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尺骨茎突骨折愈合对桡骨远端骨折术后关节功能影响 预览
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作者 牛学刚 许良 《中华关节外科杂志(电子版)》 CAS CSCD 2019年第1期114-117,共4页
目的观察尺骨茎突骨折愈合情况短期内对桡骨远端骨折内固定术后腕关节功能的影响。方法回顾性分析2012年6月至2013年6月于聊城市中医医院收治的136例单侧不稳定的桡骨远端骨折伴尺骨茎突骨折患者的临床资料,所有患者均采用锁定钢板固定... 目的观察尺骨茎突骨折愈合情况短期内对桡骨远端骨折内固定术后腕关节功能的影响。方法回顾性分析2012年6月至2013年6月于聊城市中医医院收治的136例单侧不稳定的桡骨远端骨折伴尺骨茎突骨折患者的临床资料,所有患者均采用锁定钢板固定桡骨骨折,根据尺骨茎突骨折愈合情况将患者分为尺骨茎突骨折愈合组(愈合组,n=43)和尺骨茎突骨折未愈合组(未愈合组,n=93)。根据术后X线正侧位片测量并记录患者桡骨高度(桡骨茎突与尺骨茎突之差)、掌倾角、尺偏角,评价桡骨骨折复位、愈合情况和尺骨茎突愈合情况,记录腕关节尺侧旋转疼痛的患者数量。末次随访时采用Gartlant-Werley评分和臂肩手功能障碍评分(DASH)评分评估腕关节功能,测定并记录腕关节的活动范围及握力。性别、骨折类型等计数资料比较采用卡方检验,时间、DASH评分等计量资料比较采用t检验。结果两组患者在年龄、性别、受伤至手术时间、骨折内固定研究学会(AO)骨折分型、受伤侧别和致伤原因方面比较差异无统计学意义(P> 0. 05)。尺骨茎突骨折愈合组尺侧旋转疼痛有18例(41. 9%),而未愈合组有40例(43. 0%),差异无统计学意义(χ~2=1. 021,P> 0. 05)。两组患者的住院时间、桡骨骨折愈合时间、掌倾角、尺偏角和桡骨高度方面比较,差异无统计学意义(P>0. 05),具有可比性。两组患者背伸、掌曲、桡偏、尺偏、握力和DASH评分、Gartlant-Werley评分和优良率方面比较差异无统计学意义(P> 0. 05)。结论尺骨茎突骨折愈合情况在短期内对桡骨远端骨折内固定术后腕关节功能的康复无明显影响。 展开更多
关键词 尺骨 骨折 骨折 软骨 桡骨骨折 骨折固定 腕关节
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Clinical outcome after orbital floor fracture reduction with special regard to patient's satisfaction
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作者 Stefan Hartwig Marie-Christine Nissen +4 位作者 Jan Oliver Voss Christian Doll Nicolai Adolphs Max Heiland Jan Dirk Raguse 《中华创伤杂志:英文版》 CAS CSCD 2019年第3期155-160,共6页
Purpose: Primary reconstruction via transconjunctival approach is a standardized treatment option for orbital floor fractures. The aim of this study was to compare the findings of specific ophthalmologic assessment wi... Purpose: Primary reconstruction via transconjunctival approach is a standardized treatment option for orbital floor fractures. The aim of this study was to compare the findings of specific ophthalmologic assessment with the patient's complaints after fracture reduction. Methods: A retrospective medical chart analysis was performed on patients who had undergone transconjunctival orbital floor fracture reduction for fracture therapy with resorbable foil (ethisorb sheet or polydioxanone foil). A follow-up assessment including ophthalmological evaluation regarding visual acuity (eye chart projector), binocular visual field screening (Bagolini striated glasses test) and diplopia (cover test, Hess screen test) was conducted. Additionally, a questionnaire was performed to assess patients' satisfaction. Results: A total of 53 patients with a mean follow-up of 23 months (ranging from 11 to 72) after surgical therapy were included. Diplopia was present preoperatively in 23 (43.4%) and reduced in follow-up examination (n = 12, 22.6%). Limitations in ocular motility reduced from 37.7% to 7.5%. The questionnaire about the patient's satisfaction revealed excellent outcomes in relation to the functional and esthetical parameters. Conclusion: Transconjunctival approach is a safe approach for orbital fracture therapy. Postoperative diplopia is nearly never perceptible for the individual and differs to pathologic findings in the ophthalmic assessment. 展开更多
关键词 ORBITAL FLOOR FRACTURES BLOW out FRACTURES Transconjunctival approach Clinical OUTCOME
Extra-articular distal tibial fractures, is interlocking nailing an option? A prospective study of 147 cases
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作者 PNVSV Prasad Amit Nemade +1 位作者 Rashid Anjum Nilesh Joshi 《中华创伤杂志:英文版》 CAS CSCD 2019年第2期103-107,共5页
