单臂外固定架治疗儿童胫腓骨远端骨折

目的探讨单臂外固定器固定在儿童胫腓骨远端骨折治疗中的可行性及其并发症的防治,提高对儿童该类骨折的治疗水平。方法采用单臂外固定器固定治疗儿童胫骨或胫腓骨远端骨折23例,其中男性17例,女性6例;年龄2～13岁,平均年龄5岁7个月。开放性骨折8例。结果随访2～4年。23例均未见骨折不愈合及畸形愈合。按照Paley骨折愈合标准评分:优13例,良7例,中3例;优良率87%。其中发生延迟愈合5例,6例有针道感染征象,5例有螺钉部分松动,4例行超踝关节固定患儿术后踝关节功能受限,恢复较差。结论采用单臂外固定器固定治疗儿童胫腓骨远端骨折是一种安全、简便的固定方法,软组织损伤轻,骨折端血运破坏少,骨折临床愈合快,并允许早期关节活动及负重练习,减少了关节功能障碍的发生,适用于几乎所有类型的儿童胫腓骨骨折,尤其是合并严重软组织损伤修复后需长期换药或合并血管、神经损伤者;但对于合并有严重骨质疏松、广泛皮肤病变,及因为年龄或其他因素不能配合术后管理的患儿应慎用。     

单侧外固定器治疗四肢骨折的适应证和并发症探讨

目的 探讨单侧外固定器治疗四肢骨折的适应证和并发症。方法 应用单侧外固定器治疗四肢骨折共３６０例。分析各种骨折的疗效和并发症。结果 单侧外固定器在胫腓骨、肱骨干、股骨粗隆间骨折及儿童股骨干骨折等方面疗效满意,对火器伤和多发伤骨折的救治更有其独特优超性,而对股骨干骨折并发症较多。针孔感染、针松动及个别关节功能受限是本组病例主要的并发症。结论 在单侧外固定器应用技术中,正确的操作,骨折解剖对位可增加外     

可任意穿针固定及生理应力加压的骨外固定器研制及临床应用

目的 解决目前外固定器普遍存在的如稳定性差、操作繁琐、应力遮挡大、扩展功能差等功能缺陷的问题。方法 应用研制的骨外固定器对102例四肢骨干骨折进行治疗观察。本组男84例，女18例；年龄5～78岁。胫腓骨骨折76例，股骨干(儿童)骨折10例，股骨转子或转子下骨折4例，尺骨或桡骨骨折7例，肱骨干骨折5例。结果 所有患者经全程观察均取得良好疗效。其中76例胫腓骨骨折随访3个月～1年，骨折坚强愈合平均时间为3．5个月，膝踝关节功能同步恢复优良率为93．4％，无骨折端移位及再骨折出现。结论 此种新型外固定器的结构、功能符合现代骨外固定技术应用要求。     

单侧纵轴多功能外固定器治疗长骨干骨折282例

单侧纵轴多功能外固定器治疗骨折的效果 ,目前已得到充分的肯定 ,但临床发生的问题也不少 ,尤其是适应证的选择更显重要。笔者就我院从 1992年至1999年应用单侧纵轴多功能外固定器 ,治疗四肢不同部位的长骨干骨折 2 82例的临床效果差异作一简单回顾性分析 ,探讨该固定器治疗四肢长骨骨干骨折的临床适应证。临　床　资　料1.一般资料 :病历资料齐全的 2 82例不同部位四肢长骨干骨折临床情况见表 1。2 .治疗方法及结果 :对于开放性的长骨干骨折 ,先行清创和整复后再安置外固定器 ;对于粉碎型骨折和不稳定型骨折均先做小切口对位 ,再安置外固定…     

有效固定治疗胫腓骨中下段骨折168例体会

目的：评价有效固定治疗胫腓骨中下段骨折的临床效果。方法：从1988年以来采用有效固定方法治疗胫腓骨中下段骨折，均采用切开复位简单内固定结合石膏外固定的方法。结果：168例患者均随访1年以上，全部骨性愈合，取出内固定物，肢体功能良好。结论：有效固定具有达到解剖复位、愈合率高、并发症低的优点，同时可减少辐射损伤，且操作简单、费用低，适用于基层医院。     

