带血管的骨膜—骨移植术治疗腕舟骨骨折不愈合

带血管的骨膜－骨移植术治疗腕舟骨骨折不愈合周谋望，秦建中，伍骥骨科主题词腕骨，骨折，骨移植，骨膜／移植腕舟骨骨折后易破坏舟骨的血供，继而出现骨折不愈合，甚至缺血坏死，导致腕关节功能障碍。作者设计带血管的骨膜－骨移植术治疗腕舟骨骨折、缺血坏死获得良好疗...     

应用带骨间掌侧动脉背侧支血管蒂桡骨瓣治疗腕舟骨骨折不愈合

目的　探讨一种良好的治疗腕舟骨骨折不愈合的方法 ,丰富治疗腕舟骨骨折不愈合的手术方式。方法　切除腕舟骨骨折不愈合之硬化骨 ,以克氏针贯穿固定骨折端 ,用带骨间掌侧动脉背侧支血管蒂桡骨瓣翻转移植治疗腕舟骨骨折不愈合 15例。结果　术后随访 3～ 6个月 ,骨折完全愈合 ;9～ 18个月 ,腕关节活动正常无痛。结论　前臂间掌侧动脉背侧支解剖位置恒定 ,变异少 ,位置较表浅 ,血管蒂长、口径粗、游离安全容易 ,血供充分 ,能有效地促进舟骨骨折愈合。     

应用带骨膜蒂桡骨块植入修复腕舟骨骨折不愈合1例

腕舟状骨骨折不愈合治疗方法很多,我科采用带骨膜蒂桡骨块植入治疗腕舟骨骨折不愈合1例,效果满意,现报告如下.临床资料患者,男性,20岁,因右腕摔伤致舟骨骨折2年入院.X线片示舟骨腰部骨折,骨折端     

桡骨骨钉治疗腕舟骨骨折不愈合

目的探讨桡骨骨钉治疗腕舟骨骨折不愈合的疗效及可行性。方法对我院自1999年4月—2005年9月收治的52例腕舟骨骨折不愈合患者采用桡骨骨钉治疗的情况进行回顾性分析。本组患者均于开放复位后,凿取1.5 cm×0.4 cm×0.4 cm桡骨骨钉进行内固定,术后石膏固定2~3个月。结果全部病例术后随访6个月~1年,52例骨折全部愈合,优27例,良22例,可3例。结论采用桡骨骨钉治疗腕舟骨骨折不愈合,能够牢靠固定骨折,并明显促进骨折愈合,是治疗腕舟骨骨折不愈合的有效方法。     

逆行掌侧螺钉内固定治疗战士腕舟骨骨折

目的探讨逆行掌侧螺钉内固定治疗战士腕舟骨骨折的手术疗效。方法对14例战士腕舟骨骨折采用掌侧切开复位逆行螺钉内固定治疗,用Cooney’s临床评分系统对患腕的疼痛情况,腕关节活动度及握力进行评分。结果14例中有13例愈合,1例不愈合,平均愈合时间为12周,平均腕关节活动度为健侧的90%,握力为健侧的95%,12例患者没有疼痛,1例轻度疼痛,另外l例不愈合有中度疼痛,除1例不愈合患者外,其余都能胜任原有的工作,按Cooney’s评分10例优,3例良,1例差。结论逆行掌侧螺钉内固定治疗腕舟骨骨折手术操作简单,对腕舟骨残存的血运破坏小,固定牢靠,可缩短骨折愈合时间及提高骨折愈合率,是治疗腕舟骨骨折的一种有效的手术方法。     

武警战士腕舟骨骨不连26例

腕舟骨骨折约占腕部骨折的71.2%,是武警部队常见训练伤之一,由于腕舟骨自身的血供较差,骨折后不当治疗容易导致骨不连、骨缺血坏死,严重影响部队正常训练及战斗力。自2005-02至2011-02,我科收治武警战士腕舟骨骨不连病例共26例,经行带桡动脉茎突返支骨瓣植入联合克氏针内固定术治疗,取得满意疗效。     

31例腕舟骨骨折早期漏诊,误治分析

３１例腕舟骨骨折早期漏诊、误治分析武警湖北总队医院一外科魏晓艳张长云（武汉４３００６１）关键词腕舟骨骨折漏诊我院自１９９２年５月～１９９５年９月共收治３４例次部队腕舟骨骨折患者（１名战士为两次受伤致双腕舟骨腰部骨折），仅两例在伤后３周内确诊予及时治疗...     

微创加压螺钉内固定治疗士兵腕舟骨骨折11例

腕舟骨骨折占全身骨折的2%~7%,占腕部骨折的50%以上,多见于青壮年。士兵长年进行高强度训练,更容易发生腕舟骨骨折[1]。虽然对于新鲜无移位的腕舟骨骨折采用传统石膏固定多能愈合,但由于固定时间相对较长,容易造成腕关节僵硬。     

腕舟骨骨折的治疗

<正> 诸腕骨中最易发生骨折的是腕舟骨,而且常因漏诊和治疗不当造成舟骨骨折迟延愈合或不愈合。Leslie和Dickson(1981)统计的247例腕骨骨折中有222例是舟骨骨折。舟骨骨折罕有自然愈合,因漏诊及治疗不当所致之不愈合常引起腕关节永久性功能障碍。而且该骨     

数字断层融合摄影技术在腕舟骨骨折诊断中的应用价值

目的:探讨数字断层融合摄影(DTS)技术在腕舟骨骨折诊断中的应用价值。方法:搜集30例临床怀疑腕舟骨骨折的患者,所有患者均行普通DR、DTS及CT检查,以CT检查结果为标准,比较普通DR与DTS的诊断符合率、敏感度及特异度。结果:DTS对腕舟骨骨折的诊断符合率为86.67%(26/30),显著高于普通DR(56.67%,17/30),差异具有统计学意义(P<0.05)。DTS检查对腕舟骨骨折的诊断敏感度为88.89%,显著高于普通DR(敏感度为59.26%),差异具有统计学意义(P<0.05)。DTS检查对腕舟骨骨折的诊断特异度为66.67%,普通DR为33.33%,两者之间差异无统计学意义(P>0.05)。结论:DTS对腕舟骨骨折的诊断效能高于普通DR,能清晰显示骨折情况,具有一定的临床应用价值。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.