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find Author "吴永伟" 13 results
  • 钛网包裹自体松质骨打压植骨修复桡骨节段缺损一例

    目的介绍一种新的利用钛网包裹自体松质骨打压植骨修复桡骨节段缺损方法。 方法2011年10月,收治1例53岁机器击伤致左桡骨中下段开放粉碎性骨折合并5.4 cm桡骨缺损患者,待伤口愈合和局部皮肤条件改善后,二期采用切开复位钢板内固定和钛网包裹自体髂骨松质骨打压植骨修复桡骨节段骨缺损。 结果术后4个月见断端连续性骨痂连接、初步植骨融合表现,局部无压、叩痛,腕关节功能轻度受限,达临床愈合标准;术后6个月断端植骨融合更清晰,腕关节活动度接近正常,Green-O’Brien腕关节功能临床评分90分,为良;术后12个月末次随访,骨折愈合及腕关节功能临床评分无变化。 结论采用钛网包裹自体松质骨打压植骨修复桡骨节段缺损,不仅成骨快、愈合良好,且简便、安全。

    Release date:2016-08-31 04:06 Export PDF Favorites Scan
  • 改良打压游离植骨治疗长段骨缺损一例

    目的 介绍改良打压游离植骨治疗长段骨缺损的手术方法及疗效。 方法 2009 年6 月,对1 例46岁外伤性左胫骨中下段骨折合并骨外露、骨髓炎致骨缺损长6.5 cm 男性患者,在伤口愈合和感染控制后二期采用切开交锁髓内钉固定、可吸收线网包裹自体骨行打压游离植骨。 结果 术后随访24 个月,踝关节活动度仅轻度受限,美国矫形足踝协会(AOFAS)踝关节功能评分87 分,为良;术后6 个月见断端骨痂初步连接,术后10 个月断端完全骨性愈合。未行髓内钉取出。 结论 打压游离植骨方法的成功,改变了既往认为gt; 6 cm 长段骨缺损只适宜带血运的骨移植而不适宜游离植骨的传统观点;改良打压游离植骨是治疗长段骨缺损的有效方法之一,较钛网打压游离植骨费用更低。

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • 闭合复位经皮可吸收螺钉固定治疗踝部骨折

    目的 总结闭合复位经皮可吸收螺钉固定治疗踝部骨折的疗效。 方法 2002 年1 月- 2009 年3 月,采用闭合复位经皮可吸收螺钉固定治疗31 例外伤致踝部骨折患者。男19 例,女12 例;年龄15 ~ 67 岁,平均39 岁。内踝骨折12 例,外踝骨折6 例,双踝骨折10 例,三踝骨折3 例(后踝lt; 1/4)。骨折AO 分型:A 型22 例,B 型6 例,C 型3 例。伤后至入院时间为2 h ~ 7 d,平均4.5 h;入院至手术时间3 h ~ 11 d。 结果 术后患者切口均Ⅰ期愈合。31 例均获随访,随访时间20 ~ 36 个月,平均24 个月。1 例术后2 个月螺钉断裂、骨折移位,二次手术采用金属螺钉固定后3 个月骨折达临床愈合。其余30 例骨折临床愈合时间为3 ~ 4 个月,平均3.2 个月。末次随访时,参照Mast 等疗效评定标准,获优22 例,良7 例,可2 例,优良率93.5%。 结论 闭合复位经皮可吸收螺钉固定治疗易于闭合复位的踝部骨折,创伤小,固定较可靠,避免了二次手术取出,是一种较好的治疗方法。

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • EFFECTIVENESS OF SHARP TEETH HOOK PLATE FOR TREATMENT OF OLECRANON FRACTURES

