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find Author "庄胤" 5 results
  • 肘关节后方入路结合钢板螺钉内固定治疗向后孟氏骨折脱位

    目的总结肘关节后方单切口入路结合钢板螺钉内固定治疗向后孟氏骨折脱位的疗效。 方法2012年1月-2014年1月,收治9例向后孟氏骨折脱位患者,均经肘关节后方单切口入路行钢板螺钉内固定。男6例,女3例;年龄25~49岁,平均33.7岁。致伤原因:高处坠落伤5例,摔伤4例。骨折分型:Jupiter A型3例,B型4例,C型2例。均合并不同程度桡骨小头骨折。伤后至手术时间为5~9 d,平均6.5 d。 结果术后患者切口均Ⅰ期愈合。9例患者均获随访,随访时间13~32个月,平均16.3个月。X线片复查示骨折均愈合,愈合时间2~4个月,平均3.2个月;随访期间无创伤性骨关节炎及异位骨化等发生。末次随访时,Mayo肘关节功能评分87~95分,平均91.7分;其中优6例,良3例,优良率100%。 结论采用肘关节单切口入路结合钢板螺钉内固定治疗向后孟氏骨折脱位具有手术视野显露充分、损伤小等优点,可获得较好疗效。

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  • EFFECTIVENESS COMPARISON OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION BETWEEN BY AUTOLOGOUS AND ALLOGENEIC TENDON GRAFTS COMBINED WITH HOOK PLATE FIXATION FOR TREATING ACROMIOCLAVICULAR JOINT DISLOCATION

    ObjectiveTo compare the effectiveness of coracoclavicular ligament reconstruction between by using autologous plantaris tendon graft combined with hook plate fixation and allogeneic tendon graft combined with hook plate fixation for treating acromiocavicular joint dislocation. MethodsThirty-three patients with acromioclavicular joint dislocation who accorded with the inclusion criteria between January 2013 and June 2014 were assigned into 2 groups. The patients were treated with autologous plantaris tendon graft combined with hook plate fixation in group A (n=17), and with allogeneic tendon graft combined with hook plate fixation in group B (n=16). Thirteen-one patients was followed up more than 12 months (15 in group A and 16 in group B). There was no significant difference in gender, age, cause of injury, sides, time between injury and surgery, and type of dislocation (P>0.05). The assessments included operation time, hospitalization time, hospitalization expenses, shoulder range of motion, gap of acromioclavicular, Constant-Murley scores, and visual analogue scale (VAS) for pain. ResultsThe operation time of group A was significantly longer than that of group B, and the hospitalization expense was significantly lower than that of group B (P<0.05). There was no significant difference in hospitalization time (t=1.046, P=0.316). The incisions healed by first intention, and hook plate was removed after 3 months. The mean follow-up time was 21.3 months (range, 19-34 months) in group A and was 23.7 months (range, 18-37 months) in group B. X-ray examination showed no osteolysis. There was no significant difference in gap of acromiocavicular between 2 groups at preoperation, 1 week after operation, and last follow-up (P>0.05). No redislocation of acromioclavicular joint and rejection reaction occurred during follow-up. At last follow-up, there was no significant difference in shoulder range of motion, Constant-Murley score, and VAS score between 2 groups (P>0.05). ConclusionCoracoclavicular ligament reconstruction by autologous plantaris tendon or allogeneic tendon graft combined with hook plate fixation for the treatment of acromioclavicular joint dislocation can achieve good effectiveness. The appropriate treatment should be chosen according to the patient's economic situation.

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  • 足背动脉岛状皮瓣联合载万古霉素硫酸钙治疗胫骨远端创伤性骨髓炎伴软组织缺损

