半导体激光穴位照射与药物治疗急慢性关节损伤的疗效比较

目的探讨低功率半导体激光对急慢性关节损伤的治疗作用.方法1999年至2004年急慢性关节损伤的患者240例,随机分为两组,各120例,激光组采用低功率半导体激光治疗仪照射痛点;对照组口服活血止痛胶囊,外用沈阳红药膏治疗.结果两周后的疗效比较.激光组有效率为85.0%,痊愈率为44.2%;对照组有效率为71.7%,痊愈率为20.8%;差异有显著意义.激光组中,急性关节损伤的患者痊愈率为52.9%,慢性关节损伤患者的痊愈率为32.7%,差异有显著意义(P＜0.05)有效率,差异无显著性意义.结论低功率半导体激光对急慢性关节损伤,尤其是急性小关节损伤有很好的疗效.     

Image technique optimization in MR imaging of a titanium alloy joint prosthesis

The purpose of this study was to explore systematically the effect of the imaging parameters changeable by the user in spin-echo (SE) imaging sequences to minimize image distortion when imaging joint prostheses. A titanium alloy hip joint prosthesis was studied at 1.0 T. The SE imaging parameters were bandwidth/pixel (BW/p), TE, strength of encoding gradients (matrix size), echo train length (ETL), and direction of phase and frequency encoding. The effect of ETL in rapid acquisition relaxation enhanced (RARE) sequences was also evaluated with a turbo-SE sequence using a different ETL with the same TR and an effective TE. It is concluded that an optimized image quality can be achieved in SE imaging by using a high bandwidth/pixel value (at least 130 Hz/pixel), a high resolution matrix (256–512), sequences with multiple refocusing, and a frequency-encoding axis parallel to the long axis of the prosthesis. The degree of distortion is reduced with this optimized technique.     

跖跗关节骨折脱位手术治疗21例报告

我院自 1993年 5月 - 2 0 0 1年 5月采用闭合复位或切开复位克氏针内固定治疗跖跗关节骨折脱位2 1例 ,取得满意疗效 ,现报告如下。1　临床资料　　本组 2 1例 ;男 14例 ,女 7例 ;左侧 12例 ,右侧 8例 ,双侧 1例 ;年龄 2 1～ 6 8岁 ,平均 4 0 5岁 ;闭合性骨折脱位 16例 ,开放性骨折脱位 5例 ;按照Kuss分类法 :同向性脱位 15例 ,分离性脱位 6例 ;伤因 :车祸伤 12例 ,高处坠落伤 5例 ,重物压伤 3例 ,扭伤 1例。同时伴肢体骨折 6例 ,胸腹伤 3例。2　治疗方法本组 16例闭合性损伤均采用闭合复位克氏针内固定。一般在硬麻下进行 ,取平卧位 ,膝关…     

螺旋CT多功能重建在骨关节外伤中的应用

目的 探讨螺旋cT功能重建在骨与关节外伤中的应用，提高重建技术的使用能力和诊断水平。方法 对使用双层螺旋CT，SSD，MPR，MIP等多种方式重建检查的49例复杂的骨与关节外伤病例进行回顾性分析。结果 49例骨关节外伤重建成像，其中，颅底3例，颌面部7例，颈、胸、腰、骶椎共17例，肩胛骨3例，髋关节8例，膝关节11例。SSD在显示碎骨片明显移位的空间关系方面较MIP，MPR为佳，它可以直观地、立体地、清晰地、多角度显示骨关节损伤，而MIP在显示骨折细节方面较优，尤其在外伤中颅窝观察有关神经孔方面。结论 螺旋CT的SSD，MPR和MIP技术的综合应用，对复杂的骨折、关节损伤的显示效果良好，具有较高的临床应用价值。     

Measurement of upper extremity orientation by video stereometry system

In the attempt to gain a broader understanding of the causal relationships behind work-related symptoms of pain in the human shoulder, monitoring of arm position is crucial. Different methods have been used with varying accuracy. A video-based stereometry system, using infra-red light and reflecting markers for motion analysis, has been introduced for measurements in the fields of ergonomics, biomechanics and sports medicine. The purpose of this study is to investigate the sources of error in using this system for posture registration of the upper limb. Measurements are performed on a calibration fixture, on a mechanical model of the upper limb and on a subject with an exoskeleton. Particular, attention is given to inconsistencies and relative errors due to the finite geometrical precision with which the markers are positioned in the calibration fixture and on the studied objects, the limited capability to align the objects relative to the coordinate system of the calibration fixture and the errors connected to angular measurements using protractors etc. It is concluded that the system makes a valuable addition to existing instruments for non-contact posture measurement, and produces position data with an adequate accuracy in normal handling.     

