克氏针张力带钢丝内固定治疗儿童肱骨髁上骨折

目的:探讨儿童肱骨髁上骨折的治疗方法及克氏针"8"字张力带钢丝固定治疗儿童肱骨髁上骨折的临床效果。方法:取肘后切口,行双"8"字张力带钢丝克氏针交叉内固定治疗儿童肱骨髁上骨54例,骨折类型全部为闭合性伸直型损伤。结果:按陆裕朴[1]评定标准,优良率96%,结论:"8"字张力带钢丝克氏针交叉内固定治疗儿童肱骨髁上骨折,固定牢靠,关节功能恢复好,是治疗小儿肱骨髁上骨折的有效方法。     

张力带法治疗儿童肱骨髁上骨折

目的 介绍一种治疗儿童肱骨髁上骨折的方法。方法 采用交叉克氏针加桡侧“8”字钢丝内固定治疗儿童肱骨髁上骨折26例。结果 全组经6个月以上随访，无骨不连发生，肘关节活动良好，无肘内翻发生。结论 张力带法治疗儿童肱骨髁上骨折是一种比较理想的方法之一。     

小儿肱骨髁上骨折内固定的生物力学评价

目的　比较三种治疗小儿肱骨髁上骨折的内固定方法 ,为临床选用提供科学依据。方法　采用 8具尸体上肢标本 ,制成骨折损伤模型 ,随机分组分别适用交叉克氏针加 8字钢丝 ,交叉克氏针、平行克氏针等三种方法固定后 ,模拟肘关节伸、屈和扭转三种情况下进行加载。结果　采用交叉克氏针加 8字钢丝无论在强度还是刚度方面均优于单用交叉克氏针内固定 ,更比平行克氏针内固定的效果好 ,前者比后者强度平均高出 12 %和 30 %。刚度平均高出 15 %和 33% (P <0 0 1)。结论　交叉克氏针加钢丝固定 ,它操作简单、牢固、稳定性好 ,是治疗肱骨髁上骨折防止肘内翻的较好方法。     

改良张力带钢丝治疗肱骨髁上骨折的生物力学研究及其临床应用

目的 应用自行设计改良张力带钢丝内固定技术治疗小儿肱骨髁上骨折。方法 对11侧人工肱骨髁上骨折标本应用改良张力带钠丝与交叉克氏针固定后，进行相关的生物力学测试。临床治疗肱骨髁上骨折患儿46例，随访6－78个月，平均38个月。结果 生物力学试验测试结果显示改良张力带钢丝的桡侧绑结可使骨折端产生压应力，固定强度明显优于交叉克氏针。临床随访显示骨折愈合佳，功能活动好，术后并发症发生率低。结论 改良张力带钢丝内固定治疗肱骨髁上骨折的效果明显优于克氏针交叉内固定，其稳定性允许废弃外固定，并能早期活动肘关节，是一种更符合生物力学原理的技术，值得临床推广应用。     

张力带在儿童肱骨髁上骨折治疗中的应用

目的：评估克氏针钢丝张力带治疗儿童肱骨髁上骨折的临床效果。方法：本组患儿98例,男72例,女26例,年龄3岁～14岁。采用肘外侧或肘后正中切口,清理骨折断端,直视下复位,2枚克氏针交叉固定,1枚钢丝8字缠绕固定于桡侧的两个针尾。结果：98例患儿经6月。3年的随访,骨折一期愈合,肘关节功能正常,无肘内、外翻发生。结论：克氏针钢丝张力带内固定方法操作简便,固定可靠,能有效的防止肘内翻畸形的发生,是治疗儿童肱骨髁上骨折较为理想的方法。     

纵行双“8”字钢丝交叉克氏针内固定治疗肱骨髁上骨折

治疗肱骨髁上骨折的常用方法较多，双根克氏针交叉固定术后仍要用石膏固定，不能早期进行肘关节功能锻炼．易致肘关节的功能障碍。笔者自1999年10月～2003年10月采用纵行双“8”字钢丝固定治疗的16例肱骨髁上骨折．使患者能早期行肘关节功能活动．提高临床治疗水平和康复质量。     

双“8”字张力带钢丝双克氏针交叉内固定治疗肱骨髁间骨折

目的：探讨双“8”字张力带钢丝双克氏针交叉内固定治疗肱骨髁间骨折的临床效果。方法2011年1月~2013年9月,本院收治肱骨髁间骨折129例,取肘后切口,行双“8”字张力带钢丝双克氏针交叉内固定治疗肱骨髁间骨折129例。结果129例中,102例复位良好,13例前倾角减少约20°左右,14例髁关节面错位约1个皮质。合功能恢复：129例患者平均住院18天,随访4个月~到2年,平均7.9个月,全部愈合,优99例,良23例,可7例,优良率94.6％。结论双“8”字张力带钢丝双克氏针交叉内固定治疗肱骨髁间骨折,局部损伤小,固定坚强,不需外固定,关节功能恢复好。     

