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find Author "刘雷" 29 results
  • 老年股骨颈骨折治疗方式的临床应用进展

    随着全球逐渐步入老龄化社会,股骨颈骨折已经成为老年人最常见的疾病之一。虽然全球各地的学者都对老年股骨颈骨折作了大量的研究,治疗方式也层出不穷,但如何降低老年患者术后并发症的发生率和伤残率仍然是临床治疗上需要攻克的难点。现阶段对于老年股骨颈骨折患者的治疗方式主要分为内固定和人工关节置换两大类。常用的内固定器材包括三翼钉、空心钉、动力髋螺钉、非平行螺钉、股骨近端髓内钉、股骨近端锁定钢板等。而人工关节置换也有人工股骨头置换和全髋关节置换两类。此外,一系列治疗老年股骨颈骨折患者的辅助方法也常常应用于临床,例如关节囊切开减压、骨瓣移植、计算机辅助导航技术等。虽然治疗手段上不断修正和更新,但是仍存在着并发症多、伤残率高等问题。现就老年股骨颈骨折患者的治疗方式作一个综述,提出存在的问题,并给出解决问题的方向,以期为未来的研究提供详实可靠的依据。

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  • 老年人股骨转子间骨折国内外治疗进展

    股骨转子间骨折临床多发,多见于老年人。保守治疗时间长,并发症多,病死率高;现在临床上已对采取手术治疗达成共识,手术治疗缩短卧床时间,并降低由此带来的并发症发生率及病死率,早期功能锻炼促进功能康复。本文就近年来国内外对老年人股骨转子间骨折治疗进展作一综述。

    Release date:2016-09-07 02:38 Export PDF Favorites Scan
  • Müller-Weiss病的现状研究

    Müller-Weiss病在临床上很少见。由于其病因及发病机制多样,临床症状不典型,往往给诊断和治疗带来困难。现阶段主要根据Müller-Weiss病的特征,临床症状以及影像学改变来进行诊断与鉴别。对于Müller-Weiss病的治疗方式,除少数轻症患者可选择保守治疗外,大部分患者仍需采用手术的方式进行治疗。手术治疗的术式包括距舟-舟楔关节融合术、距舟关节融合术、足舟骨经皮减压术、切开三关节融合术和关节镜下三关节融合术等。虽然对于Müller-Weiss病的研究正在不断加深,但仍存在许多不清楚的地方。现对Müller-Weiss病的临床特征、诊断和治疗等方面进行归纳总结,以期望能为相关的科研和临床工作提供科学依据。

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  • PROTEOMICS STUDY ON EFFECT OF BASIC FIBROBLAST GROWTH FACTOR LONG CIRCULATION LIPOSOME ON SPINAL CORD TRACTION INJURY IN RATS

    ObjectiveTo explore the possible active mechanism of the basic fibroblast growth factor (bFGF) long circulation l iposome (LCL) (bFGF+LCL) on spinal cord traction injury in rats at the level of proteomics. MethodsTwenty Sprague Dawly rats were randomly divided into groups A and B, 10 rats in each group. The models of spinal cord traction injury was established at T12-L3 spines. The rats were not treated in group A, and the rats were treated with bFGF+LCL (20μg/ kg) in group B. At 3 weeks after operation, the rats were sacrificed for harvesting T13-L2 spinal tissue specimens. The protein was extracted and quantified in the spinal tissue firstly. The proteins from spinal tissue were separated by two-dimensional gel electrophoresis and identified by mass spectrometry. The different expression profiling was established in each group, and the differentially expressed protein was determined by comparing the level of each spot with gel imaging software and manually. The proteins were identified by nano ultra-high performance liquid chromatography-electrospray tandem mass spectrometry (NanoUPLC-ESI-MS/MS), and the proteins were classified. ResultsThe differentially expressed protein spots were found in 2 groups. Compared with group A, 4 spots were up-regulated and 6 were down-regulated in group B. NanoUPLC-ESI-MS/MS results showed that 18 significant proteins were identified in 26 differentially expressed proteins, including 4 apoptosis-related proteins, 3 nerve signal transduction related proteins, 7 proteins involved in metabolism, 1 unknown function protein, and 3 unnamed proteins. ConclusionThe differentially expressed proteins are found in spinal cord traction injury of rats treated with bFGF+LCL. bFGF+LCL can affect the proteins expression in rats with spinal cord traction injury. The possible active mechanism is that it has protective and repair effects on injured spinal cord by nerve signal transduction, and regulation of nerve cells apoptosis and metabolism.

