先天性脑积水合并手足多指(趾)骈指趾畸形1例报告

患儿 ,男 ,产前Ｂ超诊断胎儿脑积水 ,产后Ｘ线片见胎儿颅腔增大 ,颅板变薄 ,颅缝增宽等脑积水征象 (图 1)。胎儿双手紧握不能分开 ,外观见双手指间软组织性骈指畸形 ,双足亦见软组织性骈趾畸形 ,趾端宽大呈扇形 ,趾节分界不清。Ｘ线片见 ,双手掌骨 6节 ,指骨大部缺如 ,双足跖骨 6节 ,趾骨第 1节 7个 ,第 2节 8个 ,3节缺如 ,1～ 3趾节骨形态不规则 ,排列不整 ,大小不均 (图 2 ) ,其它无异常。讨论 :先天性脑积水合并手足多指 (趾 )骈指趾畸形文献虽有记载 ,但在程度上此例尚属罕见。一般多发生于拇指 (趾 )或第 5指趾 ,常伴有骈指 (趾 ) ,短…     

跖趾人工关节置换一例报告

患者 ,女 ,63岁 ,因右足第一跖趾畸形、活动受限、疼痛 7年 ,加重 1年于 2 0 0 1年 5月 8日入院 ;检查 :右足第一跖趾关节畸形、肿大、压痛 ,背伸、跖屈受限 ;X线片显示右足第一跖趾关节严重骨赘增生 ,关节间隙狭窄拇外翻 1 7°。诊断 :右足第一跖趾关节骨性关节炎。于 2 0 0 1年 5月 8日行　跖趾人工关节置换术。材料采用铰链式拇跖趾人工关节一套 ,3S规格 ,美国 Wright医疗器械公司生产。在硬膜外麻醉下行右拇跖趾关节移植术 ,内侧纵行切口 ,内侧做一筋膜皮瓣 ,术中见跖趾关节严重骨质增生 ,软骨面严重破坏 ,截除 2～ 3mm两侧关节面 ,扩…     

多指(趾)骨型畸形10例报告

多指(趾)畸形又称赘生指(趾)或额外指(趾),由肢体分裂过程而形成。本文搜集10例报告于后。一般资料(见附表)。讨论:多指(趾)畸形常为不完全性,掌(跖)骨数目并不同时增多。一般常发生拇指((足母)趾)侧及小指(趾)侧的边缘,以前者多见。本文10例中掌(跖)     

小儿先天性双手双足多发性畸形3例

自1990年以来,我院收治小儿先天性双手双足多发性畸形3例,经治疗收到较满意的效果。 例1 女,7岁。生后双手双足畸形,否认家族遗传史。检查见右手拇指末节缺如,无指甲,食、中指缺如,掌骨正常,环、小指正常。左手拇指的3个指节畸形细长。左食指于近端指节间关节水平呈侧方屈曲挛缩,左中、环指完全性皮肤并指,指甲分离,活动尚可。右足2、3趾缺如,2、3跖骨缺如,前足部裂开呈蟹足状。左足所见同右足,活动尚可。在全麻下保留     

先天性巨趾症2例

先天性巨趾症较少见,我们遇见2例,报告如下.例1男,17岁.出生时即发现左足较对侧粗大,第1、2趾粗长,并随年龄增长,3、4、5趾发育细小,肤色正常.测量左足长32.5cm,右足及全身它处无异常,家族中无类似畸形病史.X线表现:左足第1、2跖趾骨明显粗长,骨小梁粗大,周围软组织增厚,两趾间距增宽,3、4、5跖趾骨发育细小(图1).X线诊断:先天性巨趾症(左)     

双足多趾移植急诊再造拇指缺损4例

1992年3月以来，我院采用双足多趾游离移植期急诊再造拇指，恢复手功能4例，效果良好，报道如下。l临床资料本组对3例，女1例；年龄19～50岁。5指缺如1例，3指缺如2例，2指缺如1例。同时再造树、示、中指2例，还造拇、示指2例。血管吻合以两侧足背动脉分别与挠动脉近远端端一端吻合3例，与烧动脉及其腕背支吻合1例。一侧趾种经与指固有神经吻合，另一侧足杯皮神经’j挠神经浅支吻合。术后再造指均个部成活，其中1例第二、二趾同时移植再造水、巾指周克氏针固定斤皮下损伤指动脉致再造示指尖部分缺血坏死。第三周拔除克氏针，第同周开始被、…     

