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31.
V. Lenin Babu K. Baskaran 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2005,15(2):148-150
We report the case of a 20-year-old man with an ipsilateral mid-third clavicle fracture with grade V acromioclavicular joint (ACJ) dislocation. The combination of these two injuries is rare. A literature search produced various treatment algorithms. In this case, the patient was successfully treated with a Bosworth screw.This work was carried out in the Department of Orthopaedics, William Harvey Hospital, Ashford, Kent, UK 相似文献
32.
螺旋CT三维重建成像在先天性高肩胛症手术方式选择中的作用 总被引:4,自引:2,他引:2
[目的]探讨螺旋CT三维重建技术在先天性高肩胛症分度和手术方式选择中的作用。[方法]22例先天性高肩胛症术前应用螺旋CT对病变部位进行扫描并三维重建,测量以肩胛骨肩胛冈内侧缘为参照点,两侧肩胛骨高度差。根据测量结果依据Cavendish分度将其分类,并根据三维重建成像选择不同的矫形手术术式。[结果]本组22例病人,随访2—4年,外观及功能均有不同程度的改善,未出现神经、血管和椎体等的损伤。[结论]根据螺旋CT扫描和三维重建检查结果,术前即可直观的明确先天性高肩胛症的病变程度,相互关系,伴发畸形,患侧肩胛骨与正常对侧肩胛骨的外观差异等,便于手术操作方案的制定,避免了手术操作的盲目性,减少医源性并发症的发生。 相似文献
33.
Abstract Surgical treatment of proximal humeral fractures still remains a challenge. This is primarily due to the fact that sufficient
implant fixation in humeral head fractures is often not achieved due to substantial bone tissue loss with increasing age.
In the last few years the locking plates and locking nails have been introduced into clinical practice with varying results.
The biomechanical studies have focused on locking plate osteosynthesis as well. The following paper focuses on bone quality,
biomechanical studies and biology of proper osteosynthesis and reviews the most recent literature. 相似文献
34.
Manuel Sosa P. Saavedra J. del Pino-Montes J. Alegre R. Pérez-Cano G. Martínez Díaz Guerra M. Díaz-Curiel C. Valero M. Muñoz-Torres A. Torrijos J. Mosquera C. Gómez-Alonso GIUMO Study Group 《Journal of clinical densitometry》2005,8(4):430-435
Measurement of ultrasonographic parameters provides information concerning not only bone density but also bone architecture. We investigated the usefulness of ultrasonographic parameters and bone mineral density (BMD) to evaluate the probability of Colles' fracture. Two-hundred eighty-nine postmenopausal women (62.3 +/- 8.7 yr) with (n = 76) and without (n = 213) Colles' fracture were studied. BMD of lumbar spine and proximal femur was evaluated in all women by dual-energy X-ray absorptiometry (DXA) and speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness in the calcaneus were measured by a Sahara ultrasonometer (Hologic). Patients suffering from Colles' fracture had lower values of BMD adjusted by height at the lumbar spine, L2-L4 (0.797 g/cm2 vs 0.860 g/cm2), femoral neck (0.685 g/cm2 vs 0.712 g/cm2 ), SOS (1518 m/sg vs 1525 m/sg), and stiffness (74.6 vs 77.7) (p < 0.05). Nevertheless, BUA values were similar in both groups. After stepwise logistic regression analysis, the area found under receiver operating characteristic (ROC) curves was 0.60 for L2L4 and 0.63 for a formula combining L2L4 and height. Our data suggest that patients suffering from Colles' fracture have lower values of BMD by DXA, SOS, and stiffness. However, the ability of these techniques to discriminate is low because the values for the area under ROC curve are 0.60 for L2-L4 and 0.63 for a formula derived of the combination of L2-L4 and height. 相似文献
35.
Abstract – In the treatment of crown fractures, adhesive fragment reattachment provides a good alternative to other restorative techniques, offering several advantages. The present paper reports a case in which the treatment of a cervical crown fracture was accomplished by reattaching the tooth fragment with a flowable resin composite. Orthodontic root extrusion was performed with a modified Hawley appliance prior to fragment reattachment. The clinical and radiographic results after 2.5 years were successful. 相似文献
36.
本文报告了作者研制的改良哈氏棒治疗胸腰段脊柱不稳定骨折的临床效果。1991年1月~1994年10月,治疗26例,伤椎椎体前缘高度从41.91%,恢复至95.57%,椎体后缘高度从81.03%恢复至100%,后凸畸形(Cobb氏法)从26°恢复至5°,有5例恢复前凸8°~10°,神经功能恢复1.8级(Frankel分级)。作者认为回复生理前凸的纵轴上纵向撑开力,更有助于胸腰段脊柱骨折的解剖复位。 相似文献
37.