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  • Application and research progress of subtalar distraction bone block arthrodesis in treatment of calcaneus fracture malunion

    Objective To review the application and research progress of subtalar distraction bone block arth-rodesis in the treatment of calcaneus fracture malunion. Methods The recent literature concerning the history, surgical technique, postoperative complication, indications, and curative effect of subtalar distraction arthrodesis with bone graft block interposition in the treatment of calcaneus fracture malunion was summarized and analyzed. Results Subtalar distraction bone block arthrodesis is one of the main ways to treat calcaneus fracture malunion, including a combined surgery with subtalar arthrodesis and realignment surgery for hindfoot deformity using bone block graft. The advantage is on the base of subtalar joint fusion, through one-time retracting subtalar joint, the posterior articular surface of subtalar joint implants bone block can partially restore calcaneal height, thus improving the function of the foot. Compared with other calcaneal malunion treatments, subtalar distraction arthrodesis is effective to correct complications caused by calcaneus fracture malunion, and it can restore the height of talus and calcaneus, correct loss of talocalcaneal angle, and ease pain. Conclusion Subtalar distraction bone block arthrodesis has made remarkable progress in the treatment of calcaneus fracture malunion, but it has the disadvantages of postoperative nonunion and absorption of bone block, so further study is needed.

    Release date:2017-06-15 10:04 Export PDF Favorites Scan
  • Progress of treatments for old calcaneal fractures

    Objective To review the progress of treatments for old calcaneal fractures. Methods The related literature of treatments for old calcaneal fractures were reviewed and analyzed from the aspects such as the pathoanatomy, classifications, and surgical treatments. Results Old calcaneal fractures are common in clinical, the anatomical changes are very complicated. In addition to classical open reduction and internal fixation, arthrodesis, and osteotomy, techniques of minimally invasive operation, external fixator, and three-dimensional printing are more and more widely applied, treatments for old calcaneal fractures nonunion have also received increasing attention. Conclusion Although the perfect strategy for treating old calcaneal fractures has not yet been developed, great progress has been achieved recently, the personalized therapy need to be further studied, and therapies for the early stage old calcaneal fractures and old calcaneal fractures nonunion need to be further explored.

    Release date:2017-10-10 03:58 Export PDF Favorites Scan
  • Progress of hip fracture treatment in children

    ObjectiveTo review the progress of hip fracture treatment in children.MethodsLiterature about the hip fracture treatment in children was extensively reviewed and summarized in terms of anatomy and blood supply, fracture classification, surgical treatment principles, and complications.ResultsThe anatomical structure of children’s hips and the characteristics of peripheral blood supply constantly change with age. Delbet classification is the most classic classification of hip fracture in children. Children’s age and Delbet classification have significant effects on surgical treatment strategies and post-fracture complications. The timing of surgical treatment, accurate anatomical reduction, and appropriate internal fixation can effectively improve the prognosis and reduce the incidence of complications. Common complications include osteonecrosis of the femoral head, coxa vara, premature physeal closure, and nonunion. Conclusion There are still some controversies on the treatment concept and internal fixation choice for children’s hip fracture. So it is necessary to further study the anatomy and blood supply characteristics of children’s hip, improve the selection and application skills of internal fixation devices, so as to avoid serious complications.

