隔;病灶周围骨质未见明显异常,无骨膜反应,软组织未见明显肿胀。右侧骶髂、髋关节间隙不窄,关节关系正常。诊断意见:骨巨细胞瘤可能性大(图1)。CT检…     

Callus patterns in femur lengthening using a monolateral external fixator

Objective We studied the callus pattern seen in femoral lengthening using monolateral external fixator to determine whether callus types and shapes can predict the final outcome of the procedure. Material and methods The radiographs of 41 cases of femoral lengthening (33 unilateral and 8 bilateral) in 33 patients with a mean age 11.9 years (range 4–22 years) were retrospectively analysed by four observers and classified into different shapes and types in concordance with the Ru Li classification. The classification was tested for concurrence and reproducibility by inter-observer studies. Results An average of 6.2 cm of lengthening (range 3–10.8) was achieved with an external fixator index of 36.5 (range 20.9–55.3). The fusiform type of callus (fixator index 32.04, maturation index 21.6) showed the best result followed by the cylinder type of callus (fixator index 35.7, maturation index 22.3) and the lateral type of callus (fixator index 33.2, maturation index 21.5). However, the concave type of callus showed poor results with a fixator index of 49.4 and a maturation index of 37.1. The homogeneous path showed the best results (fixator index 30.4, maturation index 18.6). The heterogeneous path also showed good results (fixator index 36.4, maturation index 23.9). The mixed path (fixator index 42.5, maturation index 30.8) and the lucent path (fixator index 45.1, maturation index 32.8) showed poor results. Conclusion Analysis of the callus pattern helps the surgeon to predict the outcome of the procedure and guide him in planning any additional interventions if necessary. Each author certifies that he has no commercial associations (e.g. consultancies, stock ownership, equity interests, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.     

Intraosseous pneumatocyst of the ilium: CT findings in two cases and literature review

Intraosseous pneumatocyst of the ilium is a rare lesion of uncertain origin. It predilects male subjects and may be associated or not with sacroiliac joint degenerative disease, intra-articular gas, sacral pneumatocyst, and communication with the articular space. To our knowledge, only 16 observations have been reported in the literature. We have evaluated with plain radiographs and CT two additional cases. Plain films frequently identify these lesions, but CT is the method of choice in demonstrating their air density and assessing the possible abnormalities of the surrounding bone and sacroiliac joints. Received 5 August 1996; Revision received 31 January 1997; Accepted 12 February 1997     

数字化及3D打印技术结合非血管化髂骨修复外伤性上颌骨前牙区骨缺损的疗效

目的 探讨数字化及3D打印技术结合非血管化髂骨修复外伤性上颌骨前牙区骨缺损的疗效.方法 采用回顾性病例系列研究分析2013年6月至2018年1月郑州大学第一附属医院收治的8例外伤性上颌骨前牙区严重骨缺损患者临床资料,其中男6例,女2例;年龄18～43岁[(31.9 ±9.0)岁].术前均采用数字化技术对上颌骨进行重建,...     

Biometric sex assessment from the femur and tibia in a modern Greek population

Forensic anthropologists assess sex by analysing quantitative and qualitative characters of the human skeleton. In general, the pelvis and skull are the skeletal regions used most often, but in many cases, they are missing or fragmentary. In such circumstances, where only limb bones are present, it is necessary to use techniques based on other skeletal elements. Metric traits of the long bones of the lower extremities have been reported as reliable indicators of sex. This study was designed to determine whether the two main long bones of the leg, the femur and tibia, can be used for the assessment of sex on a Greek skeletal population. The skeletal sample used in this study comes from the modern human skeletal collection that is currently housed at the National and Kapodistrian University of Athens and is known as The Athens Collection. It consists of 371 femora and 372 tibiae corresponding to 200 adult individuals (111 males and 89 females). The age range is 19–96 years for males and 20–99 years for females. The maximum lengths and epiphyseal widths were measured for the present study, and it was found that the discriminant analysis of the metrical data of each long bone provided high sex discrimination accuracies. The rate of correct sex discrimination based on different long bones ranged from 91.50 % (left femur) to 93.40 % (left tibia). Our results suggest that lower limb bones can be used effectively for sexing in forensic contexts, in addition to other sex assessment techniques.     

Inflammatory metachronous hyperostosis of the clavicle and femur in children

Two preteenage girls developed painful swelling of the left clavicle. This was followed by painful swelling of the femur, 7 months later in one girl and 8 years later in the other. Radiographic studies showed a predominantly sclerotic process in one patient and destruction associated with cortical thickening in the other. The patients received analgesic medications only, followed by gradual healing with cortical and medullary sclerosis. Long-term follow-up suggests that the condition is self-limited and that, with or without treatment, the bones eventually return to normal. Although the etiology of the lesions remains unknown, the radiographic features suggest an inflammatory reaction.     

Percutaneous hamstring lengthening in cerebral palsy: Technique and gait outcomes based on GMFCS level

BackgroundIncreased knee flexion at initial contact and in stance is a common problem for children with cerebral palsy. Surgical correction with percutaneous hamstring lengthening is an alternative to open hamstring lengthening; however, outcomes are less well documented, and there is concern about increasing anterior pelvic tilt. The purpose of this study was to evaluate the short-term outcomes of percutaneous hamstring lengthenings in children with cerebral palsy using comprehensive gait analysis techniques.Research QuestionDoes percutaneous hamstring lengthening improve knee function, and do knee and anterior pelvic tilt outcomes vary by GMFCS level?MethodsA convenience sample of 52 patients with both pre and post-surgical gait analyses was evaluated retrospectively for changes in gait function in terms of temporal-spatial parameters, kinematics and kinetics. Patients were divided into two GMFCS subgroups: GMFCS level I/II and III.ResultsThe percutaneous hamstring lengthening results in statistically significant improvements in knee function during gait with increased knee extension at initial contact (mean 32° SD 13° to mean 21° SD 11°, p = 0.000) and improved mean knee flexion in stance (mean 23° SD 12° to mean 16° SD 11°, p = 0.000) for the total study cohort. Beneficial changes were found for knee function in both GMFCS level subgroups; however, there was an increase in pelvic tilt pre to post-surgery in the GMFCS level III subgroup (mean 21° SD 8° to mean 26° SD 6°, p = 0.012) but not the GMFCS level I/II subgroup (mean 18° SD 7° to mean 20° SD 8°, p = 0.427).SignificancePercutaneous hamstring lengthening can improve knee function for all patients; however, the impact on anterior pelvic tilt varies by GMFCS level, with increasing anterior tilt for GMFCS level III only. This study highlights the importance of understanding differences in surgical outcomes by GMFCS level to better predict post-surgical function.     

带旋髂深血管蒂的髂骨瓣转位移植治疗股骨颈骨折12例

临床验证带旋髂深血管蒂的髂骨瓣转位移植治疗股骨颈骨折的有效性、安全性.     

Arthroscopic assisted reduction and internal fixation of lateral femoral epiphyseal injury in adolescent soccer player: a report of one case

Ligament injuries are more common than fractures in adolescents. We operated on an adolescent soccer player, who had a lateral femoral epiphyseal injury using arthroscopic-assisted reduction and percutaneous internal fixation. During second-look arthroscopy 2 years after the first operation, there was articular cartilage congruity, without any visible step-off. The axial alignment did not reveal any residual valgus deformity.