Purpose:Distal tibia fractures comprise about 7%-10% of lower extremity trauma.Because of the peculiarity of the soft tissue and subcutaneous location of the bone there are many controversies in the ideal treatment of... Purpose:Distal tibia fractures comprise about 7%-10% of lower extremity trauma.Because of the peculiarity of the soft tissue and subcutaneous location of the bone there are many controversies in the ideal treatment of distal tibia fractures especially extra articular pilon fractures.Plating is fraught with complications of wound dehiscence and infection.There are limited studies which document outcomes in such cases using intramedullary interlocking nail.We intend to study the outcome and complications of extra articular distal tibial fractures treated with interlocking nailing.Methods:This is a prospective study conducted in a tertiary care orthopaedic hospital in southern India.There are 147 patients of distal tibia extra-articular fractures managed by IM nailing with follow up of more than one year were included in this study.Only cases with fresh injury (less than 1 week),fracture below the isthmus,closed and open Gustilo Anderson type 1 and 2 fractures were included in the study.Patients were reviewed at 3,6,12 and 24 weeks after surgery and thereafter at one year and were assessed for clinical and radiological signs of healing,any complications,time to union and functional outcome.Results:There were 102 males and 45 females (male/female ratio is 2.3∶1) with a mean age of 38.96 (range 23-65) years.According to AO classification,there were 78 cases (53.06%) of 43-A1,39 cases (26.53%) of 43-A2 and 30 cases of 43-A3 constituting 20.40%.The fracture united in all the patients at an average of 18 weeks (range 16-22 weeks),none of the patient in our series had a delayed or non-union.Two patients (1.47%) had the fracture united in mild valgus but it was well within the acceptable limits (<5°).The functional outcome was assessed in all the patients at final follow up using Olerud and Molander score all the patients fared an excellent to good score,there were no cases with poor score.Conclusion:Intramedullary nailing is a viable option to treat distal tibial fractures with excellent outcome.Wound complications rel 展开更多
关键词 DISTAL TIBIA FRACTURES Extra-articular Pilon FRACTURES Interlocked NAILING
Lauge-Hansen旋后-内收型Ⅱ度踝关节骨折的CT影像解剖学特点及手术治疗 被引量:1
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作者 鹿亮 刘彬 +7 位作者 张雨 尚希福 洪浩 曾建学 董凯旋 陈伟健 李多玉 俞光荣 《中华解剖与临床杂志》 2019年第2期106-111,共6页
目的总结Lauge-Hansen旋后-内收型Ⅱ度踝关节骨折的CT影像解剖学特点,为临床手术治疗方法的选择提供参考。方法回顾性分析中国科技大学附属第一医院(安徽省立医院)骨科2014年6月—2017年12月收治的36例Lauge-Hansen旋后-内收型Ⅱ度踝关... 目的总结Lauge-Hansen旋后-内收型Ⅱ度踝关节骨折的CT影像解剖学特点,为临床手术治疗方法的选择提供参考。方法回顾性分析中国科技大学附属第一医院(安徽省立医院)骨科2014年6月—2017年12月收治的36例Lauge-Hansen旋后-内收型Ⅱ度踝关节骨折患者的临床资料,其中男24例、女12例,年龄19~56岁;左踝21例,右踝15例。所有患者行切开复位支撑钢板内固定术,8例合并骨缺损者予一期植骨。应用人体三维可视化手术规划与仿真系统软件(V1.0.0)对患者术前骨折CT影像学资料进行处理,测量以下指标:内踝骨折面与胫骨纵轴的夹角(α)、胫骨远端关节面塌陷的最大深度(d)、塌陷面积(S)、塌陷体积(V)和腓骨骨折线与胫骨远端关节面穹隆顶点的距离(L),分析d、V与α的相关性,总结Lauge-Hansen旋后-内收型踝关节骨折的影像解剖学特征。采用美国骨科足踝协会(AOFAS)踝关节-后足评分标准和术后疼痛视觉模拟评分(VAS)评价治疗效果。结果术前CT影像测量结果显示,本组36例患者α为4.5°~15.5°(9.85°±4.05°),其中20例胫骨远端关节面塌陷患者α为5.04°±1.49°,明显小于16例未塌陷患者α(12.83°±2.87°),两组差异有统计学意义(t=-9.847, P<0.05);20例胫骨远端关节面塌陷患者d、S、V分别为(8.86±3.69)mm,(47.69±13.95)mm^2和(680±620)mm^3,关节面塌陷集中在前内侧,且d、V与α角无明显相关性(rs=0.309、0.389, P值均>0.05)。36例患者腓骨骨折线主要发生在胫骨穹隆最高点以上,L为1.27~12.55(5.50±5.54)mm。所有术后随访时间10(6~15)个月,骨折均解剖复位并完全愈合,愈合时间10.5(9~16)周,术后AOFAS评分和VAS分别为(85±8)分和(2.1±0.9)分。结论Lauge-Hansen旋后-内收型Ⅱ度踝关节骨折患者的内踝骨折线与胫骨的夹角较小,骨折线与胫骨纵轴越接近平行,提示合并胫骨远端内侧关节面塌陷的可能性越大;该型骨折剪切力较大,手术治疗以切开复位支� 展开更多
关键词 踝关节 骨折 骨折固定术 旋后内收型踝关节骨折 放射解剖学
Sanders Ⅳ型复杂跟骨关节内骨折经单轴与多轴锁定钢板治疗疗效对比
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作者 闫玉 刘兴国 +1 位作者 杨益宏 杨文斌 《中国医师进修杂志》 2019年第2期105-108,共4页
