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find Author "董航" 2 results
  • 克氏针锚钉张力带治疗第五跖骨基底部粉碎性撕脱骨折

    目的总结采用克氏针锚钉张力带治疗第5跖骨基底部粉碎性撕脱骨折的疗效。 方法2011年8月-2013年10月,采用克氏针锚钉张力带治疗第5跖骨基底部粉碎性撕脱骨折患者26例。其中男16例,女10例;年龄18~52岁,平均34.5岁。按照Lawrence和Botte解剖分区,均为Ⅰ区骨折。骨折块均较粉碎且移位超过2 mm,18例波及跖骰关节面骨折块移位。受伤至手术时间2~9 d,平均4 d。 结果术后切口均Ⅰ期愈合。术后20例获随访,随访时间8~18个月,平均13个月。X线片示无内固定物断裂、骨折复位丢失、骨折不愈合或迟缓愈合等并发症发生。骨折愈合时间75~98 d,平均87 d。末次随访时,根据美国矫形足踝协会(AOFAS)中前足功能评分标准评分为85~100分,平均92分;疼痛视觉模拟评分(VAS)为0~2分,平均0.6分。 结论应用克氏针锚钉张力带治疗第5跖骨基底部粉碎性撕脱骨折,既能起到骨折端加压作用,又避免了对皮肤的干扰刺激,疗效满意。

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  • Clinical evaluations of anterior cruciate ligament reconstruction with platelet rich plasma

    Objective To investigate the clinical outcomes of autologous platelet rich plasma (PRP) for anterior cruciate ligament (ACL) reconstruction. Methods Between August 2014 and August 2016, 42 patients with ACL ruptures who underwent arthroscopic ACL reconstruction were randomly divided into 2 groups: 21 patients received graft soaked with PRP (trial group) and 21 patients received routine graft in ACL reconstruction (control group). Because 6 patients failed to be followed up, 17 patients of trial group and 19 of control group were enrolled in the study. There was no significant difference in gender, age, body mass index, side, injury reason, disease duration, Kellgren-Lawrence grade, and preoperative visual analogue scale (VAS), Lysholm score, and International Knee Documentation Committee (IKDC) activity scores between 2 groups (P>0.05). VAS score, Lysholm score, and IKDC activity scores were used to evaluate pain and function at 3 and 12 months postoperatively. Further, second arthroscopy and MRI examination were performed at 12 months postoperatively. Results The patients in both groups were followed up 3 to 12 months with an average of 9.83 months. The VAS score, Lysholm score, and IKDC activity scores were significantly improved at 3 and 12 months after operation in 2 groups (P<0.05), and the scores of trial group were significantly better than those of control group at 3 months (P<0.05), but no significant difference was found between 2 groups at 12 months (P>0.05). No complications of effusion, infection, and allergy were observed in 2 groups during follow-up. MRI showed good position of ACL grafts and good signal quality of the graft in the majority of the cases. However, mixed hyperintense and presence of synovial fluid at the femoral bone-tendon graft interface were found in 3 patients of trial group and 4 patients of control group, indicating poor remodeling ligamentation. MRI score was 3.53±1.13 in trial group and was 3.21±0.92 in control group, showing no significant difference (t=0.936,P=0.356). The second arthroscopy examination showed ligament remodeling score was higher in trial group than control group (t=3.248,P=0.014), but no significant difference was found in synovial coverage score and the incidence of cartilage repair (t=2.190,P=0.064;χ2=0.090,P=0.764). Conclusion PRP application in allograft ACL reconstruction can improve knee function and relieve pain after operation, which may also accelerate graft remodeling.

    Release date:2017-04-12 11:26 Export PDF Favorites Scan
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