目的 研究分析负压封闭引流技术治疗骨创伤创面软组织损伤的临床效果.方法 我院接收200例骨创伤创面软组织损伤患者,时间为2015年1月—2017年1月.根据患者入院时间先后分为对照组和观察组.对照组实行常规治疗方法,观察组患者采用负压引流技术治疗.对比两组患者的临床治疗效率.结果 对比两组患者创面面积、换药次数、VAS疼痛评分以及住院时间,观察组患者均具有明显的优势,差异有统计学意义(P<0.05).结论 临床治疗骨创伤创面软组织损伤,对比常规性的治疗措施,负压引流技术临床效率更显著,可减轻患者疼痛,改善创面,更有助于患者康复.

目的 分析早期闭合复位经皮穿针固定治疗闭合性Lisfrance关节骨折脱位的临床效果.方法 回顾性选取选取2002年1月至2016年6月期间我科室收治的31例Lisfrance骨折脱位患者的临床资料,均经X线或CT断层扫描确诊,行早期(受伤后24h内)闭合复位经皮穿针固定治疗,术后定期复查X线片或CT.采用Maryland足部评分系统评定手术效果,并记录并发症发生情况.结果 与术前相比,31例患者术后1年Maryland足部评分中疼痛、活动度、步态行走距离、外观、踝、稳定度、支撑、跛行、鞋、上下楼梯、地形评分及总分均显著提高,差异有统计学意义(P＜0.01).31例患者中,Lisfrance关节骨折脱位足部手术疗效评价为优者19例、良12例,优良率为100％.随访期出现感染、关节炎者各1例,并发症发生率为6.45％.结论 早期闭合复位经皮穿针固定治疗闭合性Lisfrance关节骨折脱位的临床复位效果满意,并发症少,对改善患者预后有重要意义.

Objective To explore the morphological characteristics and change rule of thoracic joint angles in children aged from 10 to 12 years through thinner CT scanning and 3D reconstruction,and to provide theoretical basis for early diagnosis,treatment and prevention.Methods Totally 30 normal cases aged from 10 to 12 years were admitted into this study.There was no bone destruction,deformity,fractures,tumors and spine surgery involved.DICOM 3.0 data of multi-slice spiral CT (0.625 ～ 1.25 mm),ranging from T1 to T12,were used for 3D reconstruction,measurement and statistical analysis.Results The difference between left and right sagittal section angle of zygopophysis was less than 10°.There was no significant differences between T1,T11,and T12for sagittal section angle of upper zygopophysis (P ＞ 0.05).So was it between T3,T4,T9,T10 and T11 for sagittal section angle of lower zygopophysis (P ＞ 0.05).While there were significant differences between others(P ＜ 0.05).The was no significant difference between left and right coronal plane angle of zygopophysis (P ＞ 0.05).Coronal plane angle of lower and upper zygopophysis tended to be ‘ spike-like’,and the maximum points were at T7 to T9.For horizontal plane angle,left and right upper zygopophysis made significant differences between T2,T4,T8,T10 and T12 only,so did T7 lower zygopophysis (P ＜ 0.05).Horizontal angle of upper zygopophysis tended to be stable in the upper thoracic both in the left and right side,while a decreasing trend was shown in lower thoracic.Horizontal angle of lower zygopophysis showed a decreasing trend generally except individual vertebrae.Both upper and lower zygopophysis showed negative angle at T11 and T12 levels.Conclusion Thoracic joint angles(coronal,sagittal and horizontal angle) in children aged from 10 to 12 years can directly reflect the developmental regularity with growth,and it verified the tendency that horizontal facet joints of the cervical spine gradually changes to coronal facet joints thoracic spine and then changes to sagittal facet joints of lumbar spine.And the left and right side facet joints are basically symmetrical with the angle difference less than 10°.

目的 对于四肢骨折合并创伤性休克患者的临床资料进行临床分析,同时观察早期急救对于患者生命的抢救和病情评估的效果.方法 50例四肢骨折合并创伤性休克患者,对所有患者的临床资料进行调查研究,并作回顾性分析,对患者的临床急救方法和效果作出统计.结果 50例患者经过早期抗休克治疗和骨折固定复位治疗后,48例患者救治成功,并结转入普通病房接受康复治疗,救治成功率为96.0%;2例患者经过抢救和干预后无效死亡,死亡率为4.0%.结论 临床上对于四肢骨折合并创伤性休克患者进行干预护理时,患者配合早期治疗能有效提高抢救成功率,降低死亡率.

