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目的:探讨膝关节后内侧微创入路结合锚钉固定治疗后交叉韧带胫骨止点撕脱性骨折的疗效.方法:总结我院自2008年1月至2010年1月,对16例后交叉韧带胫骨止点撕脱性骨折经膝后内侧微创入路行复位和锚钉固定的手术效果.结果:手术时间20~40 min,平均28 min.随访14~36个月,平均18个月,X线片显示所有骨折均复... 相似文献
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记忆合金弓齿钉内固定治疗第5跖骨基底部骨折 总被引:1,自引:0,他引:1
目的探讨记忆合金弓齿钉内固定治疗第5跖骨基底部骨折的临床疗效。方法本组25例,其中男18例,女7例,平均39岁。受伤原因:跌倒时扭伤19例,重物砸伤6例。22例为闭合性骨折,3例为开放性骨折,其中1例合并同侧距骨骨折。第5跖骨基底部Ⅰ区骨折14例,Ⅱ区骨折10例,Ⅲ区骨折1例。结果本组病例获8~28个月(平均18个月)随访。全部病例获得骨性愈合,平均愈合时间7.5周(6~10周)。未发生深部感染、骨不连、足部畸形等并发症。本组病例术后8个月~1年半左右再次手术将内固定顺利取出。按Mary-land足部评分系统评分,优20例,良5例,优良率100%。结论记忆合金弓齿钉治疗第5跖骨基底部骨折固定可靠,可使患者早期下床活动,获得满意的疗效,是一种较理想的内固定方式。 相似文献
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目的探讨应用锚钉髌骨环形固定术治疗髌骨下极撕脱性骨折的临床疗效。方法回顾性分析2007年1月~2010年12月,采用美国施乐辉公司生产的5.5 mm钛质双固定钉(锚钉),行髌骨环形固定术治疗髌骨下极撕脱骨折58例,术后早期行膝关节功能锻炼。结果随访6~32个月,平均18个月,均未发现骨折分离移位。采用Lysholm评分标准评价疗效,优48例,良8例,可2例,优良率为96.55%。结论采用锚钉行髌骨环形固定术治疗髌骨下极撕脱性骨折,能有效复位固定骨折,膝关节功能恢复优良率96.55%。此方法安全简便易掌握,是治疗髌骨下极撕脱性骨折的有效方法,值得推广。 相似文献
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交叉韧带损伤的早期手术治疗 总被引:3,自引:0,他引:3
目的 探讨膝关节交叉韧带损伤的早期手术治疗方法与效果。方法 分析 1989年 5月~ 1999年 5月收治的 4 1例交叉韧带损伤病例的临床资料。韧带上下止点撕脱骨折 2 9例 ,前交叉韧带实质断裂 12例 ,膝关节合并伤 2 1例。 4 1例均在伤后 1~ 19天内手术。撕脱性骨折用钢丝固定 ;实质断裂直接缝合 5例 ,骨 -膑腱 -骨重建前交叉韧带 7例。结果 在获得随访的 38例中 ,平均随访时间 4 .2年 ,撕脱性骨折手术优良率 88% ;实质断裂直接缝合优良率 2 0 % ,骨 -膑腱 -骨重建优良率 6 0 %。结论 交叉韧带止点撕脱骨折早期手术效果良好 ,实质断裂骨 -膑腱 -骨重建效果较好 ,直接缝合效果较差。 相似文献
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目的比较关节镜下胫骨髁间棘撕脱骨折"8"字缝线与带线锚钉固定两种方法的疗效。方法笔者收集2007年1月~2013年9月收治的52例胫骨髁间棘骨折患者,均为Meyers-MckeeverⅡ型、Ⅲ型的患者,28例行"8"字缝线固定(A组),包括男性21例,女性7例;平均年龄24岁;24例行带线锚钉固定(B组),包括男性19例,女性5例;平均年龄22岁。比较两组伸膝功能、屈膝功能、关节稳定性及Lysholm关节功能评分。结果术后平均随访9.2个月。A组与B组伸膝功能有统计学差异(P=0.040.05),两组屈膝功能、关节稳定性及Lysholm关节功能评分无统计学差异。结论关节镜下"8"字缝线固定治疗胫骨髁间棘撕脱骨折的疗效优于带线锚钉固定。 相似文献
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目的比较切开内、外排锚钉固定与空心螺钉固定治疗后交叉韧带(PCL)胫骨止点撕脱骨折的临床疗效。方法选取自2017年1月至2019年1月沈阳市骨科医院收治的28例PCL胫骨止点撕脱骨折患者为研究对象。其中,行切开内、外排锚钉固定的14例患者设为内、外排锚钉组,行空心螺钉固定的14例患者设为空心螺钉组。比较两组患者的手术时间。术后1周和术后1、3、6个月复查X线影像,评估骨折愈合情况;采用国际膝关节文献委员会(IKDC)评分、 Lysholm评分及Tegner评分评估患侧膝关节功能恢复情况。结果所有患者术后切口均Ⅰ期愈合并获得随访。内、外排锚钉组手术时间为(42.0±13.5)min,低于空心螺钉组的(65.0±19.3)min,差异有统计学意义(P<0.05)。术后6个月,所有患者X线影像示骨折均已愈合;两组患者IKDC评分、Lysholm评分及Tegner评分均较术前明显改善,但两组间各评分比较,差异无统计学意义(P>0.05)。结论切开内、外排锚钉固定及空心螺钉固定治疗Meyers-McKeeverⅡ、Ⅲ型PCL胫骨止点撕脱骨折均具有骨折复位满意、术后关节功能恢复佳等优点;与空心螺钉固定相比,内、外排锚钉固定手术时间短,对于骨折块大小及骨质条件无特殊要求,且操作相对简单。 相似文献
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PURPOSE: To evaluate the normal anatomy of the structures supporting the proximal portion of the fifth metatarsal bone and investigate the pathogenesis of fractures in this region. MATERIALS AND METHODS: In two cadaveric feet, the region of the lateral component of the plantar aponeurosis (PAL), short peroneal muscle (SPM) tendon, and third peroneal muscle (TPM) tendon was dissected. These two foot specimens and four nondissected foot specimens were studied at magnetic resonance (MR) imaging. Two of the six specimens were studied at computed tomography (CT). Sectioning the nondissected foot specimens enabled anatomic correlation. In two additional specimens, simulation of the presumed mechanism of fifth metatarsal bone fracture was attempted. The radiographic, CT, and MR images obtained in 13 patients with fractures of the proximal portion of the fifth metatarsal bone were evaluated. RESULTS: Anatomic, CT, and MR imaging studies revealed broad insertion of the PAL into the plantar aspect of the proximal portion of the fifth metatarsal bone in all specimens. The SPM tendon was consistently attached more distally and to the lateral side of the tuberosity, blending with the PAL fibers. The TPM tendon was inconsistently identified inserting anteriorly to the SPM tendon. No fracture was created in the specimens subjected to attempted injury. Frequent attachment of the PAL and the SPM tendon to the avulsed fragment was confirmed in clinical cases. CONCLUSION: The pathogenesis of fractures of the proximal portion of the fifth metatarsal bone appears to be related to avulsion injury of PAL and SPM tendon fibers. 相似文献