少趾畸形1例

少趾畸形又称缺趾畸形,较罕见。 患儿,女,３岁。出生时右足只有４个足趾。父母非近亲结婚,无家族遗传性疾病史。 体检：发育良好,营养中等。右足仅４足趾,右足明显窄于左足,双足等长,双侧股骨,胫腓骨,双手掌指骨,左足跖趾骨数目及发育正常。 Ｘ线检查：右足缺失１块跖骨和１个趾骨,所保留跖趾骨发育及趾骨节数均正常。舟骨及第２、３楔骨尚未出现（图１）。 讨论 足部畸形多见于并趾,多趾或合并其它部位的先天性畸形。少趾畸形是一较罕见的畸形,其形式和程度也各不相同,常是一个或数个足趾连同跖骨缺如,拇趾及小趾两部分常…     

超声诊断胎儿多发畸形1例

1　病历简介孕妇 2 3岁 ,第一胎 ,孕 5月余来院检查。Ｂ超所见 :胎头未探见完整的颅骨光环 ;四肢 :左前臂比右前臂短 1 0ｃｍ ,左手指显示不清 ;右手未见明显异常 ;左足见四趾 ,大趾特长 ,其长度为足长的 1/2 (图 1) ;右足缺如 ,右小腿仅见 1根骨 ,外周无明显软组织 (图 2 )。Ｂ超提示 ,无脑儿 ,多肢体畸形。引产后所见 :无脑儿 ;左前臂明显短于对侧 ,左腕关节内翻 ,左手只有 3个手指 ;右手 6指 ,其中 1指在大拇指桡侧外凸 ,中指和无名指相连 ;左足 4趾 ,前半足底分成三部分 ,内侧部分与大趾相连并歪向内侧 ,使大趾特长 ,中间部分连 2个足趾…     

前跗关节楔形截骨术治疗高弓仰趾畸形足(附20例分析)

本文对1973年以来收治的20例高弓仰趾畸形足进行了临床分析。针对畸形特点采用相应的截骨方法,对18只足进行随诊,平均随诊5年7个月,均获得优良效果。本文重点讨论以下两点:(1)高弓仰趾畸形足的畸形焦点是足纵弓的高度增加及前足下垂,其纵弓的顶点位于舟楔关节处,故在此处进行截骨是最合理的,且优于McElvenny和Caldwell的跖跗关节截骨术及Japas设计的V形跖跗关节截骨术;(2)高弓仰趾畸形足的X线测量与手术疗效有密切关系。通过对内弓角、外弓角、距跖角及跟1长度,跟5长度的测量,把畸形分为重、中、轻3度,作为决定本病治疗措施的依据。     

家族性中节指（趾）骨缺如（4代8例报告）

家族性中节指（趾）骨缺如（４代８例报告）山东省平邑县中医院放射科华逢涛，杨建坤，刘新萍先天性指（趾）骨不发育为一少见骨发育畸形。我们近遇一个家族４代８人均为两节指、趾骨，殊为罕见，报告如下：本文调查一个家族１８人，其中８人发病，男４例，女４例，年龄在...     

掌指骨的X线测量及相互间数学比例关系的临床应用研究

目的　对掌、指骨进行X线测量 ,为临床诊断及手外科提供可靠的解剖学数据和资料 ,同时提供掌骨长、指骨长之间的数学比例关系式 ,对手外科掌指骨长度的确定和假体的设计提供参考依据。方法　随机选择健康汉族大学生 186人 (男 90人 ,女 96人 ) ,进行双手后前位X线拍片 ,分别测量各掌骨与指骨长 ,将所得数据应用SPSS软件进行统计学分析。结果　得出各掌骨长、各节指骨长的比例关系 ,其中一 /二、二 /四、二 /五、三 /四掌骨长比值 ,拇指 /示指、拇指 /环指、示指 /小指近节指骨长比 ,示指 /小指、中指 /小指、环指 /小指中节指骨长比 ,拇指 /示指、拇指 /中指远节指骨长比值性别差异均有显著性意义。结论　以上比例关系式在手矫形外科中对各种原因引起的手骨缺陷进行理想的掌长及指长选择 ,从而为假体设计提供帮助     