    ObjectiveTo investigate the effectiveness of sharp teeth hook plate by cutting for the treatment of olecranon fractures by comparison with Kirschner wire tension belt and locking plate. MethodsBetween January 2011 and April 2015, 32 cases of olecranon fractures were treated. Fracture was fixed with sharp teeth hook plate by cutting in 12 cases (trial group) and with Kirschner wire tension belt or locking plate in 20 cases (control group). There was no significant difference in gender, age, side and type of fracture, and time from injury to operation between 2 groups (P > 0.05). The healing time of fractures and complications were recorded. At 1 year after operation, the subjective function results were evaluated according to Disability of Arm, Shoulder, and Hand (DASH) score, and objective function results by Mayo Elbow Score (MEPS); visual analogue scale (VAS) was used for elbow joint pain, and range of motion of flexion and extension of elbow joint was measured. ResultsAll incisions healed by first intention, with no vascular and nerve injuries. All patients were followed up 12-36 months with an average of 18 months. All fractures healed, and there was no significant difference in the healing time between 2 groups (P > 0.05). Loosening of Kirschner wire occurred in 2 cases of control group, but no loosening of internal fixation was observed in trial group after operation. There was no significant difference in the incidence of complications between 2 groups (P > 0.05). The DASH, MEPS, VAS score, and range of motion of flexion in trial group were superior to those in control group, showing significant differences (P < 0.05) at 1 year after operation. There was no significant difference in range of motion of extension between 2 groups (P > 0.05). ConclusionSharp teeth hook plate for treatment of olecranon fractures overcomes the shortcomings that Kirschner wire tension is easy to slide and locking plate has a compression effect on triceps tendon, so it has good effectiveness.

    Release date:2016-10-02 04:55 Export PDF Favorites Scan
  • 自制齿状钩钢板治疗后交叉韧带胫骨止点撕脱骨折

    目的总结自制齿状钩钢板治疗后交叉韧带(posterior cruciate ligament,PCL)胫骨止点撕脱骨折的疗效。 方法2012 年 11 月—2016 年 4 月,采用自制齿状钩钢板治疗 PCL 胫骨止点撕脱骨折 11 例。其中男 6 例,女 5 例;年龄 37~63 岁,平均 48.5 岁。致伤原因:交通事故伤 4 例,高处坠落伤 2 例,跌伤 5 例;均为新鲜骨折,受伤至手术时间 3~11 d,平均 5.2 d。骨折按 Meyer-McKeever 分型:Ⅱ型 4 例,Ⅲ型 7 例。术前膝关节屈曲活动度 40~90°,平均 65.9°。术前 Lysholm 评分 50~69 分,平均 58.5 分。 结果术后切口均Ⅰ期愈合。11 例患者均获随访,随访时间 6~20 个月,平均 11 个月。术后 3 个月 X 线片示患者骨折均愈合,骨折端无明显移位。术后 6 个月,患肢膝关节屈曲活动度达 115~130°,平均 121.8°;膝关节后抽屉试验均呈阴性,未见膝关节伸直功能障碍及腘窝部血管、神经损伤并发症;Lysholm 评分为 85~99 分,平均 92.8 分。 结论自制齿状钩钢板治疗 PCL 胫骨止点撕脱骨折可行,操作简便、固定效果可靠,术后疗效满意。

    Release date:2017-06-15 10:04 Export PDF Favorites Scan
  • Application of vascular augmentation of an extra-long latissimus dorsi flap through an intercostal artery in limb wound repair

