重度肩锁关节脱位的手术治疗

目的：对15例重度肩锁关节脱位的手术7治疗进行治疗，方法：15例全部为Allman分型中的Ⅲ型损伤，其中有11例切除纤维软骨盘，7例修复锁韧带，3例加用一枚松质骨螺钉固定于锁骨与喙空间，肩锁韧带全部修复，用两枚克氏针交叉固定于肩锁关节。结果：经10个月－6年的随访。疗效评价按Karlsson分类A级为12例，B级3例，病人均重返原工作岗位，有10例喙锁间隙软组织钙化，但对病人肩关节活动并无影响，结论：对重度肩锁关工锐位的病人应尽早手术治疗。克氏针交叉内固定是一种简单而有效的方法，纤维软骨盘是否切除和喙锁韧带是否修复对预后无明显影响。

Operative Treatment of Severe Acromioclavicular Joint Dislocation

Objective: To detect whether the matrix metalloproteinaes 3 and its tissue inhibitor of metalloproteinase 1 expressed among intervertebral disc and comprehend the pathogenesis of intervertebral disc herniation and degeneration.Methods: MMP3 and TIMP1 statement in 60 specimens of disc herniation(classified as protrusions,extrusions,sequestrations) and 16 nonherniated discs were detected by immunohistochemistry(ABC assay).Results:Statement of MMP3 observed in prolapsed discs was significantly higher than in nonprolapsed disc.The MMP3 positive cell ration in the extrusion and sequestration types were significantly higher than in the protrusion type.No significant difference of MMP3 positive cell ration was found between the extrusion and sequestration type.Positive statement of TIMP1 were not observed in nonherniated discs the protrusion type while were observed and in the exteusion and sequestration types and there were no significant difference between them.Conclusion: Imbalanced statement of MMP3 and TIMP1 in intervertebral disc may induce the intervertebral disc degeneration.Difference in degenerative degrees of intervertibral disc may be the biological basis of different disc herniatied types in clinic.