目的对比Sanders Ⅳ型复杂跟骨关节内骨折经单轴与多轴锁定钢板治疗的临床疗效。方法对2012年1月至2016年12月收治的Sanders Ⅳ型复杂跟骨关节内骨折72例患者资料做回顾性分析,其中A组采用单轴锁定钢板治疗(38例),B组采用多轴锁定钢板治... 目的对比Sanders Ⅳ型复杂跟骨关节内骨折经单轴与多轴锁定钢板治疗的临床疗效。方法对2012年1月至2016年12月收治的Sanders Ⅳ型复杂跟骨关节内骨折72例患者资料做回顾性分析,其中A组采用单轴锁定钢板治疗(38例),B组采用多轴锁定钢板治疗(34例),对比两组患者手术情况、骨折愈合情况及影像学资料,以Maryland足部评分对临床疗效进行评估。结果A、B组手术时间比较均差异无统计学意义(P>0.05)。A组术后随访(23.2±5.4)个月,B组术后随访(22.5±4.9)个月,两组患者均骨性愈合。B组术后3、12个月Bohler角[(31.6±4.5)°比(27.6±6.1)°、(30.7±4.2)°比(27.0±5.4)°]和Gissane角[(109.2±10.8)°比(96.8±9.5)°、(107.3±10.1)°比(95.4±10.2)°]均较A组增高,均差异有统计学意义(P<0.05)。末次随访时B组Maryland足部评分优良率为91.2%(31/34),与A组的84.2%(32/38)比较差异无统计学意义(P>0.05)。结论Sanders Ⅳ型复杂跟骨关节内骨折经单轴或多轴锁定钢板治疗均可获得较好骨折愈合,而多轴锁定钢板在维持跟骨关节内骨折复位方面更有优势且更有利于足部功能恢复。 展开更多
关键词 跟骨 骨折 锁定钢板 骨折固定术
不同黏度骨水泥用于严重骨质疏松性椎体压缩性骨折的效果比较
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作者 郭宇宁 贾本让 张钦 《中国基层医药》 CAS 2019年第13期1561-1565,共5页
目的探讨经皮椎体成形术(PVP)术中低黏度与高黏度骨水泥对严重骨质疏松性椎体压缩性骨折(OVCF)患者活动功能、解剖学指标及渗漏率的影响。方法选取运城市中心医院2015年10月至2017年6月收治的OVCF患者136例为研究对象,采用随机数字表法... 目的探讨经皮椎体成形术(PVP)术中低黏度与高黏度骨水泥对严重骨质疏松性椎体压缩性骨折(OVCF)患者活动功能、解剖学指标及渗漏率的影响。方法选取运城市中心医院2015年10月至2017年6月收治的OVCF患者136例为研究对象,采用随机数字表法分为对照组(68例)和观察组(68例),分别在PVP术中采用低黏度和高黏度骨水泥辅助治疗;比较两组患者手术前后视觉模拟评分(VAS评分)、Oswestry功能障碍指数问卷表(ODI)评分、健康状况调查简表(SF-36)评分、后凸Cobb角、伤椎高度恢复率、骨水泥注入量及术后骨水泥渗漏率。结果术前,两组VAS评分、ODI评分、SF-36评分、后凸Cobb角均差异无统计学意义(均P >0.05)。术后12个月,对照组VAS评分、ODI评分、SF-36评分分别为(1.90±0.32)分、(30.38±3.52)分、(76.07 ±9.38)分,观察组分别为(1.94 ±0.34)分、(29.72 ±3.34)分、(77.10 ±9.60)分,两组均显著优于术前(对照组:t =4.27、5.01.4.02,观察组:t=4.21、4.89、3.87,均P < 0.05),但两组间均差异无统计学意义(均P>0.05);观察组术后12个月后凸Cobb角为(14.02 ±2.59)°,显著低于术前的(27.78 ±4.09)。和对照组术后的(16.83 ±3.31)。(t=4.99、2.64,均P <0.05);观察组伤椎高度恢复率为(28.34 ±5.70)%,显著高于对照组的(22.72 ±4.16)%(t = 3.42,P<0.05);两组患者骨水泥注入量差异无统计学意义(P >0.05);观察组术后骨水泥渗漏发生率为10.29%(7/68),显著低于对照组的30.88%(21/68)(x^2 = 12.15,P<0.05)。结论PVP术中低黏度和高黏度骨水泥用于严重OVCF患者在缓解疼痛、提高活动功能和生活质量方面效果接近,但高黏度骨水泥有助于改善伤椎解剖学指标,降低术后骨水泥渗漏发生率。 展开更多
关键词 骨折 压缩性 骨质疏松性骨折 椎体成形术 骨水泥成形术 黏度 日常生活活动 解剖学 局部 临床对照试验
经皮椎体成形术与保守治疗联合康复治疗对骨质疏松性椎体压缩骨折患者临床价值研究
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作者 丁磊 卢士学 +2 位作者 张军 沙玉山 李俊 《中国骨与关节杂志》 CAS 2019年第6期470-475,共6页
目的探讨经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床价值。方法回顾性分析2016年1月至2017年1月,于我院接受治疗的90例OVCF患者的临床... 目的探讨经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床价值。方法回顾性分析2016年1月至2017年1月,于我院接受治疗的90例OVCF患者的临床资料,其中45例行PVP治疗(PVP组),45例行保守治疗联合康复治疗(对照组),记录PVP组手术情况及两组随访期间并发症发生情况;比较两组随访不同时间点的疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)评分及QUALEFFO-41评分;通过影像学比较两组Cobb’s角及椎体高度恢复情况。结果本组90例均获随访,随访时间12~16个月,平均(13.26±3.67)个月。PVP组术后1天(4.83±2.35 vs. 7.22±3.41)、1周(4.36±2.14 vs. 6.74±2.64)、1个月(3.86±1.34 vs. 6.14±2.64)、3个月(3.62±1.42 vs. 4.48±2.04)、6个月(3.72±1.53 vs. 4.31±1.24) VAS评分均低于对照组,差异有统计学意义(P<0.05)。PVP组术后1周(64.88±8.66 vs. 75.68±8.68)、1个月(45.76±8.24 vs. 73.44±8.17)、3个月(41.22±6.42 vs. 69.15±8.28)、6个月(40.65±7.63 vs. 61.28±7.94)、1年(31.52±8.22 vs. 42.68±9.42)的ODI评分均低于对照组,差异有统计学意义(P<0.05)。PVP组患者术后1个月[(11.24±4.39)°vs.(15.23±5.25)°]、6个月[(10.46±3.98)°vs.(15.41±4.71)°]的Cobb’s角低于对照组,差异有统计学意义(P<0.05)。PVP组患者术后1个月(85.29±9.67 vs. 67.67±7.68)、6个月(84.36±8.67 vs. 66.81±6.31)的伤椎椎体前缘高度比低于对照组,差异有统计学意义(P<0.05)。PVP组患者QUALEFFO-41评分(41.23±6.85 vs. 52.48±7.24)低于对照组,差异有统计学意义(P<0.05)。结论 PVP治疗OVCF患者疗效显著,早期降低疼痛程度,改善下肢功能,恢复椎体高度,值得临床推广。 展开更多
关键词 椎体成形术 骨折 压缩性 骨质疏松性骨折 疼痛
腰椎骨折的X线片与磁共振成像对照分析 预览
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作者 沈红梅 景国芳 《实用医技杂志》 2019年第6期683-685,共3页
目的探讨腰椎骨折的X线片表现,以磁共振成像(MRI)扫描为对照,比较两者异同,提高X线片对诊断腰椎骨折的认识和能力。方法收集32例外伤后先作腰椎X线片检查,而后在2周内又行MRI的腰椎骨折病例,对照MRI所见,分析其骨折的X线片表现和特点以... 目的探讨腰椎骨折的X线片表现,以磁共振成像(MRI)扫描为对照,比较两者异同,提高X线片对诊断腰椎骨折的认识和能力。方法收集32例外伤后先作腰椎X线片检查,而后在2周内又行MRI的腰椎骨折病例,对照MRI所见,分析其骨折的X线片表现和特点以及X线片诊断腰椎骨折的优点及不足之处。结果 32例腰椎骨折中,X线片诊断屈曲压缩型27例,爆裂型骨折5例;主要表现为椎体一侧高度减低或椎体变扁以及骨折线,骨折线表现为骨皮质中断、双边征或椎体致密带;有5例X线片诊断屈曲压缩型骨折经磁共振检查后,重新诊断为爆裂型骨折,有4例X线片诊断骨折但经磁共振扫描后诊断为陈旧骨折。结论根据椎体形态改变及骨折线等X线片能较好地诊断腰椎骨折,但在骨折的分型、新旧识别以及骨折对脊髓损伤的评估上X线片有一定的局限。 展开更多
