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1.
《The Foot》2020
PurposeOptimum management of displaced intra-articular calcaneal fractures (DIACF) still controversial. Open surgery carries the risk of wound complications, while non-operative management has a high incidence of arthrosis. To avoid these complications, minimally invasive and percutaneous fixation was introduced. The purpose of this study was to prospectively evaluate the short term clinical and radiological outcomes after closed reduction and percutaneous fixation of DIACF using K-wires.Patients and methodsOutcomes of twenty patients were evaluated at the final follow up. A functional assessment using the AOFAS scoring system. Radiological parameters recorded included three angles (Böhler’s, Gissane and posterior facet inclination angles) and three distances (calcaneal length, height and width). Any complications were reported at any follow-up.ResultsThe mean patient’s age was 33 ± 15.2 years, 8 (40%) patients with type II fractures, 10 (50%) patients with type III fractures, and 2 (10%) with type IV fracture according to Sanders classification. After a mean follow-up of 9 months, the mean AOFAS score was 84, excellent in 9 patients (45%), good in 9 (45%), and fair in 2 (10%). At the final follow-up the Böhler’s angle, Gissane angle and PFIA was 25.1° ± (5.2), 119.9° ± (9.4) and 51.7° ± (5.9) respectively and the calcaneal height, length and width was 41.8 mm ± (2.1), 75.1 mm ± (3.01) and 40.9 mm ± (2.6) respectively. We had no cases of deep infection, 20% had significant subtalar arthritis.ConclusionThe closed reduction and percutaneous fixation technique for DIACF management offered acceptable clinical and radiographic outcomes, with fewer complications when compared to other management options. 相似文献
2.
Christopher N. Cooley Tyler J. Beranek Matthew A. Warpinski Robert Alexander Amanda O. Esquivel 《The American journal of emergency medicine》2019,37(2):199-203
Introduction
In the United States there has been a large increase in participation in lacrosse for both males and females. The purpose of this study was to analyze the number of head injuries, injury rates (calculated using the reported number of participants) and types of head injuries that are seen in emergency departments in the United States.Methods
We compared injuries between male and female lacrosse participants. This was a retrospective study using a publicly available database produced by the US Consumer Product Safety Commission and information about lacrosse participation from US Lacrosse.Results
A linear regression was performed and showed a positive correlation between number of head injuries to males and time from 2002 to 2010 (R2?=?0.823; p?=?0.001). While the number of injuries to the head in female lacrosse participants was not significant. There was a negative correlation between the number of head injuries to males from 2010 to 2016 (R2?=?0.800; p?=?0.007), but again, there was no significance for female injury count (R2?=?0.417; p?=?0.117). Other significant differences between head injuries in males and females included the mechanism of injury and the type of injury recorded.Conclusion
The most recent data from 2010 to 2016, suggest that both males and females have had a decrease in injury rate. However the total number of female head injuries is not significantly decreasing and as the sport continues to grow there will likely be more total head injuries and visits to the emergency department. 相似文献3.
4.
泵式自体输血过滤引流系统在急症救护中的应用 总被引:5,自引:1,他引:4
自体输血、胸腔闭式引流,是缓解血源矛盾、赢得抢救时机、防治心肺衰竭及ARDS/MOF的重要措施。笔者研制成功的手控泵式储血过滤引流系列在战地、灾害现场,以及平时的心肺手术中,共应用3000余例,现重点对其功能设计和用于自体输血、紧急救护做讨论和评估。 相似文献
5.
Abstract: The use of neuromuscular electrical stimulation (NMES) for rehabilitation of gait in spinal patients is widely known. The best results can be obtained with the use of biomechanical sensors and a closed loop NMES system. One of the biggest problems faced in the design of control systems for closed-loop operation, in gait rehabilitation, is the variation of the mechanical conditions during the phases of gait. This work presents a new approach to ease the design of rule-based closed loop systems for operation in conditions such as gait rehabilitation. 相似文献
6.
肱骨近端骨折手术与非手术治疗方法疗效分析 总被引:19,自引:0,他引:19
目的分析肱骨近端骨折手术及非手术治疗方法的疗效。方法2002~2003年对43例肱骨近端骨折分别采用切开复位解剖钢板、拉力螺钉、克氏针固定及手法复位夹板固定治疗。采用Constant-murley评分方法评定疗效。结果所有患者随访10~19个月,平均11.5个月。24例手术患者中优11例,良8例,可4例,差1例,优良率为79.2%;19例非手术患者中优6例,良7例,可6例,优良率为68.4%;手术疗效明显优于非手术疗效,差异有显著性意义(P<0.05)。X线片示无骨折不愈合及肱骨头坏死发生。结论对Neer分型中Ⅰ型和Ⅱ型中部分患者应采用非手术手法复位夹板固定治疗。而Ⅲ、Ⅳ型应采用手术方法治疗,主要采用解剖钢板固定。拉力螺钉、克氏针作为一种辅助手段,在手术中不宜过多使用。 相似文献
7.
