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find Author "胡宏宇" 3 results
  • 陈旧性第一掌骨基底部骨折脱位的手术治疗

    目的 总结手术治疗陈旧性第 1 掌骨基底部骨折脱位(Bennett骨折)疗效。 方法 2012 年 2 月—2015 年 3 月,采用韧带松解联合克氏针固定方法治疗 10 例陈旧性 Bennett 骨折患者。其中男 8 例,女 2 例;年龄 24~44 岁,平均 35.3 岁。伤后至手术时间为 5~14 周,平均 7.5 周。术前拇示指捏力为 1~3 级,平均 1.8 级。术后石膏外固定 4~8 周,骨折愈合后去除克氏针,期间在康复师指导下进行功能锻炼。 结果 术后切口均Ⅰ期愈合。10 例均获随访,随访时间 7~16 个月,平均 12.5 个月。X 线片及 CT 检查示第 1 腕掌关节对位好,无再脱位发生;骨折均愈合,愈合时间 2~4 个月,平均 3.5 个月。1 例伤后 14 周手术患者,术后第 1 腕掌关节仍存在持续疼痛症状,X 线片检查见关节毛糙、间隙变窄,证实第 1 腕掌关节炎形成;其余患者无关节炎发生,第 1 腕掌关节处无明显疼痛,关节稳定。末次随访时,拇示指捏力为 3~12 级,平均 6.8 级。根据手指关节总活动度(TAM)系统评定方法评价疗效,优 7 例,良 2 例,差 1 例,优良率 90%。 结论 对于陈旧性 Bennett 骨折,通过适当松解桡背侧韧带联合克氏针内固定治疗,可取得良好疗效。

    Release date:2017-06-15 10:04 Export PDF Favorites Scan
  • IN VITRO EFFECT OF ALENDRONATE ON CHONDROCYTES AND ARTICULAR CARTILAGE AND SUBCHONDRAL BONE IN RABBIT ANTERIOR CRUCIATE LIGAMENT TRANSECTION MODEL

    Objective To examine the effects of alendronate (ALN) on IL-1β-stimulated chondrocyte of rabbit in vitro and on cartilage and subchondral bone in rabbit osteoarthritis (OA) induced by anterior cruciate l igament transection (ACLT). Methods The chondrocytes from articular surface of healthy 3-month-old Japanese White rabbits were obtained by the method of enzyme digestion and cultured in vitro. The third generation chondrocytes were assigned into three groups: thechondrocytes were cultured in DMEM medium with 10 ng/mL IL-1β for 2 days, subsequently with (ALN group, group A1) orwithout (IL-1β group, group B1) 1 × 10-6 mol/L ALN for 3 days; the chondrocytes in vacant group (group C1) were cultured in DMEM medium for 5 days. The expression of Col II and MMP-13 were analyzed by immunocytochemical staining observation and real time RT-PCR test. Another twenty-four 3-month-old male Japanese White rabbits were randomized into three groups (n=8 per group). The OA model was made by ACLT in ACLT+ALN group (group A2) and ACLT group (group B2); the joint cave was sutured after exposure of ACL in sham group (group C2). After 4 days, the rabbits of group A2 received the subcutaneous injection of ALN at a dosage of 10 μg/(kg·d) for 8 weeks. Rabbits of group B2 and C2 received equal normal sal ine treatment. After 8 weeks, the rabbits were executed. The macro-pathologic changes of right knee joints were observed, so were the histological changes of femoral condyles. Expression levels of Col II and MMP-13 were detected by immunohistochemical staining. The bone histomorphometry analysis was appl ied to subchondral bone of proximal tibia. Results In vitro, the Col II immunocytochemical staining showed intensely positive staining in group C1, and the intensity of staining was sl ightly decreased in group A1, but the intensity of Col II immunocytochemical staining was extremely lower in the group B1. The integrated absorbance (IA) value for Col II in group A1 was significantly higher than that of group B1 (P lt; 0.05), but there was no significant difference between group A1 and group C1 (P gt; 0.05). Immunocytochemical detection of MMP-13 showed intense staining in group B1, and the intensity of staining was sl ightly decreased in group A1, but no MMP-13 expression was detected in the group C1. The IA value for MMP-13 in group A1 was significantly lower than that of group B1 (P lt; 0.05), but significantly higher than that of group C1 (P lt; 0.05). The real time RT-PCR analysis showed significantly higher mRNA levels of Col II in group A1 than in group B1 (P lt; 0.05), but there was no significant difference between group A1 and group C1 (P gt; 0.05). The MMP-13 mRNA level of the chondrocytes in group A1 was significantly lower than that of group B1 (P lt; 0.05), but significantly higher than that of group C1 (P lt; 0.05). In vivo, the gross appearance of surface of knee joint showed that there was no ulcer in group C2, and there was some ulcers in group A2, but many and all layers ulcers in group B2. Mankin score of group A2 was significantly lowerthan that of group B2 (P lt; 0.05), but significantly higher than that of group C2 (P lt; 0.05). Immunohistochemical staining showed that Col II in articular cartilage was intensely staining in group C2, the intensity of staining was sl ightly decreased in group A2, and the intensity of Col II immunohistochemical staining was extremely low in group B2, but there was no significant difference between group A2 and group C2 (P gt; 0.05..........

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 克氏针双夹扣法固定治疗远节指骨背侧基底不稳定骨折

    目的总结克氏针双夹扣法固定治疗远节指骨背侧基底不稳定骨折的疗效。 方法2008年9月-2014年3月,对15例远节指骨背侧基底不稳定骨折患者采用切开复位、克氏针双夹扣法固定。男12例,女3例;年龄18~53岁,平均32.5岁。致伤原因:戳伤8例,扭伤2例,摔伤3例,挤压伤2例。损伤指别:示指5例,中指3例,环指2例,小指5例。受伤至手术时间2~9 d,平均3.8 d。 结果患者术后切口均Ⅰ期愈合。15例均获随访,随访时间6~20个月,平均12.5个月。X线片示骨折均愈合,愈合时间5~8周,平均6.1周。术后8~12周,平均9.2周取出内固定物。末次随访时,根据总主动活动度(TAM)评价标准评定手指功能,获优9例,良5例,中1例,优良率93.3%。 结论克氏针双夹扣法固定治疗远节指骨背侧基底不稳定骨折,可使骨折、关节复位且固定牢固,允许手指早期功能锻炼,是一种有效治疗方法。

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