关键词 骨折 压缩性 眶骨折 体层摄影术 X线计算机
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Ipsilateral proximal and distal radius fractures with unstable elbow joint: Which should we address first?
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作者 Nur Azuatul Akma Kamaludin Nur Azree Ferdaus Kamudin +1 位作者 Shalimar Abdullah Jamari Sapuan 《中华创伤杂志:英文版》 CAS CSCD 2019年第1期59-62,共4页
Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture... Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Clinically her right elbow was posteriorly dislocated and right wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of radius and a comminution radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) showed no significant ligament injuries. We addressed her distal radius first with an an atomical lock ing plate followed by her radial head with a radial head replacement. Our rationale to treat the distal end radius: first was to obtain a correct alignment of Lister's tubercle and correct the distal radius height. Lister's tubercle was used to guide for the correct rotation of the radial head prosthesis. Correcting the distal end fracture radial height helped us with length selection of the radial head prosthesis and address the proximally migrated radial shaft and neck. Postoperative radiographs showed an acceptable reduction. The Cooney score was 75 at 3 months postoperatively, which was equivalent to a fair functional outcome. 展开更多
关键词 Simultaneous IPSILATERAL FRACTURES Radius FRACTURES IRREDUCIBLE elbow dislocation RADIAL HEAD RADIAL HEAD ARTHROPLASTY
G型臂X线机在椎体后凸成形术治疗骨质疏松性椎体压缩骨折中的应用分析 预览
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作者 张杰 王飞 李长红 《临床误诊误治》 2019年第4期55-59,共5页
目的分析G型臂X线机在椎体后凸成形术(percutaneous kyphoplasty, PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture, OVCF)中的应用效果。方法选取延安大学附属医院骨科2016年3月-2017年9月采用PKP治疗OVC... 目的分析G型臂X线机在椎体后凸成形术(percutaneous kyphoplasty, PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture, OVCF)中的应用效果。方法选取延安大学附属医院骨科2016年3月-2017年9月采用PKP治疗OVCF患者154例(182椎体),根据术中引导、监测方法的不同分为G臂组75例(90椎体)和C臂组79例(92椎体),G臂组采用G型臂X线机辅助PKP治疗OVCF,C臂组采用C型臂X线机辅助PKP治疗OVCF。比较两组患者手术时间、术中X线透视次数、骨水泥漏发生情况,术前、术后及末次随访时伤椎前缘高度、伤椎后凸Cobb角、疼痛视觉模拟评分(visual analogue scale, VAS)、Oswestry功能障碍指数(Oswestry dability index, ODI)评分。结果两组手术均顺利完成,术中均未发生神经、血管损伤等并发症。G臂组手术时间短于C臂组,术中X线透视次数少于C臂组,差异均有统计学意义(P<0.01);两组骨水泥漏发生率比较差异无统计学意义(P>0.05)。两组术后及末次随访时伤椎前缘高度、伤椎后凸Cobb角、VAS评分、ODI评分均较术前显著改善,差异均有统计学意义(P<0.01);但两组术后、末次随访时上述指标比较差异均无统计学意义(P>0.05)。结论 G型臂X线机辅助PKP治疗OVCF安全可行,与常规C型臂X线机辅助治疗相比,还可有效地缩短手术时间、减少术中X线透视次数。 展开更多
关键词 骨折 压缩性 骨质疏松性骨折 G型臂X线机 C型臂X线机
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桃红四物汤辅助经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折效果观察 预览
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作者 彭昌华 涂扬茂 《解放军医药杂志》 CAS 2019年第1期92-95,共4页
目的研究桃红四物汤辅助经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折的临床效果。方法选取2015年6月—2017年7月收治的60例老年骨质疏松性胸腰椎压缩骨折患者,按照治疗方式的不同分为研究组与对照组,每组30例。对照组给予经皮... 目的研究桃红四物汤辅助经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折的临床效果。方法选取2015年6月—2017年7月收治的60例老年骨质疏松性胸腰椎压缩骨折患者,按照治疗方式的不同分为研究组与对照组,每组30例。对照组给予经皮椎体后凸成形术,研究组在对照组基础上联合桃红四物汤。比较2组的临床疗效,以及2组治疗前后骨折愈合情况、疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评分,同时观察并发症及不良反应发生情况。结果治疗后2个月,2组椎体矢状面Cobb角和椎体楔变角均低于治疗前,且研究组低于对照组(P<0.05)。治疗后2个月,2组椎体前缘高度高于治疗前,且研究组高于对照组(P<0.05)。治疗后1、3、6个月,2组VAS及ODI评分均低于治疗前,研究组低于对照组(P<0.05)。研究组总有效率高于对照组,并发症及不良反应总发生率低于对照组(P<0.01)。结论桃红四物汤辅助经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折可以获得良好的临床效果,能减轻疼痛,改善日常活动能力,且安全性较高。 展开更多
关键词 桃红四物汤 椎体后凸成形术 骨质疏松 骨折 压缩性 脊柱骨折