C. Faldini M. Manca S. Pagkrati D. Leonetti M. Nanni G. Grandi M. Romagnoli M. Himmelmann 《Journal of orthopaedics and traumatology》2005,6(4):188-193
Abstract Complex tibial plateau fractures are a challenge in trauma surgery. In these fractures it is necessary to anatomically reduce
the articular part of the fracture and to obtain stable fixation. The aim of this study is to review the results of a surgical
technique consisting of fluoroscopic closed reduction and combined percutaneous internal and external fixation. Thirty-two
complex tibial plateau fractures in 32 patients were included. Twenty-one fractures were closed, 4 were open Gustilo grade
I, 3 were Gustilo grade II and 4 were Gustilo grade III. The mean age was 37.8 years (range 21–64 years). Surgery was performed
with patients in transcalcaneal traction and the knee flexed at 30° was used. Through a 1-cm incision centred over the tibial
metaphysis of the tibia, a 3.2-mm hole was drilled in the antero-medial tibial aspect. The tibial plateau fracture fragments
were elevated using either 1 or 2 curved Kirschner wires under fluoroscopy to control the reduction. Then the fragments were
fixed with 2 cannulated AO screws inserted through small incisions into the medial aspect of the tibial plateau. Knee rehabilitation
started postoperatively. Weight bearing started after 8–12 weeks depending upon the radiographic appearance. All external
fixators were removed in outpatient facilities. All patients were clinically and radiographically evaluated at a mean follow-up
of 48 months (range 38–57 months). Clinical results were evaluated according to the Knee Society clinical score. Average healing
time was 24 weeks (range 18–29 weeks). In 1 patient a non-union occurred. This patient was treated with open reduction and
plate fixation. In 2 patients a varus knee deformity occurred and a surgical correction was performed. There were no surgical
complications. Mean knee range of motion was 105° (range 75–125°) and mean Knee Society clinical score was 89. Twenty-five
results were scored as excellent, 4 good, 2 fair and 1 poor. Using this technique there is limited soft tissue damage and
virtually no periosteum damage to the fracture fragments. However anatomical reconstruction of the joint can be obtained.
Furthermore knee rehabilitation can be started immediately after surgery. We think that these factors were responsible for
the optimal clinical long-term results. 相似文献
8.
紧闭式氧化亚氮麻醉方法的探讨 总被引:2,自引:1,他引:1
25例选择期手术病人采用紧闭式氧化亚氮麻醉方法,术中持续监测呼气末氧和氧化亚氮浓度,脉搏血氧饱和度和呼吸循环指标,术中观察紧闭式麻醉后呼吸末氧化亚氮,氧浓度变化,结果:紧闭式麻醉1,2,3h后氧化亚氮浓度分别为52.7%,56%,64.9%,氧浓度为42.1%,34.4%,30.8%,随麻醉时间的延长,气道压力先降后回升,约3h恢复至紧闭麻醉前的水平,紧闭式麻醉前后在本组观察时间内动脉血气分析提示 相似文献
9.
闭合复位经皮穿针治疗移位的肱骨外科颈骨折 总被引:13,自引:0,他引:13
目的总结闭合复位经皮穿针治疗移位的肱骨外科颈骨折的方法及结果。方法2001年1月~2002年12月,采用闭合复位、经皮穿针治疗移位的肱骨外科颈骨折46例,仅对其中随访资料完整的34例患者进行分析。结果34例获得22个月(10~34个月)的平均随访。采用Constant-Murley评分方法,平均Constant-Murley绝对值为92分(76~100分),优良占86%(29/34),可占14%(5/34),无差病例。所有骨折在术后6~8周愈合,无固定失效,未出现肱骨头坏死病例。结论闭合复位经皮穿针治疗移位的肱骨外科颈骨折手术时间短、软组织损伤小、固定可靠,术后可早期功能锻炼,取针简便。 相似文献
10.
食管癌术后乳糜胸:(附9例报告) 总被引:2,自引:0,他引:2
本文报告我院从1954年12月~1988年12月切除食管癌733例,发生乳糜胸9例(中段食管癌8例,下段食管癌1例,均侵犯食管左后壁),发生率1,2%,死亡3例。乳糜胸发生的中位年龄63岁。男8例,女1例。9例均行闭式引流。5例保守病例中2例死亡,4例2次手术病例中,死亡1例。乳糜胸的发生在术后2~8天,乳糜引流量为3500~8680ml。保守1例中,使用四环素加50%葡萄糖胸内注入,治愈。 相似文献