Objective To access the effect of V+L-type high tibial osteotomy and plate fixation for the treatment of varus of knee.Methods After the screening before surgery,we measured the angle of varus deformity and then calculated the thickness of the V osteotomy,posterior tibial cortical bone is not cut off,was in near L shaped transverse cross-sectional bone,and then fixed with tibia plate.Results The effect is satisfactory in all the patients.Conclusion That the use of V+L-type proximal tibial osteotomy and internal fixation of varus knee surgery has good clinical result.

Objective To explore the repair of the open compound wounds in lower extremities caused by multiple factors. Methotis Transplantation of cutaneous.musculo-cutaneous or greater omentum flaps were applied to 155 patients of open compound lower extremity wounds. Results The wound healing rate following first operation was 50% and that following two operations was 14.8%.While the wounds were healed in 7.7% of patients after three operations. Conclusion Transplantations of cutaneous,musculo-cutaneous or greater omentum flaps ale effective to repair and reconstruct the open compound lower extremity wounds.

骨科切口感染是影响手术效果的重要因素.骨科切口感染的预防虽经临床医师的不懈努力,其感染发生率仍在0.7%～8.5%之间,甚至带来灾难性后果.近年来我院实施综合性切口感染的预防措施,获得了535例骨科无菌切口无感染的良好效果.

目的观察胫骨高位截骨、胫骨结节旋转抬高治疗膝内翻伴胫骨旋转畸形的效果.方法通过膝关节生物力学研究,简化了胫骨高位截骨的测量方法,在胫骨高位截骨的同时进行胫骨结节旋转抬高,恢复胫股关节、髌股关节的生理功能.结果随访1～8年,通过X线、CT检查及膝关节功能评定,其优良率为88%.结论胫骨高位截骨、胫骨结节旋转抬高治疗膝关节内侧间隔退行性关节炎、胫骨旋转所致髌股关节炎,符合生物力学要求,长期随访效果满意.

1 病例报告 患者男,38岁.1999年12月被高空坠落物(约100 kg)砸伤颈后部,当时感颈后剧痛,且向双肩放散,颈活动障碍,无昏迷及恶心、呕吐,无上下肢活动障碍及大小便失禁.经当地医院 X 线检查诊断为 C4、5 骨折脱位,C4、5 棘间、棘上韧带、黄韧带完全性断裂.MR 检查示:C4、5 椎体脱位,脊髓纡曲绕行与脱位成角椎体一致.行颅骨牵引后复位,但去除牵引后再次脱位,遂带颈围出院.出院后两年中病情无加重,可从事重体力劳动.2%硝酸银液治疗支气管胸膜瘘3例

股骨颈骨折内固定前准确复位非常重要.我院自1990年以来应用Wellmerling股骨颈骨折复位技术并加以改进,治疗移位的股骨颈骨折37例,取得了满意效果.

患儿:女,3岁。1990年10月入院。1990年6月,因先天性髋脱位髋臼发育不良而施行髋臼造盖,股骨旋转截骨术,术中取髂骨髋臼造盖,用1枚克氏针贯穿植骨块与髂骨固定。术后,单髋人字石膏固定3个月,去石膏。1990年9月在当地医院局麻下取克氏针,因患儿哭闹,取针失败,转我院。