内侧半月板半脱位与后根部撕裂的相关性

目的 探讨膝关节内侧半月板半脱位对诊断后根部撕裂的价值。方法 回顾性分析经关节镜证实的120例内侧半月板撕裂患者的MRI图像,将其中60例后根部撕裂患者作为后根部撕裂组,其他撕裂的60例作为对照组,于MRI图像上测量半月板突出长度,将半月板突出长度≥3 mm定义为半月板半脱位,比较两组半月板半脱位的发生率。结果 后根部撕裂组中,合并半月板半脱位者56例(56/60,93.33%),对照组中合并半月板半脱位者13例(13/60,21.67%),差异有统计学意义(χ²=60.15,P<0.01)。内侧半月板半脱位提示后根部撕裂的敏感度、特异度及阳性似然比分别为81.16%(56/69)、92.16%(47/51)及10.35。结论 膝关节内侧半月板半脱位可用以提示后根部撕裂。     

Cervical cyst of the ligamentum flavum and C7-T1 subluxation: case report

A patient with progressive gait disturbance resulting from a cyst of the cervical ligamentum flavum associated with C7-T1 listhesis is reported. Surgical removal of the cyst improved the patients myelopathy. Intraspinal degenerative cysts are preferentially located in the lumbar region:unusual is the cervical localization. Differential diagnosis includes ligamentum flavum cyst, synovial and ganglion cysts. Association between degenerative intraspinal cysts and listhesis is discussed. To our knowledge, this is the first case of cyst of the ligamentum flavum associated with cervical subluxation.     

小儿桡骨小头半脱位的临床分析

目的探讨桡骨小头半脱位的发病机制、易发年龄及治疗方法。方法对207例桡骨小头半脱位患儿的易发年龄及诊治进行回顾性分析。结果207例桡骨小头半脱位患儿中6个月至≤3岁158例,占76.33%,〉3岁~6岁49例,占23.67%,两年龄段相比差异有统计学意义（u=7.577,P〈0.01）;179例患儿经手法复位后痊愈,无复发;28例患儿复位后复发,经再次复位后给于石膏托固定3周后痊愈,再无复发。结论本文资料显示,桡骨小头半脱位多见于3岁及3岁以下患儿,对就诊患儿进行及时诊断及治疗,必要时对复发的病例予以石膏托固定3周,均可取得满意疗效。     

单侧性寰枢关节半脱位的X线诊断

目的探讨X线对单侧性寰枢关节半脱位的诊断价值。方法经临床和X线片诊断的单侧性寰枢关节半脱位患者894例,分别测量两侧寰齿间隙距离,并取其差值(LADS),同时测量寰齿前间隙(ADI)。结果894例单侧性寰枢关节半脱位患者的颈椎张口正位片上LADS均表现为成人>3.0mm,儿童>5.0mm,颈椎侧位片上ADI成人>2.5mm,儿童>4.5mm。结论单侧性寰枢关节半脱位的X线诊断标准是:齿状突与寰椎侧块的关系失常,齿状突偏位,LADS不对称,ADI增大,且不对称情况不能通过头左或右旋转15°来纠正,但须除外骨折、先天性发育异常或寰枢关节前脱位等情况。     

超声乳化吸除术治疗晶状体脱位白内障的临床观察

目的 探讨超声乳化吸附术治疗晶状体不全脱位白内障的疗效。方法 对18例（19只眼）晶状体不全脱位白内障患者行超声乳化白内障吸附联合人工晶状体植入术,其中2只眼联合玻璃体切除、视网膜复位术。结果 18只眼术后视力有不同程度提高,1只眼因术前黄斑挫伤,视力无改善。结论 采用超声乳化吸附术治疗晶状体不全脱位白内障患者,有效避免了其他手术方法并发症的发生,取得了良好疗效。     

髋骨截骨术治疗成人髋关节半脱位

有症状的成人髋关节半脱位临床上并不罕见，手术治疗的种类多。为了评估髋骨截骨术的治疗效果，于１９８５年～１９９１年采用此术式治疗２６例，男１２例，女１４例。年龄２２岁～３８岁，平均２６．５岁。病程３年～６年，平均３．４年。原发病包括先天性髋关节脱位１２例，股骨头骨软骨病１０例，未确定４例。手术指征是有症状的髋关节半脱位，而且有一定宽度的关节间隙，一定范围的关节活动度，特别是有一定程度的头臼相称。术中采用新设计的髋臼移位方法———置术侧足于对侧股部，然后施力。根据临床和Ｘ线片检查评定疗效，优１１例，良１５例。认为，经选择的患者，髋骨截骨术是合适的，新的移位方法简便而有效     

Jaccoud-Arthritis bei systemischem Lupus erythematodes

Zusammenfassung Die Jaccoud-Arthritis ist eine Manifestation bei systemischem Lupus erythematodes und anderen rheumatischen Systemerkrankungen. Sie ist durch nichterosive Subluxationen und eine Synovialitis charakterisiert, die zu schwerer Deformität der Hände führt. Der klinische Aspekt lässt oftmals zunächst an deformierende Veränderungen der rheumatoiden Arthritis denken.     

Evolving Concepts in the Management of Shoulder Instability

BackgroundShoulder instability exists on a spectrum ranging from subtle subluxation and pain to dislocation and can be the result of a traumatic event or repetitive microtrauma. Shoulder instability can result in significant disability and often requires surgical intervention, especially amongst younger, active patient populations. The optimal treatment of shoulder instability depends on the degree of instability and concomitant pathology involving the labrum, capsule, and bony anatomy of the glenoid and humeral head. Even with surgical intervention, recurrent instability remains a relatively common and difficult problem to address.PurposeWith a focus on anterior instability, the purpose of this review article is to discuss the current assessment and treatment of shoulder instability, and highlight current and future treatment modalities, as well as to identify current trends and deficiencies in our current management. We also provide an algorithm for the surgical treatment of anterior shoulder instability.MethodsLiterature databases were extensively searched for recent articles related to the mechanism, diagnosis, and treatment of shoulder instability to comprise a comprehensive review.Conclusion Although there are multiple treatment modalities available for shoulder instability, such as nonoperative management, open and arthroscopic Bankart repair, Latarjet procedures, and remplissage, orthopaedic surgeons continue to learn about the most appropriate method of management as increasing long-term outcomes become available.     

Early dislocation after total hip arthroplasty

Background The average incidence of dislocation after total hip arthroplasty is approximately 3%. However, the choice of surgical approach can affect the rate of postoperative dislocation. A 5.8% dislocation rate has previously been reported when a posterolateral approach was used compaired with 2.3% when an anterolateral approach was used. The aim of this study was therefore to assess the dislocation rate after total hip replacement with the posterolateral approach.Methods: Between January 1992 and December 1998, a posterolateral approach was used for 427 consecutive primary total hip replacements. There were 291 women and 136 men. The average age of the women was 71 years (range 40–91 years) and the average age of the men was 65 years (range 34–86 years). The one-year dislocation rate was recorded.Results: A total of 24 hip replacements (6 in men and 18 in women) dislocated. The one-year dislocation rate was 6/136 = 4.4% for men and 18/291 = 6.2% for women. The overall one-year dislocation rate was therefore 24/427 = 5.6%. The average delay between the operation and the dislocation was 7 weeks (range 1 day to 1 year).Conclusions Our results seem to confirm a high postoperative dislocation rate when the posterolateral approach is used. Most dislocations occured within the first 3 months after the surgery. An unexpected annual variation in the dislocation rate was found. No explanations was found for this variation.