微型钢板螺钉内固定治疗桡骨头骨折

目的 研究微型钢板螺钉内固定治疗桡骨头骨折的治疗方法 和疗效.方法 对18例桡骨头骨折行切开复位微型钢板螺钉内固定并进行早期功能锻炼.结果 按Metaizeau肘关节治疗评定方法:优12例,良4例,可2例.结论 用微型钢板螺钉对桡骨头骨折作内固定,具有复位满意、固定可靠、方法 简单,减少了关节僵硬、异位骨化的发生率,有...     

微型锁定钢板内固定治疗多发掌骨粉碎性骨折

目的探讨微型锁定钢板治疗多发性掌骨粉碎性骨折的疗效。方法自2010年1月至2014年3月共收治多发掌骨粉碎性骨折21例,均为闭合性骨折,有4例合并第5腕掌骨关节脱位,均采用切开复位微型锁定钢板固定,对伴腕掌关节脱位者则术中复位后同时行克氏针固定,术后指导患者进行功能锻炼。结果术后随访3~6个月,平均随访4个月,骨折愈合时间8~12周。按手指主动活动度功能评定,优16例,良2例,中2例,差1例,优良率85%。结论微型锁定钢板对于掌骨多发骨折是一种良好内固定,固定可靠,疗效满意,有利于患者手功能恢复。     

Bold空心加压螺纹钉结合微型钢板治疗MasonⅡ、Ⅲ型桡骨头骨折

[目的]探讨Bold螺钉结合微型钢板治疗MasonⅡ、Ⅲ桡骨头骨折的临床疗效.[方法]2005年2月～2009年3月共收治MasonⅡ、Ⅲ型桡骨头骨折,行Bold螺钉内固定,其中5例加用微型钢板固定.术后早期功能锻炼.通过随访根据X线检查、活动范围及Broberg、Morrey功能评分对肘关节的功能及疗效进行评估.[结果]术后随访15～45个月,平均28个月,骨折均愈合.Broberg、Morrey功能评分:优9例,良6例,可2例,优良率88.2%.[结论]应用Bold螺钉结合微型钢板治疗MasonⅡ、Ⅲ型桡骨头骨折可获得较满意疗效.     

国产微型钢板螺钉固定掌指骨骨折疗效评价

目的：探讨国产微型钢板螺钉固定掌、指骨骨折的疗效。方法：切开复位，微型钢板螺钉固定掌、指骨骨折，术后外固定0—2周，然后去除外固定，进行早期主动性手部功能训练。定期随访摄片，骨折愈合时间为6—10周，骨折愈合后2—3个月取出钢板螺钉。结果：55例患均获满意疗效，功能恢复优良(96％)。结论：国产微型钢板螺钉固定掌、指骨骨折可提供稳定可靠的内固定，又可进行术后早期功能训练，能缩短骨折愈合时间，有利于手部功能早日康复。治疗效果明显优于常规的固定方法，值得应用和推广。     

桡骨头骨折的手术治疗

目的评价桡骨头骨折切开复位微型钢板螺钉内固定的临床效果。方法应用微型钢板螺钉治疗桡骨头骨折21例，术后将肘关节伸直位前臂中立位固定5～10d。结果术后随访6．5个月。21例患者中19例骨折愈合，平均愈合时间10周。肘关节活动好，无活动痛。2例骨折未愈合，1例行单纯桡骨头切除术，1例行假体置换术。结论就目前随访结果分析，切开复位微型钢板螺钉固定治疗桡骨头骨折，愈合率高，肘关节功能优良。该方法操作简单，易于掌握，是一种桡骨头骨折理想的治疗方法。     

