三种方法治疗股骨干骨折的比较

目的 探讨股骨干骨折的合理固定方法.方法 210名从1999年1月～2009年10月在本院收治的股骨骨折患者共212个肢体,采用三种固定方法治疗:A0有限接触钢板86例、锁定钢板56例、带锁髓内钉70例.所有患者均进行随访并观察术后的平均愈合时间、感染率、骨不连率和并发症.结果 平均愈合时间A0有限接触钢板为11.2个月,锁定钢板为10.7个月,带锁髓内钉为12.9个月,感染率:A0有限接触钢板为13.3%,锁定钢板为8.9%,带锁髓内钉为10.3%;关节功能障碍:A0钢板为11.1%,锁定钢板2.2%,带锁髓内钉为3.7%.     

新鲜跟腱断裂的手术治疗

目的:探讨新鲜跟腱断裂的术中手术方法选择及术后康复,为临床治疗提供相应资料。方法:回顾研究2006年4月～2009年6月在我院骨科治疗的新鲜跟腱断裂31例,术中选择不同方法治疗,随访术后并发症及疗效。结果:所有患者均获得随访,术后1年优良93.55%。结论:不同的手术方法治疗新鲜跟腱断裂都有良好的临床疗效。     

膝关节半月板半脱位的MRI测量与诊断

目的探讨膝关节半月板半脱位MRI测量方法与表现,提高对该病的认识和诊断准确性。方法回顾性分析200例膝关节症状患者的临床和影像资料,该批患者均行单膝关节MRI检查,采用统一的检查和测量方法,分析膝关节内、外侧半月板MRI表现(正常、退变、撕裂)与半月板半脱位发生率的关系。结果内侧半月板:MRI表现正常的31例,其中发生半脱位1例;MRI表现为退变的86例,发生半脱位14例;MRI表现为撕裂的52例,半脱位16例。内侧半月板不同MRI表现半脱位发生率的差别有统计学意义(χ2=7.261,P0.05)。外侧半月板:MRI表现正常的41例,其中半脱位1例;MRI表现为退变的95例,半脱位8例;MRI表现为撕裂的46例,半脱位9例。外侧半月板不同MRI表现半脱位发生率的差别有统计学意义(χ2=6.079,P0.05)。内、外侧半月板半脱位的发生率的差别有统计学意义(χ2=3.930,P0.05)。结论选择合理的测量方法,有利于膝关节半月板半脱位的诊断;膝关节内、外侧半月板撕裂后半月板半脱位的发生率增大。     

丹参接骨胶囊对骨折SD大鼠TGFβ1 mRNA及蛋白表达的影响

目的:建立左股骨中段闭合折骨经皮髓内克氏针固定的标准骨折模型,观察丹参接骨胶囊对SD大鼠骨折愈合过程中局部转化生长因子β1(transforming growth factor beta 1,TGF-β1)mRNA、蛋白表达,通过RT-PCR,ELISA法进行分析转化生长因子β1的表达,探讨丹参接骨胶囊对大鼠骨折愈合的机制。方法:建立闭合性的股骨干骨折髓内固定模型,分别给与相应药物灌胃治疗,在不同时相通过RT-PCR,ELISA法进行分析TGF-β1 mRNA及蛋白表达。结果:丹参接骨胶囊能促进骨折SD大鼠TGF-β1 mRNA及蛋白的表达。结论:大鼠股骨中段闭合折骨髓内克氏针固定骨折模型稳定,可操作性强,重复性好。丹参接骨胶囊能促进骨折SD大鼠TGF-β1 mRNA及蛋白的表达。     

迟发性骑跨于小脑幕上下硬膜外血肿并发急性脑积水1例

2002年8月31日,我院收治1例迟发性小脑幕上下骑跨硬膜外血肿并发急性脑积水患者,实属罕见。1病例报告患者,男,58岁,车祸中左枕部着地受伤,昏迷约5分钟,醒后感觉头痛、头晕,伤后1h就诊。既往患慢性支气管炎15年。检查:神志清楚,语言流利,有逆行性遗忘;左枕部头皮轻度肿胀,余无异常。就诊时CT显示,蛛网膜下腔出血,左人字缝、左枕乳缝分离。伤后1dCT复查示,双侧脑室、第三脑室扩张,第四脑室高密度,左幕下硬膜外血肿。因临床表现无异常,而保守治疗。伤后48h患者头痛加重,呕吐2次,烦躁,呼唤后睁眼,问答错乱,不能按指令动作,GCS计分12分,呼吸困…     

锁定钢板微创治疗管状骨骨折

目的 探讨锁定钢板微创治疗管状骨骨折的方法以及疗效.方法 42例四肢管状骨骨折患者,其中闭合性骨折39例,开放性骨折3例.采用小切口锁定钢板插入,对骨折进行闭合手法复位后,利用锁定钢板结合直径3.5mm克氏针来维持手法复位后的位置,同时通过C形臂X线调整骨折位置,最后通过桥接固定的方式固定.结果 42例患者均获随访,平均8个月(4～18个月).骨折愈合时间3～7个月,平均4.5个月.按0vadia标准,优19例,良21例,可2,差0例,优良率95%.结论 锁定钢板微创固定治疗管状骨骨折具有微创,固定牢靠,避免大面积骨膜剥离,保护了血供,有利于骨折的顺利愈合等优点,特别适用于粉碎性骨折.     