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Analysis of early treatment of multiple injuries combined with severe pelvic fracture
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作者 Guang-Bin Huang Ping Hu +1 位作者 Jin-Mou Gao Xi Lin 《中华创伤杂志:英文版》 CAS CSCD 2019年第3期129-133,共5页
Purpose: To summarize and analyze the early treatment of multiple injuries combined with severe pelvic fractures, especially focus on the hemostasis methods for severe pelvic fractures, so as to improve the successful... Purpose: To summarize and analyze the early treatment of multiple injuries combined with severe pelvic fractures, especially focus on the hemostasis methods for severe pelvic fractures, so as to improve the successful rate of rescue for the fatal hemorrhagic shock caused by pelvic fractures. Methods: A retrospective analysis was conducted in 68 cases of multiple trauma combined with severe pelvic fractures in recent 10 years (from Jan. 2006 to Dec. 2015). There were 57 males and 11 females. Their age ranged from 19 to 75 years, averaging 42 years. Causes of injury included traffic accidents in 34 cases (2 cases of truck rolling), high falling injuries in 17 cases, crashing injuries in 15 cases, steel cable wound in 1 case, and seat belt traction injury in 1 case. There were 31 cases of head injury, 11 cases of chest injury, 56 cases of abdominal and pelvic injuries, and 37 cases of spinal and limb injuries. Therapeutic methods included early anti-shock measures, surgical hemostasis based on internal iliac artery devasculization for pelvic hemorrhage, and early treatment for combined organ damage and complications included embolization and repair of the liver, spleen and kidney, splenectomy, nephrectomy, intestinal resection, colostomy, bladder ostomy, and urethral repair, etc. Patients in this series received blood transfusion volume of 1200e10,000 mL, with an average volume of 2850 mL. Postoperative followup ranged from 6 months to 1.5 years. Results: The average score of ISS in this series was 38.6 points. 49 cases were successfully treated and the total survival rate was 72.1%. Totally 19 patients died (average ISS score 42.4), including 6 cases of hemorrhagic shock, 8 cases of brain injury, 1 case of cardiac injury, 2 cases of pulmonary infection, 1 case of pulmonary embolism, and 1 case of multiple organ failure. Postoperative complications included 1 case of urethral stricture (after secondary repair), 1 case of sexual dysfunction (combined with urethral rupture), 1 case of lower limb amputation (femoral ar 展开更多
关键词 Multiple TRAUMA PELVIC FRACTURES Internal ILIAC artery Consumptive COAGULOPATHY HEMOSTASIS
Epidemiology of pelvic fractures in adults: Our experience at a tertiary hospital
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作者 Subhajit Ghosh Sameer Aggarwal +2 位作者 Vishal Kumar Sandeep Patel Prasoon Kumar 《中华创伤杂志:英文版》 CAS CSCD 2019年第3期138-141,共4页
Purpose: Pelvic fractures are severe injuries and are often associated with multiple system injuries, exacerbating the overall outcome. In India, the incidence of pelvic fractures is on a rise due to suboptimal roads ... Purpose: Pelvic fractures are severe injuries and are often associated with multiple system injuries, exacerbating the overall outcome. In India, the incidence of pelvic fractures is on a rise due to suboptimal roads and traffics but related literature regarding the overall epidemiology of these injuries is scarce and scanty. Our aim was to study the epidemiology of patients admitted with pelvic fractures at a level 1 trauma centre in India. Methods: A 16-month (between September 2015 and December 2016) prospective