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81.
[目的]探讨外固定支架结合骨折端局部注射自体骨髓多能干细胞治疗桡骨远端粉碎性骨折的有效性。[方法]应用外固定支架结合骨折端局部注射自体骨髓多能干细胞治疗桡骨远端粉碎性骨折18例。[结果]随访6~15个月(平均8个月),优10例,良6例,可2例,差0例。优良率为88.9%。没有一例出现针道浅表感染等并发症。[结论]外固定支架结合骨折端局部注射自体骨髓多能干细胞是治疗桡骨远端粉碎性骨折的一种方便、有效的方法,不仅骨折愈合效果满意,而且固定确实可靠,并能早期功能调整和训练。 相似文献
82.
中华长城系统治疗胸腰椎爆裂骨折 总被引:1,自引:0,他引:1
目的探讨中华长城椎弓根钉系统治疗胸腰椎爆裂骨折的优越性,并评价其临床效果。方法选择后正中入路椎管减压或单纯使用中华长城内固定系统治疗胸腰椎爆裂骨折40例。结果经3~18个月随访,椎体平均高度由术前的前34.5%和后74.5%恢复到术后的前95%和后98.5%,Cobb′s角由术前平均16.0°恢复为术后平均1.5°。对脊髓损伤的患者Frankel分级平均提高1.5级。未出现椎弓根钉松动和断裂。结论中华长城系统治疗胸腰椎爆裂骨折操作安全、固定确实、椎弓根大小设计合理,具有较明显的优越性,有待进一步临床应用观察。 相似文献
83.
Osteochondral Fracture of the Fourth Metatarsal Head Treated by Open Reduction and Internal Fixation
Praveen K.R. Mereddy MBBS MSOrth DNB Orth MRCSEd Andrew Molloy MBchB MRCS FRCS Michael S. Hennessy BSc MBchB FRCSEd 《The Journal of foot and ankle surgery》2007,46(4):320-322
Fracture of the metatarsal head is uncommon, and reports of isolated osteochondral fracture of the metatarsal head are rare. Because of the distal location of the fracture, it is difficult to achieve and maintain reduction, and potential complications include avascular necrosis and subchondral fatigue fracture. The authors present a case of an osteochondral fracture in a 40-year-old man, which was treated by open reduction and internal fixation with a single twist-off screw, with good results 12 months postoperatively. 相似文献
84.
人工股骨头置换术治疗高龄非稳定性股骨转子间骨折 总被引:14,自引:3,他引:11
目的探讨高龄患者非稳定性股骨转子间骨折行人工股骨头置换术的临床疗效。方法本组74例,年龄75~89岁,平均80.3岁;骨折类型按Evans分类:ⅢA型31例,ⅢB型24例,Ⅳ型19例。其中3例为经内固定治疗失败病例,合并内科疾病者69例,在相关内科协同治疗后行双极骨水泥型人工股骨头置换术,术后早期进行康复锻炼。结果74例都顺利通过手术,住院期间无死亡病例;72例获得随访,随访时间3~16个月,平均9.2个月;无一例出现畸形,髋关节功能接近或恢复到受伤前水平,生活可自理;2例于出院后5个月、11个月死于其他疾病。结论人工股骨头置换术治疗高龄非稳定性股骨转子间骨折是一种效果确切的治疗方法,操作简单、创伤小、卧床时间短、并发症低、死亡率低,提高了高龄患者的生活质量。 相似文献
85.
François Lavigne P. Culpan T. Judet P. Piriou 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2009,19(5):321-325
Objective Stiffness and severe deformity pose a major challenge in total knee arthroplasty. Numerous techniques have been described
to gain exposure and improve knee flexion. Tibial tubercle osteotomy provides excellent and safe exposure of the joint, although
mechanical and wound complications have been reported.
Materials and methods We present a series of 32 consecutive complex primary total replacements where an osteotomy of the tibial tubercle was utilised.
Results The patients had a mean follow-up of 2 years and 11 months. Following the procedure, with the exception of one case complicated
with deep infection, all of the patients had improved clinically. The mean postoperative range of motion had increased to
102° (give P value < 0.005) and there were no cases of delayed union or non-union. A mechanical complication related to technique occurred
in one patient; there were no other cases with a postoperative extension lag.
Conclusion In this challenging population group, we have found a tibial tubercle tuberosity osteotomy to greatly facilitate exposure
without compromising the clinical and radiographic outcome. 相似文献
86.
