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find Author "左玉明" 7 results
  • 儿童肱骨外髁骨折合并孟氏骨折二例

    Release date:2024-02-20 04:11 Export PDF Favorites Scan
  • 封闭式负压引流技术联合腓肠神经营养血管皮瓣修复儿童足跟部软组织缺损

    目的总结封闭式负压引流技术(vacuum sealing drainage,VSD)联合腓肠神经营养血管皮瓣修复儿童足跟部软组织缺损的疗效。 方法2010年1月-2012年6月,收治7例足跟部软组织缺损患儿。男5例,女2例;年龄5岁11个月~11岁1个月,平均8岁1个月。致伤原因:重物砸伤2例,车轮绞伤4例,机械皮带绞伤1例。受伤至入院时间3~5 h,平均4 h。软组织缺损范围为5 cm × 3 cm~8 cm × 6 cm。入院急诊清创、VSD治疗5~7 d后,切取大小为6 cm × 4 cm~9 cm × 7 cm的腓肠神经营养血管皮瓣修复创面。供区游离植皮、皮瓣修复或直接拉拢缝合。 结果术后皮瓣均顺利成活,创面Ⅰ期愈合;供区皮瓣及植皮均成活,切口Ⅰ期愈合。患儿均获随访,随访时间6~15个月,平均9个月。皮瓣质地优良,外观无臃肿,耐磨。术后6个月足踝部功能采用美国矫形足踝协会(AOFAS)后足评分系统进行评价,均为优。 结论VSD联合腓肠神经营养血管皮瓣修复儿童足跟部组织缺损简便安全,降低了感染率,可有效判断周围皮肤条件,减少皮瓣切取面积,且皮瓣血运可靠。

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • 儿童网球腿的临床特点与治疗

    目的总结儿童网球腿的临床特点及治疗方法选择、疗效。 方法回顾分析2010年3月-2013年3月收治的5例网球腿患儿临床资料。男3例,女2例;年龄9岁8个月~11岁1个月,平均10岁3个月。均为交通事故伤。1例伤后因外院漏诊发生马蹄足畸形,伤后至该次入院时间8个月;行跟腱延长术治疗。4例为急诊入院,伤后至入院时间为3~7 h,给予冷敷、制动等保守治疗。 结果手术患儿切口Ⅰ期愈合,无手术相关并发症发生。5例患儿均获随访,随访时间7~13个月,平均10个月。患儿均于治疗后2个月恢复至伤前活动水平,步态正常,无跛行。踝关节活动均恢复正常。随访期间均无复发。 结论儿童网球腿多由交通事故引起,早期可选择保守治疗,晚期形成马蹄足畸形时应手术矫正。

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  • CLASSIFICATION AND TREATMENT OF MONTEGGIA EQUIVALENT FRACTURES IN CHILDREN

    Objective To investigate the classification and treatment of Monteggia equivalent fractures in children. Methods A retrospective analysis was made on the clinical data of 35 cases of Monteggia equivalent fractures between January 2008 and January 2012. There were 17 boys and 18 girls with an average age of 7 years and 5 months (range, 1 year and 2 months to 14 years and 11 months). The causes of injury were tumbling injury in 25 cases, falling injury in 3 cases, and sport injury in 7 cases. The disease duration from injuries to admission ranged from 1 hour to 16 days (median, 28 hours). According to the criteria of self-made classification, there were 22 cases of type I (ulnar fracture with radial neck fracture or proximal radial epiphysis injury), 2 cases of type II (posterior elbow dislocation with radial neck fracture or proximal radial epiphysis injury), 10 cases of type III (ulnar fracture and/or olecranon fracture with humeral lateral condylar fracture), and 1 case of type IV (fractures of radius and ulna with radial neck fracture or proximal radial epiphysis injury). All patients were treated by open reduction and internal fixation/external fixation. Results All incisions healed by first intention without infection. Thirty-four cases were followed up 14 months on average (range, 12-18 months). All fractures healed at 2.5 months on average (range, 6 weeks to 5 months). According to Hospital for Special Surgery (HSS) score system, the results were excellent in 29 cases, good in 4 cases, and fair in 2 cases, with an excellent and good rate of 94%. No cubit varus/valgus or delayed ulnar nerve injury was observed. Conclusion New self-made classification is simple and easy to remember, and it is helpful to reduce omission diagnose rate and select therapeutic methods. Surgery is an effective method to treat Monteggia equivalent fractures.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 儿童浮肘损伤的治疗

