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find Author "徐希彦" 2 results
  • 涉及跟距关节的跟骨骨折手术治疗

    目的 总结跟骨钢板内固定治疗涉及跟距关节的跟骨闭合性骨折的临床疗效。 方法 2004 年4 月- 2008 年6 月,采用经足跟部外侧延长的L 形切口显露跟骨,切开复位跟骨钢板内固定治疗高处坠落伤所致涉及跟距关节的跟骨骨折18 例。其中男12 例,女6 例;年龄26 ~ 57 岁,平均37 岁。左侧7 例,右侧11 例。骨折按Sanders 分型:Ⅱ型12 例,Ⅲ型5 例,Ⅳ型1 例。术前常规行跟骨侧位、轴位X线片及CT 检查,骨折均累及距下关节并伴有不同程度移位,Gissane 角及Bouml;hler 角明显减小。受伤至手术时间5 ~ 7 d。 结果 术后3 d 1 例伤口感染,术后5 d 1 例创缘部分缺血坏死,经对症治疗后伤口愈合;余患者切口均Ⅰ期愈合。18 例均获随访,随访时间8 ~ 12 个月,平均10 个月。X 线片示所有患者骨折均达骨性愈合,愈合时间2 ~ 4 个月,平均3 个月。末次随访时Gissane 角及Bouml;hler 角均较术前明显改善。术后8 个月,按Maryland 足部评分标准,获优5 例,良10 例,差3 例,优良率83.3%。 结论 切开复位跟骨钢板内固定是治疗涉及跟距关节的跟骨骨折的一种有效方法。

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • APPLIED ANATOMICAL STUDY ON APPROACH NEXT TO ERECTOR SPINAE FOR SPINAL CANAL DECOMPRESSION THROUGH INTERVERTEBRAL FORAMEN

    Objective To observe and measure the approach next to the erector spinae in the thoracic and lumbar segments of the spine and adjacent anatomical structures by the topographic method, to clarify the positioning method and safe range so as to provide the anatomical basis of the approach for spinal canal decompression. Methods Twelve formaldehyde-treated adult cadaver specimens were selected, including 6 males and 6 females with an average age of 43 years (range, 27-52 years) and with an average height of 166 cm (range, 154-177 cm). The related data of the approach at T1-S1 levels were respectively measured: the distance between the lateral edge of the erector spinae and the spinous process, the length of the approach, the angle between the approach and the horizontal plane, the size of intervertebral foramen, and the vertical distance between the segmental artery and the upper edge of the vertebrae. Results The distance between the lateral edge of the erector spinae and the spinous process ranged from (41.75 ± 3.29) mm to (74.54 ± 7.08) mm. The length of the approach ranged from (66.75 ± 10.81) mm to (97.13 ± 13.35) mm. The angle between the approach and the horizontal plane ranged from (38.38 ± 6.16)° to (53.67 ± 4.40)°. The vertical distance between the segmental artery and the upper edge of the vertebrae ranged from (9.50 ± 0.60) mm to (18.30 ± 1.56) mm. The size of foraminal was also measured. The spinal canal could reach when iliocostalis lateral edge was used as the starting point in the lumbar segments, and longissimus lateral edge as the starting point in the thoracic segments. It was confirmed that there was enough safe space for the spinal decompression without the resection of the articular process. Conclusion The approach next to the erector spinae can reach spinal canal to achieve the purpose of decompression through the intervertebral foramen. The minimally invasive approach is feasible and safe. It has the value of the operative application.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
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