单边外固定器加负压封闭技术治疗小腿严重开放性骨折

目的　探讨治疗小腿严重开放性骨折的有效治疗方法。方法　 2 9例小腿严重开放性骨折(Gustilo分类III型以上 )接受单边外固定器 负压封闭技术 (VS)治疗 ,清创后骨折用Orthofix单边外固定器固定 ,创面上或创腔内用Vacuseal材料覆盖 ,接负压封闭吸引 ,5～ 7天后二期缝合、植皮或皮瓣转移。结果2 9例创面均愈合 ,骨折愈合 2 6例 (89.7% ) ,延迟愈合 3例 (10 .3% ) ,无骨不愈合。平均愈合时间为 5 .8个月。除浅表感染 1例 (3% )和针道感染 5例 8针 (7% ) ,无其他并发症发生。结论　Orthofix单边外固定架固定结合VS技术治疗小腿严重开放性骨折 ,在迅速有效地稳定骨折的同时 ,能安全有效地封闭创面 ,简化二期创面修复技术 ,有利于骨折良好愈合 ,减少并发症     

单臂外固定器在胫腓骨骨折治疗中的应用

探讨外固定器治疗胫腓骨骨折的疗效.作者回顾性分析1997～2002年间应用单臂外固定器治疗胫腓骨骨折38例临床资料,认为外固定器治疗胫腓骨骨折可获良好效果.     

单臂外固定器在胫腓骨骨折治疗中的作用

探讨外固定器治疗胫腓骨骨折的疗效。作者回顾性分析1997－2002年间应用单臂外固定器治疗胫腓骨骨折38例临床资料，认为外固定器治疗胫腓骨骨折可获良好效果。     

胫腓骨不稳定骨折的支架外固定治疗

采用双臂全贯穿针式胫腓骨骨折外固定支架治疗了１０例不稳定型胫腓骨骨干骨折（其中２例为开放性骨折）。本组有９例在伤后２周内手术患者的骨折获得解剖或接近解剖复位，１例伤后３１日手术的骨折留有侧位一个骨皮质厚度的移位，正位整复完全。所有患者都获得骨折愈合，平临床愈合时间为１３５日７例因体育运动等低能量外伤因素所致的骨折平均愈合时间为１１１日；其他３例因车祸高能量外伤造成的骨折，其平均愈合时间是１９０日。全组病人无骨感染发生，除１例合并有踝关节骨关节病的患者伤后１４个月随访时仍有伸踝功能受限外，其余病人的踝关节无功能障碍。     

重度开放性胫腓骨骨折固定方式的临床评价

目的：通过对不同固定方式治疗重度开放性胫腓骨骨折的临床结果进行比较,评价合理的固定方式。方法：本组121例、129侧肢体、均为新鲜Ⅲ度开放性胫腓骨骨折,Ⅰ期截肢5侧,清创后行石膏固定或骨牵引者28侧,内固定42例,单侧外固定支架固定54例,结果：石膏固定或骨牵引组28侧,骨折愈合率78．6％,平均愈合时间7．3个月;浅表感染率,深部感染率分别为21．4T和25．0％;远期并发症60．7％,内固定组42例,手术后8h死亡1例,骨折愈合率80．0％,平均愈合时间8．1个月;浅表感染率,深部感染率分别为12．2％和31．7％;延期截肢1例,远期并发症45．0％,外固定支架组54侧,延期截肢1例,骨折愈合率90．65,平均愈合时间8．9个月;浅表感染率,深部感染率为13．2％和7．5％;远期并发症22．6％。结论：外固定支架在治疗重度胫腓骨开放骨折中能达到有效固定,减少深部感染率,有利于功能恢复的目的。     

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.     

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).     

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.     

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.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.