observational study was carried out on trauma patients with pelvic fractures at a level 1 trauma centre of a tertiary care hospital. Demography of patients, mechanism of injuries and complications were recorded prospectively. Results: We observed 75 patients who presented with pelvic fractures, where 56 were males and 19 were females. Mean age of the study populationwas 37.57 years. Road traffic accidents were the most common mode of injuries. Lateral compression injuries were the most common pattern. Associated injuries frequently encountered were lower extremities and acetabulum fractures, blunt abdominal trauma, urogenital injuries and head injuries. Out of the 75 patients, 52 were treated surgically and 23 were managed by conservative methods. Associated injuries of the extremities, head, abdomen and urogenital system indicated a longer hospital stay. Conclusion: Pelvic fractures, although belong to a relatively rare trauma subset, cause a high morbidity and mortality with considerable burden on the economy. Proper road safety training and driving etiquettes along with its strict implementation in true sense and spirit are the need of the hour. 展开更多
关键词 PELVIC FRACTURES EPIDEMIOLOGY INCIDENCE
Brown tumor of the femur and ulna in a woman with hyperparathyroidism 预览
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作者 Lu Jiang Yi Huang Yazhou Han 《肿瘤学与转化医学:英文版》 2019年第2期98-101,共4页
Objective A typical brown tumor caused by hyperparathyroidism(HPT) is rare. In this report, we describe our pathological findings along with a review of the literature to enhance understanding of the disease and preve... Objective A typical brown tumor caused by hyperparathyroidism(HPT) is rare. In this report, we describe our pathological findings along with a review of the literature to enhance understanding of the disease and prevent misdiagnosis, as well as to provide evidence for treatment and prognosis.Methods We present a case of brown tumor of the left proximal femur and pelvis in a 57-year-old woman who was admitted to our hospital(Dalian Municipal Central Hospital, Dalian, China). Pelvic computed tomography(CT) showed cystic expansile lesions in the left proximal femur and pelvis. Lung and abdominal CT also revealed multiple lytic lesions in the ribs and lumbar spine. X-ray of the left ulna and radius showed that the middle of the left ulna had a fracture caused by a brown tumor. A bone biopsy from the left proximal femur showed focal distribution of giant cells, with hemorrhage and fibrin hyperplasia. Results The patient underwent internal fixation of the left intertrochanteric fracture, and postoperative bone biopsy showed focal distribution of giant cells with hemorrhage and fibrin hyperplasia. The patient had a parathyroidectomy 5 months after discharge. Two weeks later, the patient developed a fracture in the right femoral neck and pain in the left forearm. X-ray of the left ulna and radius showed that the middle of the left ulna was affected by a pathological fracture caused by a brown tumor. The patient was debilitated and declined surgical treatment. The patient and her family chose discharge.Conclusion Brown tumor of bone, also called osteitis fibrosa cystica, is a rare non-neoplastic lesion that reflects abnormal bone metabolism in patients with HPT. However, with fine needle aspiration cytology in combination with biochemical tests, a correct diagnosis can be reached. The increase in osteoclast activity leads to decalcification and dissolution of bone, and formation of a cystic bone defect with hyperplastic fibrous tissue. This eventually becomes a brown tumor, with deformed and bleeding fibrous tissue. The p 展开更多
