Acromioclavicular Separations Treated Conservatively: A 5-year Follow-up Study

Seventy patients with acute acromio-clavicular separation were examined retrospectively after treatment with a minimum of immobilization. the mean interval between injury and follow-up was 6 years. in 37 patients with partial separation, the results were excellent in 24 and good in 13. in 30 patients with complete separation, the results were excellent in 7, good in 23 and unsatisfactory in 3. the radiographic findings are discussed. At follow-up, complete separation had often caused remodeling with stability of the joint.     

EMG profiles of knee joint musculature during walking: changes induced by anterior cruciate ligament deficiency

A tear of the anterior cruciate ligament (ACL) disrupts the delicate balance of static stabilizers of the knee, leading to significant alterations in joint kinematics. Little is known about the dynamic compensatory responses of the patient to these kinematic alterations. This lack of quantitative information on the muscle synergy patterns has limited the surgeon's ability to evaluate various operative and rehabilitative techniques. Twelve subjects with documented ACL deficiency for at least 1 year and 15 normal participants were studied. Each subject was asked to walk at free and fast speeds on a 12 m walkway. The right and left foot contact patterns and the linear envelopes from the surface electromyogram (EMG) patterns of the gastrocnemius, medial and lateral hamstrings, rectus femoris, and vastus lateralis were measured. Significant differences were found in the muscle synergy patterns during walking. During the swing-to-stance transition, the ACL-deficient subjects showed significantly less activity in the quadriceps and gastrocnemius muscles and more activity in the biceps femoris than in the normal group. During early swing, the vastus lateralis is more active than normal, and during midstance and terminal stance, the hamstrings appear to be less active than normal subjects. These dynamic compensatory mechanisms suggest that use of the hamstring tendons in reconstructive procedures may alter important compensatory mechanisms about the knee joint. Application of dynamic EMG techniques to the study of reconstructive procedures should provide additional information that will assist the clinician in the rational choice of a surgical procedure.     

下腰椎形态与椎管退行性狭窄的关系及其临床意义

目的:探讨腰椎形态与退行性椎管狭窄的关系。方法:测量男、女各100例体检人员L3/4以下椎间小关节角,椎体冠状径、矢状径,椎管中央和侧隐窝的前后径,了解椎体参数、椎间小关节角与椎管狭窄的相关关系,并进行统计学分析。结果:相关和偏相关分析显示椎间小关节角与椎管前后径为负相关关系,且与中央矢状径负相关程度更大;椎体矢状径、冠状径和椎管前后径均为正相关关系。偏相关分析显示椎体冠状径和侧隐窝正相关系数最大。P值均小于0.05。结论:腰椎小关节角增大会改变应力分布,加重不稳定倾向,加速腰椎退变;椎体矢状径、冠状径的增大有助于减轻退行性椎管狭窄。提示临床手术中应注意腰椎前、后路的重建、固定,特别是椎间小关节角已增大时。     

脊柱后路显微内窥镜手术治疗中央型腰椎间盘突出症

目的：介绍经脊柱后路显微内窥镜椎间盘切除术系统(MEDII/METRX)治疗中央型腰椎间盘突出症。方法：1999年12月一2002年2月用metrx治疗中央型腰椎问盘突出症48例，详细介绍了手术过程，设计“L”形凿刀进行切除的操作技巧及手术适应证。结果：平均随访16．5个月，按Nakal疗效评定分级：优39例，良7例，可1例，差1例；优良率95．8％。结论：完善的器械、娴熟的操作技巧、预防性止血是中央型腰椎间盘突出症行MED治疗成功的关键。     

张力带钢丝治疗重度肩锁关节脱位

由于肩锁关节的解剖及生物力学特点，重度肩锁关节脱位的固定困难且易导致失败。本文应用ＡＯ张力带原理，固定治疗重度肩锁关节脱力和再脱位，并就术中生物力学测定及固定方法作了介绍。共治疗２１，随访１７例，平均随访１９个月，全部病人疗效优。去除外固定后允许并鼓励病人早期功能锻炼。作者认为ＡＯ张力带固定治疗重度肩锁关节脱位及再脱位是简单有效的方法。     

