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目的观察锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折的临床效果。方法回顾分析应用锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位24例治疗结果,19例病人获得10个月以上随访,按kavlsson标准评价疗效。结果优15例,良4例,差0例。无感染和钢板螺钉松动折断,取出钢板后无再骨折和脱位。结论锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折操作相对简单,固定可靠,不损伤肩锁关节面,可以早期进行肩关节功能锻炼。锁骨钩钢板是目前治疗肩锁关节脱位和锁骨远端骨折的理想选择。 相似文献
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目的观察有手术指征的锁骨远端骨折及肩锁关节脱位应用锁骨钩钢板进行切开复位内固定手术的临床效果,探讨理想的手术治疗方法。方法自2002年5月至2008年5月使用锁骨钩钢板治疗锁骨远端骨折64例,肩锁关节脱位28例,锁骨远端骨折合并肩锁关节脱位16例,共108例。结果101例(93.5%)患者获得随访,平均13个月。按Karlsson疗效评定标准:优74.3%,良20.7%,差5%;治疗优良率达95%。结论锁骨钩钢板在锁骨远端骨折及肩锁关节脱位的治疗中,固定牢靠,可早期功能锻炼,肩关节功能恢复快,骨折愈合好,并发症少,疗效显著。 相似文献
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目的观察锁骨钩钢板治疗急性重度肩锁关节脱位和锁骨远端骨折的临床疗效。方法从2002年5月—2005年12月采用锁骨钩钢板及韧带修复治疗Post 3~6型肩锁关节脱位和Neer 2型锁骨远端骨折共5例。结果术后所有患者X线片评估复位率达100%,所有患者均获得随访,随访时间6~36个月,平均15.3个月;术后无一例发生伤口感染、内固定松动或断裂,内固定取出后无一例发生脱位和骨折,按ChenW J疗效评价标准,肩关节功能恢复优良率97.14%。结论锁骨钩钢板是近年来治疗急性重度肩锁关节脱位和锁骨远端骨折的一种较好的手术方法。 相似文献
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锁骨骨折是常见骨折,约占全身骨折的4%[1];以中1/3为主,远端骨折仅占锁骨骨折的12%~21%[2];肩锁关节脱位占肩部损伤的12%[3]。近年来,锁骨钩钢板越来越多地应用到RockwoodⅢ型肩锁关节脱位及锁骨远端骨折的治疗,虽然技术日趋成熟,但术后肩部疼痛等并发症也较为多见。2008年6月—2013年6月,我们采用锁骨钩钢板内固定治疗RockwoodⅢ型肩锁关节脱位及锁骨远端骨折70例,其中发生术后肩 相似文献
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目的探讨锁骨钩钢板在NeerⅡ型的锁骨远端骨折和Rockwood Ⅲ型的肩锁关节脱位治疗中的临床疗效。方法我院自2007年1月~2010年2月共收治141例Neer Ⅱ型锁骨远端骨折和Rockwood Ⅲ型肩锁关节脱位的患者,均运用锁骨钩钢板治疗,按Constant-Murley评分随访观察各病例恢复情况。结果 141例患者均获得随访,共随访6~26个月,平均13.1个月。术后1周所有患者均能进行肩关节主动活动,术后6周均完全恢复日常生活和工作能力,无1例患者出现伤口感染。随访的患者X线未见肩锁关节半脱位,无内固定物松动或断裂。结论锁骨钩钢板是治疗NeerⅡ型锁骨远端骨折和Rockwood Ⅲ型肩锁关节脱位的一种较好的手术方法。 相似文献
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Magnetic resonance imaging of the clavicular ossification 总被引:4,自引:4,他引:0
Schmidt S Mühler M Schmeling A Reisinger W Schulz R 《International journal of legal medicine》2007,121(4):321-324
Assessment of the degree of ossification of the medial clavicular epiphyseal cartilage is of vital importance in forensic
age diagnostics of living individuals aged more than 18 years. To date, reference studies on the assessment of clavicular
ossification using imaging procedures only relate to conventional radiography and computed tomography (CT). In this study,
magnetic resonance (MR) scans of 54 sternoclavicular joints of bodies aged between 6 and 40 years were evaluated prospectively.
All of the examined medial clavicular epiphyseal cartilages permitted an assessment of the degree of ossification. Stage 2
was first observed at the age of 15.0 years, the earliest age at which stage 3 was observed was 16.9 years, and stage 4 was
first observed at the age of 23.8 years. The observed age intervals of the respective degrees of ossification correspond to
the known data from X-ray and CT scan examinations. The achieved results should be examined with a larger number of cases.
