股骨近端交锁髓内钉治疗股骨粗隆间及粗隆下粉碎性不稳定骨折

总结29例股骨粗隆周围骨折采用闭合复位股骨近端交锁髓内钉(PFN)内固定治疗结果,认为PFN是治疗粉碎性不稳定股骨粗隆间和粗隆下骨折的有效固定方法.     

股骨近端交锁髓内钉治疗股骨粗隆间及粗隆下粉碎性不稳定骨折

总结29例股骨粗隆周围骨折采用闭合复位股骨近端交锁髓内钉（PFN）内固定治疗结果，认为PFN是治疗粉碎性不稳定股骨粗隆间和粗隆下骨折的有效固定方法。     

撬拨辅助钉道控制在闭合治疗股骨转子下骨折中的意义

目的 评估术中使用斯氏针撬拨辅助钉道控制闭合复位的效果. 方法 23例股骨转子下骨折,术中用斯氏针置入股骨大转子后部协助复位,闭合复位后股骨近端髓内钉(PFN)或抗旋股骨近端髓内钉(PFNa)固定. 结果 23例患者手术时间30～55 min,平均39 min,出血量50～120 ml,平均76 ml.术中透视、术后X线复查骨折对位对线优良,骨折全部获得愈合,无严重并发症. 结论在髓内钉治疗股骨转子下骨折时,股骨近侧置入斯氏针撬拨辅助钉道控制能较好纠正和控制股骨转子下骨折近端骨折块的移位,手术时间短,创伤小,固定可靠.     

股骨远端解剖钢板微创治疗股骨干骨折的临床应用

目的通过临床病例的总结,比较分析远端解剖钢板与髓钉微创治疗股骨干骨折的疗效。方法将符合加长型股骨远端解剖钢板微创治疗指征的35例股骨干骨折患者设为实验组,适用带锁髓内钉治疗的35例患者设为对照组。术后平均随访12.8个月。结果两组患者均未出现骨折不愈合、延迟愈合、内固定失败、切口延迟愈合或感染等并发症;两组间切口失血量无统计学差异（P〉0.05）,切口总长度实验组长于对照组（P〈0.05）,但在手术时间、预防骨质劈裂、骨折成角畸形、脂肪栓塞、折端切开复位等不良事件方面,实验组明显优于对照组（ P〈0.05）。结论对符合指征的患者,加长型股骨远端解剖钢板微创技术的疗效确切,并发症较少,是一个值得选择的治疗手段。     

AO股骨近端髓内钉在股骨转子间骨折治疗中的应用

目的 讨论应用国际内固定研究学会(AO)股骨近端髓内钉(PFN)治疗股骨转子间骨折的临床疗效.方法 应用AO产 PFN 治疗股骨转子间骨折35例,并随访疗效.结果 34例获得随访,时间6～24个月,平均14个月,骨折全部愈合,髋关节功能优良31例(91.2%).结论 AO股骨近端髓内钉治疗股骨转子间骨折具有手术创伤小、微创、固定牢靠、病人可早期进行功能活动,并发症少等优点,是目前治疗股骨转子间骨折较理想的内固定物.     

逆行交锁髓内钉治疗股骨远端骨折的近期疗效分析

目的　评价逆行交锁髓内钉治疗股骨远端骨折的效果。方法　 2 0 0 0年 6月～ 2 0 0 1年 1 2月 ,对1 9例股骨远端骨折 (A型 7例 ,C型 1 2例 )采用逆行交锁髓内钉治疗 ,并用Merchan膝关节功能评分对结果进行评价。结果　 1 8例随访 8～ 2 6个月 ,平均 1 8.5个月 ,骨折均愈合。按Merchan膝关节功能评分 ,优 9例 ,良7例 ,可 2例 ,优良率 88.9%。结论　使用逆行交锁髓内钉治疗股骨远端骨折具有关节面复位好、固定可靠、便于膝关节早期功能锻炼等优点 ,初期疗效满意     

