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find Author "路来金" 28 results
  • 陈旧性月骨脱位的治疗

    月骨脱位在腕骨的骨折脱位中并不少见,只要仔细阅读x线片并结合受伤历史,诊断不困难。早期,常可用手法复位治疗。晚期多采用月骨摘除术治疗。对月骨摘除后遗留的间隙,若不充填,则可能出现头骨向近端移位,舟骨和三角骨向两侧移位,发生腕蹋陷。因此,有用假体、肌腱、豆状骨等替代的报道。作者采用切开复位,用有血供的桡骨片逆行移位植入月骨中,试图防止月骨的缺血坏死。若有月骨脱位切开复位,不植入有血供的骨瓣病例作对照,则作者提出的手术方法是必要的。

    Release date:2016-09-01 11:41 Export PDF Favorites Scan
  • “对《大鼠臂丛神经根吻合后脊髓病理改变和轴突再生的研究》一文的几点感想”作者回复

    Release date:2016-09-01 09:19 Export PDF Favorites Scan
  • DIAGNOSIS AND TREATMENT OF COMPLICATIONS ASSOCIATED WITH CLOSED MULTI FRACTURES IN METACARPALS

    Objective To pay attention to the diagnosis and treatment of the complications associated with closed multifractures in metacarpals. Methods From 1997 to 2000, out of 382 patients with closed multi-fractures in metacarpals, 12 had complications. In 7 cases of fractures at the second , third , fourth and fifth metacarpal shaft, complicated by acute compartment syndrome in hand, compartmental fascia were incised for decompress; open reduction and internal fixation were performed. In 4 cases of fractures at the metacarpal base, complicated by acute carpal tunnel syndrome, the fracture was reduced and fixed without transection of the transverse carpal ligament. In 1 case of fracture at metacarpalbase, complicated by direct contusion of the median nerve, the fracture was reduced without treatment of the median nerve. Results All patients were followed up for 3 months. Fracture healed 46 weeks postoperatively. No claw deformity anddysfunction of the median nerve occurred. The arc of motion of the proximal interphalangeal and distal interphalangeal joints were normal.Conclusion During fracture reduction, we should pay attention to the complications associated with closed multi-fractures at metacarpal to decrease hand malfunction.

    Release date:2016-09-01 09:35 Export PDF Favorites Scan
  • 鞘管内屈肌腱损伤的Ⅰ期修复

    Release date:2016-09-01 11:40 Export PDF Favorites Scan
  • 儿童豌豆骨发育畸形手术治疗一例

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  • LATERAL COLUMELLA BASE- LABRUM TRANSPOSITION FLAP FOR REPAIRING MILD UNILATERAL ECLABIUM DEFORMITY OF UPPER LIP

    Objective To study the feasibil ity of repairing the mild unilateral eclabium deformity of the upper l ip with the lateral columella base-labrum transposition flap. Methods From March 2006 to March 2008, 8 patients with mild unilateral eclabium of the upper l i p were repaired with the lateral columella base-labrum transposition flap. There were 4 males and 4 females, aging 18-51 years. There were 5 at left sides and 3 at right sides. All mild unilateral eclabium were attributed to the contracture of scar after trauma. The disease course was 1 to 5 years (average 2.5 years). The size ofthe transposition flaps ranged from 1.5 cm × 1.4 cm to 1.6 cm × 1.5 cm. Results All the flaps survived and incision healed by first intention. The eclabiun deformity was corrected. The postoperative follow-up period was 3-18 months with an average of 9.9 months. All the patients remained just soft l inear scars without hyperplasia. The nostril and columella hardly changed compared with the postoperative immediate view. Conclusion The mild unilateral eclabium deformity of upper l i p repairing with lateral columella base-labrum transposition flap is an easy, mininally invasive and nearly no secondary malformation method.

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • IDENTIFICATION OF PROPERTY OF NERVE FASCICLES BY PHYSICAL AND HISTOCHEMISTRY METHODS

    【Abstract】 Objective To explore a method to identify the sensory and motor fascicles in peri pheral nervetrunk. Methods Thirty Wistar rats were selected to obtain whole spine. The spinal gangl ion, its dorsal root and ventral root,and sciatic nerve were harvested, Annexin V and Agrin specificities were observed with Western blot. In the experimental group,anterior branch and posterior branch of spinal nerve, sciatic nerve, and its muscular branch and cutaneous branch were harvested from 15 rats to make the observation of immunohistochemistry. In the other 15 rats, first antibody was replaced by PBS as control group. Different nerve fascicles were studied with Micro Raman scattering technique in 16 12-month-old New Zealand rabbits. Results The Annexin V and Agrin were special substances of sensory and motor nerves respectively and can act as specific antigens for identifying different nerve fascicles. There were significant differences in the intensity and breadth of the peak of the spectral properties between motor and sensory fascicles at frequencies of 1 088, 1 276, 1 439, 1 579 and 1 659 cm-1 .The peak intensity ratios of 1 276 to 1 439 cm-1 were 0.95±0.06 in motor nerve fascicles and 1.17±0.08 in sensory fascicles, showing significant differences (P lt; 0.05). Conclusion The Micro Raman spectra is more effective than immunohistochemistry in identifying different nerve fascicles, and it possesses as feasibil ity for cl inical appl ication.

