超声诊断近端指间关节伸指肌中央腱断裂的临床研究

目的 从临床上评价超声检查对诊断近端指间关节伸指肌中央腱断裂的准确性.方法 67名近端指间关节受伤的病人接受了超声检查.超声采用5～10MHz实时线性变曲探头.并采用了3种临床体格联合检查方法,对伤情进行了判断.以手术探查结果为标准,对超声检查结果和临床体格检查结果进行了比较.结果 手术探查结果证实39名病人有伸指肌中央腱断裂.超声检查结果与手术探查结果有非常好的一致性.超声检查和临床体格检查的敏感性分别为100%和89.74%,特异性为96.4%和8.14%.两种检查方法经统计学处理有显著差异(P<0.01).结论 超声检查是一种非侵入性早期准确诊断近端指间关节伸指肌中央腱断裂的方法.     

近端指间关节侧副韧带断裂二种手术治疗方法的效果比效

目的:比较韧带修复手术及韧带重建手术对近端指间关节侧副韧带损伤的治疗效果。方法:2003年~2006年对50例(58指)侧副韧带损伤随机分组,用以上两种手术方法分别治疗27指及31指。结果:经随诊1~3d,按Saetta等标准判定疗效,侧副韧带修复组27指,优良率66.7%,侧副韧带重建组31指,优良率93.5%,经卡方检验,有显著性养异(χ2=10.45,P<0.05)。结论:近端指间关节侧副韧带损伤韧带重建术优于韧带修复术。     

Simultaneous double dislocation of the interphalangeal joint in one finger

Isolated traumatic dislocation of the distal and proximal interphalangeal joints of fingers is a common occurrence.However,simultaneous double dislocation of the interphalangeal joints in one finger is rare.Here we report one case of simultaneous dorsal dislocation of both interphalangeal joints in the little finger with a review of the literature.     

Chronic rupture of the extensor apparatus of the knee joint

Chronic ruptures of the extensor mechanism of the knee are uncommon injuries, and previously reported literature assumes the presence of an intact patella for repair. We present a case of chronic rupture following patellectomy done twelve years previously. The defect in the extensor apparatus was extensive (18cm), and this was bridged using a large fascia lata graft from the opposite thigh, with reasonably successful results.     

弹性外固定支具治疗22例指伸肌腱断裂

2004-2006年，我院以不锈钢和橡皮筋为材料，设计并应用滞性外固定支具治疗挖例指伸肌睫断裂，获得满意效果。     

Simultaneous double dislocation of the interphalangeal joint in one finger: case report and literature review

Isolated traumatic dislocation of the distal and proximal interphalangeal joints of the fingers is a common occurrence. However, simultaneous double dislocation of the interphalangeal joints in one finger is rare. Here we report one case of simultaneous dorsal dislocation of both interphalangeal joints in a little finger with a review of the literature.     

Double dislocation of the interphalangeal joints in the finger

A case of simultaneous dislocation of the proximal and distal interphalangeal joints of the same digit is described. The case presented at Princess Basma Teaching Hospital after athletic trauma. It was treated successfully with close reduction followed by two weeks immobilization in slight flexion position. The condition is described in this report with review of the relevant literature.     

Lesser proximal interphalangeal joint arthrodesis: a retrospective analysis of the peg-in-hole and end-to-end procedures

A retrospective study was performed to compare the prevalence of complications in peg-in-hole and end-to-end arthrodesis procedures. The authors reviewed 177 second, third, and fourth proximal interphalangeal joint fusions for the correction of hammer toe deformities in 85 patients from 1988 to 1998 at the Temple University School of Podiatric Medicine. The average age of the patients was 49 years. Sixteen percent (14) of the subjects were male and 84% were (71) female. Upon follow-up, the fourth digit was generally associated with a greater number of complications for the end-to-end and peg-in-hole procedures, with the second digit being the most common site of fusion. The prevalence of complications was evaluated using contingency table analysis and expressed as a percent of total complications (27%, the end-to-end group; 17%, the peg-in-hole group). A subset of complications deemed clinically relevant was also computed. Similarly, the prevalence of clinically relevant complications for the end-to-end (10%) and the peg-in-hole (9%) procedures was not statistically significant. Therefore, this study showed no statistically significant differences in the total or clinically relevant complications between end-to-end and the peg-in-hole arthrodesis procedures.     

Hammer toe correction by arthrodesis of the proximal interphalangeal joint using a cortical bone allograft pin

In hammer toe correction by means of digital fusion, fixation so that the bone can unite while maintaining appropriate realignment can be a challenge. Metal fixation pins can be associated with many problems and potential complications. The author presents a method of rigid internal fixation using 2.4-mm-diameter pins fashioned out of freeze-dried allogeneic cortical bone. These devices avoid most of the risks of metal pins. Proximal interphalangeal joint arthrodesis using cortical bone pins was performed on 26 toes in 18 patients with very few complications. The author concludes that use of cortical bone pins can yield successful results in most cases. The outcomes of the fusions can be further enhanced by using flexor digitorum longus tendon transfer.     