髋动力锁定钢板与交锁型股骨近端髓内钉治疗中老年股骨转子间骨折体会

背景:老年股骨转子间骨折进行积极的内固定治疗已被大家认同,但选择何种固定方式,尚无权威标准.目的:比较应用髋动力锁定钢板与交锁型股骨近端髓内钉两种不同内固定方式修复股骨转子间骨折的疗效,探讨内固定选择的临床依据.方法:选择2005年8月至2014年4月在吐鲁番地区中心医院骨科收治的中老年股骨转子间骨折患者66例,分别接受髋动力锁定钢板(锁定钢板组)与交锁型股骨近端髓内钉(交锁髓内钉组)内固定治疗,分析比较两组患者下地活动时间及负重时间、骨折愈合时间、功能恢复程度及并发症发生情况.结果与结论:所有患者治疗后随访18-24个月,平均20个月.锁定钢板组和交锁髓内钉组患者骨折愈合时间均为12周左右,修复后2周Harris髋关节功能评分比较差异无统计学意义(P＞0.05),但交锁髓内钉组患者下地活动时间及负重时间短于锁定钢板组(P＜0.01).随访过程中,锁定钢板组1例发生髋内翻,交锁髓内钉组1例因摔倒坠落再次发生骨折.结果提示两种内固定系统治疗股骨转子部骨折均可获得良好的疗效,应根据患者具体情况选择适合的修复方式和植入物.     

AO股骨近端髓内钉在股骨转子间骨折治疗中的应用

目的讨论应用国际内固定研究学会（AO）股骨近端髓内钉（PFN）治疗股骨转子间骨折的临床疗效。方法应用AO产PFN治疗股骨转子间骨折35例，并随访疗效。结果34例获得随访，时间6—24个月，平均14个月，骨折全部愈合，髋关节功能优良31例（91．2％）。结论AO股骨近端髓内钉治疗股骨转子间骨折具有手术创伤小、微创、固定牢靠、病人可早期进行功能活动，并发症少等优点，是目前治疗股骨转子间骨折较理想的内固定物。     

股骨粗隆间骨折的微创治疗

目的探讨微创治疗股骨粗隆间骨折的手术疗效及并发症。方法对2006年1月-2008年9月收治的84例股骨粗隆间骨折进行闭合复位,38例采用Gamm a-3髓内钉固定,46例采用股骨近端髓内钉（PFN）固定。随访6-12个月,骨折临床愈合后,患髋行Harris髋关节功能评分。结果84例骨折全部愈合,愈合时间3-6个月,未发生螺钉切割出股骨头颈、髋内翻畸形、切口深部感染等严重并发症。患肢髋关节功能评定：Gamm a-3固定优良率为89.4%,PFN固定为86.9%。结论采用Gamm a-3髓内钉和PFN微创治疗股骨粗隆间骨折,疗效可靠,并发症少,创伤小,值得临床推广使用。     

倒打交锁髓内钉治疗股骨远端骨折

目的　总结倒打交锁髓内钉 (GSH钉 )治疗股骨远端骨折的效果。方法　 32例股骨远端骨折采用GSH钉固定 ,骨折按AO/ASIF分类 :A型 2 1例 (A110例、A2 7例、A3 4例 ) ,C型 11例 (C18例、C2 3例 )。A型骨折采用闭合复位 ,C型骨折采用开放复位 ,髁间先用 2枚松质骨拉力螺丝钉固定。结果　平均手术时间为15 6分钟 ,平均手术出血量为 2 82ml;平均随访 16个月 ,30例骨折正常愈合 ,1例骨折不愈合 ,1例延迟愈合 ,平均骨折愈合时间为 3.8个月 ;平均膝关节活动度为 95°,A型骨折 98° ,C型骨折 91° ;3例钉尾外留过长 ,膝关节屈曲时撞击髌骨产生疼痛 ;1例骨折端内翻 8°,1例外翻 6°。结论　倒打交锁髓内钉可有效治疗股骨远端骨折 ,具有手术时间短、出血少 ,固定牢靠、骨折愈合率高、并发症少等优点     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.