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find Keyword "粉碎性骨折" 19 results
  • TREATMENT OF FIRST METATARSAL DIAPHYSIS COMMINUTED FRACTURES WITH MINI-PLATE VIA MEDIAL APPROACH

    ObjectiveTo explore the effectiveness and operative methods to treat first metatarsal diaphysis comminuted fractures with mini-plate via medial approach. MethodsBetween January 2012 and January 2013, 15 patients with first metatarsal shaft comminuted fractures were treated. There were 11 males and 4 females (6 left feet and 9 right feet) with an average age of 38.6 years (range, 27-56 years). The injury causes included falling injury in 6 cases, crash injury of heavy object in 7 cases, and sprain in 2 cases. The left side was involved in 6 cases and the right side in 9 cases. The time from injury to operation was 8.5 days on average (range, 7-10 days). According to AO classification, all cases were rated as 81(T)-C2 type. The surgical treatments included open reduction and internal fixation with mini-plate by medial approach. ResultsPrimary healing of incision was obtained in all cases, and no infection occurred. Twelve patients were followed up 18 months on average (range, 12-24 months). All fractures healed well, and the mean time of bone union was 11.5 weeks (range, 10-14 weeks). No loosening or breakage of internal fixation was observed. At last follow-up, the patients could walk with full weight-bearing, and had no pain. According to American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale, the mean score was 85.2 (range, 76-96). ConclusionAnatomic reduction and stable internal fixation are important for first metatarsal comminuted fracture, which is the key point for recovery of foot form and foot arch function. And the medial approach could achieve full exposure and improve the cosmetic results.

    Release date:2016-08-25 10:18 Export PDF Favorites Scan
  • 可吸收线缝扎结合解剖钢板内固定治疗尺骨鹰嘴近中段粉碎性骨折

    目的 总结可吸收线缝扎结合解剖钢板内固定治疗尺骨鹰嘴近中段粉碎性骨折的临床疗效。 方法2005年10月-2010年8月,采用可吸收线缝扎结合解剖钢板内固定治疗12例尺骨鹰嘴近中段粉碎性骨折患者。男7例,女5例;年龄17~62岁,平均37.2岁。致伤原因:摔伤8例,交通事故伤3例,高处坠落伤1例。骨折按AO分型标准:21-B1型骨折9例,21-C1型骨折3例。受伤至手术时间4 h~18 d。 结果术后发生切口浅表感染2例,其余患者切口均Ⅰ期愈合;骨关节炎一过性加重1例,异位骨化1例,余均无相关并发症发生。患者均获随访,随访时间6~18个月,平均7.7个月。X线片示骨折均达临床愈合,愈合时间为2~4个月,平均2.6个月。无骨不连、内固定物松动及断裂发生。末次随访时肘关节功能根据X线片及Mayo肘关节功能评分标准,获优7例,良3例,可2例。 结论可吸收线缝扎结合解剖钢板内固定治疗尺骨鹰嘴近中段粉碎性骨折符合生物力学特点,固定可靠,有利于骨折愈合及早期功能锻炼。

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • 锁骨粉碎性骨折合并锁骨下静脉损伤二例

    详见正文

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • MANAGEMENT OF INFERIOR POLAR COMMINUTED FRACTURES OF PATELLA AND PATELLAR TENDON INJURY