    Objective To explore the clinical application of vascular augmentation of an extra-long latissimus dorsi flap through an intercostal artery in limb wound repair. Methods Between January 2016 and December 2017, 5 patients with limb wounds were treated with the extra-long latissimus dorsi flaps. The vascular augmentation of the extra-long latissimus dorsi flap through the intercostal artery was applied during the operation. There were 4 males and 1 female, with an average age of 45.8 years (range, 43-59 years). The time from post-traumatic admission to flap repair was 7-25 days (mean, 12.3 days). The causes of injury included machine injury in 2 cases, traffic accident in 2 cases, and roller crush injury in 1 case. The wounds were located at the anterior of upper limb in 3 cases, the posterior of upper limb in 1 case, and the posterior of leg in 1 case. The size of wounds ranged from 26 cm×8 cm to 38 cm×10 cm. The size of the latissimus dorsi flap ranged from 36 cm×6 cm to 43 cm×7 cm. The size of the muscle flap ranged from 36 cm×10 cm to 43 cm×15 cm. The donor sites were closed directly. Results The distal flap necrosis occurred in 1 case and healed after symptomatically treatment. The other flaps survived completely. The wounds and incisions at donor sites healed by first intention. All patients were followed up 8-18 months with an average of 14.9 months. At last follow-up, the flaps had satisfactory appearances, soft textures, and function of sweating. Conclusion Application of vascular augmentation of the extra-long latissimus dorsi flap through the intercostal artery in repair of limb wound can reduce the incidence of distal flap necrosis and achieve satisfactory effectiveness.

    Release date:2018-12-04 03:41 Export PDF Favorites Scan
  • INDUCED MEMBRANCE TECHNIQUE OF HOLLOW POROUS ANTIBIOTICIMPREGNATED BONE CEMENT FORMING IN VITRO AND LAVAGE IN VIVO FOR TREATMENT OF OSTEOMYELITIS

    ObjectiveTo explore the effectiveness of induced membrane technique of hollow porous antibioticimpregnated bone cement forming in vitro and lavage in vivo for the treatment of osteomyelitis. MethodsBetween January 2010 and March 2014, 14 cases of osteomyelitis were treated by induced membrane technique of hollow porous antibiotic-impregnated bone cement forming in vitro and lavage in vivo after debridement at the first stage, then the bone cement with bone graft was replaced during the induced membrane after infection was controlled at the second stage. The time from first to second stage operation was 8-12 weeks (average, 10.2 weeks). There were 11 males and 3 females, aged 18 to 69 years (average, 39.2 years). According to Cierny-Mader classification of osteomyelitis, 2 cases were rated as intramedullary type, 5 cases as limited type, and 7 cases as diffusing type. The course of osteomyelitis was 3 months to 20 years, averaged 1.9 years. The healing of bone defect and the functionary recovery of adjacent joint were evaluated according to Paley's method. ResultsDebridement was performed for two times in 1 case, and for one time in 13 cases for control of bone infection at the first stage. All incisions healed by first intention after second stage. All patients were followed up 15-48 months (average, 13.4 months), with no recurrence of infection. All bone defects healed, and the clinical healing time was 4-5 months (average, 4.4 months). The results of bone healing grade were excellent in all cases at 1 year after operation; the functional recovery of adjacent joint at last follow-up was excellent in 4 cases, good in 8 cases, and fair in 2 cases, and the excellent and good rate was 85.7%. ConclusionInduced membrane technique of hollow porous antibiotic-impregnated bone cement forming in vitro and lavage in vivo for treatment of osteomyelitis has the advantages of high rate of elution of antibiotics, ease of lavage of medullary cavity, and no damage to induced membrane and bony interface between bone and bone cement when removing cement, it is effective for control of bone infection and repair of bone defect.

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  • AO “分水岭”万向锁定加压钢板在桡骨极远端骨折治疗中的应用

    目的 比较 AO“分水岭”万向锁定加压钢板内固定与外支架结合克氏针外固定治疗桡骨极远端骨折的临床效果。 方法 回顾分析 2016 年 1 月—11 月,采取 AO“分水岭”万向锁定加压钢板内固定治疗的 9 例桡骨极远端骨折患者临床资料(内固定组),并与采用外支架结合克氏针外固定治疗的 20 例患者(外固定组)进行疗效比较。两组患者年龄、性别、致伤原因、骨折分型、受伤至手术时间等一般资料比较差异均无统计学意义(P>0.05),具有可比性。 结果 两组患者均获随访,随访时间 5~15 个月,平均 10.7 个月。所有患者术后切口均Ⅰ期愈合,无感染、血管神经损伤、内固定物(内固定组)移位失败等并发症发生。两组骨折愈合时间比较差异无统计学意义(t=0.891,P=0.391);但内固定组住院费用显著低于外固定组,末次随访时腕关节 Mayo 评分及上肢功能调查量表(DASH)评分显著优于外固定组,比较差异均有统计学意义(P<0.05)。 结论 与外支架结合克氏针外固定相比,AO“分水岭”万向锁定加压钢板内固定治疗桡骨极远端骨折具有内固定牢靠、便于患者早期功能锻炼、术后腕关节功能恢复良好等优点。

