目的:探讨锁骨中段骨折最适内固定方式。方法:总结1990年1月～2007年6月426例锁骨中段骨折采用钢丝、克氏针、钢板内固定治疗，术后随访6个月～12个月，对不同内固定疗效进行评估。结果:钢丝固定53例，固定失败18例，优良率66.04%；克氏针固定97例，固定失败12例，优良率87.63%；钢板固定276例，固定失败19例，优良率93.12%。结论:钢丝固定锁骨中段骨折不确切，克氏针固定适应症窄，钢板内固定可靠，对抗上肢旋转剪力、内外张力，有利于骨折愈合和锁骨功能的早期建立。在应用的四种类型钢板中:解剖钢板、重建钢板术后并发症少，是治疗锁骨中段骨折较为理想的内固定方式。
目的 探讨外伤闭合性脾破裂行脾保留手术的术式及疗效。方法 回顾性分析我院2001年6月至2012年5月期间对外伤闭合性脾破裂行脾保留手术的32例患者的临床资料。结果 32例外伤闭合性脾破裂患者中行单纯黏合剂止血6例（Ⅰ级），单纯缝合修补6例（Ⅰ级），缝合修补加黏合剂止血13例（Ⅰ/Ⅱ级），脾部分切除手术4例（Ⅱ/Ⅲ级），脾动脉结扎加脾修补术3例（Ⅱ/Ⅲ级）。32例行脾保留手术患者中除1例因手术后再出血行脾切除获治愈外，其余31例均获保脾成功，术后3～6个月行B超和CT检查示脾脏生长良好，IgM、C3、C4等免疫功能指标均在正常范围。结论 对Ⅰ～Ⅲ级外伤闭合性脾破裂行脾保留手术安全、可行，疗效好，对保留和恢复脾脏功能有重要意义。
Objective To review the basical research progress of porous tantalum in bone tissue engineering. Methods The related basical research in fabrication, cytobiology, and surface modification of porous tantalum was reviewed and analyzed. Results The outstanding physiochemical properties of porous tantalum granted its excellent performance in biocompatibility and osteointegration, as well as promoting cartilage and tendon tissue restoration. However, the clinical utilization of porous tantalum is somehow greatly limited by the complex and rigid commercial fabrication methods and extraordinary high cost. Along with the publication of novel fabrication and surface modification technology, the application of porous tantalum will be more extensive, the promotion in bone tissue regeneration will be more prominent. Conclusion Porous tantalum has advantage in bone defect restoration, and significant breakthrough technology is needed in fabrication methods and surface modification.
ObjectiveTo evaluate the effectiveness of a new type of sutured titanium wire combined with titanium nail internal fixation in correction of serious old medial canthus deformity.MethodsBetween March 2012 and June 2015, 18 patients with unilateral serious old medial canthus deformity were treated. There were 14 males and 4 females. The patient’s age ranged from 23 to 62 years (mean, 42 years). The causes of deformity included accident injury in 10 cases, boxing injury in 4 cases, sharp device scratching in 3 cases, and animal bite in 1 case. All patients had been treated with suture or steel wire fixation in other hospitals to correct the medial canthus deformity and the deformity recurred. The interval between this operation and the first operation was 6 months to 2 years (mean, 16 months). The nasal root or medial canthus skin scar incision was used as the operative approach, and the adhesion of the medial canthus ligament to the adjacent tissues was fully loosened, then the tail end of the new type sutured titanium wire was fixed to the residual end of the medial canthus ligament. After passing through the scar tissue, the needle end of wire was fixed on the titanium nail in the bone wall of anterior lacrimal crest. The position and shape of the medial canthus angle was determined by adjusting the tightness of titanium wire.ResultsAll incisions healed by first intention. All patients were followed up 6-12 months (mean, 10 months). In 16 cases, the medial canthus deformity was obviously corrected, and the appearances of bilateral eyes were basically symmetrical, without exposure of titanium nail and titanium wire. The medial canthus was retreated at 2 mm after 6 months in 2 cases, who were satisfied with their appearance without reoperation.ConclusionApplication of the new type of suture titanium wire combined with titanium nail in the correction of serious old medial canthus deformity can achieve good effectiveness with the low recurrence rate.
ObjectiveTo summarize the relationship between shoulder instability and superior labrum anterior posterior (SLAP) lesion. MethodsThe characteristics of shoulder instability and SLAP lesion were analyzed, and the relationship between them in pathogenesis, clinical symptoms, and biomechanics was discussed by referring to relevant domestic and foreign literature. ResultsShoulder instability and SLAP lesion can occur both spontaneously and respectively. SLAP lesion destroys the superior labrum integrity and the long head of biceps tendon (LHBT) insertion, causing excessive humeral head displacement against glenoid, and leading to shoulder instability. While chronic repetitive or acute high-energy traumatic shoulder instability can in turn aggravate SLAP lesion, resulting in expansion and increased degree of the original lesion. Conclusion SLAP lesion destroys mechanisms of shoulder stability, while shoulder instability causes tears of the upper labrum and the LHBT, showing a connection between shoulder instability and SLAP lesion. However, the existing evidence can only demonstrate that shoulder instability and SLAP lesion induce and promote the development of each other, instead of a necessary and sufficient condition. Therefore, the specific causal relationship between the two remains unknown and needs to be further studied.
ObjectiveTo explore the application value of MRS combined with VEEG on the surgical treatment of temporal lobe epilepsy. MethodsThere were 31 males and 20 females, age between 4 and 62 years.Their illness duration ranged from 4 to 10 years.The clinical manifestations showed complex partial seizure in 10 cases, secondary generalized seizure in 12 and generalized tonic-clonic seizure in 29. Based on their results of clinical manifestations, MRS and VEEG results, all the patients underwent anterior temporal lobectomy(including the most parts of the hippocampus and amydala). ResultsThe follow-up of 1~3 years after the operation showed seizure free in 36 cases(Engle Ⅰ), and significant improvement in 11(Engle Ⅱ), no improvement in 4 cases(Engle Ⅳ). The overall effective rate was 92.16%. ConclusionsMRS combined with VEEG has significant localization value for temporal lobe epilepsy. The prognosis of postoperative result is quiet good to the patient of typical temporal lobe epilepsy after anterior temporal lobectomy.