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Fractures of the base of the fifth metatarsal 总被引:1,自引:0,他引:1
T G Munro 《Journal l'Association canadienne des radiologistes》1989,40(5):260-261
In 1902 Sir Robert Jones described a fracture of the fifth metatarsal which he incurred while dancing. Since that time, fractures of the base of the fifth metatarsal have been called "Jones fractures". Fractures of the tuberosity at the base of the fifth metatarsal are common and usually respond readily to conservative treatment. Less frequently the fracture occurs more distally through the proximal metaphysis. Eleven patients with fractures of the proximal metaphysis were reviewed to determine if they represented a clinically distinct subgroup. Seven of the patients were men between 19 and 25 years of age who fractured the fifth metatarsal playing sports. The fractures were slow to heal and one required internal fixation with bone grafting. Fractures of the proximal metaphysis of the fifth metatarsal have a different mechanism of injury and a less favourable prognosis than do tuberosity fractures. When they occur in young athletes, more aggressive treatment is required. 相似文献
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K O Meurman 《The British journal of radiology》1981,54(637):1-7
In a series of 827 stress fractures in soldiers, 15 were found in the first metatarsal, representing 11% of all stress fractures in the metatarsals. All were in the proximal end of the bone. Eight fractures were found in the fourth and four in the fifth metatarsal. In the cuneiform bones three fractures were found, and one in the talus. One fracture was revealed in the lateral sesamoid of the hallux and one in the peroneal bone. Ten patients had stress fractures in other bones too. The radiological appearance and the corresponding stress mechanisms are discussed. 相似文献
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OBJECTIVE: To our knowledge, this article is the first to describe a series of patients with avulsion fractures of the base of the fifth metatarsal that were not seen on conventional radiography using the standard three views of the foot but that were seen on radiography of the ankle. CONCLUSION: Because routine radiographs of the foot may fail to reveal an avulsion fracture of the base of the fifth metatarsal, an additional projection should be obtained to better assess this region in the symptomatic patient. The additional view should be an anteroposterior radiograph of the ankle that includes the base of the fifth metatarsal because this projection has been shown to help in the diagnosis of this avulsion fracture. 相似文献
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Metatarsal fractures represent a relatively common injury, especially in athletes. The pertinent anatomy, evaluation, diagnosis, classification, and treatment of acute and chronic (stress) metatarsal shaft fractures are discussed. Fractures of the proximal fifth metatarsal, which are unique and important injuries, are also discussed. Treatment remains relatively straightforward for the traumatic metatarsal injury, whereas traditional stress fractures typically heal with decreased activity. The problematic proximal fifth metatarsal fracture (Jones fracture) frequently requires surgical intervention in patients who want to avoid non-weight-bearing cast immobilization. The authors' current treatment for this fracture includes the option of intramedullary fixation versus cast immobilization. 相似文献