    Objective To investigate the treatment and effectiveness of inferior polar comminuted fractures of patella and patellar tendon injury. Methods Between January 2003 and December 2008, 5 patients with inferior polar comminuted fractures of patella and patellar tendon injury were treated with Nitinol Patellar Concentrator and fascia lata allograft. There were 3 males and 2 females with a mean age of 33.7 years (range, 20-48 years). The interval of injury and operation was 1-5 days. Fracture degree: 3 cases had 3 fractures of patella, 2 cases had 4 fractures; patellar tendon injury degree: 3cases had horizontal rupture of middle l igament, 1 case had obl ique rupture of tibial tubercle, and 1 case had longitudinal partial rupture. Results Heal ing of incision by first intention was achieved in all patients, and no compl ication of infection or deep venous thrombosis occurred. The X-ray films at 2 days after surgery showed that patella recovered to normal height, which meaned ratio of patella height to patellar tendon length recovered to 1 : 1. Five cases were followed up 18 months on average (range, 10-22 months). At 3-12 weeks after surgery, the knee function of the injury side almost reached that of the normal side in 4 patients, and the knee range of motion was about 100° in 1 patient. The fracture heal ing time was 3-5 months. At 12-15 months after surgery, patella holder was taken out and no lost of reduction or refracture occurred. During follow-up, there was no fracture displacement, loosening and breakage of implant, or rerupture of patellar tendon. According to ZHANG Chuncai’ s criterion for knee joint function, the results were excellent in 3 cases, good in 1 cases, and fair in 1 case with an excellent and good rate of 80%. According to XU Shaoting’s criterion for knee joint function, the results were excellent in 2 cases, good in 2 cases, and fair in 1 case with an excellent and good rate of 80%. Conclusion Nitinol Patellar Concentrator and fascia lata allograft is a new method to treat inferior polar comminuted fractures of patella and patellar tendon injury, and it can ensure the knee joint stabil ity in early motion after surgery.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • TREATMENT OF DISTAL COMMINUTED HUMERAL FRACTURE WITH SERIOUS OSTEOPOROSIS BY TOTAL ELBOW ARTHROPLASTY

    Objective To analyse short-term cl inical effect of total elbow arthroplasty in treatment of distal comminuted humeral fracture with serious osteoporosis in geratic patients. Methods From April 2006 to October 2007, five cases of distal comminuted humeral fractures were treated by total elbow arthroplasty with bone cement. Of them, there were 2 males and 3 females, aging 50-76 years old (mean 67.6 years old), including 4 cases of closed fracture and 1 case of open fracture (II type Gustilo-Anderson). All fractures were caused by tumbl ing. According to classification of AO, there were 2 cases of type C1, 2 cases of type C2 and 1 case of type C3. The Barnett index of osteoporosis was 0.40-0.45. The time from injury to operation was 4 to 18 days (mean 7.2 days). The rehabil itation exercise of function was done after 2 days of operation. Results The operative time was from 120 to 180 minutes (mean 150 minutes), the bleeding amount was from 150 to 250 mL (mean 200 mL). All incision achieved primary heal ing. No compl ication occurred. Five cases were followed up for 19 to 36 months (mean 24.5 months). The mean motion range of elbow joint include 141.6° for flection, 6.5° for extention, 10.2° for the degree of ectropion, 81.7° for revolve forward, and 73.8° for revolve behind respectively after 4 months of operation. The length discrepancy of upper l imb was less than 1.5 cm, the muscle force for flexion and extention of finger and wrist was normal. The X-ray films showed that the position of artificial joint was satisfactory without prosthesis dislocation or loosening. According to Mayo elbow performance score, the excellent and good rate was 80% (excellent in 1 case, good in 3 cases, and fair in 1 case). Conclusion Total elbow arthroplasty with bone cement is an effective method in treatment of distal comminuted humeral fracture with serious osteoporosis obviously in the geratic patients, but indication and technique of operation should be mastered strictly.

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 切开复位内固定治疗桡骨头粉碎性骨折

    目的 总结采用切开复位内固定治疗桡骨头粉碎性骨折的临床疗效。 方法 对2002 年1 月- 2006年6 月收治的15 例桡骨头粉碎性骨折采用切开复位内固定治疗。男11 例,女4 例;年龄21 ~ 45 岁。左侧10 例,右侧5 例。伤后至手术时间1 ~ 10 d,平均5.3 d。按照Mason 分型均为Ⅲ型。 结果 术后未见关节感染、神经损伤、金属异物反应、腕部畸形等并发症。术后患者均获随访,随访时间1 ~ 4 年,平均2.3 年。骨折均于术后6 个月内达骨性愈合。肘关节功能根据Broberg 和Morrey 评分标准进行评分,优5 例,良7 例,可2 例,差1 例,优良率为85.71%。 结论 切开复位内固定治疗桡骨头粉碎性骨折可获得良好的疗效。