前移下颌第二磨牙及竖直水平阻生的第三磨牙矫治下颌第一磨牙缺隙的牙槽骨改建的研究

目的用正畸方法前移第二磨牙及竖直水平阻生的第三磨牙关闭下颌第一磨牙缺失后的间隙。方法12例患者一侧下颌第一磨牙严重龋坏或缺失,且在相同区内存在下颌第二磨牙和形态发育正常的水平阻生的下颌第三磨牙,除8例下颌第一磨牙已拔除外将余下4例严重龋坏的第一磨牙拔除,通过正畸近中移动磨牙代替缺失的磨牙,分析治疗前后前移磨牙的牙槽骨改建情况。结果所有病例在22~32个月内成功完成治疗,并建立了良好的邻接与咬牙合关系,口腔全景X线片可见所有病例矫治后前移磨牙牙槽骨改建良好。结论在某些病例中前移第二磨牙及竖直水平阻生的第三磨牙矫治下颌第一磨牙缺隙远胜于传统的修复治疗。     

Osseous and pulmonary sarcoidosis in a 12 year old girl. Radiological study (author's transl)]

The authors present a rather rare case of sarcoidosis in a 12 year old child. Boney involvement constitutes the first manifestation of the condition, with micro-cystic radiological appearance of the second phalanges of both third fingers. The chest X-ray demonstrated glandular and parenchymatous involvement. The diagnosis was histologically confirmed by osseous biopsy. The authors compare their case with other previously published cases.     

The role of bone scanning in severe frostbite of the extremities: a retrospective study of 88 cases

We performed a retrospective study of the results of two-phase technetium-99m hydroxymethylene diphosphonate bone scans in 88 patients with severe frostbite of the extremities. All patients were evaluated within 48 h after rewarming and all underwent a first bone scan (BS1) within 5 days after rewarming (median, day 2) (group 1). An excellent correlation was found between absence of tracer uptake in the phalanges and later amputation; this correlation was especially strong during the bone phase of the scans (specificity = 0.99, sensitivity = 0.96, positive predictive value = 0.92). Normal or high uptake in the phalanges was a reliable indicator of ultimate healing (negative predictive value = 0.99). The sensitivity of the examination was enhanced by performing a second scan (BS2) more than 5 days (median, day 8) after rewarming (group 2, n = 36). A comparative analysis of BS1 and BS2 demonstrated that some of the lesions continued to evolve between day 2 and day 8. This suggests that the lesions could still be modified during this period. On the basis of the findings it is recommended that bone scan be performed close to day 2 in all patients who present with lesions extending proximally to include the entirety of one or more phalanges. In the case of severe sepsis, the results of the first bone scan, BS1, can serve as an indication for emergency amputation. BS2 should be performed close to day 8 only if there is an area of low or absent uptake on BS1. It is concluded that scintigraphy is an excellent means of evaluating patients with severe frostbite of the extremities: as early as day 2 after the injury it can indicate whether amputation is necessary, and between days 2 and 8 it provides valuable information on the efficacy of treatment.     

The role of bone scanning in severe frostbite of the extremities: a retrospective study of 88 cases

We performed a retrospective study of the results of two-phase technetium-99m hydroxymethylene diphosphonate bone scans in 88 patients with severe frostbite of the extremities. All patients were evaluated within 48 h after rewarming and all underwent a first bone scan (BS1) within 5 days after rewarming (median, day 2) (group 1). An excellent correlation was found between absence of tracer uptake in the phalanges and later amputation; this correlation was especially strong during the bone phase of the scans (specificity = 0.99, sensitivity = 0.96, positive predictive value = 0.92). Normal or high uptake in the phalanges was a reliable indicator of ultimate healing (negative predictive value = 0.99). The sensitivity of the examination was enhanced by performing a second scan (BS2) more than 5 days (median, day 8) after rewarming (group 2, n=36). A comparative analysis of BS1 and BS2 demonstrated that some of the lesions continued to evolve between day 2 and day 8. This suggests that the lesions could still be modified during this period. On the basis of the findings it is recommended that bone scan be performed close to day 2 in all patients who present with lesions extending proximally to include the entirety of one or more phalanges. In the case of severe sepsis, the results of the first bone scan, BS1, can serve as an indication for emergency amputation. BS2 should be performed close to day 8 only if there is an area of low or absent uptake on BS1. It is concluded that scintigraphy is an excellent means of evaluating patients with severe frostbite of the extremities: as early as day 2 after the injury it can indicate whether amputation is necessary, and between days 2 and 8 it provides valuable information on the efficacy of treatment. Received 16 September and in revised form 27 December 1999     

Comparison of an impedance device to a displacement plethysmograph for study of finger blood flow.