半关节切除+肌腱重建术治疗近侧趾间关节陈旧性脱位的临床疗效

目的 探讨半关节切除+肌腱重建术治疗近侧趾间关节陈旧性脱位的临床疗效.方法 回顾性分析2008年5月至2018年5月本院收治的16例近侧趾间关节陈旧性脱位患者的临床资料,均有明确外伤史,采用趾骨头颈截骨半关节切除+趾长伸肌腱缩短重建手术治疗,分析治疗效果.结果 所有患者随访6～24个月,平均14个月.末次随访时评定疗效:优10例,良5例,差1例,优良率为93.75％.结论 半关节切除+肌腱重建术治疗近侧趾间关节陈旧性脱位引起的锤状趾畸形,具有恢复快、费用低、创伤小、效果良好等优点,值得临床推广应用.     

指间关节同时脱位：临床实践及文献复习

近侧和远侧指间关节同时脱位十分罕见,本文报告一例病例并介绍临床治疗经验,并进行文献复习。     

早期类风湿性关节炎手腕部关节病变的超声诊断

目的探讨高频超声在早期类风湿性关节炎诊断中的应用价值。方法回顾性分析我院早期类风湿性关节炎患者62例,记录常规病史、体格检查、血液生化检查[包括血沉(ESR)、C反应蛋白(CRP)、类风湿性因子(RF)、抗环瓜氨酸抗体(CCP)],行双侧手、腕部彩超与MRI检查。超声评估包括炎症性评估(滑膜增厚、滑膜能量多普勒血流信号、关节腔积液、腱鞘炎)及关节结构破坏性评估(骨侵蚀),各超声指标进行半定量分级,掌指关节及近端指间关节取评分最高者为代表。结果超声在滑膜炎、关节腔积液及腱鞘炎的诊断方面与MRI接近,差异无统计学意义(P0.05),在骨侵蚀的诊断方面,MRI优于超声,差异有统计学意义(P0.05),在骨髓水肿的诊断方面,超声均未能检出,MRI则具有较高的阳性率(54.84%,P0.05);能量多普勒超声(PDUS)与灰阶超声(GSUS)在滑膜炎的诊断中差异有统计学意义(χ~2=7.84,P0.05),GSUS敏感性优于PDUS。结论超声对早期类风湿性关节炎的滑膜炎、关节腔积液、腱鞘炎及骨侵蚀诊断有很高的可靠性,是诊断早期RA的首选检查方法。     

Arthroplasty of the interphalangeal joint of the great toe using costal osteochondral grafting

Although many reports have been published on the usefulness of costal cartilage grafting in the reconstruction of interphalangeal joints of fingers, there are only a few published reports on the reconstruction of interphalangeal joints of toes. We describe a 21-year-old woman with a tissue defect of the dorsum pedis and a partial defect of the interphalangeal joint of the great toe caused by a motor-vehicle accident. We attempted arthroplasty using a free latissimus dorsi myocutaneous flap and a costal osteochondral graft. The grafted rib and cartilage survived, allowing the patient to resume functional ambulation for day-to-day activities. Arthroplasty using costal osteochondral grafts seems to be an effective means of reconstructing the interphalangeal joints of toes.     

Arthrodesis of the interphalangeal joint of the hallux: a simple and effective technique

The authors present a simple and effective technique to achieve arthrodesis of the hallucal interphalangeal joint. Stabilization is achieved by external fixation with crossing Kirschner wires joined together to create a single functional unit, a technique that avoids common problems often associated with Kirschner-wire fixation. The authors propose that this simple technique be considered for patients in whom it has been determined that screw fixation should not be used to obtain fusion of the interphalangeal joint.     

吲达帕胺治疗中枢性尿崩症的疗效及机制探讨

目的：观察吲达帕胺治疗中枢性尿崩症的效并初步探讨其作用机制。方法：采用随机区组设计，对８例中区性尿崩症患者轮流给予吲达帕胺２．５－７．５ｍｇ·ｄ＾－１或卡马西平１５０－３００ｍｇ·ｄ＾－１或双氢氧噻嗪５０－７５ｍｇ·ｄ＾－１口服治疗，连续８ｄ，停药８ｄ，停药４ｄ，依次更换药物二次，动态观察尿量及水盐代谢指标。结果：三药在用药的第４ｄ，第８ｄ尿量均较用药前为低；吲达帕胺在用药的第４ｄ，第８ｄ血钾、血     

手指血管球瘤的MRI诊断

目的探讨手指血管球瘤的MRI诊断价值及技术方法。方法3例手指血管球瘤患者行MRI平扫，扫描序列包括：自旋回波序列（SET1WI，T1WI＋FS），快速自旋回波序列（TSET2WI），快速小角度单次激发梯度回波序列加脂肪抑制（FLASH＋FS）矢状位、冠状位、轴位以及增强扫描。结果3例患者的病程最短3年，最长9年。3例肿瘤均发生在环指，2例位于指骨远端掌侧面，1例位于甲床下。MRI上病变呈结节状，在T1WI上为等信号或稍低信号，在T2WI和FLASH上均为高信号。增强后病灶明显强化。结论MRI的T1WI、T2WI、FLASH＋FS及增强扫描可以很好地显示手指血管球瘤这种微小病变，对本病的诊断及手术前定位有较高的临床应用价值。