    Release date:2016-09-01 09:09 Export PDF Favorites Scan
  • SPINAL PATHOLOGIC CHANGES AND AXONAL REGENERATION AFTER BRACHIAL PLEXUS ROOT ANASTOMOSIS IN RATS

    Objective To evaluate the feasibil ity of direct anastomosis in the rat model of the brachial plexus extravertebral foramen nerve root division of C5-7. Methods Forty-eight SD rats (male or female) aging 4-6 months and weighing 250-300 g were selected to make the model of extravertebral foramen nerve root division of C5-7. The left C5-7 nerve roots, as the experimental sides, were separated to the brachial plexus nerve trunk and the transected roots were sutured to theproximal stump immediately after cutting off the brachial plexus extravertebral foramen nerve root division. The right C5-7nerve roots, as the control sides, received no operation. The general condition of rats after operation was observed. The gross observation, the histological observation and BDA nerve tracing technology were adopted to observe the wet weight of musculus biceps brachii, the cross section of biceps brachii and the spinal cord and distal nerve trunk at 3 weeks, 3 months and 6 months after operation. Results All rats survived well after operation. Claudication and unfold claw reflex were observed in the experimental sides, and the unfold claw reflex disappeared 3 months later. Comparatively, the control sides were normal. Nerve adhesion aggravated gradually and the neural stems were shriveled within 6 months after operation in the experimental sides. Comparatively, the control sides were normal. The wet weight of biceps brachii in the experimental sides and the control sides at 3 weeks, 3 months and 6 months after operation was (0.28 ± 0.12), (1.37 ± 0.33), (0.58 ± 0.10), (1.36 ± 0.35), (1.39 ± 0.31), (1.37 ± 0.38) g, respectively, indicating significant differences between two sides at 3 weeks and 3 months (P lt; 0.05), but no significant difference at 6 months (P gt; 0.05). The modified Marsland and the LFB staining of spinal cord and superior trunk of brachial plexus showed that the number of neurons, cell nuclear and Nissl body decreased and cell bodies changed from swell ing to shrinkage, dyeing nerve fibers increased, neural axone was thin and myel in sheath was sl ightly stained at each time point in experimental side. The number of motor neurons in cornu anterius medullae spinal is in the experimental side was 84.5% ± 3.2%, 74.4% ± 4.5%, 73.7% ± 3.8% of that in the control side at each time point, respectively. HE staining of biceps brachii detected thatthe muscle denaturation was very serious at 3 months after operation and then recovered. Neural tracing used BDA showed that the closer to the proximal of nerve trunk, the more obviously stained it was of myel in sheath and the more massive of axon at 6 months after operation. And there was almost no myel in and axon stained in musculocutaneous nerve. Conclusion In the rat model of brachial plexus extravertebral foramen nerve root division, the motoneuron in cornu anterius medullae spinal is necrosis rate reaches 20%-30%, and most of the residual neurons are pathologic. The regenerated fibers manifest as insufficient dynamic power and incomplete development, making no sense for the recovery of end organ function. Therefore, the exact mechanism of the recovery of biceps brachial muscle demands further study.

    Release date:2016-09-01 09:17 Export PDF Favorites Scan
  • 足跟慢性溃疡的修复

    目的 回顾分析外科治疗足跟慢性溃疡的临床资料、治疗方法及疗效。方法 1997年5月~2006年12月,收治足跟慢性溃疡患者23例。男20例,女3例;年龄18~79岁,平均45.6岁。病程1个月~7年。良性溃疡18例,恶性溃疡5例。溃疡创面2.5 cm×1.5 cm~10.5 cm×7.0 cm。患者予以局部扩创或溃疡扩大切除后,采用足底内侧皮瓣修复7例,带足背皮神经的足背皮瓣修复1例,小腿前外侧逆行岛状皮瓣修复4例,腓肠神经营养血管皮瓣修复11例,切取皮瓣4.0 cm×2.5 cm~18.0 cm×9.0 cm。供区游离植皮覆盖。结果 术后创面均Ⅰ期愈合。20例皮瓣完全成活,1例出现静脉危象,予以蒂部缝线拆除后成活;2例皮瓣远端部分坏死,经换药后愈合。供区植皮均成活,切口Ⅰ期愈合。21例获随访3个月~2年,平均11个月。皮瓣质地及外观良好,足底内侧皮瓣及足背皮瓣感觉恢复良好,小腿前外侧逆行岛状皮瓣及腓肠神经营养血管皮瓣痛温觉部分恢复。患足可正常负重,足跟溃疡未见复发。结论 足跟慢性溃疡以预防为主,创面应早期手术行皮瓣修复,以防止溃疡复发。

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • 足部逆行岛状皮瓣修复前足及足趾软组织缺损

    Release date:2016-09-01 09:24 Export PDF Favorites Scan
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