屈膝过程中的胫股运动特性分析

本文采用三维位移测量方法，测试１０例离体人膝标本的胫股关节三维运动特性。发现屈膝过程中，胫股运动也具有典型的三维运动特点。其中在屈膝初期的３０°内，胫骨内旋最明显并伴有胫骨内翻现象，平均内旋８°，内翻６－７ｍｍ，膝关节完全伸直时胫股扣锁使膝关节稳定，屈曲时胫股“解锁”使膝关节松弛，具重要的临床意义，同时提示，在解释传统的胫股扣锁现象时不应遗漏伴随发生的胫骨内／外翻现象。     

Rotational occlusion of the vertebral artery at the atlantoaxial joint: is it truly physiological?

We present a patient with vertebrobasilar insufficiency, with vertigo and horizontal nystagmus, induced by turning the head to the right. Angiography demonstrated transient occlusion of the left vertebral artery at the atlantoaxial joint during rotation of the head. The pathogenesis and angiographic findings are discussed.     

350例膝关节镜检查分析

自1981年以来进行了350例膝关节镜检查。明确诊断340例(97.1%),纠正诊断52例(14.7%),补充诊断47例(13.4%)。关节镜检查不仅有助于确定临床诊断,而且提高了手术的准确性。     

手部创伤性骨关节缺损的处理

治疗手部骨关节缺损常采用植骨内固定、关节融合、关节成形及关节置换等方法．为总结经验，对１９８９年以来１０１例手部创伤性骨与关节缺损进行分析。单纯掌、指骨缺损３９例，行直接短缩对位，克氏针内固定６例，１例发主骨不连；对３３例缺损较大者用自体骨块植入克氏针交叉内固定，部分病例同时植人ＲＢＸ或异体骨粒，１０例发生延迟愈合，余全部正常愈合。骨与关节部分或完全缺损６２例，采用关节成形术４６例，其中以肋软骨移植效果最好，骨膜移植次之，筋膜衬垫或硅胶膜植入法较差；行关节融合术１１例．均达顺利融合；采用自体关节置换５例，均成活，术后关节活动度均＞７０°。我们认为：自体骨块植入克氏针交叉内固定，必要时植入ＲＢＸ骨粒．是治疗手部创伤性骨缺损的有效方法。关节缺损应按关节的重要性，分别采用关节融合术、关节成形术或关节置换术。     

羟基磷灰石涂层人工股骨柄的临床应用

自１９８９年１２月～１９９３年１１月，共收治各类髋关节病１４例（１５髋），均行ＦＵＲＬＯＮＧ羟基磷灰石（ＨＡ）涂层人工髋关节置换术。术后平均随访３２个月，髋关节功能按Ｈａｒｉｓ评分结果为平均９５分。无患肢疼痛和其它不适症状，亦无术后并发症发生。Ｘ线结果显示，股骨侧假体无松动、下沉表现，周围未见明显透亮线。术后３个月假体表面出现增生性骨反应，并在术后３～４年内逐渐增加。无明显骨萎缩表现。结合实验及临床研究结果，证明此种髋假体应用的短期疗效令人满意，其长期疗效尚有待进一步观察。     

第一掌背动脉双叶皮瓣在手外科中的应用

我们设计主要以第1掌背动脉为蒂的手背双叶皮瓣,同时修复两个部位的手部皮肤缺损和拇指再造,共10例均获成功。皮瓣面积最小10cm×3cm,最大13cm×5cm,蒂宽1.5cm×2.5cm。皮瓣每叶面积最小为3.5cm×2cm,最大6cm×3cm。文中介绍了本皮瓣的解剖学基础,并对其手术适应证和优缺点进行了讨论。     

镍钛记忆合金锁骨钩环抱器治疗新鲜重度肩锁关节脱位

目的 评估镍钛记忆合金锁骨钩环抱器治疗新鲜重度肩锁关节脱位的临床疗效。方法 选择16例新鲜重度肩锁关节脱位患者，其中3例合并锁骨远端骨折，应用镍钛记忆合金锁骨钩环抱器治疗并进行临床疗效观察。随访6～12个月，平均7.6个月。结果 所有患者肩关节肌肉无萎缩，外观正常，肩关节活动范围正常，x线片示无再脱位征象。采用Karlsson术后疗效分级：A级15例，B级1例。结论 镍钛记忆合金锁骨钩环抱器治疗新鲜重度肩锁关节脱位创伤小，简便易行，疗效好，对合并锁骨远端骨折病人更具有独特优点，具有临床推广应用价值。     

Arthroscopic distal clavicle resection

The acromioclavicular joint is a potential source of pain in the shoulder. There are a variety of disorders that can affect this joint, including distal clavicle osteolysis, posttraumatic arthritis, osteoarthritis, and rheumatoid arthritis. Nonoperative treatment for this condition with nonsteroidal medication and activity modification can alleviate the pain. When conservative treatment is exhausted, surgical resection of the distal clavicle is often necessary. Arthroscopic resection of the distal clavicle preserves the acromioclavicular ligaments to prevent postoperative distal clavicle instability. The procedure is performed in either the beach chair or lateral position and requires the use of a shaver, electrocautery, and a burr for soft tissue and debridement and bone resection.     

Ainhum (dactylolysis spontanea): A Radiological survey of 6000 patients

Dactylolysis spontanea is an idiopathic condition affecting the fifth toe, and sometimes other toes, that is frequently bilateral, with lesions in different stages. Between 1977 and 1999, a total 6000 radiographic studies of the feet were reviewed in a mainly African American population in Chicago, Illinois. After an initial screening based on the Cole criteria, 581 patients were selected and re-examined, and amplification techniques were performed. After reviewing the complementary exams, 102 patients were diagnosed with dactylolysis spontanea or ainhum. Soft-tissue constriction was the most frequently presented radiological sign on the initial screening. Kurtosis at the digit plantar fold and marked rotation of the fifth toe were normal findings in asymptomatic patients. Demographics, comorbidities, and radiological findings were analyzed in the selected population. Associated diseases occurring in these patients appeared to have no specific etiologic correlation with ainhum. African Americans and the dark-skinned population are affected exclusively by this condition, presumably due to the fibrogenic tendency of these individuals. Early diagnosis and accurate staging of ainhum are facilitated by radiological examination of the feet. The findings suggest that this condition is underdiagnosed and overlooked because its low prevalence and variable clinical presentations that might mimic more common etiologies, including localized trauma.     

少年儿童颞下颌关节紊乱综合征的错雅(牙合)特征

①目的 探讨少年儿童颢下颌关节紊乱综合征(TMJD)的错拾特征。②方法 用一般口腔检查工具对青岛地区的550例TMJD病人进行拾检查。③结果 80．0％的病人有不同程度的错He，其中个别牙齿错位所占的百分率最高(42．4％)，其次为高度不调、长度不调和宽度不调；不同牙龄期病人错He特征不同。④结论 本研究结果可以作为TMJD早期正畸治疗以及治疗时对错He分析和诊断的参考。