晚期月骨无菌性坏死的一种新疗法(附3例报告)

月骨无菌性坏死又称Kienbock氏病,系因慢性损伤而致月骨的缺血坏死,临床病例较少见,治疗也较困难。我们利用腕背侧动脉网,成功地用带血管筋膜蒂头状骨移位治疗晚期月骨无菌性坏死3例,术后随访一年,手术效果较满意,现报告如下。 手术方法 1、切口和显露:臂丛麻醉下,上臂上止血带。腕背侧纵行切口,切开皮肤,皮下组织和腕背韧带,向两侧牵开伸拇长肌腱和。食指固有伸肌、伸指总肌腱,可见骨间掌侧动脉背侧支及伴行的静脉走行于桡骨远端和腕骨的背侧。     

静脉桥接治疗手部感觉神经缺损

本文介绍了7例静脉桥接治疗周围感觉神经缺损的病例。其中,前臂部桡神经浅支2条,尺神经浅支1条;指总神经1条,指固有神经3条。神经缺损长度1.5～2.5cm。通过术后6个月至1年以上的随访,疼痛觉及两点辨别党都有恢复。     

纯钛金属板螺钉内固定治疗锁骨骨折

目的：研究锁骨骨折采用纯钛金属板及螺钉内固定治疗的效果。以探讨锁骨肌折更满意的治疗方法。方法：本组１６例锁骨骨折,单纯横形骨折２例,斜形骨折４例,粉碎性骨折１０例,全部手术切开复位行ＡＯ纯钛金属板及螺钉固定。结果：本组病例随访８－１４个月,骨折部位全部愈合,肩关节活动达正常生理活动度１５例（９３.75%)。结论：锁骨骨折采用金属板固定,复位好。固定稳固确切,有利患者早期行肩功能练习,ＡＯ纯钛金属板材质薄而轻,与机体组织反应小,容易塑形,较适合位于体表外形呈“Ｓ”状的锁骨骨折的内固定治疗,是一种值得推荐的治疗方法。     

Compound injection of Radix Hedysari to promote peripheral nerve regeneration in rats

OBJECTIVE: To study the effect of compound injection of Radix Hedysari on peripheral nerve regeneration in rats. METHODS: Seventy-five healthy adult SD male rats, weighing 150 g, were randomized into 5 groups (15 rats in each group). The bilateral sciatic nerves of the rats were exposed and clamped with a smooth clamp to make an injury area of 2 mm. After clamp operation Group 1 was injected with compound injection of radix Hedysari (CIRH) 1.5 ml/day, Group 2 with CIRH 1.0 ml/day, Group 3 with CIRH 0.5 ml/day, Group 4 with nerve growth factor (NGF) 50 U/day, and Group 5 was taken as the control group without any management. The bilateral sciatic nerve was taken out at 3 days, 1, 2 and 4 weeks after clamping, stained with osmic acid and observed microscopically. The myelinated nerve fibers were counted. The nerve conduction velocity was determined 2 and and 4 weeks before sample taking the sciatic nerve function index was measured 4 weeks before sample taking. RESULTS: The results of nerve conduction velocity, the myelinated nerve fiber count and the sciatic functuion index in the CIRH treated groups were better than those in the control group. The results of the nerve conduction velocity and the myelinated nerve fiber count at 2 weeks and the nerve conduction velocity at 4 weeks in Group 1 were better than those of Group 4. Biological observation showed that degenerated and necrotic myelin sheath in CIRH treated Groups at 2 and 4 weeks decreased remarkably compared to the NGF treated group. CONCLUSIONS: CIRH can promote regeneration of peripheral nerves and absorption of degenerated and necrotic injured nerves. It has the same effect as NGF.     

晚期月骨无菌性坏死一种新的治疗方法(附3例报告)

本文报告治疗晚期月骨无菌性坏死一种新的手术方法,报告我院利用腕背动脉网,将带血管筋膜蒂的头状骨移位以替代坏死的月骨、保持桡腕关节功能的方法。临床应用此法3例,术后随访一年,效果较满意。     

晚期月骨无菌性坏死的一种新疗法（附5例报告）

月骨无菌性坏死又称Kienbock氏病，系因慢性损伤而致月骨的缺血坏死，临床病例较少见，治疗也较困难。我们利用腕背侧动脉网，成功地用带血管筋膜蒂头状骨移位治疗晚期月骨无菌性坏死3例，术后随访一年，手术效果较满意，现报告如下。     

锁骨骨折应用钛金属板镙钉治疗的研究

锁骨骨折是常见的外伤.长期以来,治疗方法主要分为外固定和内固定两类.内固定对于开放性骨折、合并血管神经损坏以及移位、疼痛明显的病人是较理想的治疗方法.以往较常用的方法是克氏针内固定,近来有报告采用张力带内固定及外固定等方法.本组病例选用AO纯钛金属板和镙钉治疗锁骨骨折,取得满意的疗效.     

上臂软组织开放性损伤

上臂软组织开放性损伤常见于锐器切、扎伤、砸压伤、枪伤等。因臂部内含诸多支配肘、前臂及手部的神经、血管等。损伤后如果处理不及时或不得当常常会导致严重后果。所以重视和掌握上臂软组织开放性损伤的正确诊断及治疗非常必要。一、解部要点臂区深浅筋膜较薄,其上与三角肌和胸大肌筋膜延续,下与前臂筋膜相连,在肱二头肌内,外侧沟处发出臂内外侧间隔深人屈肌与伸肌之间,附于肱骨干内、外侧缘和上髁上嵴,因此将臂部分成两个骨筋膜鞘。鞘向上与腋窝和肩部组织间隙相通,向下与肘和前臂的组织间隙相通,前鞘中包绕喙肱     

碱性成纤维细胞生长因子在大鼠坐骨神经损伤修复中的作用

目的　研究碱性成纤维细胞生长因子（ｂ Ｆ Ｇ Ｆ）对周围神经损伤的促修复作用。方法　建立大鼠坐骨神经离断模型,镜下进行神经外膜缝合,局部滴加药物和术后肌注ｂ Ｆ Ｇ Ｆ 以及临床用药神经生长因子（ Ｎ Ｇ Ｆ）,通过神经传导速度和功能指数评定观察坐骨神经修复情况。结果　术后１ 个月,以正常对照为标准,０ 基线为正常水平,生理盐水、 Ｎ Ｇ Ｆ、ｂ Ｆ Ｇ Ｆ 使用组神经功能指数评定结果分别为：－ １１４．３０±１０．３４、－ ７０．５０±１１．０１、－ ５０．４５±７．８２;术后３ 个月,分别为：－ ５４．９６±１６．４６、－ ３５．２１±１０．８０、－ ２７．５３±１１．２３,ｂ Ｆ Ｇ Ｆ组神经传导速度明显快于生理盐水组和 Ｎ Ｇ Ｆ 组（ Ｐ＜ ０．０１）。结论　ｂ Ｆ Ｇ Ｆ对坐骨神经损伤具有显著的促功能修复作用,并且在神经损伤早期就能最有效地发挥作用,效果明显优于临床用药 Ｎ Ｇ Ｆ。