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find Author "钟易林" 2 results
  • RECONSTRUCTION OF THE MEDIAL COLLATERAL LIGAMENT OF ELBOW

    【Abstract】 Objective To evaluate the cl inical effect of excising the radial head, repairing or reconstructing themedial collateral l igament (MCL) in treating comminuted fracture of the radial head accompanying by MCL injury. Methods From September 2000 to April 2006, 18 patients with comminuted fractures of radial head accompanying by MCL injury were treated by excision of the radial head, repair or reconstruction of the MCL. Of them, there were 12 males and 6 females,aged 21 to 57 years. Injury was caused by high fall ing in 10 cases and by traffic accidents in 8 cases. According to Mason classifications,13 fractures were of type Ⅲ and 5 of type Ⅳ . Fifteen cases of fresh fractures were operated within 2 weeks, 3 cases of old fractures at 4, 6, and 14 months after injury respectively. Four cases underwent MCL repair and 14 cases underwent MCL reconstruction. Results All the 18 cases were followed up 1-5 years (mean 3 years ). According to Broberg and Morrey scoring system, 4 patients were rated as excellent, 12 as good, 1 as fair, and 1 as poor. The excellent and good rate was 88.9%.Three patients had l ight pain of elbow, 1 patient had moderate pain and the other 14 had no pain. The range of elbow motion was from 110 to 140°(mean 130°). The pronation averaged 75° (35-85°). The supination averaged 80° (65-89°). Compared with normal l imbs, the grip strength decreased by 3% to 28% (mean 15%); the extension strength decreased by 8% to 39% (mean 30%); the flexion strength decreased by 7% to 29% (mean 18%); the pronation strength decreased by 7% to 31% (mean 20%);the supination strength decreased by 15% to 45% (mean 25%). The X-ray films showed that carrying angle increased by 0 to 11°(mean 5° ) under two-newton-meter valgus torque. There were significant differences between injured l imbs and normal l imbs (P lt; 0.05). Conclusion The MCL was the primary valgus stabil izer of the elbow. If the radial head replacement could not becarried out, the repair or reconstruction of the medial collateral l igament was effective.

    Release date:2016-09-01 09:09 Export PDF Favorites Scan
  • 闭合复位掌骨间克氏针固定治疗第一掌骨基底部骨折

    目的总结闭合复位第1、2掌骨间克氏针固定治疗第1掌骨基底部骨折的临床疗效。 方法2009年4月-2012年3月,采用闭合复位第1、2掌骨间克氏针固定治疗第1掌骨基底部骨折患者29例。男22例,女7例;年龄25~51岁,平均30.5岁。伤后至手术时间1 h~3 d,平均9.6 h。骨折根据Green-O’Brien分型:Ⅰ型13例,Ⅱ型5 例,ⅢA型9例,ⅢB型2例。采用疼痛视觉模拟评分(VAS)评估拇指关节疼痛情况;测量第1腕掌关节屈伸活动度(range of motion,ROM)、拇指外展ROM及握力,分别与健侧比较;末次随访时摄X线片根据改良Eaton-Littler分期标准评估骨关节炎表现。 结果患者均获随访,随访时间12~16个月,平均13.2个月。其中3例发生针道感染,2例发生克氏针松动。患者骨折均获骨性愈合,愈合时间为3~4个月,平均3.3个月。末次随访时VAS评分为(0.48±0.06)分。第1腕掌关节屈伸ROM、拇指外展ROM及握力与健侧比较,差异均无统计学意义(P>0.05)。第1腕掌关节骨关节炎表现:Ⅰ期15例,Ⅱ期6例,Ⅲ期8例。 结论闭合复位第1、2掌骨间克氏针固定操作简便、损伤小、疗效确切,是治疗第1掌骨间基底部骨折的有效方法。

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