目的:分析带线锚钉与可吸收缝线重建喙锁韧带+锁骨钩板对陈旧性肩锁关节脱位治疗效果及视觉模拟自评量表(VAS评分).方法:选定本院2019年1月至2022年1月住院的120例陈旧性肩锁关节脱位患者,以随机法将其分组(每组60例),对比组给予锁骨钩钢板治疗,观察组给予带线锚钉与可吸收缝线重建喙锁韧带+锁骨钩板治疗,对比两组治疗优良率、VAS评分、肩关节Constant-Murley评分、肩关节活动度(ROM)、并发症总发生率.结果:观察组治疗优良率(95.00％)高于对比组(75.00％),观察组治疗后VAS

OBJECTIVE To compare the clinical efficacy of distal radius T-plate combined with suture anchor and distal clavicle anatomical locking plate combined with suture anchor in the treatment of Neer Ⅱb distal clavicle fracture. METHODS From June 2014 to June 2018, 42 patients with Neer Ⅱb distal clavicle fractures were retrospectively analyzed. According to different surgical methods, they were divided into the observation group (T-shaped plate combined with suture anchor) and the control group (anatomical locking plate combined with suture anchor). There were 22 patients in the observation group and 20 patients in the control group. In the observation group, there were 13 males and 9 females, aged from 22 to 70 (45.78± 14.44) years old, 12 cases on the left side and 10 cases on the right side, 8 cases of traffic accident injury and 14 cases of fall. In the control group, there were 12 males and 8 females, aged from 24 to 66 (44.17±15.58) years, 13 cases on the left side and 7 cases on the right side, 6 cases of traffic accident injuryand 14 cases of fall. The operation time, intraoperative blood loss and fracture healing time were compared between the two groups, and Constant Murley score was used to evaluate shoulder joint function. RESULTS The patients in both groups were followed up for 18 to 24 (20.96±2.02) months. The incisions of both groups were healed at stageⅠ. The fracture ends of both groups were bony healed at the last follow up. There was no significant difference in operation time, intraoperative blood loss and fracture healing time between two groups (P>0.05);there was no significant difference in shoulder joint function between two groups at 3 months after operation (P>0.05). CONCLUSION The two methods can obtain satisfactory results in the treatment of Neer Ⅱb distal clavicle fractures, especially suitable for patients with comminuted distal clavicle fractures or osteoporosis; the clinical effect of the treatment of NeerⅡb distal clavicle fractures with T type distal radius plate combined with suture anchor is satisfactory, which provides another feasible treatment scheme for clinic.

目的 观察超声辅助下闭合复位克氏针固定治疗儿童肱骨髁上骨折的临床疗效.方法 自2014年10月—2018年10月本院收治住院患者,临床诊断为肱骨髁上骨折,采用超声辅助下闭合复位克氏针固定治疗儿童肱骨髁上骨折,术后评估其临床疗效.结果 本组48例患者均获得6～12月随访,平均随访时间8个月,所有患者伤口均Ⅰ期愈合,无感染及神经损伤症状,术后1个月、3个月、6个月复查肘关节X线片,见骨折均对位对线良好,固定坚强.48例患者骨折均获得愈合,愈合时间为10～24周,平均12.8周.均无断钉及骨折不愈合及创伤性关节炎等并发症发生,效果满意.结论 采用超声辅助下闭合复位克氏针固定可准确显示骨折复位情况及尺神经位置,引导穿针,可有效避免尺神经损伤,提高穿针的安全性,临床效果满意.

目的:观察腓骨远端解剖钢板治疗旋后-内收型Ⅱ度内踝骨折的临床疗效.方法:自2010年3月至2017年8月,对28例旋后-内收型Ⅱ度踝关节骨折患者,采用腓骨远端解剖钢板固定内踝骨折,术后评估其临床疗效.结果:本组28例患者均获得6～24个月随访,平均随访时间14个月.所有患者伤口均I期愈合,术后1,3,6及12个月复查踝关节X线片,28例患者骨折均获得愈合,平均愈合时间16.8周.根据AOFAS踝-后足评分系统评价:术后评分75～94分,优16例,良9例,可3例.结论:采用腓骨远端解剖钢板治疗旋后-内收型Ⅱ度内踝骨折,固定坚固,对软组织损伤较小,并发症少,临床效果满意.

