腕管综合征96例分析

自1993年1月-2000年12月,诊治腕管综合征96例,其中手术治疗31例,现将有关资料进行分析。1临床资料1.1一般资料本组96例,男25例,女71例;年龄为26～63岁,平均43岁。16例为双侧性,病程最短为1周,最长为10年。病因:腕部外伤史17例,手部关节酸痛史23例,18例女性患者认为发病与妊娠或     

镍钛记忆合金腕骨四角融合器的研制及生物力学测试

目的研究一种新的用于四角融合的内固定器械和方法.方法根据国人头状骨、月骨、三角骨和钩骨的测量数据及解剖特点,采用镍钛记忆合金制作腕骨四角融合器（NiTi shape memory alloyfour-corner arthrodesis concentrator,NT-FCAC）;取32侧成人头状骨、月骨、三角骨和钩骨标本,分别采用NT-FCAC和克氏针固定,体外模拟四角融合术,用858型双轴液压材料测试系统（858-MTS）测试其固定强度;2件NT-FCAC施加20～200N循环拉伸载荷（1Hz）,观察NT-FCAC的形变情况;分析试验结果,评价NT-FCAC的生物力学特性.结果NT-FCAC固定臂产生的回复力可将头状骨、月骨、三角骨和钩骨聚合于一体,体部可遮挡植入上述4处腕骨间关节间隙的松质骨,防止其滑脱;NT-FCAC组固定强度大于克氏针组（P＜0.05）;2件NT-FCAC发生形变达到6%时,施加的载荷次数分别为4 239次和4068次.结论NT-FCAC的设计符合头状骨、月骨、三角骨和钩骨的解剖特点,其固定强度可满足四角融合术后不需外固定、早期功能锻炼的生物力学要求,疲劳强度可满足四角融合术后达骨性愈合的需要.     

拇指掌指关节内侧籽骨的出现时间及其临床意义

本文对正常人和某些内分泌疾病患者的拇指掌指关节内侧籽骨的出现情况进行了X线观察和分析,证实该籽骨的出现遵循一定时序,正常在青春发动期出现。在性早熟时该籽骨出现时间显著提前;而在垂体性侏儒症时则出现延迟,对某些内分泌疾病具有诊断价值。     

月骨,三角骨周围性腕骨轴向崩解症

本文报告３例罕见的新鲜性月骨、三角骨周围性腕骨轴向崩解症。该症是在腕的三个纵向功能解剖的基础上，遭受了以纵向为主兼有侧向偏斜的暴力而发生的。它的基本病变是月骨及三角骨与桡骨关系正常，而其余腕骨皆在其三个纵轴间发生崩解，致使患腕在结构上出现了严重紊乱。在这种复杂的病变中月骨和舟骨起着关键的作用，亦是腕骨轴向崩解的基础。本病在受伤机制、临床诊断以及治疗方法上，均与月骨周围性脱位或创伤性腕骨轴向脱位有着明显的区别，因而本病应视为一种独立的病种。本组病例有桡偏型２例，采用切开复位；另１例为尺偏型，采用闭合手法而顺利复位。本组病例经７～３６个月的随访，结果表明患腕功能恢复良好。     

人皮质骨矿化基质中骨盐框架结构

目的：研究人皮质骨矿化基质中骨盐的框架结构及框架中骨微间隙。方法：应用透射电镜、场发射扫描电镜观察、电脑图像分析及能谱分析，分析无骨病成人长骨、扁骨２００例骨盐分布特征。结果：骨盐框架结构由微柱、微梁、微小梁、弓状梁、致密点、隔板和骨微间隙构成。骨微间隙由洞、内衬和壁组成，洞平均直径为８４．４±７５．６ｎｍ，与骨小管相比有显著差异（Ｐ值＜０．００１），平均密度为１１～１７个／μｍ２，与骨小管之比超过１０：１。骨盐分针形结晶和微颗粒结晶。结论：骨盐框架结构及骨微间隙是骨盐在人皮质骨矿化基质中的存在形式，可能与骨盐吸收、沉着有关。     

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.     

The assimilated os sustentaculi

The assimilated os sustentaculi is a projection of bone from the medial aspect of the sustentaculum tali which is surmounted by a similar projection from the medial tubercle of the talus. The accessory joint so formed may develop secondary osteoarthritis changes. This congenital anomaly is very rate. The present report is of 2 additional cases.     

The bipartite tarsal navicular bone: Radiographic and computed tomography findings

Two cases of bipartite tarsal navicular bone are presented. The radiographic and computed tomography (CT) findings of this anatomical variant are described. Correct recognition of this entity is important, both because it may be the cause of symptoms perse, and because it may be misdiagnosed as a fracture. When plain films are not diagnostic, CT scanning is helpful in distinguishing between a fracture and this variant.     

Assessment of bone mineral content byin vivo measurement of flexural wave velocities

The determination of loss of bone mineral in an early stage of development is important. At the present time there exists no noninvasive or nonradiological methods which can be used for routine checks. An alternative method to obtain information about mineral content of bone is to measure the mechanical properties. A new method to measure the mechanical properties of long bones by means of the dispersion analysis of flexural waves is proposed. To be independent of the frequency spectrum of the impact pulse, the phase velocities were calculated from the signals of two accelerometers placed in vivo on the tibia. This method has the advantage that the velocities can be calculated for a frequency range. The results from this method were compared with the results from a well established measurement method for bone mineral content. Both methods were applied to 43 subjects selected in such a way that a broad range of bone mineral values was covered. The results imply that the proposed method can be used to test the mechanical properties of long bones.     

重组合异种骨临床疗效观察

重组合异种骨（ＲＨＢ）骨形成蛋白（ＢＭＤ）与去除抗原特性后的异种松质骨的复合物，是近年来医学研究的一个新成果。既具有ＢＭＰ的高度诱导成骨作用，又具有松质骨的支架作用，十分便于临床使用、填充骨缺损。作者等应用ＲＨＢ治疗１６例骨缺损及骨不连，证实它是一种高效的成骨诱导物质，诱导生骨作用肯定，无明显副作用，临床使用方便，较自体骨移植愈合时间快，避免了取自体髂骨的痛苦。作者等认为，本生物制品颇值得大力推广应用。