目的：对比分析人工全髋关节置换术和股骨头置换术治疗老年股骨颈骨折的临床效果。方法选取漯河市中医院2013年1月至2014年12月收治的120例股骨颈骨折老年患者，随机分为对照组和观察组，各60例。对照组行股骨头置换术，观察组行人工全髋关节置换术治疗。比较两组患者的疗效，并统计手术时间、住院时间和术中出血量以及并发症发生情况。结果对照组优良率为65.0%，观察组优良率为91.7%；观察组优良率高于对照组，差异有统计学意义（P ﹤0.05）。观察组手术时间、住院时间较对照组短，术中出血量较对照组小，差异有统计学意义（ P ﹤0.05）。结论人工全髋关节置换术治疗老年股骨颈骨折效果显著，能缩短手术时间和住院时间，减少并发症的发生，是治疗老年股骨颈骨折的有效方法。
目的：探讨股骨粗隆间粉碎性骨折老年患者行双极人工股骨头置换术的效果。方法选取2012年9月至2014年7月符合诊断标准的股骨粗隆间骨折患者144例，随机分为两组，每组72例。对照组实施 PFNA 内固定术，研究组患者实施人工股骨头置换术。比较两组患者的手术时长、失血量、不良事件率。6个月后随访比较其髋关节功能。结果研究组失血量大于对照组，不良事件率小于对照组，两组差异均有统计学意义（ P ＜0.05）。术后髋关节功能优良率研究组为98.61%，对照组为81.94%。结论股骨粗隆间粉碎性骨折老年患者采用人工股骨头置换术虽手术创伤大，但不良事件少，术后髋关节功能优良率高。
Objective To investigate the clinical effect of percutaneous vertebroplasty on osteoporotic vertebral compression fractures.Methods Fifty cases of patients with osteoporotic compression fractures who were treated with percutaneous vertebroplasty in traditional Chinese medicine hospital of Luohe from May 2013 to May 2014 were selected as research subjects,and their clinical data before and after treatment were reviewed.Results Preoperative and postoperative Cobb angle,anterior height of the vertebral body height and central loss rate had no significant difference (P ＞ 0.05).Postoperative pain scores were significantly lower than the preoperative ADL score,they were significantly higher than before surgery (P ＜ 0.05).Conclusions Vertebral compression fractures treated by percutaneous vertebroplasty treatment can promote improvement of clinical symptoms and improve patients' activities of daily living;the short term treatment effect is ideal,but in terms of kyphosis correction and compression vertebral height restoration,there are certain research space to the greatest degree of improvement in the prognosis for protecting the quality of life of patients.
Objective To observe the clinical curative effect of proximal femur anatomic locking plate( PFALP) and proximal femoral nail antirotation ( PFNA) in the treatment of elderly osteoporotic femoral intertrochanteric fracture. Methods The patients were respectively treated by PFALP in 42 cases of 85 cases of elderly osteoporotic intertro-chanteric fracture of the femur ( group PFALP) and PFNA in 43 cases ( group PFNA); two groups were compared with the operation time, intraoperative bleeding volume, time of fracture healing, postoperative complications, Harris hip score. Results All cases were followed up from 10 months to 26 months. In group PFNA, operation time, a-mount of bleeding, fracture healing time was significantly lower than the group PFALP, the results showed significant difference (P<0. 05);the excellent and good rate of group PFNA score was 93. 02%, group PFALP was 85. 71%, the difference between the two groups had no statistical significance (P>0. 05);Group PFNA postoperative compli-cations rate (4. 65%) was significantly lower than that of the group PFALP(26. 19%), the difference was statistical-ly significant (P<0. 05). Conclusions PFALP and PFNA in the treatment of senile osteoporotic intertrochanteric fracture of the femur are effective, while PFNA is with shorter operation time and travel less, fast recovery and less postoperative complications and other advantages.