Empirical values of finger blood flow, determined with a commercial electrical impedance device, were compared with blood flow measurements made with a pulsatile air displacement plethysmograph. The measurements were made on the medial phalanges of the first, second, and third fingers of the left and right hands. Blood flow indices were calculated from extrapolated slopes of the recorded impedance and mechanical changes occurring during systole. Two series of observations were made on seven healthy male subjects. The first series consisted of 33 simultaneous measurements with the impedance rheograph and the air displacement plethysmograph on the same finger segment. In the second series of experiments, 16 measurements were made on comparable segments with the rheograph on one side of the body and the air displacement plethysmograph on the other side. The positions of the mechanical and electrical transducers were then exchanged and the procedure repeated. The right and left results were then averaged for each of the two flow measurement systems. Blood flow indices, determined with the impedance rheograph, were consistently 30% lower than those obtained with the air displacement system. The overall mean (+/- S.E.) for the impedance to air displacement blood flow ratio for the first series of measurements was 0.69 +/- 0.03 (range = 0.46 to 1.02). The mean (+/- S.E.) impedance to air displacement ratio for the second series of experiments was 0.68 +/- 0.06 (range = 0.30 to 1.14).     

Cyclic voiding cystouretrography without the use of fluoroscopic monitoring

PURPOSE: To determine whether cyclic voiding cystourethrography (VCUG) examinations can be performed without using real-time fluoroscopic monitoring. MATERIALS AND METHODS: VCUG examinations were performed in 209 children (133 girls and 76 boys). In each child, it was performed in a cyclic manner (three consecutive cycles) without using fluoroscopic monitoring and one radiograph was taken in each cycle of the examination. All patients were sedated by midazolam prior to examination. The degree of vesicoureteric reflux (VUR) was graded for each of the kidney ureter units (KUU) (total 418 KUU) separately. Statistical analysis included the comparison of the presence and absence of VUR and three ordinal-matched comparisons of each cycle. RESULTS: VCUG was detected in 37.3% of the children (78/209) and 28.7% (120/418) of the KUU. The absence of or same degree of VUR in three consecutive cycles were obtained in 345 KUU and the agreement was calculated as 82.5%. The same degree and presence of reflux were found in 85 and 89 refluxing KUU, the same negative findings (absence of VUR) in 306 and 298 KUU, and discordant findings in 27 and 31 KUU (between the first and second and between first and third cycles), respectively. Therefore, the agreement was 93.5 and 92.5% between the first and second cycles (p=0.70) and between the first and the third cycles (p=0.15), respectively. CONCLUSION: Both the cyclic nature of this study and the results indicated that VCUG without real-time fluoroscopic monitoring could be used where adequate fluoroscopic examination is not possible for children in whom VUR detection is necessary and impacts treatment. However, the responsibility of pediatric radiologist always must also include the task to provide proper equipment for imaging children with suspected VUR.     

Analysis of structural and numerical chromosomal anomalies at the first, second, and third mitosis after irradiation of one-cell mouse embryos with X-rays or neutrons

One-cell mouse embryos were irradiated with X-rays or neutrons. Analysis of the first, second, and third postradiation mitoses revealed that the yields of structural aberrations increased linearly after exposure to both radiation qualities. For X-rays the aberration frequency decreased from the first to the third mitosis, whereas after neutrons it decreased from the first to the second mitosis but then increased in the third mitosis. RBEs of 4.7, 4.8, and 7.4 were calculated for the corresponding mitoses. It was clearly demonstrated that new aberrations were produced after the first postradiation mitosis and expressed during the second and third mitosis. Chromosome loss also increased with increasing radiation dose at the second mitosis. An RBE of 2 was calculated for this effect. Comparing the presented data with previous investigations on embryonic and fetal death after prenatal irradiation, it was concluded that the high radiosensitivity of the one-cell embryo is due to the induction of structural as well as of numerical chromosome aberrations.     

Phalangeal osteoid osteoma

Although the typical features of osteoid osteomas are well known, those arising in phalanges are frequently misdiagnosed. This is partly because of their rarity (9% of osteoid osteomas in the Bristol Bone Tumour Registry occur in phalanges), and also because of atypical radiological features. The most common appearance is of an eccentric lesion with soft-tissue swelling and a relative absence of sclerosis, suggesting osteomyelitis.