锁骨钩钢板内固定术治疗肩锁关节脱位和锁骨远端骨折36例临床分析

对36例肩锁关节脱位和锁骨远端骨折患者采用锁骨钩钢板内固定术治疗.结果术后随访5～22 个月,按照Lazzcano评分标准,29例肩关节功能为优.认为手术采用颈丛浅支阻滞及臂丛肌间沟法阻滞复合麻醉、扩大消毒与铺巾范围、行喙锁韧带修复有助于提高手术效果.     

30例爆裂型、脱位型腰椎骨折手术效果分析

目的提高爆裂型、脱位型腰椎骨折的手术疗效及安全性。方法对30例爆裂型、脱位型腰椎骨折取后路椎弓根螺钉系统复位固定、全椎板切除椎管减压及植骨融合术治疗,根据CT测定的椎体旋转角度确定螺钉置入角度,个体化置钉。结果术后近远期疗效满意,椎管面积扩大,神经症状改善。结论后路椎弓根螺钉系统复位固定、全椎板切除椎管减压及植骨融合术治疗严重爆裂型和骨折脱位型腰椎骨折疗效确切,术中应根据旋转角度确定螺钉置入角度。     

带锁髓内钉内固定治疗股骨干骨折142例疗效观察

2003年2月～2005年12月，我们应用带锁髓内钉治疗股干骨折142例，疗效较好。现报告如下。     

长柄双极股骨头置换术治疗高龄股骨粗隆间骨折疗效观察

目的观察采用长柄人工股骨头置换术治疗高龄(70岁以上)股骨粗隆间骨折的疗效。方法 33例高龄股骨粗隆间骨折患者,均采用长柄人工股骨头置换术治疗,术后早期进行功能锻炼。结果术后均获得随访,髋关节功能按Harris评分标准优19例,良11例,可3例。随访期间,未发现人工关节脱位、松动及感染发生。结论长柄人工股骨头置换术治疗高龄股骨粗隆间骨折疗效满意。     

下肢骨折内固定后行早期主动功能锻炼59例护理体会

2004年1月～2006年1月,我们对59例下肢骨折(不稳定性骨折除外)内固定患者应用主动运动康复方法,效果满意。现报告如下。1资料与方法1.1临床资料本组118例,男98例,女20例,22～69岁,平增多35岁。其中股骨骨折44例,胫腓骨骨折35例,膝关节19例,多发性骨折20例,均实施切开复位内固定     

封闭负压引流技术在损伤感染创面中的应用

封闭负压吸引（vacuum sealing drainage,VSD）是指含有引流管的聚乙烯酒精水化海藻盐泡沫敷料来覆盖或填充皮肤、软组织缺损的创面,再用生物半透膜对之进行封闭,使其成为一个密闭空间,把引流管接通负压源，通过可控制的负压来促进创面愈合的一种治疗方法，其生物半透膜水蒸气可透过但液态水不能透过，使创面与外界隔开，构成防止细菌入侵的屏障，有效地预防了常规换药和引流导致的污染与感染，并能保持持续的高负压状态。     

PLGA膜预防术后硬膜外瘢痕粘连20例效果观察

椎板切除术后，硬膜周围组织纤维化形成瘢痕，与硬膜及神经根粘连，使硬膜囊受压，引起复发性神经根病变或者下腰部疼痛，可导致手术失败或造成不同程度的脊柱功能障碍。2004年1月～2005年1月，我们应用PLGA可吸收防粘连膜预防椎板切除术后硬膜外瘢粘连20例，效果较满意。现报告如下。     

Analysis of early treatment of 12 cases with congenital knee dislocation北大核心CSCD

Objective To investigate the curative effect of the Pavlik harness and polyester material casting bandage for the early treatment of congenital knee dislocation (CDK). Methods The clinical data of 12 patients (13 knees) with CDK treated in Provincial Hospital Affiliated to Shandong First Medical University from December 2011 and January 2019 were studied retrospectively. There were 3 males and 9 females. The median age at the initial visit was 3 days (1-29 days). Eleven patients had unilateral CDK, and 1 patient had bilateral CDK. There were 5 cases (5 knees) with dislocation and 7 cases(8 knees) with subluxation. Associated musculoskeletal anomalies were observed in 7 patients, which included developmental dysplasia of the hip (DDH) in 6 patients, bilateral DDH and right clubfoot in 1 patient. The Pavlik harness was applied to keep the knee in position for 1.5-2.0 months if passive flexion achieved 90°or more. If passive flexion was below 90°, the polyester material casting bandage was employed to increase knee flexion, and the bandage was changed once a week. After passive flexion reached 90°, the patient was treated with the Pavlik harness for 1.5-2. 0 months. Cases with DDH who worn the Pavlik harness were evaluated by ultrasonography in the follow - up period, and cases with clubfoot were treated with Ponseti polyester material casting bandages. Results Three children (4 knees) were directly fixed with Pavlik harness for 1.5-2. 0 months, 9 children (9 knees) were fixed with Pavlik harness for 1.5-2.0 months after 1-8 times (average 2. 9 times) of plaster fixation. No plaster and Pavlik harness complications were found during the treatment. Twelve patients were followed up for 29. 8 months on average (12.0 to 65. 0 months). Ten patients (11 knees) were rated excellent, and 2 patients (2 knees) were rated good. Conclusions The Pavlik harness and polyester material casting bandage for early treatment of CDK is simple, effective and safe. Associated musculoskeletal anomalies can also be corrected in the treatment process. The knee joint dislocation should be treated at first. © 2022 Chinese Journal of Applied Clinical Pediatrics. All rights reserved.