切开复位钢板螺钉内固定治疗Ruedi—AllgowerⅡ型的Pilon骨折疗效分析

目的回顾分析了切开复位钢板螺钉内固定治疗Ruedi—AllgowerⅡ型的Hlon骨折所适宜类型，手术时机和手术疗效。方法对2001年3月～2004年5月共16例行切开复位钢板螺钉内固定治疗Ruedi—AllgowerⅡ型的Pilon骨折患者进行随访，平均年龄38岁，伤后至手术时间7～13天，治疗采用切开复位钢板螺钉内固定，胫骨应用三叶草钢板或胫骨远端解剖钢板置于内侧固定，腓骨应用1／3管型钢板或重建钢板置于外侧或后侧固定，术后石膏托辅助固定4～8周。结果采用Mazur评分系统评估手术疗效，16例患者，优7例，良7例，中2例，优良率达87．5％。切口并发症2例中1例切口裂开，1例浅表感染，无深部感染。结论对Ruedi—AllgowerⅡ型的Pilon骨折，应用切开复位钢板螺钉内固定是合适的。     

应用微型钢板螺钉内固定治疗跖骨骨折

目的：探讨应用微型钢板螺钉内固定治疗跖骨骨折的临床疗效。方法2009年6月-2012年12月对84例85足跖骨骨折患者采用切开复位微型钢板螺钉内固定治疗,术后于医生指导下行康复功能锻炼。结果本组84例均获得随访,随访时间6～24个月,平均10个月。84例85足患者中一期愈合82例83足,1例术后3 d出现皮下血肿感染,1例开放性骨折术后出现皮肤坏死,采取相应治疗措施后愈合。术后定期复查X线片,骨折愈合时间为8～16周,平均13周。术后无骨折不愈合及内固定松动断裂等情况,平均14周（9～18周）可完全负重行走,平均6个月（5～12个月）取出内固定物。参照美国足踝矫形协会（AOFAS）前足评分标准评估,优29足,良49足,可5足,差2足,优良率91.76%。结论采用微型钢板螺钉内固定治疗跖骨骨折,不仅可恢复足弓生理形态,而且有利于患足关节功能恢复,骨折愈合快,值得临床推广应用。     

无头变径空心螺钉结合微型钢板治疗中青年Mason Ⅲ型桡骨头骨折

目的 探讨切开复位无头变径空心螺钉结合微型钢板治疗中青年Mason Ⅲ型桡骨头骨折的临床疗效.方法 自2014年7月至2019年7月,我们共收治21例Mason Ⅲ型桡骨头骨折患者,采用切开复位无头变径空心螺钉结合微型钢板固定治疗.术后随访观察骨折愈合、并发症发生率,并测量术后肘关节屈伸及前臂旋转活动范围,对其进行评价...     

微型锁定钢板在MasonⅢ型桡骨头骨折治疗中的应用

目的观察微型锁定钢板在MasonⅢ型桡骨头骨折治疗中的临床疗效。方法对11例MasonⅢ型桡骨头骨折采用传统Kocher入路行切开复位微型锁定钢板螺钉内固定术,对其临床资料进行回顾性分析。结果 11例获得随访6-18个月,平均10个月,采用Broberg和Morrey肘关节评分标准：优6例,良3例,中2例。结论采用微型锁定钢板内固定治疗MasonⅢ型桡骨头骨折效果可靠、并发症较少,有利于早期功能锻炼及肘关节功能恢复。     

跟骨关节内骨折钢板内固定手术疗效及并发症分析

目的探讨切开复位钢板内固定治疗跟骨关节内骨折的疗效及手术并发症。方法对68例（75足）跟骨关节内骨折行切开复位钢板内固定治疗,均行跟骨外侧L形切口,复位关节面骨折,恢复Bohler角和±issane角后用钢板固定。采用AOFAS评分评定手术效果。结果68例均获得平均22（12—46）个月随访,骨折均愈合。Bohler角由术前（6．5±11．6）°恢复至术后（27．2±6．8）°,Gissane角由术前（88．7±10．4）°恢复至术后（123．5±10．2）°。19足出现并发症。结论切开复位、钢板内固定治疗跟骨关节内骨折疗效满意,适当的手术时机和熟练的手术技巧可以减少手术并发症。     

Pilon骨折59例疗效分析

目的 探讨Pilon骨折治疗方法的选择。方法 对59例Pilon骨折按保守治疗、有限内固定结合外支架、苜蓿叶形钢板内固定三组进行比较分析：结果 参照Helfet标准，有限内固定结合外支架与苜蓿叶形钢板内固定组疗效优于保守治疗组。结论 治疗方案的选择在Pilon骨折的治疗、预后中起重要的作用。     

Unstable Trochanteric Fractures: A Comparative Analysis of Four Methods of Internal Fixation

A series of 1,071 patients with unstable trochanteric fractures were treated by the McLaughlin or Jewett nail—plate, the sliding screw—plate or con—dylocephalic nailing according to Ender.