    目的 总结采用逆行足背动脉岛状皮瓣联合载万古霉素硫酸钙植骨治疗合并软组织缺损的胫骨远端创伤性骨髓炎的疗效。 方法 2014 年 3 月—2016 年 4 月采用一期彻底清创,足背动脉岛状皮瓣结合载万古霉素硫酸钙植骨治疗胫骨远端创伤性骨髓炎 11 例。男 10 例,女 1 例;年龄 43~72 岁,平均 51.6 岁。均为骨折内固定术后所致慢性骨髓炎,病程 4 周~5 个月。骨折原因:交通事故伤 5 例,高处坠落伤 3 例,机械绞伤 2 例,扭伤 1 例。皮肤软组织缺损范围 3 cm×3 cm~13 cm×9 cm;创面细菌培养均为阳性。 结果 术后 2~3 周患者切口均 Ⅰ 期愈合,供受区均未发生感染。11 例均获随访,随访时间 6 个月~2.5 年,平均 15.5 个月。术后骨折均愈合,愈合时间 3~9 个月,平均 4.6 个月。末次随访时足部功能采用美国矫形足踝协会(AOFAS)评分,获优 9 例,良 2 例;皮瓣感觉 S4 8 例,S3 2 例,S2 1 例。所有患者骨髓炎均治愈;1 例胫腓骨中下段骨髓炎术后出现骨缺损,大小约 4 cm×3 cm,再次手术植入自体髂骨后骨愈合。 结论 足背动脉岛状皮瓣移植联合万古霉素硫酸钙人工骨植骨治疗伴软组织缺损的胫骨远端创伤性骨髓炎,手术简便有效,是一种较理想的方法。

    Release date:2017-05-05 03:16 Export PDF Favorites Scan
  • 肘前方入路治疗Mason Ⅱ型桡骨小头骨折合并Regan-Morrey Ⅱ型尺骨冠状突骨折

    目的总结肘关节前方入路治疗MasonⅡ型桡骨小头骨折合并Regan-MorreyⅡ型尺骨冠状突骨折的疗效。 方法2010年1月-2013年6月采用肘关节前方入路、Herbert螺钉内固定治疗8例MasonⅡ型桡骨小头骨折合并Regan-MorreyⅡ型尺骨冠状突骨折患者。男6例,女2例;年龄27~53岁,平均36.4岁。致伤原因:高处坠落伤3例,摔伤5例。受伤至手术时间4~10 d,平均4.6 d。 结果术中无血管、神经损伤,术后手术切口均Ⅰ期愈合。8例患者均获随访,随访时间16~27个月,平均18.6个月。X线片复查示骨折均愈合,愈合时间2~4个月,平均2.8个月;无异位骨化、创伤性骨关节炎等并发症发生。末次随访时,Mayo肘关节功能评分86~95分,平均92.3分;其中优5例,良3例,优良率100%。肘关节屈伸活动范围96~145°,平均128°;前臂旋转活动范围140~170°,平均150°。 结论对于MasonⅡ型桡骨小头骨折合并Regan-MorreyⅡ型尺骨冠状突骨折,采用肘关节前方入路可清晰暴露骨折,Herbert螺钉内固定牢靠,治疗效果满意。

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  • 跖肌腱移植重建喙锁及肩锁韧带结合钢板固定治疗肩锁关节脱位

    目的总结应用跖肌腱重建喙锁及肩锁韧带结合钩钢板固定治疗肩锁关节脱位的临床效果。 方法2012年8月-2014年8月,采用跖肌腱“8”字固定重建喙锁及肩锁韧带联合钩钢板固定治疗9例急性肩锁关节脱位患者。男7例,女2例;年龄21~51岁,平均31.7岁。Rockwood分型:Ⅲ型3例,Ⅳ型5例,Ⅴ型1例。受伤至手术时间2~5 d,平均3.3 d。术后随访患者Constant-Murley功能评分、肩关节活动度、复位维持情况及疼痛视觉模拟评分(VAS)。 结果9例均获随访,随访时间12~26个月,平均17.4个月。术后无肩峰撞击、肩峰下骨溶解、再脱位等并发症发生;末次随访时患侧肩关节前屈上举(178.8±1.1)°。末次随访时Constant-Murley评分健患侧比较差异无统计学意义(t=1.142,P=0.312);VAS评分较术前显著改善(t=3.623,P=0.002)。术后1周及末次随访时患侧喙锁间隙距离均较术前显著改善(t=3.294,P=0.004;t=3.237,P=0.005);术后1周与末次随访比较差异无统计学意义(t=0.724,P=0.635)。 结论跖肌腱移植“8”字重建喙锁及肩锁韧带联合钩钢板治疗肩锁关节脱位符合生物力学要求,临床疗效满意且学习曲线短。

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