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find Author "杜东鹏" 2 results
  • APPLICATION OF AN UMBRELLA-SHAPED MEMORY ALLOY FEMORAL HEAD SUPPORT DEVICE FOR MINIMALLY INVASIVE TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD

    ObjectiveTo investigate the technique and short-term effectiveness of the umbrella-shaped memory alloy femoral head support device (umbrella-shaped support device for short) for the treatment of avascular necrosis of femoral head (ANFH). MethodsThe umbrella-shaped support device was fabricated with Ni-Ti alloy, and its biomechanics characteristics were tested by three-dimensional finite element analysis with pro/mechanica software. Between October 2009 and December 2012, 10 patients (18 hips) with ANFH were treated. There were 7 males (12 hips) and 3 females (6 hips), aged 21-53 years (mean, 40.6 years). The disease duration was 1-5 years (mean, 3.3 years). According to Ficat staged criteria, 10 hips were rated as stage Ⅱ, 6 hips as stage Ⅲ, and 2 hips as stage IV. Microtrauma methods were used to erase the necrotic tissue of the femoral head, and the umbrella-shaped support device, autogenous iliac bone graft, and artificial bone were implanted to support the collapsed femoral head. ResultsThree-dimensional finite element analysis showed that the largest stress of umbrella-shaped support device was 1 500 MPa and the largest displacement was 1.75 mm. Operation was successfully completed in the other 10 patients (17 hips) except 1 failure hip (total hip arthroplasty was performed after 6 months). The average follow-up period was 19.7 months (range, 15-26 months). At last follow-up, the results were excellent in 5 hips, good in 9 hips, fair in 2 hips, and poor in 1 hip; the excellent and good rate was 82.35%. The Ficat stage had no change when compared with preoperative stages. ConclusionThe advantages of the umbrella-shaped support device for the treatment of ANFH are to thoroughly remove the sequestrum, to rebuild blood circulation of the femoral head, to increase the machinery supporting of subchondral bone in weight-bearing area of femoral head, and to decrease the localized stress, and it has good short-term effectiveness, but long-term effectiveness needs further observation.

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  • 关节镜辅助下空心螺钉固定治疗新鲜腕舟骨骨折

    目的 探讨关节镜辅助下空心螺钉固定治疗新鲜腕舟骨骨折的疗效。方法 2022年5月—2023年2月,采用关节镜辅助下空心螺钉固定治疗30例腕舟骨骨折患者。男15例,女15例;年龄22~64岁,平均44.1岁。致伤原因:运动伤9例,交通事故伤9例,跌倒伤12例。骨折根据Herbert分型标准为B1型9例、B2型21例,均未合并三角纤维软骨复合体及韧带损伤。受伤至手术时间2~14 d,平均6.0 d。记录手术时间、术中出血量以及并发症发生情况。影像学复查骨折愈合情况,12个月时行改良Mayo腕关节评分及Herbert和Fisher腕舟骨骨折评价,测量腕关节主动屈、伸及桡偏、尺偏活动度并与健侧进行比较。结果 手术时间40~65 min,平均53.5 min;术中出血量5~20 mL,平均11.2 mL。患者均获随访,随访时间12~15个月,平均13.3个月。术后切口均Ⅰ期愈合,未出现感染、神经血管损伤等并发症。影像学复查示术后6个月时骨折均达骨性愈合,随访期间未出现螺钉松动等并发症。术后12个月,改良Mayo腕关节评分达优27例、良3例;Herbert和Fisher腕舟骨骨折评价达0级27例、1级3例;患侧腕关节主动屈、伸、桡偏、尺偏活动度均小于健侧,差异有统计学意义(P<0.05)。结论关节镜辅助下空心螺钉固定具有微创、精确复位及快速康复的优势,是治疗新鲜腕舟骨骨折有效方法。

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