Extrinsic compression of the renal artery by diaphragmatic crus

Extrinsic compression of the renal artery due to a fibromuscular band originating from the diaphragm was encountered in a 26-year-old patient who had systemic hypertension associated with stenosis and kinking of one of her renal arteries. After surgical decompression, the renal artery assumed a normal expansion with disappearance of hypertension. Six other cases of extrinsic compression of the renal artery have been found in the literature. Surgical treatment is mandatory in all cases because the mechanism that causes the lesion makes percutaneous transluminal angioplasty illusory.     

膝内侧改良切口结合NT-pc治疗粉碎性髌骨骨折

目的 寻找一种有利于粉碎性髌骨骨折术中复位、固定和术后恢复的手术入路。方法 采用膝内侧改良切口结合NT-聚髌器(NT-pc)治疗粉碎性髌骨骨折38例，其中碎骨块呈3块者18例、4块者13例、5块者5例、6块者2例。结果 38例随访时间3个月—2年6个月，除1例因二次手术病程较长、1例术后缺乏锻炼致膝关节功能稍受影响外，其他患者膝关节活动均恢复正常，切口愈合好，按李纯志等疗效评定标准，优良率94．7％。结论 膝内侧改良切口具有充分显露髌骨、切口短、组织损伤小，有利于术中手指对骨块抚平复位和对关节面复位质量的检查及术后功能恢复；NT-pc符合张力带原理，对严重粉碎性髌骨骨折的骨折面具有持续的纵向及横向的应力作用，有复位及固定的双重作用。对于严重粉碎性髌骨骨折，采用内侧改良切口及NT-pc固定不失为一种较理想的方法。     

Radiologic features compared to clinical findings in a prospective study of 153 patients with metastatic spinal cord compression treated by radiotherapy

Summary Plain radiography, myelography and post-myelographic CT-scan are described and related to clinical findings in a prospective study of 153 consecutive patients with myelographic signs of spinal cord compression. The majority of the metastatic tumours arise in the vertebral body or the pedicles. In 80% of the patients with total blockage to the contrast medium on myelography the post-myelographic-CT showed passage of the contrast medium. Ambulatory function at time of diagnosis was correlated to the degree and the localization of the epidural block. In 64 patients who underwent a second myelography, the post-treatment findings of sensory function were correlated to radiological regression.     

压缩回复式椎管扩大成形术治疗胸腰椎骨折并脊髓损伤

目的介绍压缩回复式椎管扩大成形加内固定术在胸腰椎骨折并脊髓损伤中的应用。方法对58例胸腰椎骨折合并脊髓损伤患者，采用自制组合式嵌打整复器对突入椎管的碎骨块，嵌击复位压缩成形，从而扩大椎管容积，同时重建病椎棘上棘间韧带，并行内固定，恢复脊柱后部结构的稳定性。结果50例获得随访，平均2年6个月，30例已恢复轻工作，9例可扶拐下地活动。结论压缩回复式椎管扩大成形术是治疗胸腰椎骨折合并脊髓损伤的新术式，值得在基层医院推广。     

双枚和三枚细加压螺纹钉内固定治疗股骨颈骨折的疗效比较

近年来我院采用手法复位的同时用双枚或三枚细加压螺纹钉内固定治疗股骨颈骨折,效果良好,现对比分析报告如下。1 临床资料 1991年1月-2000年1月,共收治新鲜股骨颈骨折患者480例,采用内固定治疗者388例,其中采用X线闭路电视下手法整复双枚或三枚细加压螺纹钉内固定者282例。为缩小年龄跨度,便于比较疗效,年龄小于45岁和大于75岁31例未收集。因死亡而不能继续随访者21例,死亡均发生于术后半年以上,与骨折或手术无直接关系。因其他原因而失访者16例。其余214例资料较完整,其中男86例,女128例。有5例伴同侧的Colles骨折,3例同侧肱骨外科颈骨折,其他无严重并发症。所有伤侧髋关节手术前无明显关节炎改变。加压螺纹钉规     

逆行交锁髓内钉治疗肱骨骨折

我科2001年1月-2002年12月采用带锁髓内钉逆行穿钉的方法治疗肱骨干骨折23例，疗效满意。     

前路减压Z-plate内固定治疗胸腰段爆裂性骨折伴不全性截瘫

目的 探讨胸腰段爆裂性骨折伴不全瘫前路减压内固定优越性以及Z-plate系统的优点。方法 采用前路减压Z-plate内固定治疗胸腰段爆裂性骨折伴不全瘫25例。结果 全部病例均获随访，随访时间6～24个月，平均17个月。按Frankel分级评定有1～3级恢复，随访期间无后凸加重及内固定松动，植骨融合。结论 前路减压Z-plate内固定是治疗胸腰段爆裂性骨折的较好方法。     

Array compression for MRI with large coil arrays.

Arrays with large numbers of independent coil elements are becoming increasingly available as they provide increased signal-to-noise ratios (SNRs) and improved parallel imaging performance. Processing of data from a large set of independent receive channels is, however, associated with an increased memory and computational load in reconstruction. This work addresses this problem by introducing coil array compression. The method allows one to reduce the number of datasets from independent channels by combining all or partial sets in the time domain prior to image reconstruction. It is demonstrated that array compression can be very effective depending on the size of the region of interest (ROI). Based on 2D in vivo data obtained with a 32-element phased-array coil in the heart, it is shown that the number of channels can be compressed to as few as four with only 0.3% SNR loss in an ROI encompassing the heart. With twofold parallel imaging, only a 2% loss in SNR occurred using the same compression factor.     

弯曲工况下钉数和钉的分布对胫骨骨折外固定稳定性的影响

目的揭示不同钉分布和钉数对胫骨-外固定器稳定性的影响.方法以人干燥的尸体胫骨中部行单侧外固定器固定为实验模型.通过电测法观测不同加压量固定的不同实验模型在不同等级弯曲工况下骨表面的应变及轴向位移变化;并设定节点和单元后对胫骨-外固定器系统进行计算应力分析.结果在弯曲工况下,4钉均匀分布及6钉均匀分布的稳定性较强,但后者稳定性更佳.结论应用单侧外固定器治疗胫骨骨折时,应采用4钉均匀分布,条件许可时采用6钉均匀分布.     

肱骨干骨折内固定的选择及应注意的问题

目的正确选择肱骨干骨折手术内固定.方法对107例肱骨干骨折分别进行交锁髓内钉(34例)、加压钢板(29例)、Y型钢板(38例)、螺钉(6例)等内固定,并随访比较分析. 结果所有病例均得到随访,平均随访6.3个月.交锁髓内钉、螺钉内固定组全部愈合;加压钢板内固定组愈合26例,伴桡神经损伤2例;Y型钢板内固定组全部愈合,伴肘关节僵硬2例. 结论根据肱骨干骨折的部位和类型选用适当的内固定方法,骨折愈合良好,可有效的减少并发症的发生.