32例骨梗死患者的MRI资料分析

骨梗死临床较少见，早期临床表现多不典型，X线平片检查常为阴性，易出现漏诊或误诊。笔者回顾性分析了我院2005年至2008年确诊为骨梗死的32例患者的MRI资料，现将结果报告如下。     

风湿定痛汤治疗膝骨性关节炎296例

目的:研究膝骨性关节炎的有效治疗方法及药物。方法:治疗组296例采用内服风湿定痛汤治疗,并与对照组140例服用西药非甾体药物治疗进行比较,判断治疗结果。结果:治疗组总有效率为91.0%,对照组为75.0%,治疗组疗效优于对照组(P<0.05)。结论:风湿定痛汤治疗膝骨性关节炎疗效满意。     

丹参接骨胶囊对闭合性股骨骨折模型大鼠骨折愈合的影响

BACKGROUND: Salvia miltiorrhiza bone-setting capsule is a traditional Chinese medicine for the treatment of fractures due to activating blood circulation to dissipate blood stasis, reducing swelling and pain. OBJECTIVE: To observe the effects of Salvia miltiorrhiza bone-setting capsule on the fracture healing in a rat model of closed femoral fractures. METHODS: Rats were randomly divided into salvia miltiorrhiza bone-setting capsule group, physiological saline group and normal group. In the salvia miltiorrhiza bone-setting capsule group and physiological saline group, rat models of closed femoral fractures were prepared, and then given physiological saline and salvia miltiorrhiza bone-setting capsule 2 pills by intragastric administration. In the normal group, rats were housed normally. At 7, 14 and 28 days after fractures, hematoxylin-eosin staining conditions, serum osteocalcin, the expression of collagen type I, and the expression of protein and mRNA callus transforming growth factor-beta 1 were observed in the salvia miltiorrhiza bone-setting capsule group and physiological saline group. RESULTS AND CONCLUSION: (1) Hematoxylin-eosin staining demonstrated that at 7 days after fractures, no significant difference was found in pathological changes of femoral fracture in salvia miltiorrhiza bone-setting capsule group and physiological saline group. At 14 and 28 days after fractures, pathological repair was more obvious in the salvia miltiorrhiza bone-setting capsule group than in the physiological saline group. (2) At 3 and 7 days after fractures, serum osteocalcin and the expression of type I collagen were significantly increased in the salvia miltiorrhiza bone-setting capsule group and physiological saline group  (P < 0.05), and the expression trend was consistent in both groups. The expression was always higher in the salvia miltiorrhiza bone-setting capsule group than in the physiological saline group, and significant differences were found at 14 and 28 days after fractures (P < 0.01). (3) Transforming growth factor beta 1 expression reached a peak at 3 days after fractures, gradually reduced, increased at 14 days (the second peak), and diminished at 28 days in the salvia miltiorrhiza bone-setting capsule group and physiological saline group. The expression trend of transforming growth factor beta 1 was consistent in the salvia miltiorrhiza bone-setting capsule group and physiological saline group. At 7, 14 and 28 days, the transforming growth factor beta 1 expression was higher in the salvia miltiorrhiza bone-setting capsule group than in the physiological saline group. (4) Results showed that salvia miltiorrhiza bone-setting capsule could promote fracture healing, and its mechanism was probably associated with serum osteocalcin, the expression of collagen type I and transforming growth factor-β1.       

儿童肱骨髁上骨折内固定治疗分析

目的：探讨闭合复位加克氏针内固定治疗儿童肱骨髁上骨折的临床疗效,并与手术切开复位固定内固定效果进行比较。方法：2006年10月～2009年10月山东省即墨市中医院收治儿童肱骨髁上骨折患者80例,其中44例（观察组）采取闭合复位经皮克氏针内固定治疗,36例（对照组）采取手术切开复位内固定治疗,比较两组治疗效果及并发症。结果：随访时间为6个月～3年,平均1.5年,两组患者治疗后优良率比较,差异无统计学意义（χ2=4.56,P〉0.05）,但观察组患者住院时间、出血量、治疗费用等均低于对照组,两组比较,差异有统计学意义（χ2=9.27、17.34、21.41,P〈0.05）。结论：闭合复位经皮克氏针内固定治疗儿童肱骨髁上骨折,患者恢复快,创伤小,固定可靠,值得临床应用。