Anders Moller MD Ralph Hasserius PhD Inga Redlund-Johnell PhD Acke Ohlin PhD Magnus K. Karlsson PhD 《The spine journal》2007,7(6):701-707
BACKGROUND CONTEXT: Several studies report a favorable short-term outcome after nonoperatively treated two-column thoracic or lumbar burst fractures in patients without neurological deficits. Few reports have described the long-term clinical and radiological outcome after these fractures, and none have, to our knowledge, specifically evaluated the long-term outcome of the discs adjacent to the fractured vertebra, often damaged at injury and possibly at an increased risk of height reduction and degeneration with subsequent chronic back pain. PURPOSE: To evaluate the long-term clinical and radiological outcome after nonoperatively treated thoracic or lumbar burst fractures in adults, with special attention to posttraumatic radiological disc height reduction. STUDY DESIGN: Case series. PATIENT SAMPLE: Sixteen men with a mean age of 31 years (range, 19-44) and 11 women with a mean age of 40 years (range, 23-61) had sustained a thoracic or lumbar burst fracture during the years 1965 to 1973. Four had sustained a burst fracture Denis type A, 18 a Denis type B, 1 a Denis type C, and 4 a Denis type E. Seven of these patients had neurological deficits at injury, all retrospectively classified as Frankel D. OUTCOME MEASURES: The clinical outcome was evaluated subjectively with Oswestry score and questions regarding work capacity and objectively with the Frankel scale. The radiological outcome was evaluated with measurements of local kyphosis over the fractured segment, ratios of anterior and posterior vertebral body heights, adjacent disc heights, pedicle widths, sagittal width of the spinal canal, and lateral and anteroposterior displacement. METHODS: From the radiographical archives of an emergency hospital, all patients with a nonoperatively treated thoracic or lumbar burst fracture during the years 1965 to 1973 were registered. The fracture type, localization, primary treatment, and outcome were evaluated from the old radiographs, referrals, and reports. Twenty-seven individuals were clinically and radiologically evaluated a mean of 27 years (range, 23-41) after the injury. RESULTS: At follow-up, 21 former patients reported no or minimal back pain or disability (Oswestry Score mean 4; range, 0-16), whereas 6 former patients (of whom 3 were classified as Frankel D at baseline) reported moderate or severe disability (Oswestry Score mean 39; range, 26-54). Six former patients were classified as Frankel D, and the rest as Frankel E. Local kyphosis had increased by a mean of 3 degrees (p<.05), whereas the discs adjacent to the fractured vertebrae remained unchanged in height during the follow-up. CONCLUSIONS: Nonoperatively treated burst fractures of the thoracic or lumbar spine in adults with or without minor neurological deficits have a predominantly favorable long-term outcome, and there seems to be no increased risk for subsequent disc height reduction in the adjacent discs. 相似文献
87.
88.
扩髓交锁髓内钉治疗股骨、胫骨干骨折 总被引:7,自引:2,他引:5
目的探讨交锁髓内钉治疗股骨、胫骨干骨折的临床效果.方法应用交锁髓内钉治疗不同类型的股骨干骨折18例,胫骨干骨折15例.结果33例患者随访8~24个月,平均15.2个月,33例均骨性愈合.未出观畸性愈合、再骨折、断钉及膝、踝关节僵硬等并发症.结论交锁髓内钉治疗股骨、胫骨干骨折治愈率高,并发症少,效果满意. 相似文献
89.
延迟性脑脊液鼻漏病理机制及诊治探讨 总被引:18,自引:0,他引:18
目的总结15例经手术治疗的延迟性脑脊液鼻漏的临床资料,探讨脑脊液鼻漏的病理机制及其与诊断治疗的关系。方法本组共15例脑脊液鼻漏患者,其中颅底骨折13例,自发性1例和垂体瘤术后1例。重点分析术前CTMRI扫描,术中所见,以及疗效三者之间的关系。结果术中见14例患者神经组织疝入鼻窦,垂体瘤术后鼻漏为鞍上池下疝,其中后7例的CT扫描显示骨缺损,MRI显示神经组织下疝与术中所见完全一致。15例术后14例治愈,1例无效,无手术并发症。结论神经组织或鞍上池经颅底缺损疝入鼻窦为外伤后或自发性脑脊液鼻漏不能自愈的病理机制的重要环节,由于上述组织的疝入,导致粘膜、硬膜、蛛网膜难以修复。冠状CT扫描和MRI可确定瘘口部位,如果冠状CT有骨缺损,MRI检查相应部位有脑组织下疝,应积极早期手术治疗。 相似文献
90.
目的:对照回顾性分析带锁髓内钉和钢板内固定两种方法治疗胫骨干骨折的效果。方法:髓内钉组32例(35处骨折),根据AO分型,42A型11处,42B型18处,42C型6处;钢板组42例(45处骨折),42A型10处,42B型22处,42C型13处。平均伤后手术时间在髓内钉和钢板组分别为3d和3.5d。随访评估患者手术时间,活动度,愈合时间,术后并发症之间的差别。结果:术后平均随访13个月(8~26个月)。髓内钉组平均手术时间为84min,钢板螺钉组平均为93min。髓内钉组踝关节平均背屈度为13°(0°~20°),钢板组为11°(0°~20°);跖屈分别为41°(30°~50°),47°(30°~50°)。愈合时间髓内钉组平均为3.3个月,钢板螺钉平均为3.5个月。术后X线片显示髓内钉固定有1例出现旋转畸形,钢板组有3例出现成角畸形,均为胫骨远端1/3骨折。结论:在治疗胫骨骨折方面,带锁髓内钉和钢板内固定两种方法都可以取得理想的效果。 相似文献