关键词 brown tumor hyperparathyroidism(HPT) fibrocystic OSTEITIS PATHOLOGICAL FRACTURES
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老年人髋关节周围骨折的护理对策和效果分析 预览
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作者 胡芳 杨淑红 张亚辉 《中华关节外科杂志(电子版)》 CAS CSCD 2019年第3期387-390,共4页
目的 通过对老年髋关节周围骨折患者的综合护理,探讨老年人髋关节周围骨折的护理对策和效果分析。方法选取河北医科大学第三医院手术室2015年2月至2018年2月收治的42例老年髋关节周围骨折患者作为研究对象,根据随机对照双盲法进行分组,... 目的 通过对老年髋关节周围骨折患者的综合护理,探讨老年人髋关节周围骨折的护理对策和效果分析。方法选取河北医科大学第三医院手术室2015年2月至2018年2月收治的42例老年髋关节周围骨折患者作为研究对象,根据随机对照双盲法进行分组,对照组(21人)患者进行常规护理,观察组(21人)进行综合护理(包括心理护理、睡眠护理、辅助患者进行术后功能锻炼等),应用 Student’s t-test 或卡方检验比较两组患者的主观满意度、住院时间、患者的活动情况(Harris评分)和并发症的发生情况。结果 观察组患者的主观满意度显著高于对照组,差异具有统计学意义(X^2=7.000, P <0.05);观察组患者的住院时间短于对照组,但差异没有统计学意义( t =1.158, P >0.05);观察组患者的Harris评分显著高于对照组,差异具有统计学意义( t =18.482, P <0.05);观察组患者并发症显著低于对照组,差异具有统计学意义(X^2=4.725, P <0.05)。结论综合护理可减少并发症的发生,提高老年髋关节周围骨折患者的主观满意度及患者的活动情况,对促进老年髋关节周围骨折患者康复有重要的临床意义。 展开更多
关键词 髋关节 骨折 老年 护理 并发症
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桡骨骨折模型兔骨折愈合:特异性环氧化酶2抑制剂与非特异性环氧化酶抑制剂的比较 预览
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作者 陈海涛 安玉光 《中国组织工程研究》 CAS 北大核心 2019年第15期2385-2390,共6页
背景:非特异性环氧化酶抑制剂和特异性环氧化酶抑制剂都是常用的镇痛、消炎类非类固醇类药,两种药物治疗对骨折创伤愈合的效果及用药时间的比较缺乏相关实验依据。目的:对比非特异性环氧化酶2抑制剂与特异性环氧化酶2抑制剂对兔桡骨骨... 背景:非特异性环氧化酶抑制剂和特异性环氧化酶抑制剂都是常用的镇痛、消炎类非类固醇类药,两种药物治疗对骨折创伤愈合的效果及用药时间的比较缺乏相关实验依据。目的:对比非特异性环氧化酶2抑制剂与特异性环氧化酶2抑制剂对兔桡骨骨折愈合的效果。方法:3-5月龄新西兰大白兔36只,雌雄不限,实验动物由广西医科大学实验动物中心提供。建立兔单侧桡骨骨折(3mm)模型共36只,随机分为3组:模型组予以等剂量蒸馏水灌胃;特异性环氧化酶2抑制剂组予以1.15mg/(kg.d)依托考昔灌胃;非特异性环氧化酶抑制剂组予以7.6mg/(kg.d)阿司匹林灌胃,每组12只。在术后2,4,8周对各组兔桡骨组织进行大体观察和组织病理切片染色观察,检测兔血清骨钙素及骨组织转化生长因子β1、血管内皮生长因子水平。结果与结论:①术后观察发现非特异性环氧化酶抑制剂组造模侧桡骨组织在骨痂的形成改建及愈合情况上均要优其他2组;②术后的各个时间点非特异性环氧化酶抑制剂组血清骨钙素水平明显高于特异性环氧化酶2抑制剂组(P<0.05);③苏木精-伊红染色结果:非特异性环氧化酶抑制剂组在胶原纤维、软骨组织、骨小梁及骨基质的形成时期均早于特异性环氧化酶2抑制剂组;④术后第4周非特异性环氧化酶抑制剂组转化生长因子β1和血管内皮生长因子免疫组织化学平均吸光度值均明显大于特异性环氧化酶2抑制剂组(P<0.05);⑤结果说明,特异性环氧化酶2抑制剂修复兔桡骨骨折的时间相对非特异性环氧化酶更长,说明环氧化酶2特异性抑制剂对骨折愈合的效率低于非特异性环氧化酶抑制剂。 展开更多
关键词 特异性环氧化酶2抑制剂 非特异性环氧化酶抑制剂 骨折 转化生长因子β1 血管内皮生长因子 环氧化酶2 组织工程
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99Tc^m-MDP全身骨显像联合局部SPECT/CT断层显像在骶骨功能不全性骨折中的诊断价值 预览
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作者 丁浩源 蔡亮 +2 位作者 陈跃 张蜀茂 张莉 《中国医学影像学杂志》 CSCD 北大核心 2019年第8期612-617,共6页
目的比较CT、MRI和99Tc^m标记亚甲基二膦酸盐(MDP)全身骨显像联合局部SPECT/CT断层显像诊断骶骨功能不全性骨折(SIF)的临床价值。资料与方法回顾性分析55例X线平片无明显异常而临床高度怀疑SIF的患者,所有患者均进一步行CT、MRI和全身... 目的比较CT、MRI和99Tc^m标记亚甲基二膦酸盐(MDP)全身骨显像联合局部SPECT/CT断层显像诊断骶骨功能不全性骨折(SIF)的临床价值。资料与方法回顾性分析55例X线平片无明显异常而临床高度怀疑SIF的患者,所有患者均进一步行CT、MRI和全身骨显像及局部SPECT/CT断层显像。结合影像学表现、临床及随访确定诊断,分析其CT、MRI和全身骨显像及局部SPECT/CT断层显像表现,对比3种检查诊断SIF的差异。结果31例患者确诊为SIF。CT、MRI和全身骨显像联合局部SPECT/CT断层显像诊断SIF的敏感度分别为74.2%、87.5%和80.0%,特异度分别为80.6%、91.7%和85.5%,准确度分别为100%、83.3%和92.7%;全身骨显像联合局部SPECT/CT断层显像的敏感度和准确度与MRI、CT比较,差异有统计学意义(P<0.05);而MRI与CT比较,差异均无统计学意义(P>0.05)。结论与CT和MRI相比,全身骨显像联合局部SPECT/CT断层显像诊断SIF具有更好的准确性。 展开更多
关键词 骨折 应力性 骶骨 体层摄影术 螺旋计算机 磁共振成像 体层摄影术 发射型计算机 单光子 99M锝美罗酸盐
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区域神经阻滞对肩胛骨骨折手术患者麻醉及镇痛效果的影响 预览
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作者 王莉萍 王坤 +2 位作者 胡杰 孙艳斌 张承民 《世界最新医学信息文摘(电子版)》 2019年第12期122-124,共3页
目的探究神经阻滞麻醉在肩胛骨骨折手术中的应用效果。方法选取近两年承德市中心医院收治的60例择期肩胛骨骨折手术治疗患者为研究对象,按随机数字表法分为观察组(Never blocks group)30例(N=30)和对照组(General anesthesia)30例(G=30... 目的探究神经阻滞麻醉在肩胛骨骨折手术中的应用效果。方法选取近两年承德市中心医院收治的60例择期肩胛骨骨折手术治疗患者为研究对象,按随机数字表法分为观察组(Never blocks group)30例(N=30)和对照组(General anesthesia)30例(G=30),G组1名患者不符合试验标准,予以剔除,最终G组29例(G=29)。N组采用区域神经阻滞麻醉联合全身麻醉,G组只采用全身麻醉,方法及用药与观察组相同。监测并记录2组患者麻醉开始前、切皮时和骨折复位时的心率(HR)与无创血压(NIBP);对比术后1、2、4、8、12h疼痛视觉模拟评分(VAS);评价并比较2组患者术后12h的镇痛疗效;计算并比较2组患者吗啡用量;观察并记录2组不良反应的发生率。结果麻醉开始前、切皮时,2组患者的HR及NIBP未见明显统计学差异(P>0.05);骨折复位时,G组的HR、NIBP均高于同期N组(P<0.05)。术后1、2、4、8h,统计学显示,N组的VAS评分显著低于G组(P<0.05);术后12h,2组VAS评分无统计学差异(P>0.05)。N组的镇痛优良率(96.7%)明显高于G组(55.2%),优良率有统计学差异(P<0.05)。N组术后12 h吗啡总量(5.3±0.9)显著低于G组(10.8±1.2),有统计学差异(P<0.05)。N组不良反应发生率为6.7%,G组为46.7%,有统计学差异(P<0.05)。结论神经阻滞麻醉联合全麻使得患者术中生命体征更为平稳,能有效减轻术后疼痛,减少吗啡用量,提供舒适的镇痛效果,安全可靠,可以成为肩胛骨骨折手术麻醉的选择。 展开更多
