目的 探讨关节镜下复位内固定治疗胫骨髁间隆突撕脱骨折的疗效.方法 回顾性分析2017年1月至2019年1月本院收治的48例胫骨髁间隆突撕脱骨折患者的临床资料,全部患者均接受关节镜下复位内固定治疗,其中27例患者接受钢丝内固定,21例患者接受空心螺钉固定,手术治疗完成3周后为其应用可调式支具制动4～5周,并开展功能锻炼指导.结果 术后进行6个月的随访,术后3个月,X线片检查显示患者的骨折均得到良好愈合,骨折愈合时间为(4.8±0.8)个月,全部患者的膝关节均具备正常活动度,同时Lachman试验以及前抽屉试验结果均为阴性.无患者出现关节感染僵硬、行走不稳、屈伸受限以及慢性疼痛等严重并发症.术后6个月Lysholm膝关节评分与优良率明显高于术后3个月,比较差异具有统计学意义(P<0.05).结论 关节镜下复位内固定治疗胫骨髁间隆突撕脱骨折的疗效确切,可促使骨折愈合,且并发症少.

目的 探讨胫骨平台骨折手术的临床效果,以供临床参考.方法 选择2009年7月-2012年6月我院收治的胫骨平台骨折患者116例作为研究对象,随机分组.A组接受双钢板内固定手术治疗,B组接受锁定钢板内固定手术治疗.术后随访1年,对比两组患者骨折愈合时间、膝关节HSS评分、术后并发症发生率的差异性.结果 与A组对比发现,B组骨折愈合时间较短,膝关节HSS评分较高,差异具有统计学意义(P＜0.05).对比两组手术并发症发生率发现,组间差异无统计学意义(P＞0.05).结论 双钢板内固定和锁定钢板内固定在胫骨平台骨折的治疗中均可获得满意的疗效,其中锁定钢板内固定在促进骨折愈合和膝关节功能恢复方面具有更大的优势,值得在今后的临床工作中推广应用.

Objective Investigate the clinical effect of proximal femoral nail ( PFNA ) and dynamic condylar screw in the treatment of femoral intertrochanteric fractures, for clinical references. Methods 85 cases with femoral intertrochanteric fractures patients in Aug. 2010 to Jul. 2012 in our hospital were choosed as research objects, randomly grouping. The control group was received PFNA treatment, the observe group was received dynamic condylar screw treatment. All cases were followed up 1 year later. The operation time, amount of bleeding, fracture healing andhip joint Harris score of the two groups were compared. Results Compared with the control group, Compared with the control group, longer surgical patients in the observation group (93.68 ± 14.85)min, greater blood loss (283.96 ± 40.12)mL, fracture healing time is shorter (97.32 ± 9.65)d, has statistically significant differences (P<0.05). Compared of The hip joint Harris score of the two groups has no significant differences. Conclusion PFNA and dynamic condylar screw in the treatment of femoral intertrochanteric fractures has good clinical effect in hip joint recovery. Two operation has advantage respectively, the operation time of PFNA is short and the amount of bleeding is little. The healing time of dynamic condylar screw fracture is short. The appropriate operation mode for femoral intertrochanteric fractures will be choosed in clinical work.

目的：观察椎体成形术治疗胸腰椎骨折的临床效果，以供临床参考。方法选择2011年8月至2012年7月我院胸腰椎骨折患者78例为研究对象，均接受椎体成形术治疗。对比治疗前后患者疼痛程度、伤椎前缘、中央高度值、后缘压缩率等差异性。结果与治疗前对比发现，治疗后患者VAS评分、伤椎前缘、中央高度值、后缘压缩率等指标明显下降，差异具有统计学意义（P＜0.05）。结论椎体成形术在胸腰椎骨折的临床治疗中疗效确切，值得临床推广应用。

Objective To observe the clinical effect of stemless hip replacement.Methods The stemless hip replacement was performed in 20 cases and the effect evaluated.Results Follow-up for average 12.6 months(5~24 months)showed satisfactory outcomes in all cases after the stemless hip replacement.Based on harris scale(averaging 92.1),the excellent result was seen in 16 cases,good in 3 cases and common in 1 case,with total excellence rate of 90.9%.Conclusions Stemless hip replacement is characterized by little trauma,less blood loss,less complications and fitting for revision.The general effects of this technique are satisfactory.It is especially suitable for the old and weak cases or the young cases who need hip replacement.The long term outcomes need further evaluation.

目的 观察脊柱胸腰段爆裂骨折前路与后路手术效果,分析两种手术后椎体矫正角度丢失对影像学结果的影响,为治疗提供依据.方法 回顾分析本院56例脊柱胸腰段爆裂骨折患者的临床资料,按照手术入路分为前路手术和后路手术两组,前路手术组26例,后路手术组30例.随访24～48(36±11.7)个月.根据随访X线侧位片测量矢状位cobb角作为评价标准,并进行统计学分析.结果 2组术前与术后即刻cobb角差异无统计学意义(P>0.05),随访结束时2组cohb角差异有统计学意义(P<0.01).结论 矫正度丢失是脊柱胸腰段爆裂骨折术后常见的并发症,前路手术对于改善和维持脊柱该段骨折的矫正度优于后路手术.