    Release date:2017-10-10 03:58 Export PDF Favorites Scan
  • Effectiveness of arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures

    Objective To investigate the effectiveness of arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures. Methods Between January 2014 and May 2016, 21 patients who suffered from extreme distal radial fractures were treated by arthroscopy-assisted combined fixation of Kirschner wire and external fixator. There were 14 males and 7 females with an age of 32-57 years (mean, 42.3 years). The causes of injury included falling in 13 cases and traffic accident in 8 cases. The fracture type included 8 cases of type 23C1, 9 cases of type 23C2, and 4 cases of type 23C3 according to AO/OTA classification. The time from injury to operation was 3-7 days (mean, 4.4 days). The Mayo score and disability of arm, shoulder, and hand (DASH) score were used to assess the pain and function of the wrist joint. Results There was no needle red swelling, tendon irritation, or orther early complications. All the patients were followed up 10-35 months (mean, 18.3 months). The fracture healing time was 9-13 weeks (mean, 10.6 weeks). At last follow-up, the Mayo score was 87-94 (mean, 90.9); and 17 cases were excellent and 4 were good. The DASH score was 7-13 (mean, 10.6). Conclusion Arthroscopy-assisted combined fixation of Kirschner wire and external fixator for treating extreme distal radial fractures has the advantages of firm fixation, early functional exercise, less postoperative complications, and good functional recovery of wrist joint.

    Release date:2017-12-11 12:15 Export PDF Favorites Scan
  • 自制齿状钩钢板结合热气球技术治疗合并侧方碎骨块的尺骨鹰嘴撕脱骨折

    目的总结自制齿状钩钢板结合热气球技术治疗合并侧方碎骨块的尺骨鹰嘴撕脱骨折的临床疗效及注意事项。方法回顾分析 2016 年 1 月—2018 年 4 月采用自制齿状钩钢板结合热气球技术固定治疗的 9 例合并侧方碎骨块的尺骨鹰嘴撕脱骨折患者临床资料。其中男 5 例,女 4 例;年龄 30~74 岁,平均 53.7 岁。致伤原因:交通事故伤 1 例,高处坠落伤 1 例,机器损伤 1 例,摔伤 6 例。均为横形骨折,合并侧方 1~3 块大小不一碎骨块。骨折按 Colton 分型均为Ⅰ型。受伤至手术时间 2~11 d,平均 5.9 d。结果术后切口均Ⅰ期愈合。9 例均获随访,随访时间 6~16 个月,平均 11.2 个月。2 例消瘦患者术后鹰嘴部皮下出现内固定激惹,1 例出现轻度异位骨化。患者术后均无内固定物松动、断裂,无继发骨折移位、再骨折,无血管神经损伤等并发症发生。术后 3 个月 X 线片示骨折均达临床愈合。术后 1 个月肘关节屈伸活动度为 10~105°,3 个月时为 5~125°,6 个月时为 5~135°,末次随访时为 3~136°。按 Broberg-Morrey 标准评定肘关节功能,获优 7 例、良 2 例,优良率 100%。结论自制齿状钩钢板结合热气球技术治疗合并侧方碎骨块的尺骨鹰嘴撕脱骨折经济简便、固定可靠,允许术后早期功能锻炼,疗效确切。

    Release date:2019-07-23 09:50 Export PDF Favorites Scan
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