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BACKGROUND: Fifth metatarsal Jones fractures are common in the athletic population. Optimal screw selection for operative treatment has not been determined. HYPOTHESIS: A 4.5-mm cannulated screw used for fixation of the fifth metatarsal Jones fractures in athletes is an effective treatment approach. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The authors studied 23 consecutive athletes (24 feet) who were treated surgically with a 4.5-mm cannulated screw for fifth metatarsal fractures (Jones fracture) with clinical and radiographic assessments. RESULTS: There have been no refractures to date. Clinical healing was 100%. The mean percentage healing as shown on radiographs was 98.9%, with a range of 90% to 100%. All athletes returned to sport at a mean time of 7.5 weeks (range, 10 days to 12 weeks). Two athletes experienced a "reinjury" without need for operative treatment. All athletes were recommended to wear orthoses until their competitive careers were completed. CONCLUSION: Fixation with a stainless steel 4.5-mm cannulated screw gives 100% clinical healing and near-100% healing as shown on radiographs. CLINICAL RELEVANCE: The 4.5-mm cannulated screws can yield reliable and effective healing as evidenced by clinical assessment and radiographs of fifth metatarsal Jones fractures in athletes. 相似文献
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跟骨开放性粉碎性骨折由于暴力的直接作用使骨折碎块上下左右分裂,因而难于获得解剖复位,易遗留严重功能障碍,笔者采用自行设计的多针张力带骨外固定治疗35例,疗效满意。结果表明:多针张力带既可使跟骨侧壁碎骨片不易滑脱移位;又可使舌型骨折、后关节面骨折移位、塌陷及Bohler角复位后固定满意。有利骨折愈合及恢复跟骨横径与后关节面平整,促进足部韧带、跖筋膜等软组织恢复生理功能及伤足早期功能锻炼。 相似文献
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Objective
To determine the incidence of injuries to the flexor and peroneal retinacula in hindfoot fractures as demonstrated on ankle computed tomography (CT).Materials and methods
Study patients were identified via review of CT records at a single institution. CT scans were retrospectively reviewed and compared with surgical reports.Results
Hindfoot fractures undergoing CT showed flexor retinacular injuries in 23.7% of cases and peroneal retinacular injuries in 10.2%. The posterior tibial tendon was partly torn in 4.2% of cases, and entrapped between fracture fragments in 16.1%. The peroneal tendon was rarely injured, being entrapped in 1.7% of cases. Pilon, distal tibial shaft, malleolar, talar, and calcaneal fractures were all associated with retinacular injuries. CT findings correlated well with surgical findings; there were no false-positive CT findings, and only 1 false-negative finding, a posterior tibial tendon that was entrapped at surgery, but in a normal position on the CT.Conclusions
Retinacular injuries are commonly demonstrated on CT in patients with ankle fractures. The contribution of these injuries to fracture outcomes is unknown. 相似文献20.
Petri J. Sillanpää Heikki M. Mäenpää Ville M. Mattila Tuomo Visuri Harri Pihlajamäki 《Knee surgery, sports traumatology, arthroscopy》2009,17(5):508-512
Patellar dislocations are associated with injuries to the medial patellofemoral ligament (MPFL). Several techniques for MPFL
reconstruction have been recently published with some disadvantages involved, including large skin incisions and donor site
morbidity. Arthroscopic stabilizing techniques carry the potential of inadequate restoration of MPFL function. We present
a minimally invasive technique for MPFL reconstruction using adductor magnus tendon autograft. This technique is easily performed,
safe, and provides a stabilizing effect equal to current MPFL reconstructions. Skin incision of only 3–4 cm is located at
the level of the proximal half of the patella. After identifying the distal insertion of the adductor magnus tendon, a tendon
harvester is introduced to harvest the medial two-thirds of the tendon, while the distal insertion is left intact. The adductor
magnus tendon is cut at 12–14 cm from its distal insertion and transferred into the patellar medial margin. Two suture anchors
are inserted through the same incision at the superomedial aspect of the patella in the anatomic MPFL origin. The graft is
tightened at 30° knee flexion. Aftercare includes 4 weeks of brace treatment with restricted range of motion. 相似文献