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find Author "邱长茂" 2 results
  • 应用解剖锁定钢板治疗O'DriscollⅡ型及Ⅲ型尺骨冠突骨折近期疗效

    目的总结解剖锁定钢板治疗O'DriscollⅡ、Ⅲ型尺骨冠突骨折的近期疗效。 方法2012年12月-2013年12月,采用解剖锁定钢板治疗11例尺骨冠突骨折患者。男7例,女4例;年龄23~68岁,平均41.2岁。致伤原因:摔伤6例,交通事故伤3例,高处坠落伤2例。根据O'Driscoll分型标准,Ⅱ型4例,Ⅲ型7例。合并尺侧副韧带损伤5例,尺神经损伤2例。受伤至手术时间2~8 d,平均4.2 d。 结果术后切口均Ⅰ期愈合。11例均获随访,随访时间6~18个月,平均12个月。X线片复查示,骨折均解剖复位并达骨性愈合,愈合时间6~10周,平均8周。末次随访时,肘关节屈伸活动度为112~145°,平均130°;前臂旋转116~148°,平均135°。Mayo肘关节功能评分为74~100分,平均87.8分;其中优6例,良4例,可1例,优良率90.9%。 结论采用切开复位解剖锁定钢板内固定治疗O'DriscollⅡ、Ⅲ型尺骨冠突骨折,固定强度佳,允许术后早期功能锻炼,肘关节功能恢复良好,并发症少。

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  • CLINICAL CHARACTERISTICS AND SURGICAL MANAGEMENT OF Eyres TYPE V CORACOID FRACTURE COMBINED WITH SUPERIOR SHOULDER SUSPENSORY COMPLEX INJURY

    ObjectiveTo investigate the cl inical characteristics of Eyres type V coracoid fracture combined with superior shoulder suspensory complex (SSSC) injuries, and the effectiveness of open reduction and fixation. MethodsBetween March 2004 and July 2012, 13 patients with Eyres type V coracoid fracture and SSSC injuries were treated. There were 10 males and 3 females with an average age of 41 years (range, 23-59 years). Injury was caused by fall ing from height in 4 cases, by traffic accident in 6 cases, and by impact of the heavy weight in 3 cases. The interval from injury to operation was 3-10 days (mean, 5.2 days). SSSC injuries included 9 cases of acromioclavicular joint dislocation, 5 cases of clavicular fractures, and 4 cases of acromion fractures. The coracoid fractures were fixed with cannulated screws; the acromioclavicular joint dislocations were fixed with hook plate (6 cases) or Kirschner wires (2 case) except 1 untreated case; the clavicular fractures were fixed with anatomical locking plate (3 cases) and hook plate (2 cases); the acromion fractures were fixed with cannulated screws (1 case), Kirschner wires (2 cases), or both of them (1 case). ResultsThe mean operation time was 158.0 minutes (range, 100-270 minutes), and the mean intraoperative blood loss was 207.7 mL (range, 150-300 mL). The other patients obtained primary healing of incision except 1 patient who had inflammation around incision, which was cured after change dressing. All patients were followed up for 22.6 months on average (range, 17-35 months). All fractures achieved union at a mean time of 3.6 months (range, 2-6 months). No nerve injury and implant fixation failure complications were observed. At last follow-up, the Constant score and the disabil ity of the arm, shoulder, and hand (DASH) score had a significant improvement when compared with scores at pre-operation (P<0.05). The shoulder range of motion in flexion, abduction, and external rotation at last follow-up were significantly higher than those at pre-operation (P<0.05). ConclusionEyres type V coracoid fracture associated with SSSC injuries usually results in the instabil ity of the shoulder. With individual surgical treatment, the satisfactory function and good effectiveness can be obtained.

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