Patrick M. Rao M.D. A. John Kuta M.D. Michele H. Johnson M.D. 《Emergency radiology》1995,2(5):303-304
We present a case in which an open fracture of the ulna penetrated the skull and caused a comminuted, depressed skull fracture
with a large intraparenchymal hematoma containing bone fragments. 相似文献
38.
D. Thiébaud P. Burckhardt M. Costanza D. Sloutskis D. Gilliard F. Quinodoz A.-F. Jacquet B. Burnand 《Osteoporosis international》1997,7(5):457-462
The relative importance of vitamin D deficiency, secondary hyperparathyroidism, nutritional deficiency and low bone mineral
density (BMD) as risk factors for hip fracture is not definitely established. In the framework of a case-control study of
risk factors for hip fractured, biochemical markers of bone metabolism and nutrition and femoral BMD data were compared in
136 female and 43 male hip fracture patients, 126 female and 44 male age-matched hospitalized controls, and 47 healthy elderly
women (8 men). Patients with hip fracture had lower albumin (−10%9 and 25(OH)-vitamin D (25(OH)D; −19%) compared with hospitalized
controls, and lower albumin (−28%) and 25(OH)D levels (−52%) compared with the elderly controls. Serum values of IGFBP-3 were
also significantly lower (−33%) in hip fracture patients than in community controls. BMD of femoral neck was lower (p < 0.001) in patients than in hospitalized and community controls. In hip fracture patients, parathyroid hormone (PTH) correlated
weakly with BMD (neck: r = −0.19, trochanter: r = −0.17; both p < 0.05). When all women were pooled (n = 233), albumin correlated significantly (age-adjusted) with BMD at all sites (neck: r = 0.27, trochanter: r = 0.25; all p < 0.001). Albumin, but not 25(OH)D, also correlated with skinfold thickness (r = 0.19, p < 0.0025) and with body mass index (BMI) (r = 0.14, p < 0.05). Male patients with hip fracture had lower BMD and albumin (both p < 0.001), 25(OH)D (p = 0.02) and IGFBP-3 levels (p <: 0.005) compared with the controls. When male patients and controls were pooled together, albumin, skinfold thickness and
BMI were significantly correlated with each other, but not with BMD. IGFBP-3 was highly correlated with albumin (p < 0.0001), 25(OH)D (p < 0.005) and, less significantly, with PTH (p < 0.05), but not with BMI or skinfold thickness. IGFBP-3 was significantly correlated with BMD at all sites (neck: r = 0.27, p < 0.05); trochanter: r = 0.40, p < 0.0005). In conclusion, low albumin and low BMD were both important risk factors for hip fracture. Low serum albumin was
the strongest independent variable correlated with hip fractures. In men, IGFBP-3 was correlated with BMD. The femoral BMD
depended only weakly on PTH and 25(OH)D, but was correlated at all sites with albumin, a non-specific parameter of nutrition
and general health. 相似文献
39.
作者自1988年1月至1993年12月收治Pilon骨折31例,根据Riled的分类祛:Ⅰ型5例,Ⅱ型10例,Ⅲ型16例.手术治疗22例,保守治疗9例.随访l-4年,疗效按Bourne的标准评定,Ⅰ型骨折手术或保守治疗优良率100%,Ⅱ、Ⅲ型骨折手术治疗优良率85%,保守治疗优良率33.3%.作者认为Pilon骨折Ⅱ、Ⅲ型应手术治疗.保守治疗仅用于Ⅰ型骨折.手术控AO的四步重建法进行.但严重的粉碎骨折或开放骨折伴软组织缺损,内固定确定难干实施者,则改用踝部超关节外固定支架固定. 相似文献
40.
Tadeusz F. Wisniewski 《European Journal of Trauma》2004,30(2):120-123
AbstractBackground: Posterior acromioclavicular dislocation is rare.
Dislocation associated with fracture of the clavicle and
simultaneous entrapment of the lateral end of the clavicle by
trapezius muscle has not been reported. Posterior dislocation
occurs frequently owing to forceful move of the scapula
anteriorly and superiorly or from direct force applied to the
lateral end of the clavicle and this may be associated with
clavicular fracture. In acute dislocations, open reduction,
internal joint stabilization and soft tissues reconstruction
have been recommended.Case Study: Acute posterior dislocation occurred in a 32-year-old man.
The lateral end of the clavicle was displaced posteriorly and
inferiorly, and firmly entrapped in trapezius muscle. The
clavicular fracture was undisplaced. The coracoclavicular
ligaments were stretched but intact. Open reduction was secured
with two smooth Kirschner wires. The disrupted soft tissues were
repaired. The clavicular fracture was not explored. Shoulder
movement started at 6 weeks. Wires were removed. 10 years later
he had pain-free, unrestricted shoulder movement, and the
radiographs showed wellreduced, essentially normal
acromioclavicular joint.Conclusion: Open reduction, internal joint stabilization and soft
tissue reconstruction will result in return and long lasting
unrestricted pain-free function of the shoulder. 相似文献