骨质疏松与股骨颈,粗隆间骨折

1 临床资料1.1 病例组成 本组232例中股骨颈骨折208例,占89.7％;股骨粗隆间骨折24例,占     

儿童股骨颈合并股骨干骨折1例

患儿，女，7岁。从高处跌下致右髋部、下肢疼痛、畸形。活动受限。伤后急诊送入我院，测血压为98／60mmHg(1mmHg=0．1333kPa)，一般情况可，右髋部、下肢疼痛、畸形。活动受限，患肢较对侧肢体短缩5cm左右。急诊行骨盆平片、患侧髋关节、股骨正侧位片检查，提示股骨颈骨折伴同侧股骨干中下段骨折，未见骨盆骨折。入院后行患肢置于布郎架上并行皮肤牵引，入院第3天在全麻下行骨折切开复位内固定术。手术方法先行股骨干骨折切开复位钢板螺丝钉内固定，后再行患侧股骨颈骨折透视下经皮行三枚克氏针“品字”型内固定术。     

中空加压螺丝钉治疗股骨颈及粗隆间骨折

中空加压螺丝钉治疗股骨颈及粗隆间骨折武警北京总队医院王伟，翟书亭，杨选平，刘冬发，赵志栋（北京１０００２７）中空加压螺丝钉治疗股骨颈骨折在国外已有报道［１］，与以往手术比较有骨折端加压可靠、内固定坚强、手术损伤小、操作准确简便等优点。我院于１９９２年...     

手术治疗股骨矩碎裂的股骨颈骨折

手术治疗股骨矩碎裂的股骨颈骨折14例,根据股骨矩骨折块有无移位采用不同的术式,疗效满意。     

股骨转子下骨折术后骨髓炎新发股骨颈骨折1例报告

老年女性,右股骨转子下骨折术后出现迟发性感染、大转子骨髓炎,骨折愈合后取出内固定物。在无明显创伤暴力情况下,新发右股骨颈骨折,予制动、抗感染、营养支持、负压闭式引流治疗后,感染得到控制,创口愈合,二期行股骨头置换术。创伤性骨髓炎患者骨折愈合、内固定物取出后,存在无诱因邻近部位骨折的可能,应避免过早负重。     

AO中空螺丝钉治疗股骨颈骨折

目的：探讨AO中空螺丝钉治疗股骨颈骨折的临床效果。方法：2000年3月－2006年10月，采用AO中空螺丝钉治疗股骨颈骨折36例。结果：本组36例经过术后随访6～24个月，按功能分级，良好21例，较好12例，差3例，优良率91．7％。结论：AO中空螺丝钉治疗股骨颈骨折为微创、操作容易、疗效良好。     

股骨转子骨折治疗的临床观察

通过对９６例老年人股骨转子骨折治疗结果的观察，确定治疗方法与其死亡率，髋内翻率的关系。方法：采用骨牵引，皮牵引，加压滑动螺钉及斯氏针四种方法治疗。结果：在精心护理的情况下，保守治疗的死亡率并不高于手术治疗，骨牵引的方法，髋内翻形成最少。     

MR imaging of rectus femoris origin injuries

Objective To describe the MR imaging findings of acute and chronic rectus femoris origin (RFO) injuries.Materials and methods A retrospective review of pelvic and hip MR imaging procedures was performed over a 4-year period for detection of cases with injuries to the RFO. Subjects were classified as having either acute or chronic symptoms. MR imaging studies, radiographs, CT scans, radiology reports, medical records, and operative notes were reviewed. Imaging analysis was directed to assess injuries affecting the direct and indirect heads of the RFO. Concurrent osseous, cartilaginous and musculotendinous injuries were tabulated.Results The incidence of RFO injuries on MR imaging was 0.5% (17/3160). With the exception of one case of anterior inferior iliac spine apophysis avulsion and partial tear of the direct head of RFO, all subjects had indirect head of RFO injuries (acute injury 8/9, chronic injury 8/8). Partial tear of the direct head of RFO was less frequently seen (acute injury 3/9, chronic injury 2/8). Partial tears of the conjoint tendon were least frequent (acute 1/9, chronic 2/8). No full-thickness tears of the RFO were noted. Associated labral tears were seen in only one case, with no other concomitant abnormality of the articular cartilage or surrounding soft tissues. All RFO injuries were treated non-operatively.Conclusion Injuries of the RFO are uncommon on MR examinations of pelvis/hips and may occur in a sequence progressing from indirect head injury to involvement of direct head and conjoint tendon in more severe cases.     