    Release date:2020-04-15 09:18 Export PDF Favorites Scan
  • ESTABLISHMENT OF TRACTIVE SPINAL CORD INJURY MODEL IN RATS WITH A NOVEL SPINAL DISTRACTOR

    Objective To develop a tractive spinal cord injury model in rats with a novel spinal distractor so as to supply the rel iable animal model for researching the pathological mechanism and rehabil itation treatment of tractive spinal cordinjury. Methods A novel spinal distractor was prepared based on previous study. Sixty adult Sprague Dawley rats (weighing 250-300 g) were randomly divided into 5 groups, 12 rats in each group. T12-L3 spinal structures in the rear area were exposed and then T13-L2 spinal cords were revealed via dual laminectomy and kept integrity. In group A, a novel spinal distractor was placed without distraction; in groups B, C, D, and E, the T12-L3 spines were tracted with a novel spinal distractor which put on transverses process of T12-L3 vertebrae. During the tractive period, the somatosensory evoked potential (SEP) was used to monitor spinal cord function. The SEP ampl itudes descended 50% and kept distracting for 5 minutes in group B and for 10 minutes in group C, and descended 70% and kept distracting for 5 minutes in group D and for 10 minutes in group E, respectively to establ ish the tractive spinal cord injury model of T11-L2. The improved combine behavioral score (ICBS) was recorded at 1 and 7 days after injury in 6 rats of each group. The T13-L2 spinal tissue specimens were harvested for the morphological observation by HE and Nissl’s staining and for neurons counting. Results In group A, the ICBS score was 0 at 1 and 7 days after operation, showing significant difference when compared with the scores of the other groups (P lt; 0.05). The ICBS scores of groups D and E were significantly higher than those of groups B and C (P lt; 0.05). Edema and hemorrhage were observed in spinal cord surface and normal morphological structures were destroyed at different extent in groups B, C, D, and E at 1 day. There were adherence and congestion between spinal cord surface and peripheral issue without luster at 7 days, and dura depression was observed at the injury section, especially in group E. Necrosis and dissolution occurred in some neurons, and Nissl body structure dissolved or disappeared in groups B, C, D, and E. The neuron counting gradually decreased in accordance with the aggravation of injury in groups B, C, D, and E, showing significant difference when compared with group A (P lt; 0.05). Significant differences in neuron counting were found among groups B, C, D, and E (P lt; 0.05). Conclusion The tractive spinal cord injury model in rats can be successfully establ ished with novel spinal distractor, and the model establ ished by SEP ampl itude descending 70% and keeping distracting for 10 minutes is more suitable for study in tractive spinal cord injury.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • TREATMENT OF OLD SCAPHOID FRACTURE WITH ABSORBABLE SCREW

    To explore a new approach to treat old scaphoid fracture by grafting bones from distal radius and fixing absorbable screws. Methods From January 2002 to May 2007, 18 patients with old scaphoid fractures were treated by grafting bones from distal radius and fixing absorbable screws. All of the 18 patients (13 males and 5 females, aged from 17 to 41 years old) had the injury history of the palm of hand touching the ground. They felt tenderness on the anatomical snuff-box and tubercle of scaphoid bone. The grasping force decreased. The range of motion of the wrist was (36 ± 2)° extension/(30 ± 3)° flexion, (8 ± 3)° radial is/(13 ± 2)° ulnaris. Results The average postoperative follow-up period was 15.7 months.A total of 18 cases achieved bone union. The range of motion of the wrist in the 16 healed cases was (68 ± 2)° extension/(65 ± 3)° flexion, (15 ± 3)° radial is/(28 ± 5)° ulnaris. There was no pain of motion and symptom of powerlessness. As to the other 2 cases, the range of motion of the wrist was (40 ± 8)° extension/(35 ± 6)° flexion, (8 ± 5)° radial is/(12 ± 5)° ulnaris; no obvious improvement was found; the patients occasionally felt painful in daily l ife; the extension force decreased. No infection and break of internal fixation were seen. Conclusion The absorbable screw as a new biomaterial for internal fixation has obvious advantages of good biocompatibil ity, promoting union of the fracture and no need of a second operation for removal.

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • Pilon骨折的手术治疗

    Pilon骨折由于创伤能量大,胫骨远端软组织覆盖少,给临床治疗带来困难。手术治疗Pilon骨折的方法包括早期切开复位内固定(ORIF)、有限内固定结合外固定、分步延期ORIF和微创技术。虽然治疗手段上不断修正和更新,但是仍存在并发症多、伤残率高等问题。现就近年Pilon骨折手术治疗研究作一综述。

    Release date:2016-09-08 09:13 Export PDF Favorites Scan
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