AO锁骨钩钢板治疗锁骨远端骨折脱位56例临床报告

目的:分析使用AO锁骨钩钢板对锁骨远端骨折及肩锁关节脱位的临床效果。方法:使用AO锁骨钩钢板螺丝钉内固定治疗56例NeerⅡ型锁骨远端骨折以及TossyⅢ型肩锁关节脱位,并进行随访。结果:56例患者均获得12~24个月随访,平均16个月。术后12个月均获痊愈,完全恢复日常生活和工作能力。按Karlsson肩关节术后功能恢复标准,优51例,良5例,优良率达100%。结论:AO锁骨钩钢板治疗NeerⅡ型锁骨远端骨折和TossyⅢ型肩锁关节脱位是一种简单而有效的手术方法,具有固定牢靠,不损伤关节面,关节功能恢复快等优点。     

中国中西部地区2010至2011年60岁以上股骨颈骨折流行病学对比

目的对比分析我国中、西部地区2010至2012年60岁以上股骨颈骨折的流行病学特点。 方法利用医学影像计算机存档与传输系统及病案查询系统收集2010年1月至2011年12月中、西部地区44家医院诊治的股骨颈骨折资料。将安徽省、河南省、吉林省、山西省、湖北省、湖南省、黑龙江省定为中部组;将新疆维吾尔自治区、四川省、重庆市、甘肃省、广西贵族自治区、贵州省、西藏自治区、内蒙古自治区、宁夏回族自治区、青海省、陕西省、云南省定为西部组。对比两组患者性别、年龄、骨折分型及侧别构成等。 结果共收集60岁以上股骨颈骨折3 683例,中部组2 067例,男女比为1∶1.98;西部组1 616例,男女比为1∶1.76。中部地区76~80岁年龄段构成比最高,西部地区71~75岁年龄段构成比最高。两组均以31B2型骨折患者构成比最高,中部组51.1%（1 056/2 067）,西部组48.3%（781/1 616）;31B1型构成比最低,中部组21.5%（444/2 067）,西部组19.7%（318/1 616）。中部左侧1 077例（52.1%）,右侧990例（47.9%）;西部组左侧797例（49.3%）,右侧819例（50.7%）。 结论老年股骨颈骨折以女性多见,中部地区以76~80岁年龄段构成比最高,西部地区以71~75岁年龄段构成比最高;中、西部均以85岁以上年龄段构成比最低。两地区31B2型骨折居多,中部地区31B1型构成比较西部高,31B3型较西部低;中部地区左侧股骨颈骨折多于右侧,西部地区右侧多于左侧。     

锁定钛板联合植骨手术治疗股骨远端粉碎性骨折的临床研究

目的 观察锁定钛板联合植骨手术治疗股骨远端粉碎性骨折的临床效果。方法 选取2017年1月~2018年8月在我院接受治疗的股骨远端粉碎性骨折患者50例,随机分为试验组与对照组,各25例。试验组采用锁定钛板联合植骨手术治疗,对照组采用AO解剖钢板内固定手术治疗。比较两组患者术中出血量、手术时间、骨折愈合时间、临床疗效及不良反应发生率。结果 观察组临床治疗总有效率高于对照组（92.00% vs 68.00%）,差异有统计学意义（P＜0.05）;观察组患者术中出血量、手术时间、骨折愈合时间、不良反应发生率均低于对照组,差异有统计学意义（P＜0.05）。结论 股骨远端粉碎性骨折患者行锁定钛板联合植骨手术,术中出血量少,患者恢复快,且术后不良少,手术效果好。     

Classification systems for tibial plateau fractures; Does computed tomography scanning improve their reliability?

Introduction

The purpose of this study was to evaluate the impact of computed tomography scanning on the inter- and intra-observer reliability of the OTA/AO, the Schatzker, and the Hohl classifications in the assessment of tibial plateau fractures.

Methods

Four independent observers classified 45 consecutive fractures of the tibial plateau according to the criteria of the OTA/AO system, the Schatzker classification, and the Hohl classification. Two sessions of readings were compared; first, the use of plain anterior-posterior and lateral X-rays alone was evaluated, then 4 weeks later the combination of plain X-rays and two-dimensional computed tomography scans were evaluated. The readings were repeated 8 weeks later to evaluate intra-observer reliability.

Results

The three classification systems showed “moderate” inter-observer reliability and “good” and “moderate” intra-observer reliability when classified solely on the basis of plain radiographs. After the addition of computed tomography scans inter-observer reliability significantly improved to “good” in all classifications. Likewise, intra-observer reliability improved to “good” in all classifications after the addition of CT-scans. Statistical analysis showed no significant difference regarding inter- and intra-observer agreement between the three classifications.

Conclusions

Computed tomography scanning improved the inter- and intra-observer reliability of the OTA/AO, the Schatzker, and the Hohl classification. Overall, all three classification systems showed “good” inter- and intra-observer reproducibility when classified with CT-scans.     

Subcellular fractionation of human eosinophils: Isolation of functional specific granules on isoosmotic density gradients

Subcellular fractionation has been an important tool in investigating human eosinophil structure and function, including localizing of cytokine/chemokines within granules, investigating granule protein translocation and intracellular transport during eosinophil secretion, and studying secretory mechanisms of granules. The resolution of organelles obtained by subcellular fractionation was improved considerably after the introduction of nonionic iodinated density-gradient metrizamide and Nycodenz media that, unlike sucrose, exhibit relatively low tonicity throughout the gradient. However, the structure and membrane preservation of isolated organelles were still compromised due to the lack of gradient isoosmolarity. This paper describes a detailed protocol of subcellular fractionation of nitrogen cavitated eosinophils on an isoosmotic iodinated density gradient (iodixanol - OptiPrep) and the isolation of well preserved and functional membrane-bound specific granules.     

切开复位AO三叶草钢板内固定配合中药治疗复杂Pilon骨折的效果

目的：探讨切开复位AO三叶草钢板内固定配合中药治疗复杂Pilon骨折的临床治疗效果。方法：以2009年1月～2011年12月期间本院收治的72例复杂Pilon骨折患者为研究对象,随机分为观察组和对照组,对照组给予单纯切开复位AO三叶草钢板内固定治疗,观察组给予切开复位AO三叶草钢板内固定配合中药治疗,按Mazür功能评价标准评价两组患者的治疗效果。结果：观察组优23例,良9例,可3例,差1例,优良率为88.88%,对照组优18例,良10例,可5例,差3例,优良率为77.78%,经统计学分析,两组的优良率之间具有统计学差异,P〈0.05。结论：在AO三叶草钢板内固定治疗的基础上加用中药治疗,能够提高复杂Pilon骨折的临床疗效,有利于患者的术后功能恢复。     

AO微型钢板内固定治疗掌骨骨折24例

目的探讨AO微型铜板治疗掌骨骨折的疗效,评价其对骨折修复及功能康复的作用。方法本组掌骨骨折24例共39处,均采用切开复位以AO微型铜板内固定治疗,术中骨折均解剖复位,术后指导患者早期功能康复锻炼,定期复查。结果24例术后全部得到2～9个月随访,平均为3．6个月,定期复查X线片均示骨性愈合时间为6～10周,平均8．6周,术后3～6个月取出内固定。根据TAM评分进行功能评定：优20例,良3例,可1例,优良率95．8％。结论AO微型钢板治疗掌骨骨折,提供牢固的内固定,适应证广,并发症少,缩短骨折愈合时间,允许患指进行早期功能锻炼,功能恢复良好,值得临床推广应用。