Deep infection was encountered in 2.5 per cent of the cases following surgery in the hip region and in 3.3 per cent of the Ender nailings.

Statistical analyses showed that the quality of the reduction was determined by the comminution of the fracture, and the technical failure of fixation or secondary displacement of the fracture was determined by the quality of the reduction.

Sliding screw—plate fixation was found to be the only suitable fixation method for unstable trochanteric fractures, because of a low failure rate, a low re—operation rate and the possibility of secondary impaction without disturbing the fracture union.     

Stable Trochanteric Fractures. A Comparative Analysis of four Methods of Internal Fixation

A series of 375 patients with stable trochanteric fractures were treated with the McLaughlin or Jewett nail-plate, the sliding screw-plate or Ender nailing.

Technical failure of fixation was encountered in 5 per cent of the cases regardless of the method of fixation used. Re-operations were performed in less than 3 per cent of cases treated with hip implants but in 20 per cent of cases with Ender nailing, mainly because of distal slipping of the nails resulting in knee problems.

With an improved technique, however, Ender nailing can be used as successfully as any of the hip implants for the internal fixation of stable trochanteric fractures.     

桥接组合式内固定系统治疗股骨干粉碎性骨折

目的：探讨桥接组合式内固定系统治疗股骨干粉碎性骨折的临床效果。方法回顾性分析2008年3月至2012年3月昆明医科大学附属延安医院采用桥接组合式骨折内固定系统治疗的45例股骨干粉碎骨折患者的临床资料,评估手术时间、出血量、骨折愈合时间及肢体功能恢复情况。结果45例患者获随访12～24个月（平均18个月）,手术时间1.0～2.5 h（平均1.5 h）、出血量100～400 mL（平均200 mL）、骨折愈合时间4.0～6.0个月（平均4.5个月）。随访期间未见伤口感染,骨不愈合,内固定松动、断裂等严重并发症。术后Sanders肢体功能评价：优40例、良2例、可3例,优良率为93%（42/45）。结论桥接组合式内固定系统操作简单、临床疗效满意,是股骨干粉碎骨折治疗的一种新选择。     

四肢骨折内固定物松动折断原因探讨

目的对四肢骨折内固定物松动折断的原因进行探讨。方法回顾性分析我院1996年3月~2006年8月收治的四肢骨折内固定术后内固定物松动断裂20例患者的临床资料。其中,股骨干骨折11例,胫骨骨折4例,肱骨骨折2例,尺桡骨骨折3例;加压钢板折断者14例,普通钢板折断者6例,螺钉折断15枚,松动12枚。发生骨不连10例。采用原固定物取出,重新复位固定处理。结果20例平均随访15个月,均骨性愈合,未再发生内固定材料松动断裂。结论内固定物选择不恰当、质量欠佳,骨不连,骨质疏松,手术操作不当,过早负重,缺乏坚强的内固定和必要的外固定以及不恰当的功能锻炼等是导致内固定物松动断裂的主要原因。     

不同类型尺骨鹰嘴骨折的内固定选择

Objective To discuss options of internal fixation devices for different types of olecranon fractures. Methods A retrospective analysis was done for 62 patients with olecranon fractures who had been treated in our department from February 2007 to November 2009. Of them, 36 cases were treated with tension band wiring (TBW) and 26 cases with plating. The differences between the 2 groups were compared according to Broberg and Morrey scales. Results The patients were followed up for 6 to 24 months (average, 11 months) . There were no significant differences between the 2 groups in terms of scores of Broberg and Morrey scales (χ2 = 1. 484, P =0. 361 ) . There were 5 losses of reduction in the TBW group while there were 2 cases of myositis ossificans in the plating group. Conclusions Internal fixation by TBW is preferred in the majority of patients with simple olecranon fractures. Dorsal plating is particularly indicated in the comminuted fracture and fracture dislocations.     