关键词 区域神经阻滞 肩胛骨 骨折 镇痛
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老年骨科患者吸入麻醉术后认知功能障碍的临床研究 预览
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作者 周晓锋 陈远声 +3 位作者 陈丽欢 古素雅 李丽婷 冯世杰 《中国医药科学》 2019年第3期92-95,共4页
目的探讨老年骨科患者吸入麻醉对术后认知功能障碍的临床影响。方法选取我院2016~2017年住院治疗的老年骨科手术患者60例,按照随机分组法(单盲法)分为观察组和对照组,各30例。对照组采用静脉麻醉,观察组采用吸入麻醉,观察对比两组患者... 目的探讨老年骨科患者吸入麻醉对术后认知功能障碍的临床影响。方法选取我院2016~2017年住院治疗的老年骨科手术患者60例,按照随机分组法(单盲法)分为观察组和对照组,各30例。对照组采用静脉麻醉,观察组采用吸入麻醉,观察对比两组患者手术前后的生物学标志物(IL-6、TNF-α和S100β蛋白)水平及认知功能(MMSE、MoCA)评分变化。结果对照组术后当天、第3天的IL-6、TNF-α和S100β蛋白水平下降幅度明显小于观察组(P<0.05);对照组术后第7天的IL-6、TNF-α水平较观察组无明显差异(P>0.05),观察组术后第7天的S100β蛋白水平与对照组相比,降低幅度明显(P<0.05);观察组术后第1天、第3天和第7天的MMSE、MoCA评分较对照组有明显提高(P<0.05)。结论吸入麻醉可减轻患者的炎症反应,减少老年患者进行性记忆力减退等认知功能的损害,提倡临床麻醉应用吸入麻醉。 展开更多
关键词 吸入麻醉 七氟醚 静脉麻醉 丙泊酚 骨伤 术后认知功能障碍
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Outcome of complex tibial plateau fractures with Ilizarov external fixation with or without minimal internal fixation
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作者 Koushik Narayan Subramanyam Madhusudhan Tammanaiah +2 位作者 Abhishek Vasant Mundargi Ritesh Nilakanthrao Bhoskar Patllola Siddharth Reddy 《中华创伤杂志:英文版》 CAS CSCD 2019年第3期166-171,共6页
Purpose: To evaluate the clinico-radiological outcome of complex tibial plateau fractures treated with Ilizarov external fixation with or without minimal internal fixation. Methods: This retrospective review was condu... Purpose: To evaluate the clinico-radiological outcome of complex tibial plateau fractures treated with Ilizarov external fixation with or without minimal internal fixation. Methods: This retrospective review was conducted on all the cases of Schatzker types V and VI tibial plateau fractures treated by Ilizarov external fixation between July 2006 and December 2015 with the minimum follow-up duration of one year. There were 30 patients: 24 males and 6 females, mean age 43.33 years, and mean follow-up 3.6 years. Three of them were open fractures;15 cases were Schatzkertype V fractures and the other 15 type VI. According to AO/OTA classification, there were 11 type C1, 12 C2 and 7 type C3 fractures. Outcome assessment was made with American Knee Society Score (AKSS) and Rasmussen's Radiological Score (RRS) at final follow-up. Results: Out of the 30 cases, mini-open reduction was performed in 7, bone graft in 4, minimal internal fixation in 10 and knee temporary immobilisation in 11 patients. Mean duration of external fixation was 11.8 weeks. All fractures united. Pin tract infections in 7 and common peroneal neuropathy in 2 patients were self-limiting. Two patients had axial misalignment of less than 10°. At final follow-up, the mean knee range of motion was 114.7, mean AKSS 81.5 and mean RRS 16.7. On statistical analysis, Schatzker type of fractures, use of minimal internal fixation and knee-spanning did not influence the final outcome. Conclusion: Ilizarov external fixator with or without minimal internal fixation provides acceptable outcome for complex tibial plateau fractures. Care must be taken to look for minor loss of alignment, especially in Type VI Schatzker fractures after removal of the fixator. However small sample size precludes firm conclusions. 展开更多
关键词 TIBIAL plateau FRACTURES Schatzker's classification ILIZAROV techniques Ring FIXATOR
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