桡侧腕短伸肌腱部分移位修复第一腕掌关节脱位的应用解剖与手术设计

目的:为桡侧腕短伸肌腱部分移位修复第一腕掌关节脱位提供解剖学依据。方法:30侧成人上肢标本,将桡侧腕短伸肌腱分为上、中、下3部分,进行形态学测量。结果:桡侧腕短伸肌腱长度为(15.3±1.9)cm(10～22.5cm),其宽度:上段为(15.4±5.2)mm(5.3～23.8mm),中段(10.0±3.0)mm(4.2～18.5mm),下段(5.5±0.6)mm(3.7～9.6mm);厚度:上段为(0.6±0.3)mm(0.1～1.4mm),中段为(1.8±0.7)mm(0.7～3.0mm),下段为(2.1±1.2)mm(0.8～3.1mm)。结论:桡侧腕短伸肌腱部分转位有足够的长度以修复第一腕掌关节脱位。     

全髋置换术后脱位的原因和治疗

目的 探讨全髋关节置换术后脱位原因与治疗的关系。方法 对28例全髋置换术后脱位的病人,进行外展肌力检查和放射学测量。结果 17例侧卧外展试验阳性,8例单纯假体位置不当,11例单纯软组织不平衡,7例同时存在软组织不平衡和假体位置不当,2例假体位置正常性脱位。20例经闭合复位或一次再置换手术治疗取得成功,8例需一次以上手术治疗,5例软组织不平衡病例使用了限制性髋臼。结论 闭合复位是早期脱位的首选治疗方法,软组织不平衡的髋关节脱位,无论假体位置不当存在与否,常需多次手术治疗,手术中要考虑其机械稳定性（使用限制型髋臼假体）。     

应用跖肌腱转移治疗腓骨肌腱滑脱症

[摘要]目的总结应用跖肌腱转移治疗腓骨肌腱滑脱症的临床应用结果。方法 2008年9月~2014年1月，对9例腓骨肌腱滑脱症患者采用跖肌腱转移治疗。其中，男7例，女2例。年龄22~46岁，平均32.6岁。左足5例，右足4例。结果 术后随访13个月~5年，平均2.5年。术后恢复率按根据Sefton踝关节手术疗效评定标准进行评定。优7例，良2例，没有发生与该项技术操作相关的并发症，取得了满意的治疗效果。结论 应用跖肌腱转移术很适宜治疗腓骨肌腱滑脱症，修复后的牢固性较好。但是，对该肌腱缺如者不适宜。     

环枕关节脱位：附二例报告

环枕脱位十分少见。此种病例,由于环枕部结构复杂,照片显示常不够清楚。人们往往只注住只注意环枢椎的关系而对环枕脱位的警惕性不足,容易漏诊,其后果是严重的。本文报道两例环枕关节脱位病例,并对该病的病因、发病机制、局部解剖、合并症及其诊断要点进行分析,并提出“斜坡－齿突线”对本病的诊断有重要意义。     

双重法固定肩锁关节脱位

为介绍一种新方法修复肩锁关节脱位。肩锁关节脱位整复后采用双重法（交叉克氏针及8字钢丝）固定肩锁关节。结果：16例肩锁关节脱位后无一复发,关节功能无影响。结论：该法操作简单,固定牢靠,可早期行关节功能锻炼,可有效防止脱位复发。     

Traitement d’une fracture-luxation chronique de l’interphalangienne proximale par un greffon d’hémi-hamatum

Fracture-dislocations of the proximal interphalangeal (PIP) joint are complex and challenging to manage once they become chronic. We report a case of PIP joint fracture-dislocation treated by hemi-hamate arthroplasty. An 18-year-old male polytrauma patient presented with a neglected PIP joint fracture-dislocation in the third finger of the left hand. After four months of follow-up, he remained disabled due to clinodactyly and stiffness. After performing a cadaver study to evaluate the feasibility of grafting, we resurfaced the bone-cartilage defect with a hemi-hamate arthroplasty. The range of motion at the last follow-up was 65° without pain; the DASH score was 2.27. The patient was able to return to heavy manual labour work at 5 months postoperative.     

Superior shoulder suspensory complex fracture dislocation case report

BackgroundAcromioclavicular joint dislocation can be more complex than it first appears. The presented case had an unusual combination of injuries to the superior shoulder suspensory complex, which yielded some interesting learning points.Case summaryThe injuries were sustained after a fall from a push bike and included acromioclavicular dislocation with coracoid process, clavicle and acromion process fractures. These were identified on the initial X-ray examination, which was followed by computed tomography for surgical planning. The injuries were successfully treated by internal fixation.ConclusionThe unexpected complexity of the injuries could have led to subtle but important findings being overlooked. This case highlights the importance of a thorough search strategy, consideration of injury biomechanics and knowledge of associated injuries.     

Spontaneous peri-talar dislocation after steroid intra-articular injections: A case report

We report a case of spontaneous peri-talar dislocation after intra-articular steroid injections. We have reviewed the literature on spontaneous peri- and sub-talar dislocations and the effects of intra-articular steroid injections.