目的:分析超声辅助下闭合复位克氏针固定治疗儿童肱骨髁上骨折的临床研究.方法:将40例儿童肱骨髁上骨折患者选为研究对象,为其选取超声辅助下闭合复位克氏针固定进行治疗,评估并探讨其治疗效果.结果:40例患者伤口均在Ⅰ期愈合,无感染、神经损伤、并发症发生,患者骨折均对位对线良好、固定坚强、获得愈合,愈合时间10～24周,平均为(12.8±6.5)周.结论:超声辅助下闭合复位克氏针固定治疗儿童肱骨髁上骨折的临床效果显著,具有较高的安全性,值得推荐.

目的：探讨前侧切开复位外侧固定联合骨髓移植治疗GardenⅢ、Ⅳ型股骨颈骨折的治疗效果。方法自2009年3月至2012年6月对32例GardenⅢ、Ⅳ型股骨颈骨折患者采用前侧切开复位外侧固定联合骨髓移植空心钉内固定治疗，术后1、3、6、9、12个月来院复查髋关节 X线片，同时进行髋关节Harris评分，记录下地负重时间，骨折线消失时间，股骨头缺血坏死或者骨不连发生时间。结果32例患者均获得18～36个月随访，平均24个月，所有患者术后伤口Ⅰ期愈合，31例患者骨折愈合，平均愈合时间为6个月，术后1例出现骨不连，1例出现股骨头坏死。结论通过前侧切口在直视下达到解剖复位，外侧切口辅助固定，它的创伤更小，对股骨头血供也无影响，同时经前侧切口进行骨髓干细胞移植，它促进了骨折区域骨的修复及损失血管的修复和再生，临床效果满意。

目的：探讨人工膝关节置换术后延迟开放引流管对失血及术后恢复的影响。方法将64例同期初次接受单侧全膝关节置换术患者随机分为延迟组30例，常规组34例，均于手术结束前放置18号硅胶引流管。延迟组术毕松开止血带后即刻关闭引流管，术后4 h开放；常规组术后一直通畅引流。两组均于术后引流量＜100 mL/d时拔出引流管。比较两组术后引流量、术后24 h血红蛋白水平，伤口愈合及膝关节功能康复情况。结果延迟组术后总引流量及血红蛋白下降值均显著低于常规组（P＜0．05）。两组术后切口感染发生率及早期膝关节功能评分无统计学差异。结论人工膝关节置换术后延迟开放引流管对减少术后出血有一定效果。

目的 探讨高频三维超声对三角韧带断裂的诊断价值.方法 对68例拟诊为三角韧带断裂患者分别采用高频三维超声和MRI检查,以手术中探查结果作为三角韧带是否断裂的最终结果,比较2种检查方法的符合率.结果 高频三维超声诊断三角韧带断裂40例,在超声下主要表现为踝关节内侧韧带连续性完全中断,部分区域出现无回声区,内翻试验无回声区间距明显增大;外/内翻韧带试验下探查见低无回声区间距增大;MRI检查诊断三角韧带断裂41例,表现为韧带的连续性中断,韧带松弛以及波浪状改变,韧带内出现异常高信号;其中有一种检查结果提示三角韧带断裂,即行三角韧带探查,42例行手术探查证实三角韧带断裂,并行三角韧带探查修补术,26例行保守治疗;高频三维超声检查真阳性39例,假阳性1例;MRI检查真阳性40例,假阳性1例;高频三维超声诊断符合率为92.85％(39/42),MRI检查诊断符合率为95.23％(40/42).结论 高频三维超声对三角韧带断裂诊断符合率接近MRI检查,具有便捷、可重复检查等优点.

OBJECTIVE:To observe the clinical effects of clavicular hook plate combined with suture anchor in treating type Tossy III chronic acromioclavicular dislocation.METHODS:From January 2008 to December 2012,18 patients with type Tossy III chronic acromioclavicular dislocation were treated with clavicular hook plate and suture anchor. There were 12 males and 6 females, aged from 20 to 56 years old with an average of 31.5 years. Ten cases were left dislocation and 8 cases were right dislocation. Operation time was 3 weeks to 4 months after injury with a mean of 1.8 months. Functional exercise was adopted 2 weeks after operation. And Karlsson standard was used to evaluate curative effect.RESULTS:All patients were followed up for 6 to 24 months with an average of 16 months. According to Karlsson standard, 17 cases were excellent and 1 was poor.CONCLUSION:Clavicular hook plate combined with suture anchor can repair conoid ligament and trapezoid ligament in treating type Tossy III chronic acromioclavicular dislocation, and had advantages of simple operation, less trauma, stable fixation, it can obtain satisfactory effects.