不同影像检查方法对骨盆骨折的临床应用价值

目的：通过观察不同影像学检查所得的影像信息,了解其对骨盆骨折的形态、部位、分型的应用价值。方法：本文骨盆骨折52例,年龄19~62岁。分别用多体位数字化摄影（DR）、螺旋CT检查。结果：使用不同的影像学检查获得的影像能充分显示骨盆骨折的形态、类型、部位以及对骨片移动的方向、距离有量化的分析：骨盆正位对简单的骨盆骨折有意义;骨盆出入口位对骨盆环、髋臼前后柱骨折及骶髂关节情况有意义;闭孔、髂骨斜位对髋臼前后壁骨折有意义;CT及三维重建则对复杂的骨盆骨折、盆腔损伤出血及并发症有意义。结论：影像学各项检查对骨盆骨折的诊断有不同的价值,合理应用各种检查,可为临床治疗、手术方案的制定提供帮助。     

Clinical evaluation of a new digital chest imaging system

A digital chest imaging system based on a selenium detector has been installed in a large teaching hospital. Up to 1 May 1994, 7000 patients have been studied by this new technique. Hard copies are printed on a laser imager. Image quality of the digital system was analysed by day-to-day comparison with a conventional chest system. In a pilot study of 40 patients conventional and digital images were compared by analysing six different anatomical regions. Two readers judged the image quality of the digital system to be better than that of a conventional chest system, all regions being better visualised on the digital images (P <0.01). Acceptance of the digital chest system by radiographers, radiologists and other medical specialists is good. More than half of the normal patient load is routinely dealth with using the new system. Retakes were hardly necessary. Post-processing is possible, but was seldom used. These preliminary overall results of a digital chest imaging system based on a selenium detector in routine clinical practice are promising and further phantom studies and clinical studies using receiver operating characteristic (ROC) analysis are currently being performed. Correspondence to: J. P. M. van Heesewijk     

Processing alternatives for digital chest imaging

Radiographic imaging of the chest remains one of the most important and most challenging problems in radiology. The wide range of information that results from the great variation of radiation behind the lungs compared with that behind the mediastinum creates a very difficult imaging problem. The introduction and continued investigation of digital techniques have presented a potential solution to this problem. In this article, the authors describe the image-processing techniques of histogram equalization and adaptive filtration in digital chest imaging.     

Ergonomics of digital imaging

There has been an increase in the use of digital imaging in recent years and radiologists have almost universally accepted the use of computers in their day-to-day work. Completely filmless radiology departments, with all reporting being done on visual display terminals and picture archiving and communications systems (PACS) around the department, are already a reality in many places in the UK and other parts of the world. There is a constant need of computers for literature searches on the web, e-mails, communication and preparing lectures and presentations. With this explosive increase in the use of computers in the hospital, it is imperative that the use of computer monitor screens for medical use is optimized in order to avoid eyestrain and fatigue. This is especially important as tired eyes and brains may be more likely to commit errors. We have reviewed the current literature to elaborate a few useful measures that can be taken to minimize the effect of excessive computer use in a soft-copy radiology reporting area on the eyes and the musculoskeletal system. We recommend that optimal placement of computer monitors with user-friendly PACS terminal interfaces will ensure greater acceptability and improve reporting efficiency and accuracy. Good work practices to ensure reduction of reporting errors are highlighted.     

Image processing in the digital tomosynthesis for pulmonary imaging

Digital tomosynthesis makes it possible to reconstruct multiple tomographs from digital data obtained during a single tomographic motion and permits digital processing, which adds a number of special advantages to the well-known advantages of conventional tomography. We performed digital tomosynthesis with a fluororadiographic TV unit with tomographic function which was capable of producing pulsed low-and high-energy X-rays alternately, and we studied digital image processing to improve the image clarity of the reconstructed tomographs. To identify the optimal parameters for processing image data by means of spatial frequency filtration we evaluated the spatial frequency distribution of image data in linear tomographs of the lung, and on the basis of the results of this study we developed several types of digital image processing to reduce tomographic blur and system noise, to improve visualisation of faint opacities, to reduce resistant tomographic blur as well as overall blur, and to generate low-noise bone images based on dual-energy subtraction tomosynthesis. Correspondence to: S. Sone     

User-friendly electronic film library for digital imaging modalities

A system that provides a simple and reliable means for archiving image data from various digital modalities has been developed and tested. In this system, image data are frame-grabbed from the acquisition device (e. g., CT, MR, or ultrasound) during the normal process of filming cases, in a manner which is essentially transparent to the technologist. Text information is derived from the frame-grabebd data by applying character recognition techniques. This system is adaptable to many types of image-generating devices manufactured by a variety of vendors. It allows for easy review and/or reprinting of previous cases and will eventually allow previous cases to be viewed at full resolution on soft displays. We have demonstrated that the system is feasible alternative to the use of film or magnetic tape for the permanent storage of CT, MR, or ultrasound image data. Correspondence to: D. GurPresented at the European Congress of Radiology, September 1991, Vienna, Austria