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find Author "姚相雨" 4 results
  • 踝关节骨折的治疗现状及进展

    踝关节骨折的发生率正随着人口老龄化的增加而逐步增长,其中,跌倒伤是踝关节骨折的主要受伤机制。关于不稳定性踝关节骨折,目前的治疗金标准仍是切开复位内固定术。关于三踝骨折的处理,应先行内外踝解剖复位坚强内固定后再行后踝处理,而后踝骨折的固定与否,由后踝骨折块的大小或胫距关节的稳定性决定。若存在踝关节上方5 cm以外的腓骨骨折或踝关节上方3.0~4.5 cm以外的腓骨骨折合并不能修复的内踝损伤应行下胫腓联合螺钉固定。若踝关节骨折合并严重的软组织损伤且明确的固定方式未定之前,临时性跨踝外支架是一种明智的选择。踝关节术后因创伤性关节炎引起的持续疼痛,去神经支配可望成为未来一种尝试性的治疗方式。踝关节镜为新型微创手术的代表,简单骨折类型如Cedell骨折、撕脱性骨折、创伤后的异化骨,都能通过该方式治疗。关于小于关节面25%的后踝骨折块是否应该固定以及下胫腓联合螺钉使用的适应证的判断有待于未来进一步的生物力学及临床研究的探索。

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  • FraserⅡC型“浮膝”损伤一例

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  • Biomechanical study of nickel-titanium three-dimensional memory alloy mesh and autologous bone in treatment of canine tibial plateau collapse fracture

    ObjectiveTo evaluate the biomechanical effect of a nickel-titanium (Ni-Ti) three-dimensional memory alloy mesh in treating a canine tibial plateau collapse fracture model and to lay a foundation for further experiments in vivo.MethodsSixteen tibial plateau specimens of 8 adult Beagle dogs were harvested. Twelve specimens were taken to prepare canine tibial plateau collapse fracture models (Schatzker type Ⅲ) and randomly divided into groups A, B, and C, with 4 specimens in each group. Four normal tibia specimens were used as blank control group (group D). In groups A and B, the bone defects were repaired with Ni-Ti three-dimensional shape memory alloy mesh combined with autologous bone and simple autologous bone respectively, and fixed with the lateral plate and screw. In group C, the bone defect was directly fixed with the lateral plate and screw. By using a biomechanical tester, a progressive load (0-1 700 N) was loaded vertically above the femoral condyle. The maximum failure load was recorded and the stiffness was calculated according to the load-displacement curve.ResultsThe maximum failure loads in groups A, B, C, and D were (1 624.72±7.02), (1 506.57±3.37), (1 102.00±1.83), and (1 767.64±24.56) N, respectively; and the stiffnesses were (129.72±20.83), (96.54±27.05), (74.96±17.70), and (169.01±35.62) N/mm, respectively. The maximum failure load and stiffness in group A were significantly higher than those in groups B and C, but which were significantly lower than those in group D (P<0.05).ConclusionNi-Ti three-dimensional memory alloy mesh combined with autologous bone can repair the Schatzker type Ⅲ tibial plateau collapse fracture, which has better biomechanical properties than simple autologous bone grafting.

    Release date:2018-05-30 04:28 Export PDF Favorites Scan
  • Biomechanical study on nickel-titanium three-dimensional memory alloy mesh combined with autologous bone for living model of canine tibial plateau collapse fracture

    ObjectiveTo evaluate the effect of nickel-titanium three-dimensional memory alloy mesh combined with autologous bone for living model of canine tibial plateau collapse fracture by biomechanical testing. MethodsSixteen healthy 12-month-old Beagle dogs were randomly divided into 4 group, 4 dogs in each group. The dogs were used to establish the tibial plateau collapse fracture model in groups A, B, and C. Then, the nickel-titanium three-dimensional memory alloy mesh combined with autologous bone (the fibula cortical bone particles), the artificial bone (nano-hydroxyapatite), and autologous fibula cortical bone particles were implanted to repair the bone defects within 4 hours after modeling in groups A, B, and C, respectively; and the plate and screws were fixed outside the bone defects. The dogs were not treated in group D, as normal control. At 5 months after operation, all animals were sacrificed and the tibial specimens were harvested and observed visually. The destructive axial compression experiments were carried out by the biomechanical testing machine. The displacement and the maximum failure load were recorded and the axial stiffness was calculated. ResultsAll animals stayed alive after operation, and all incisions healed. After 1-3 days of operation, the animals could stand and move, and no obvious limb deformity was found. The articular surfaces of the tibial plateau specimens were completely smooth at 5 months after operation. No obvious articular surface collapse was observed. The displacement and maximum failure load of specimens in groups A and D were significantly higher than those in groups B and C (P<0.05). But no significant difference was found between groups A and D and between groups B and C (P>0.05). ConclusionThe nickel-titanium three-dimensional memory alloy mesh combined with autologous bone for subarticular bone defect of tibial plateau in dogs has good biomechanical properties at 5 months after operation, and has better axial stiffness when compared with the artificial bone and autologous bone graft.

    Release date:2018-12-04 03:41 Export PDF Favorites Scan
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