    Release date:2016-09-01 09:19 Export PDF Favorites Scan
  • 上颌骨粉碎性骨折整复治疗的临床分析

    目的 探讨上颌骨粉碎性骨折的病因、并发症、检查方法及骨折整复的治疗时机、手术入路、整复材料和预后。方法 1998年5月~2005年12月,收治48例上颌骨粉碎性骨折患者。男40例,女8例;年龄16~50岁。车祸伤36 例,暴力伤 6 例,坠落伤6例。主要表现咬牙合关系障碍,张口受限,面中部凹陷畸形。20例采用钢丝内固定术,28 例采用钛板坚强内固定术 (rigid internal fixation, RIF)。结果 48例中Ⅰ类伤口31处、Ⅱ类伤口38处,术后均甲级愈合。48例患者均获随访1~3年。术前临床症状明显改善或消失。疗效评估:行钢丝固定患者满意8例,一般12例;行RIF患者满意24例,一般4例,两种方法比较差异有统计学意义(Plt;0.05)。结论 引起功能障碍和畸形的上颌骨粉碎性骨折均应行外科整复治疗, RIF为目前理想的固定技术之一。

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • 闭合复位带锁髓内钉固定治疗股骨干粉碎性骨折

    目的 评价应用闭合复位带锁髓内钉固定治疗股骨干粉碎性骨折的临床疗效。 方法 1999年8月~2005年4月,采用闭合复位顺行带锁髓内钉固定技术治疗股骨干粉碎性骨折70例。男54例,女16例;年龄17~58岁。骨折均位于股骨转子下2 cm至股骨髁上5 cm。按AO分型: B型17例,C型53例。受伤至手术时间为1~12 d,平均5.8 d。 结果 B型骨折患者手术时间为90~250 min,C型骨折患者60~180 min。70例失血量50~450 ml,平均230 ml。术中3例发生骨劈裂,1例C型骨折远端1枚锁钉锁入失误,7例肢体短缩1.0~1.5 cm。68例获随访10~60个月,平均19个月。63例于术后3~10个月骨折愈合,5例于术后3~4个月行远端锁钉取出动力化后4~10个月骨折愈合。60例髋、膝关节功能活动优良, 余8例髋或/和膝关节功能受限。 结论 闭合复位带锁髓内钉固定是治疗股骨干粉碎性骨折有效方法之一,具有损伤小、失血少、骨折愈合率高、功能恢复好的优点。

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • 自锁髓内钉在肱骨粉碎性骨折的应用

    Release date:2016-09-01 09:25 Export PDF Favorites Scan
  • TREATMENT OF COMMINUTED INFERIOR FEMORAL FRACTURES WITH COMBINATION OF SUPRACONDYLAR LOCKED INTRAMEDULLARY NAIL AND SHAPE MEMORY BLOCK HOOP INTERNAL FIXATOR UNDER ARTHROSCOPY

    Objective To investigate the advantages and the clinical outcomes of the treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. Methods From June 2002 to December 2004, 12 cases of comminuted inferior femoral fractures were treated(9 males, 3 females). Of them, 5 cases were classified as type B and 7 cases as type C according to AO classification . All cases were treated with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. In 12 cases of one-stage bone grafting, there 5 of autologous cancellous bone grafting and 7 allo-freeze drying bone grafting.Results With a follow-up of 6 to 18 months, all fractures healed within 3 to 6 months. There were no infection and nonunion. The function of all the knees joint was excellent. According to Noye’s criterion for knee scoring, the results were excellent in 9 cases and good in 3 cases; the excellent and good rate was 100%. Conclusion It is a good method to treat comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. It has many advantages of less injury to knee joint, good anatomic reduction and reliable fixation. 

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
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