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可吸收螺钉改良Dewar术治疗陈旧性Ⅲ度肩锁关节脱位

钩钢板治疗锁骨外侧端骨折伴肩锁关节脱位

REPAIR OF COLLATERAL LIGAMENT RUPTURE IN THE INTERPHALANGEAL JOINT USING SUPERFICIAL FLEXOR TENDON OF FINGER

OBJECTIVE To introduce the surgical procedure and clinical result of microsurgical repair on collateral ligament rupture in the interphalangeal joint using superficial flexor tendon of finger. METHODS From 1987, 23 cases with collateral ligament rupture in the interphalangeal joint were repaired by part of superficial flexor tendon of finger. The initial point of collateral ligament was drilled two holes, 2 to 3 mm in distance, and crossed by steel wire. Then the superficial flexor tendon of finger was crossed under the steel wire and sutured to the terminal point of superficial flexor tendon of finger by 5/0 to 7/0 nontraumatic suture thread to maintain suitable tension, and sutured to collateral ligament by 8/0 nontraumatic suture thread. Extension splint fixation was performed 4 to 6 weeks postoperatively. RESULTS Followed up 3 to 6 months, 15 cases were excellent, 6 cases were better, 2 cases were moderate, and the excellent rate was 91.34% according to Saetta standard. CONCLUSION Microsurgical repair on collateral ligament rupture in the interphalangeal joint using superficial flexor tendon of finger is a convenient and effective surgical method.

低位进钉法动力髋螺钉治疗高龄股骨粗隆间骨折

【摘 要】 目的 总结利用低位进钉法动力髋螺钉（dynamic hip screw，DHS）治疗高龄股骨粗隆间骨折的临床经验。 方法 2000 年1 月－ 2006 年12 月，利用低位进钉法DHS 治疗高龄骨质疏松股骨粗隆间骨折25 例。男11 例，女14 例；年龄70 ～ 92 岁，平均81 岁。致伤原因：撞摔伤6 例，跌倒伤19 例。病程1 ～ 7 d。骨折类型按Evan’s 分型，Ⅰ型3 例，Ⅱ型10 例，Ⅲ型8 例，Ⅳ型4 例。伴其他部位骨折4 例，颅脑损伤1 例。合并高血压病12 例，冠心病3 例，糖尿病1 例，脑血管病1 例，慢性支气管炎和肺气肿1 例。 结果 术中出现低血压4 例，静脉输血和应用升压药物后好转。术后1 个月内发生并发症13 例，其中肺部感染4 例，精神障碍3 例，深静脉血栓、肠道感染、心律失常、心肌梗死各1 例，经抗感染、抗精神药物、溶栓等内科治疗后无死亡患者。全部患者均获随访，随访时间6 个月～ 3 年，平均21 个月。骨折平均愈合时间为14 周。参照Harris 评分标准，优9 例，良12 例，可3 例，差1 例，优良率84%。无螺钉松动、移位、滑出等内固定失败发生。 结论 低位进钉法DHS 是治疗高龄股骨粗隆间骨折较好的方法，选择恰当的手术时机、采用正确的手术方法、术后适当的功能锻炼是取得满意疗效的关 键。