双极射频电热固缩治疗前交叉韧带松弛临床研究

目的:对15例前交叉韧带双极射频电热固缩治疗进行回顾性研究,评估其临床疗效。方法:从2000年1月至2005年1月采用双极射频对16例前交叉韧带松弛的患者进行电热固缩治疗。完整随访者15例,男性11例,女性4例,平均年龄29岁。12例前交叉韧带部分损伤,3例为自体绳肌重建术后。电热射频设备输出功率为284W,组织内作用温度为65℃。术后患者采用支具制动,康复计划与前交叉韧带重建术后基本相同。结果:随访时间平均15·6个月(4~25个月)。Lysholm评分,术前74·27±5·51分(66~84分),术后3个月89·6±7·11分(72~99分),两者相比有显著性差异(P<0·01);术后最终评分83·33±11·81分(56~95分),虽仍显著高于术前评分(P<0·05),但与术后3个月比较有所降低。KT-1000测量结果,术前两侧胫骨前移差值为5·47mm±1·61mm(3·5mm~10mm),术后3个月为2·67mm±1·35mm(2~7mm),与术前测量值对比存在显著性差异(P<0·01);最终测量结果为3·8mm±1·96mm(2~9mm),虽仍显著低于术前测量值(P<0·05),但较术后3个月有所增加。所有患者均未出现明显的术后并发症。2例患者(13·3%)术后失效,接受了二期重建手术。结论:电热固缩治疗前交叉韧带松弛可获得较好的短期主、客观疗效,但长期随访疗效有所下降。建议慎重选择手术适应症。     

Recurrent locking of knee joint caused by intraarticular migration of bioabsorbable tibial interference screw after arthroscopic ACL reconstruction

Two cases are reported in which, after ACL reconstruction with autologous hamstring grafts, tibial polylactide interference screws migrated into the knee joint. Clinically, both patients presented with recurrent locking of the joint. In one case, a broken 15 mm-long tip of the screw was found intra-articularly. In the other case, the whole screw had migrated into the joint cavity. The degradation process of polylactic acid, operative technique and bone quality are discussed as possible reasons for these complications.     

重建钛板枢椎椎弓根螺钉及颗粒状植骨枕颈融合术

目的 探讨重建钛板螺钉及颗粒状自体松质骨植骨在枕颈融合中的应用。方法 2002年4月～2005年1月，选择枕颈区不稳定患者19例，年龄31～67岁；病程3个月～2年。其中枕寰枢椎复合畸形8例，陈旧性寰枢椎骨折脱位8例，类风湿性关节炎所致寰椎前脱位2例，枢椎齿状突肿瘤1例。JOA脊髓功能评分平均9．8分。使用重建钛板和枢椎椎弓根螺钉固定枕颈部，同时枕骨与枢椎后弓间颗粒状自体松质骨植骨。结果 术中、术后无并发症发生，切口Ⅰ期愈合。19例均获随访6个月～2年8个月，平均16个月，均获得了骨性融合。无神经血管损伤，无断钉、断板及内固定松脱。JOA脊髓功能评分平均达14．4分。结论 重建钛板枢椎椎弓根螺钉固定可靠，置入方便，自体颗粒状松质骨具有较高的融合率，在枕颈融合中效果满意。     

Dislocation of the second through fifth carpometacarpal joints

We report a case of dislocation of the second through fifth carpometacarpal joints and review the mechanism of injury and radiographic findings in such injuries.     

人工关节假体植入后骨溶解的研究进展

假体植入后松动是许多行关节置换术病人面临的严重问题,解决这一问题对于提高人工关节置换的疗效有重要意义.目前认为导致假体植入后松动的主要原因是关节活动使得假体表面之间长期摩擦,因此产生大量磨损微粒,微粒在骨-假体界面之间迁移,诱发局部环境中细胞分泌各种细胞因子导致假体周围的骨溶解.为此,本文主要研究磨损微粒的产生过程以及微粒的产生对关节假体使用寿命的重要影响,在此基础上探讨如何减少微粒的产生以及限制其在假体周围的迁移,以此来预防骨溶解发生.……