The effects of dietary gum tragacanth in man

Following a 7-day control period, 5 male volunteers consumed 9.9 g gum tragacanth (GT) daily for 21 days. The GT was well tolerated and there were no adverse effects in any of the volunteers. The daily intake was very high in relation to the minor amounts of GT (estimated at 2 g per person per annum) likely to be ingested as a foodstuffs additive. The wide range of measurements made before and at the end of the test period show that the ingestion of GT had no significant effect on any of the following: plasma biochemistry; haematological indices; urinalysis parameters; glucose tolerance; serum cholesterol, triglycerides and phospholipids; breath hydrogen and methane concentrations. The intestinal transit time decreased and faecal fat concentration increased (P less than 0.01) for 4 subjects. The faecal wet and dry weights increased in all subjects (P less than 0.01). These changes may be of nutritional and physiological interest but do not reflect any adverse toxicological effects arising from the ingestion of large daily doses of GT.     

膝关节充气CT扫描影像学与临床意义的研究

目的：研究膝关节充气造影CT检查的诊断价值。材料和方法：对1例离休左膝关节标本，56例活体膝关节做充气造影CT检查。然后解剖离休膝关节并对有手术指征的48例56个膝关节进行手术探查、结果：初步确定了膝关节充气条件下的正常CT解剖及某些异常表现。结论：膝关节充气造影CT检查对滑膜皱赞综合征、滑股肿瘤、滑膜炎等许多洛膜病具有重要诊断价值。     

Traumatic atlantooccipital dislocation with survival: case report and review of the literature

Summary We present the case of a patient with traumatic atlantooccipital dislocation. The initial neurological examination showed no abnormalities. Dislocation was the result of rapid deceleration in a motor vehicle accident. The mechanism of injury was hyperextension/rotation, probably combined with a distraction force. Only a few cases of atlantooccipital dislocation without neurological involvement have been reported. Every report pointed out difficulties of initial diagnosis. Special attention should be directed toward the atlanto-odontoid-basion relationships as seen on lateral radiographs. Prompt recognition and surgical stabilization are essential to avoid further neurological injury.     

髋臼后壁骨折的手术治疗

目的：探讨髋臼后壁骨折治疗中的有关问题，提高治疗效果，方法：分析13例手术治疗的临床资料，结果：11例早期手术疗效优良，2例陈旧性损伤疗效差，结论：髋臼后壁骨折早期切开复位内固定可获较好疗效，对合并股骨头后脱位同时关节内有游离碎骨者，不宜手法整复脱位，就尽早手术治疗。     

Pressure distribution in the wrist joint

We performed a study to determine pressure distribution properties of the normal radio-carpal joint. A system was developed for measurement of the contact pressure within the wrist joint surfaces. The transducer was based on Fuji pressure-sensitive paper, which was inserted into the joint space through a dorsal capsular incision. The hand was then positioned using a jig that permitted free axial loading of the joint. Each of five specimens was tested in 36 positions combining flexion/extension with radio/ulnar deviation and supination/pronation. The transducers were analyzed for contact area, scapho-lunate contact area ratio, pressure, and centroid locations using a microcomputer-based video-imaging system. The scaphoid and lunate contact areas on the radius and triangular fibrocartilage were separate and distinct in all wrist positions. Together these contact areas accounted for a relatively small fraction of the total joint surface area (average contact area/total joint area = 0.206, SD = 0.0495). For an applied 103 Newton compressive load, the high pressure averaged 3.17 MPa (SD = 0.83 MPa). Overall, the scaphoid contact area was 1.47 times that of the lunate, although variations occurred with position, as in flexion, in which the scaphoid/lunate area ratio was 0.83. The high-pressure centroids of both scaphoid and lunate contact areas shifted palmarly from 20 degrees of flexion to 20 degrees of extension and then dorsally with further extension. The scaphoid-lunate intercentroid distance averaged 14.91 mm with a range of 10-20 mm.