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21.
Abstract – In the treatment of crown fractures, adhesive fragment reattachment provides a good alternative to other restorative techniques, offering several advantages. The present paper reports a case in which the treatment of a cervical crown fracture was accomplished by reattaching the tooth fragment with a flowable resin composite. Orthodontic root extrusion was performed with a modified Hawley appliance prior to fragment reattachment. The clinical and radiographic results after 2.5 years were successful. 相似文献
22.
Patrick M. Rao M.D. A. John Kuta M.D. Michele H. Johnson M.D. 《Emergency radiology》1995,2(5):303-304
We present a case in which an open fracture of the ulna penetrated the skull and caused a comminuted, depressed skull fracture
with a large intraparenchymal hematoma containing bone fragments. 相似文献
23.
作者自1988年1月至1993年12月收治Pilon骨折31例,根据Riled的分类祛:Ⅰ型5例,Ⅱ型10例,Ⅲ型16例.手术治疗22例,保守治疗9例.随访l-4年,疗效按Bourne的标准评定,Ⅰ型骨折手术或保守治疗优良率100%,Ⅱ、Ⅲ型骨折手术治疗优良率85%,保守治疗优良率33.3%.作者认为Pilon骨折Ⅱ、Ⅲ型应手术治疗.保守治疗仅用于Ⅰ型骨折.手术控AO的四步重建法进行.但严重的粉碎骨折或开放骨折伴软组织缺损,内固定确定难干实施者,则改用踝部超关节外固定支架固定. 相似文献
24.
Tadeusz F. Wisniewski 《European Journal of Trauma》2004,30(2):120-123
AbstractBackground: Posterior acromioclavicular dislocation is rare.
Dislocation associated with fracture of the clavicle and
simultaneous entrapment of the lateral end of the clavicle by
trapezius muscle has not been reported. Posterior dislocation
occurs frequently owing to forceful move of the scapula
anteriorly and superiorly or from direct force applied to the
lateral end of the clavicle and this may be associated with
clavicular fracture. In acute dislocations, open reduction,
internal joint stabilization and soft tissues reconstruction
have been recommended.Case Study: Acute posterior dislocation occurred in a 32-year-old man.
The lateral end of the clavicle was displaced posteriorly and
inferiorly, and firmly entrapped in trapezius muscle. The
clavicular fracture was undisplaced. The coracoclavicular
ligaments were stretched but intact. Open reduction was secured
with two smooth Kirschner wires. The disrupted soft tissues were
repaired. The clavicular fracture was not explored. Shoulder
movement started at 6 weeks. Wires were removed. 10 years later
he had pain-free, unrestricted shoulder movement, and the
radiographs showed wellreduced, essentially normal
acromioclavicular joint.Conclusion: Open reduction, internal joint stabilization and soft
tissue reconstruction will result in return and long lasting
unrestricted pain-free function of the shoulder. 相似文献
25.
Abstract Kyphoplasty and vertebroplasty have become recognized procedures for the treatment of vertebral fractures, especially in patients
with osteoporosis. In most cases of osteoporotic spinal vertebral fracture in elderly patients, polymethylmethacrylate (PMMA)
cement is used to fill the defect and stabilize the vertebral body. The techniques of vertebroplasty and kyphoplasty differ
in the possibility of realignment and reconstruction of the vertebral body and spinal column. Long-term results in terms of
integration of the cement and bioreactivity of the vertebral body are still lacking; so, these procedures are still no options
in the treatment of younger patients. Vertebroplasty and kyphoplasty show different success in the management of fresh traumatic
spine fractures. The acute traumatic vertebral fracture has to be classified sensitively, to find the right indication for
cement augmentation. Mild acute compression fractures can be treated by vertebroplasty or kyphoplasty, severe compression
and burst fractures by combination of internal fixation and kyphoplasty. The indications for use of biological or osteoinductive
cement in spinal fracture management must still be regarded as restricted owing to the lack of basic biomechanical research
data. Such cement should not be used except in clinical studies. 相似文献
26.
Abstract
Purpose:
Evaluation of the therapeutic usefulness of
the “pelvic C–clamp” (PCC) during emergency treatment
of multiply injured patients with unstable disruption
of the posterior pelvic ring.
Patients and Methods:
The data of 28 patients with
polytrauma in combination with an unstable fracture
of the posterior pelvic ring (average Injury Severity
Score [ISS]: 49 points; average Polytrauma Score [PTS]:
41 points) were retrospectively analyzed from the
moment they were admitted to the emergency room
until 48 h after admittance. The PCC was used immediately
for primary stabilization of the pelvis after
clinical diagnosis of the unstable pelvic fracture. Main
outcome measurements: development of mean blood
pressure, development of oxygenation level, period of
time until the PCC was placed, number of blood units
needed, period of time until circulatory stabilization
occurred.
Results:
The PCC was applied in all cases within an average
of 64.7 min after trauma. Seven patients (25%) died
within the first 45 min after admission. The surviving
patients showed:• an increase in mean blood pressure of 25% 20 min after
application of the PCC,• a hemodynamic stabilization 6 h after application of
the PCC,• a stabilization of the oxygenation level 6 h after application
of the PCC,• a decrease in the number of required blood units 6 h
after application of the PCC.
Conclusion:
The present study shows, that the application
of the PCC to critically injured patients with unstable
pelvic fractures leads to stabilization of the vital parameters
within a short period of time. 相似文献
27.
28.
29.
凹槽交锁髓内钉治疗股骨多段骨折(附18例报告) 总被引:4,自引:1,他引:3
目的探讨一种新型交锁髓内钉-凹槽交锁股骨髓内钉(Biorigid nail femur,简称BNF)治疗股骨多段骨折的方法。方法自2002年3月~2003年10月应用德国aap公司生产的BNF治疗骨折多段骨折18例。结果本组经过3~18个月、平均9个月的随访。骨折均愈合,膝、髋关节恢复良好。结论BNF具有设计独特、内固定可靠、主钉全程均可交锁的特点,能满足自股骨转子下到股骨髁之间一处或多处骨折内固定需要。 相似文献
30.
Abstract
Dealing with pediatric fracture patients requires a funded knowledge of complications and remodeling capability of the youth skeleton to find the accurate therapy decision and to avoid unnecessary invasive procedures. Due to the different mechanical environment, fractures in children occur at specific fracture-vulnerable areas. One of those is the growth plate, which on one hand gives rise to the unique ability of correcting angular deformities by specifically increasing the growth rate in definite regions, and on the other hand leads to complications like growth arrest or angular deformity. The pediatric diaphysis presents the exclusive greenstick fracture, only seen in the growing skeleton, which occurs because of the different composition of the pediatric bone. To understand these very specific features of the youth skeleton, the molecular and cellular basis should be taken into consideration. Therefore, this review will present the common characteristics of skeletal development and fracture healing. An insight into the mechanotransduction as part of the remodeling and self-correcting ability of pediatric bone is given to span the bridge between clinical treatment options and scientific background. 相似文献