A modified examination protocol is required for the MR examination of the medial clavicular epiphyseal cartilage for the purpose
of forensic age diagnostics of living individuals. 相似文献
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目的 比较锁骨远端解剖型钢板与锁骨钩钢板治疗锁骨远端骨折的疗效. 方法 选择2009年8月-2011年1月收治的26例CraigⅡ类Ⅱ、Ⅴ型锁骨外1/3骨折患者.11例应用锁骨远端解剖型钢板治疗,其中CraigⅡ类Ⅱ型8例,Ⅱ类Ⅴ型3例.15例应用锁骨钩钢板治疗,其中CraigⅡ类Ⅱ型11例,Ⅱ类Ⅴ型4例.术前两组患者一般资料具有可比性,采用Constant-Murley评分系统评价肩关节功能,并对两组患者术后的影像学结果及并发症进行对比分析. 结果 锁骨远端解剖型钢板组术后肩部疼痛发生率低于锁骨钩钢板组,肩关节活动度优于锁骨钩钢板组.在切口感染及内固定松动方面两组差异无统计学意义.术后根据Constant-Murley评定标准,锁骨远端解剖型钢板组优良率为91%;锁骨钩钢板组优良率为73%. 结论 锁骨远端解剖型钢板在治疗CraigⅡ类Ⅱ型、Ⅱ类Ⅴ型锁骨远端骨折,其术后肩关节疼痛及肩关节活动受限发生率低,术后并发症少,有利于肢体功能早期恢复. 相似文献
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Schulz R Mühler M Reisinger W Schmidt S Schmeling A 《International journal of legal medicine》2008,122(1):55-58
Determination of the stage of ossification of the medial clavicular epiphysis is a crucial part of forensic age estimation
when evaluating living subjects over 18 years of age. In the present study, we comparatively assessed conventional radiographs
and computed tomography (CT) scans of sternoclavicular joints used to perform forensic age assessments in 57 individuals undergoing
criminal proceedings. With CT, it was possible to determine the ossification stage of all clavicles studied. In the case of
conventional radiography, reliable assessment of ossification stage was not possible in 15 out of 114 clavicles studied due
to the superimposition of other structures. Regarding agreement between the methods, both radiography and CT produced identical
staging results in 97 out of 99 clavicular epiphyses. In two cases, however, ossification was classified as stage 2 by CT
and as stage 3 by conventional radiography. Regarding stages 4 and 5, both methods produced identical staging results in all
cases. In forensic age estimation practice, it is necessary that conventional radiographic reference studies be used for ossification
stage classification by conventional radiography and that CT reference studies be used for ossification stage classification
by CT. Further studies in dead bodies of known age are required to issue a recommendation as to whether conventional radiography
using obtained in three planes or CT is the method of choice for the assessment of clavicular ossification. 相似文献
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Schulz R Zwiesigk P Schiborr M Schmidt S Schmeling A 《International journal of legal medicine》2008,122(2):163-167
When preparing forensic age estimates for living subjects over 18 years of age, it is crucial to evaluate the stage of ossification
of the medial clavicular epiphysis. The establishment of radiation-free imaging techniques for assessment of clavicular ossification
would be desirable in order to reduce the radiation exposure associated with forensic age estimations. In the present study,
84 right clavicles of test subjects 12–30 years of age were prospectively evaluated by means of ultrasound. Ossification stage
classification was possible in 80 of the 84 medial clavicular epiphyses studied. In the remaining cases, stage classification
was not possible due to the presence of developmental anomalies. The earliest ages at which the respective ossification stages
were observed were 17.1 years for stage 2, 16.7 years for stage 3, and 22.5 years for stage 4. The age intervals observed
for the ossification stages are consistent with the known data from radiological and computed tomography assessments. The
present study results should be confirmed in a larger number of cases and with analysis of observer variability. Evaluation
of medial clavicular epiphyseal ossification by ultrasound could ultimately be a rapid and economic non-ionizing diagnostic
imaging procedure for forensic age estimation. 相似文献
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David J. Sartoris M.D. Richard M. Mochizuki M.D. Bruce R. Parker M.D. 《Skeletal radiology》1983,10(1):34-36
Two patients with fibromatosis colli (congenital torticollis) presented with lytic lesions in the clavicle at the insertion of the fibrosed clavicular head of the sternocleidomastoid muscle. Biopsy of one lesion showed intraosseous fibrosis. These lesions are probably not uncommon but radiographs are rarely performed in uncomplicated cases. 相似文献
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The authors' aim was to investigate the utility of US in the diagnosis of clavicular fractures in neonates. The technique, which is quite simple, consists in obtaining longitudinal scans of the bone by directing the probe along its axis. Ten cases of clavicular fracture were demonstrated in 11 neonates. Some patients were reexamined after 15 days to investigate fracture healing. After US examination, plain X-rays were always performed and the results compared: perfect correspondence was demonstrated between US and X-ray findings. Since clavicular fractures have a very good prognosis, this affection only needs documenting, for which purpose US can fully replace conventional X-rays, being quite simple to perform and avoiding the use of ionizing radiations, though yielding the same diagnostic results. 相似文献