两种手术方法治疗儿童重度肱骨髁上骨折的疗效比较

目的比较两种手术方法治疗儿童重度肱骨髁上骨折的疗效。方法将110例肱骨髁上骨折患者随机分为改良组和对照组各55例,改良组内外侧联合小切口克氏针钢丝张力带内固定,对照组交叉克氏针内固定,观察两组术后疗效。结果改良组平均骨折愈合时间比对照组提前15 d,肘关节功能恢复较好,并发症发生率较少,两组比较差异有统计学意义(P<0.05)。结论肘内、外联合小切口克氏针钢丝张力带固定较传统手术方式好,是治疗肱骨髁上骨折的一种有效方法。     

经皮交叉克氏针固定治疗移位型儿童肱骨髁上骨折的临床疗效观察

目的 探讨移位型儿童肱骨髁上骨折采用经皮交叉克氏针固定的治疗效果并评估相关的危险因素.方法 对采用经皮内外侧交叉克氏针固定治疗的64例移位型儿童肱骨髁上骨折进行回顾,根据Flynn肘关节评定标准及并发症情况,分析治疗效果及相关危险因素.结果 所有骨折均达到骨性愈合,肘关节功能及外观满意,无严重并发症发生.结论 经皮交叉克氏针固定维持复位确切、并发症较少,是治疗移位型儿童肱骨髁上骨折的安全、有效方法.     

经皮桡侧交叉克氏针固定治疗儿童肱骨髁上骨折

目的探讨闭合复位、经皮桡侧交叉克氏针固定治疗儿童肱骨髁上骨折的效果。方法采用闭合复位、经皮桡侧交叉克氏针固定治疗33例肱骨髁上骨折患儿。采用Flynn临床评定标准评价肘关节功能。结果33例均获得随访,时间8～24个月。无尺神经损伤、针道感染、骨化性肌炎、肘外翻、骨折再移位、克氏针退出等并发症发生。4例正中神经损伤均于术后6个月内自行恢复。末次随访采用Flynn临床评定标准评价肘关节功能:优28例,良4例,可1例。结论儿童肱骨髁上骨折闭合复位后采用经皮桡侧交叉克氏针固定,能避免损伤尺神经和骨折远端向尺侧再移位,无切口,创伤小,肘关节功能恢复满意。     

"Free" and "exchangeable" or "trapped" and "non-exchangeable" water in cartilage

We repeated some of our own previous experiments, as well as some of Torzilli's recent experiments (11) on which he bases his conclusions relating to a nonexchangeable "trapped water" in cartilage. We are unable to confirm Torzilli's findings. We observed partition coefficients for 3H.HO very close to unity. That both the extrafibrillar and most of the intrafibrillar water is freely exchangeable and behaves as available water towards small solutes has been independently shown (3) for other collagenous tissues. All the different permutations of partition experiments have yielded results that are fully consistent with our original picture of the very major fraction of cartilage water being free.     

"A" for Agency, "B" for Basal cell, "C" for Corticotulle, "D" for Danger

Without any proof, a governmental agency has decreed that Corticotulle was not enough efficient to be reimbursed by National Health Security. Dealing with treatment of basal cell carcinoma, another governmental agency has published recommendations which even do not follow basic rules of logic. This paper points out that economical and political methods are not scientific or medical ones.     

"Gas off" or "vaporizer off"

Editor—It is a common misconception that turning off thevaporizer while leaving the fresh gas flow (FGF) on, during     

"Custom-fit" versus "off-the-shelf" ACL functional braces

Many sports medicine practitioners believe "custom-fit" functional braces are superior in performance to "off-the-shelf" braces for anterior cruciate ligament (ACL)-deficient knees. However, this is not well substantiated. This study compares a Donjoy custom-fit ACL brace (CE 2000), Donjoy off-the-shelf brace (Goldpoint), and an athletic taping technique to determine their role in our clinical practice. Five patients (3 men and 2 women) with isolated, unilateral, chronic ACL tears with an average age of 27 years (range: 19-35 years) were used to evaluate these three restraint systems. Anterior tibial laxity, quadriceps and hamstrings strength, endurance, standing long jump, brace migration with exercise, and pattern of muscle response to forced anterior tibial displacement were studied. Each patient was tested without a brace and then in each of the three test conditions (custom brace, off-the-shelf brace, and tape), with the order of testing randomized. The Donjoy custom-fit ACL functional brace did not reduce anterior laxity or improve standing long jump, muscle strength, endurance, or muscle response times significantly more than the off-the-shelf ACL brace. Both braces improved anterior stability over knee taping when the knee muscles were contracted under the low forces used in this study. After 1 hour of exercise, brace migration was significantly greater (P=.03) for the CE-2000 custom brace (18.6 mm) than for the Goldpoint off-the-shelf brace (4.5 mm). There appears to be no advantage to the more expensive custom-fit knee brace over the off-the-shelf brace.