椎弓根螺钉固定治疗Hangman 骨折

目的 探讨C2椎弓根螺钉在治疗Hangman骨折中应用效果。方法 8例均于颅骨牵引复位后行C2椎弓根螺钉内固定治疗。结果 8例均获随访,随访时间2～8个月,平均6个月。其中6例骨性愈合,2例仍在随访中。无感染、神经损伤等并发症发生。结论 应用C2椎弓根螺钉治疗Hangman骨折是一种有效、安全并能最大程度保留患者颈部功能的较好方法。     

不稳定Hangman骨折的手术治疗

目的 探泔颈椎后路椎弓根螺钉内同定治疗不稳定Hangman骨折的临床效果.方法 2001年10月至2006年4月收治15例不稳定Hangman骨折患者,骨折按照Levine-Edwards分型:Ⅱ犁3例,ⅡA型4例,Ⅲ型8例.入院后均给予颅骨牵引,行颈后路切开复位、椎弓根螺钉内固定术治疗.在复位不完全时,脱位不严重者采用C2.3复位固定;脱位严重时,在C<.2>椎弓根钉和C3侧块螺钉固定的基础上,增加C4的侧块螺钉固定.结果 术后随访3～30个月,平均17个月.6例术前脊髓功能Frankel分级为D级的患者术后恢复至E级,所有患者术后复奋X线片示:骨折全部获得骨件愈合,无明显的颈椎功能受限.结论 C2.3或C2-4后路椎弓根螺钉内固定手术是治疗不稳定Hangman骨折的有效方法,可达到早期复位、坚强同定的目的 .     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定性Hangman骨折的手术治疗

目的：探讨不稳定性Hangman骨折的手术治疗策略。方法：回顾性分析28例不稳定性Hangman骨折患者的临床资料，根据Levine和Edwards的X线分型标准，Ⅱ型骨折9例，ⅡA型骨折12例，Ⅲ型骨折7例。男22例，女6例；年龄17～62岁，平均39岁。受伤至手术时间1～16d，平均4d。致伤原因：交通事故伤13例，头部重物砸伤6例，坠落伤、头面部撞击地面5例，颈椎过伸伤2例，其他原因2例。12例合并神经症状。20例采用了前路融合加钢板内固定术，8例行后路融合固定术，评价两组的手术效果。结果：所有患者术后均获得骨性愈合，一旦复位固定，神经功能恢复良好。20例前路内固定和4例后路椎弓根螺钉固定者，术后颈椎活动度无明显改变；4例后路复位、植骨加钢丝固定者，术后颈椎旋转活动度减少50%～70％。结论：颈椎前路融合加钢板内固定术治疗不稳定性Hangman骨折可获得良好的即时稳定性，有利于患者早期下床活动，且不影响颈椎活动度。     

跟骨骨折的手术治疗

目的:探讨AO跟骨钢板治疗跟骨有移位骨折的疗效。方法:跟骨骨折73例81足,男61例,女12例;年龄18~63岁,平均41岁。双侧跟骨骨折8例,单侧65例(左侧33例,右侧32例)。按Sanders分型:Ⅱ型36例,Ⅲ型28例,Ⅳ型9例。采用AO跟骨钢板治疗,伤后1~3d手术48例,伤后4~7d手术14例,7d以上手术11例。结果:术后73例均获得随访,时间6~26个月,平均15个月。按Fernandez标准评定分为4级,优31例,良37例,可2例,差3例。本组有7例术后出现切口边缘皮肤坏死,其中5例予以择期植皮,2例局部邻近皮瓣转移覆盖治愈。结论:AO跟骨钢板根据跟骨的解剖特点和跟骨有移位骨折的特点而设计,对跟骨骨折块进行固定有较好的把持力,增强抵抗应力,防止再移位。     

垂直旋转不稳定型骨盆骨折的手术治疗探讨

目的：探讨垂直旋转不稳定型骨盆骨折前联合入路内固定的临床疗效。方法：旋转垂直不稳定型骨盆骨折34例，男23例，女11例；年龄13-56岁，平均36岁。按Young—Burgess分类：APCⅢ型损伤9例，LCⅢ型损伤14例，VS损伤11例。入院骨盆外支架固定、抗休克处理，全身情况稳定后，均通过前联合人路切开复位钢板内同定。结果：34例术后获随访，时间12-48个月，平均21个月，术口愈合良好，骨折均3—6个月愈合。按Majeed疗效评价标准：优21例，良10例，中3例。无畸形愈合，遗留跛行3例，腰骶痛4例，双小腿、足麻木3例。结论：前联合入路切开复位内固定治疗旋转垂直不稳定型骨盆骨折，矫正畸形，重建骨盆环稳定性，效果满意。     

