国家名老中医胡黎生接骨临床经验举隅

对国家名老中医胡黎生教授正骨技法、临正经验整理。治疗Bennert骨折时术者用一手含握与之对持环扣,以拇指相抵并逐渐外展伤肢拇指同时,另外一手轻轻推、按压骨折成角部复位;尺骨鹰嘴骨折,术者一手拇食指捏断处,另一手拇食指推按尺骨鹰嘴骨折近端向远端靠拢,使断端紧密接触复位;Pott骨折伴有脱位时,术者一手掌根部置于外脚踝尖足跟外侧,对向推按足背,屈踝关节于中立位,听到骨"滑动声"即脱位已矫正,另一助手根据骨折移位方向用双手掌部施相向对压手法,纠正断端复位。复位后将内、外侧夹板分别置于踝关节内外侧,保持患足中立位,以保证"环"的稳定性。     

基于有限元法分析钝力性脾损伤的机制

Objective To explore the biomechanical mechanism of blunt spleen injury based on finite element analysis. Methods A fist finite element model was used to simulate the impact at 4-8 m/s in the spleen area of THUMS4.0 human body model from the front of the left costal area, the left anterior axillary line and the rear scapular line. The strain distribution and damage of the spleen under different conditions were observed. The simulation results were compared with the clinical cases of spleen rupture to analyze the mechanism of spleen injury. Results The damage location and strain distribution of the spleen could vary under different conditions. Due to the special anatomical location of the spleen, a blunt impact at the speed of 4-8 m/s on the front side did not easily cause spleen injury, and the strain was distributed mainly in the front of the spleen and the spleen hilum; a similar blunt impact on the left side was likely to cause spleen diaphragmatic surface injury, the splenic visceral surface could be injured by the compression of the medial tissue and organs and the traction of the splenic pedicle, and the strain was distributed in the spleen diaphragmatic and visceral surfaces; an impact on the back side was likely to cause injuries in the posterior portion and hilum of the spleen, and the strain was mainly concentrated in the injured area. Conclusion Blunt spleen injuries caused by punches on the abdomen are mostly caused by direct impact on the ribs, the compression by the surrounding tissues and organs and the traction by the spleen pedicle.