    目的总结儿童浮肘损伤的临床特点、治疗方法及疗效。 方法回顾分析2008年1月-2013年12月收治的19例浮肘损伤患儿临床资料,男14例,女5例;年龄14个月~13岁7个月,平均8岁。肱骨髁上骨折均为Gartland Ⅲ型。开放骨折1例,合并血管损伤1例,神经损伤6例。伤后至就诊时间2 h~2 d,平均7 h。肱骨髁上骨折采用闭合或切开复位克氏针固定;桡骨远端骨骺损伤或合并尺骨远端骨折(或骨骺损伤)行闭合或切开复位克氏针固定;尺桡骨干中段骨折采用闭合复位弹性钉固定。 结果18例患儿获随访,随访时间12~18个月,平均13个月。骨折均达骨性愈合,愈合时间8周~7个月,平均3个月;神经损伤均于8周内完全恢复。1例血管损伤术后第2天可触及桡动脉搏动,11 d后彩超显示血流正常。1例患儿肘关节伸直受限约10°,其余患儿肘关节及前臂活动正常。末次随访时根据改良的Flynn标准,达优16例,良1例,可1例。 结论浮肘损伤多发生在较高能量损伤中,易合并神经血管损伤及其他部位骨折,手术治疗可有效降低并发症发生率,提高疗效。

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  • SURGICAL TREATMENT OF Seymour FRACTURES IN CHILDREN AND ADOLESCENTS

    Objective To discuss the treatment method and effectiveness of Seymour fracture in children and adolescents. Methods Between January 2013 and November 2015, 26 children and adolescents with Seymour fractures were treated. There were 18 males and 8 females, aged from 1 year and 1 month to 17 years (median, 8.2 years). The injury causes included crush in 14 cases, bruise in 10 cases, and puncture in 2 cases. The thumb was involved in 2 cases, index finger in 1 case, middle finger in 12 cases, ring finger in 6 cases, and little finger in 5 cases. The time from injury to operation was 1-15 hours (mean, 3.2 hours). The patients underwent debridement, nail removal, nail matrix repair, closed reduction and osteosynthesis with Kirschner wires, and splinting in emergency. Kirschner wires and splints were removed at 4 weeks after surgery, and functional exercises were done. Results All wounds healed by first intention without infection. The follow-up duration was 2-24 months (mean, 12.3 months). The fracture healing was obtained at 1-2 months (mean, 1.4 months) on X-ray film, and no complications of nonunion, malunion, re-displacement, premature epiphyseal closure, or no growth of the nails occurred. Nail deformity developed in 1 case and no re-operation was given. At last follow-up, 1 patient had 10° extension limitation of the distal interphalangeal joint, but the flexion was normal. The motion range of distal interphalangeal joint was 0-75°, showing no significant difference when compared with that of contralateral side (0-78°). Conclusion The effectiveness for treating Seymour fracture is satisfactory by debridement, nail removal, nail matrix repair, closed reduction and osteosynthesis with Kirschner wires, and splinting in emergency.

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  • Effectiveness of rigid interlocking nails through tip of greater trochanter for fixation of femur shaft fracture in adolescent

    Objective To explore the effectiveness of rigid interlocking nails through the tip of the greater trochanter for fixation of femur shaft fracture in adolescent. Methods A retrospective analysis was made on the clinical data of 23 adolescents with femoral shaft fractures treated between June 2011 and June 2015. Of 23 cases, 19 were male and 4 were female, aged from 13 years and 6 months to 17 years (mean, 15.2 years), weighed from 40 to 77 kg (mean, 53.5 kg). The causes were traffic accident injury in 13 cases, sports injury in 7 cases, and falling injury in 3 cases. Fracture located at the proximal 1/3 in 6 cases, middle 1/3 in 10 cases, and distal 1/3 in 7 cases; fracture was typed as transverse in 10 cases, oblique in 6 cases, spiral in 1 case, and comminuted in 6 cases. The course of disease was 3-17 days (mean, 6.2 days). At last follow-up, the leg length discrepancy, femoral neck shaft angle, femoral neck diameter, and articulotrochanteric distance (ATD) were measured on the X-ray films. Results Wounds healed in all patients, and no infection occurred. All patients were followed up 15-36 months (mean, 26.5 months). The patients had no pain and had normal gait, without lameness. The X-ray films showed bone healing at 5-13 months (mean, 6.5 months). No nonunion, delayed union, malunion of more than 5 °, or rotational deformity occurred. The removal time of internal fixations was 12-24 months (mean, 19.5 months) after operation. No heterotopic ossification, re-fracture, proximal femoral deformity, or femoral head necrosis occurred during follow-up. Two patients had early epiphyseal closure of greater trochanter, which had no impact on gait; leg-length inequality of less than 1 cm was observed in 2 cases. At last follow-up, the neck shaft angle, femoral neck diameter, and ATD of normal and affected sides were (131.7±6.3) and (132.9±7.8)°, (34.1±3.2) and (33.9±3.8) mm, and (27.8±9.2) and (26.5±8.5) mm, showing no significant difference between two sides (t=–0.24,P=0.86;t=0.18,P=0.92;t=1.03,P=0.49). Conclusion It is a reliable and effective method to use rigid interlocking nails inserted through the tip of the greater trochanter for the fixation of femur shaft fracture in adolescent.

    Release date:2017-04-01 08:56 Export PDF Favorites Scan
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