BACKGROUND:Pedicle screw implantation is a common method to repair various spinal diseases, but there is a big difficulty in the safety and accuracy of screw placement. OBJECTIVE: To explore the effects of spinal pedicle screw implantation in the implementation of image guidance. METHODS:A retrospective analysis was performed on clinical data of 118 cases of pedicle screw implantation in the Luohe Hospital of Traditional Chinese Medicine from December 2010 to December 2013. They received internal fixation with pedicle screws. They were equaly divided into two groups according to guidance method. Observation group underwent three-dimensional imaging of spinal navigation. Control group received conventional X-ray fluoroscopy. Screw placement and repair-related indexes were observed in the two groups. After implantation, they were folowed up for 1-12 months. Postoperative complications were compared in both groups. RESULTS AND CONCLUSION: 59 patients in the observation group were implanted with 325 screws, and 59 patients in the control group were implanted with 319 screws. In the observation group, the excelent and good rate was 95% (319 screws). In the control group, the excelent and good rate was 78% (250 screws). There were significant differences in the excelent and good rate between the two groups (P < 0.05). The time required in screw placement was significantly shorter in the observation group than that in the control group (P < 0.05). Operation time and the intraoperative bleeding were significantly better in the observation group than in the control group (P < 0.05). The incidence rate of postoperative complications was lower in the observation group than in the control group (P < 0.05). These data suggest that under the guidance of three-dimensional imaging of spinal navigation, spine pedicle screw fixation can effectively shorten the time required for screw placement, improve the accuracy of implantation, and reduce the occurrence of postoperative complications.
Objective To investigate the clinical efficacy of lag screws supplemented with plate on ankle fracture combined with inferior tibiofibular joint separation. Methods Eighty cases of ankle fracture combined with inferior tibiofibular joint separation were selected and equally randomly divided into control group and observation group. The control group was treated with conservative treat-ment,and observation group was treated with lag screws supplemented with plate. The clinical efficacy was analyzed. Results After treatment,ambulation,discharge and treatment time of observation group were shorter than the control group(P <0. 01). One month after treatment,excellent rate of observation group was 92. 50%,and 72. 50% in control group,there was significant difference between the two groups(P <0. 01). Conclusion Lag screws supplemented with plate in treatment of ankle fracture combined with inferior tib-iofibular joint separation is a safe,significant effect treatment option,so it is worthy of clinical promotion.
四肢大面积皮肤撕脱伤多见于操作机器不慎及交通事故中车轮碾压伤,机器转动、滚轴辗压、车轮的扭转和压迫外力对皮下组织和筋膜分别造成不同程度损伤,使皮肤和皮下组织从深筋膜浅面或深面强行剥脱,常合并有肌肉、肌腱、神经、血管、骨与关节等深部组织损伤,早期可合并休克,若处理不当常可使皮肤坏死,创面感染,影响功能的恢复.如何使损伤部位的外形与功能得到最大的保留和恢复,是创伤外科一个重要的课题.我科自2000年1月至2006年12月共收治四肢大面积皮肤撕脱伤37 例,治疗效果良好,现报告如下.
2000-2006年,笔者采用桡骨茎突切除加桡动脉返支骨膜瓣移植治疗腕舟骨骨折不愈合患者22例,疗效满意,现报告如下.
自1996～2000年,作者采用带股方肌大转子骨瓣并空心加压螺钉治疗60岁以下股骨颈骨折30例,取得满意效果.现报告如下.
1995-2006年间,我科采用带血管蒂胫骨骨皮瓣交叉移植治疗胫骨和皮肤缺损38例,经随访观察,疗效满意,现总结报告如下.1资料与方法1.1临床资料本组38例中男29例,女9例;年龄18～58岁,平均39岁.左侧15例,右侧23例,圆形皮肤缺损16例,纵长形皮肤缺损8例,横形皮肤缺损8例,斜形皮肤缺损6例.骨折类型:横断型17例,蝶型12例,螺旋型9例.加压钢板固定21例,断裂4例;髓内行固定10例,断裂2例;外固定架固定7例,断裂者为固定物不合适所致.第一次手术在当地医院治疗28例,在本院治疗10例.第二次手术距受伤时间3个月12例,4个月14例,5个月以上12例,平均4.5个月.
膝后十字韧带胫骨附着处骨折临床中较少见,移位骨折治疗上亦较棘手.近10年来,我科先后收治移位骨折6例,现总结于下.
1999年3月我科引进"长弓"牌电脑控制三维多功能腰椎牵引床快速牵引,并配合其它辅助方法治疗腰椎间盘突出症(以下简称LIDP)86例疗效满意,现分析报告如下.