不同类型尺骨鹰嘴骨折的内固定选择

Objective To discuss options of internal fixation devices for different types of olecranon fractures. Methods A retrospective analysis was done for 62 patients with olecranon fractures who had been treated in our department from February 2007 to November 2009. Of them, 36 cases were treated with tension band wiring (TBW) and 26 cases with plating. The differences between the 2 groups were compared according to Broberg and Morrey scales. Results The patients were followed up for 6 to 24 months (average, 11 months) . There were no significant differences between the 2 groups in terms of scores of Broberg and Morrey scales (χ2 = 1. 484, P =0. 361 ) . There were 5 losses of reduction in the TBW group while there were 2 cases of myositis ossificans in the plating group. Conclusions Internal fixation by TBW is preferred in the majority of patients with simple olecranon fractures. Dorsal plating is particularly indicated in the comminuted fracture and fracture dislocations.     

Stripping torque as a predictor of successful internal fracture fixation

BACKGROUND: Internal fixation of fractures using plates and screws is a common method of treatment. Occasionally the internal fixation fails prior to fracture healing. This often requires revision surgery. Determining the force that internal fixation needs to withstand postoperatively would enable this force to be applied intraoperatively as a test to predict successful fixation. The purpose of the present paper was to determine the minimum stripping torque needed to predict successful internal fixation strength. METHODS: The pull-out strength and stripping torque relationships of 4.5-mm cortical bone screws in Sawbones polyurethane foam were determined. Screw forces were directly measured using an LCM load cell washer on a model intertrochanteric neck of femur fracture fixed with 135 degrees 4-hole pin and plate loaded to single leg stance conditions. Additionally a 135 degrees 4-hole pin and plate was mounted on foam blocks and loaded until failure of the shaft screws from the foam occurred. Predicted stripping torque/yield load was determined. RESULTS: Pull-out strength and stripping torque of 4.5-mm cortical bone screws in polyurethane foam have a high degree of linear correlation R(2) = 0.95. Direct measurement of shaft screw forces at single leg stance conditions were 585-686 N. This correlated with a stripping torque of 0.9 Nm. Load to yield testing at single leg stance conditions corresponded to a stripping torque of 1.8 Nm. CONCLUSION: Withstanding 0.9-1.8 Nm of torque during insertion of the femoral shaft screws of a 135 degrees 4-hole pin and plate predicts that the construct will successfully withstand single leg stance.     

Pilon骨折三种不同治疗方法疗效探讨

目的探讨Pilon骨折的三种不同治疗方法临床适应证及其疗效评价。方法对2000年2月至2006年3月间治疗的63例Pilon骨折患者进行回顾性分析。其中开放性损伤15例，闭合性损伤48例。根据骨折类型与周围软组织损伤程度，分别采用三种不同治疗方法：跟骨牵引加小夹板固定组（29例）均为闭合性骨折，内固定组（23例），外固定器组（11例）。结果所有患者均获得随访，随访8～31个月（平均15．3个月），骨愈合时间8～14周，平均10周。按Helfet疗效评价标准，本组优良者57例（90．5％），其中Ⅰ型骨折优良者26例，Ⅱ型骨折优良者15例，Ⅲ型骨折优良者16例。结论根据骨折类型及软组织条件，恰当选择固定方法是取得Pilon骨折满意疗效的关键，可有效避免并发症的发生。     

Ruedi-AllgowerⅢ型Pilon骨折的疗效分析

目的回顾分析我院治疗Pilon骨折的病例,探讨Ruedi-Allgower型Pilon骨折的治疗方法。方法对2001年10月至2004年10月共16例Ruedi-Allgower型Pilon骨折给予有限内固定结合外固定治疗,同时术后给予必要的对症治疗与合理的功能锻炼。结果随访10~24个月,平均16个月。按照Mazur评分系统评估疗效,16例患者,优6例,良8例,中1例,差1例,优良率达87.5%。1例发生伤口感染,无深部感染;1例胫前软组织坏死,骨质裸露;1例外固定器针眼感染;1例关节退行性变。结论有限内固定结合外固定治疗Ruedi-Allgower型Pilon骨折,可以减少并发症,取得良好治疗效果。