外旋型踝关节骨折中后踝的治疗

目的：总结踝关节骨折中后踝的诊断、手术方法,阐述后踝骨折复位固定的重要性。方法：2004年1月至2008年1月手术治疗的踝关节外旋型骨折合并后踝骨折患者25例,男17例,女8例;年龄21-67岁,平均34岁。按Lauge—Hansen分型,旋前外旋型Ⅳ型13例,旋后外旋型Ⅲ型7例、Ⅳ型5例。后踝骨折中20例采用螺钉内固定,5例采用石膏外固定。术后用X线即时评估标准观察手术复位效果。结果：随访时间为7～36个月,平均15个月,按Leeds临床评定标准进行评定,优21例,良2例,差2例。对踝关节作活动范围的评估并与健侧比较,两者在背伸、跖屈方面无明显差异。结论：良好的复位、固定,以及后踝正确处理是恢复踝关节正常功能的保证。     

手术治疗Pilon骨折34例

Pilon骨折是涉及胫骨踝关节面损伤的胫骨远端干骺端骨折,近年来随着高能量损伤的增多,该类型骨折有增加的趋势,自2000-2005年,采用切开复位内固定的方法治疗Pilon骨折34例,疗效满意,现总结报告如下。1临床资料本组34例,男28例,女6例;年龄13~73岁,平均为40.6岁。车祸伤16例,高处坠落伤18例。开放骨折4例。合并颅脑损伤2例,胸腰椎骨折5例,跟骨骨折1例,腓骨下1/3骨折19例、中段骨折7例。其中按R櫣edi-Allg wer分型[1]:Ⅱ型骨折13例,Ⅲ型骨折21例。伤后就诊时间1h~5d,伤后至手术时间2h~14d,平均9.5d。2治疗方法2.1闭合损伤软组织肿胀严重者,先…     

老年踝关节骨折的手术治疗

目的：分析总结老年人踝关节骨折手术治疗的效果、以及增加手术成功率的手术技巧。方法：回顾性分析2003年1月至2008年12月老年踝关节骨折手术治疗病例128例,男26例,女102例;年龄50～82岁,平均69岁。根据Lange-Hanson分型：旋后外旋型113例,旋前外旋型8例,旋后内收型5例,旋前外展型2例。所有患者施行切开复位内固定术,记录手术方法、早期并发症、患者满意度,应用美国足踝外科协会(AOFAS)踝与后足评分评定手术效果。结果：128例术后获得随访,时间6个月～6年,平均36个月。伤口延迟愈合11例(8.6%);无深部感染、骨折不愈合、内固定翻修等情况发生。AOFAS评分疼痛评分(33.5±5.6)分,功能评分(40.2±7.4)分,后足的排列均得到10分,总分(83.6±6.3)分。结论：手术治疗骨质疏松性老年人踝关节骨折应是多数情况下的首选方法。虽然骨质疏松使内固定手术的难度增加,但是通过手术方法的改进,能够使老年踝关节骨折取得好的治疗效果。     

复杂外旋型踝关节骨折中后踝的治疗策略

目的:总结和探讨复杂外旋型踝关节骨折中后踝固定的适应证、手术方法及疗效,阐明后踝骨折解剖复位、坚强内固定的重要性。方法:2007年7月至2009年6月内固定治疗后踝骨折32例,男21例,女11例;年龄19～68岁,平均36岁。按照Lauge-Hansen分型,旋前外旋型Ⅳ型13例,旋后外旋型Ⅲ型7例,旋后外旋型Ⅳ型12例。术后早期功能锻炼,同时定期随访,对踝关节功能恢复进行评定。结果:32例患者均获随访,时间7～20个月,平均14.5个月,所有骨折获得骨性愈合。疗效评定按照美国足踝骨科协会(AOFAS)推荐的足踝评分系统评分如下:优(90～100分)23例,良(80～89分)7例,可(70～79分)2例,差(<69分)0例。结论:后踝骨折良好的复位、坚强的固定及早期功能锻炼对踝关节功能恢复、降低创伤性关节炎的发生具有重要意义。     

股骨转子下粉碎性骨折的手术治疗

股骨转子下骨折为小转子以下5cm以内的股骨上端骨折，从1996年-2002年收治75例股骨转子下粉碎性骨折，采用切开复位股骨交锁髓内钉或重建钉作内固定和梅花钉内固定结合股骨髁上骨牵引，取得较好疗效，现报告如下。     

Dupuytren骨折及其治疗

我院自1998年6月收治典型Dupuytren骨折48例,效果满意,现报道如下.……