BACKGROUND:Articular process of joint is an important bony structure to maintain the spinal stability and normal physiological activities. Clinical study found that bilateral articular process asymmetry is also one of the causes of vertebral degeneration, but the existing research mainly focuses on the adult, and give priority to with cervical vertebra and lumbar vertebra. OBJECTIVE:To explore the morphological and developmental characteristics of thoracic facet joints and bony structures of 10 to 12-year-old children and compare with data of adults. METHODS:A total of 30 normal cases aging from 10 to 12 years were admitted into this study. No cases experienced bone destruction, deformity, fractures, or tumors, and spine surgery was not involved in. DICOM 3.0 data of multi-slice spiral CT (0.625-1.25 mm), ranging from T1 to T12, were used for three-dimensional reconstruction, measurement and statistical analysis. RESULTS AND CONCLUSION:(1) Joint width overal trends in“V”. Joint surface height from T1 to T12 increased gradual y with the increase of the operation sequence. (2) The joint thickness from T1 to T12 showed a gradual y increasing trend with the increase of the job sequence;articular process under the joint thickness was gentle. In the left and right sides of the upper and lower joints, joint surface width, height, and thickness did not show significant difference in addition to the significant difference between the individual vertebral body. Joints spacing on the side and there was no significant difference between upper and lower, articular process spacing between sides showed an increasing trend with the increase of operation sequence;upper and lower joints spacing increased with the job sequence, and showed wide“U”shape. (3) These results confirmed that the application of three-dimensional reconstruction techniques can display shape and characteristics of each vertebral body clearly and intuitively and improve measurement accuracy. Width and height of facet joints in 10-12-year-old school children were overal smal er than those of adults. The distance between upper and lower facet joints changed a little. Distance between left and right facet joints increased from T1 to T12, which complies with the growth and development of children.

目的:对胫骨中下段骨折患者实施经皮微创接骨板内固定术(MIPO),并对该种治疗方式的临床价值予以评价.方法:选择胫骨中下段骨折患者,据数据归纳发现有100例患者,按照丢硬币的方式分为2组,所丢硬币为正面者归类到研究组,所丢硬币为反面者归类到对照组,前组予以经皮微创接骨板内固定术,后组予以传统切开复位内固定术,对组间患者的临床治疗总优良率和并发症发生率予以评价和分析.结果:对比组间患者的临床治疗总优良率和并发症发生率方面,数据差异对比有意义,且研究组的优势性均更大,P<0.05.结论:对胫骨中下段骨折患者实施经皮微创接骨板内固定术,可以促进患者的疾病恢复,能够对患者的骨折区域血流情况予以有效维护.

目的:探讨应用锁定加压钢板微创治疗胫腓骨中下段粉碎性骨折的临床疗效。方法:2010年1月～2012年2月,38例胫腓骨中下段粉碎性骨折微创锁定加压钢板内固定治疗。结果:术后随访6～30个月,平均随访时间15.4个月,骨折平均愈合时间18.7周,疗效根据Baird-Jackson评分标准。评价:优18例,良5例,中2例,差0例,优良率92.00%。结论:微创锁定加压钢板内固定是治疗胫腓骨中下段粉碎性骨折的一种较好方法,具有手术创伤小,并发症少,骨折愈合快,功能恢复满意等优点。

<正>随着人口老龄化,老年股骨粗隆间骨折已经非常普遍,为减少因此带来的并发症,提高病人的生活生存质量,良好的手术治疗已经成为创伤骨科医生高度认知的问题。从2009年9月~2010年10月内我们应用锁定加压接骨板微创治疗老年股骨近端骨折31例取得了良好疗效,先介绍其方法与同行探讨。

目的合理选择胫骨平台骨折的手术方案。方法对23例胫骨平台骨折LCP+开窗植骨复位,分析治疗效果。结果 23例患者均取得良好的效果。结论膝关节是下肢主要负重关节,大多数胫骨平台骨折改变了膝关节的解剖形态及膝关节的轴向对线,所以要求手术治疗恢复其精确的解剖关系,良好的复位,内固定及术后早期功能锻炼是恢复膝关节功能的关键。

<正>跟骨骨折是临床上常见的复杂骨折,其治疗长期以来存在争议,预后多不太满意。近年来,随着Sanders CT分型及内固定器材和手术方法的改进,对跟骨关节内骨折的手术治疗,已能取得较为满意的效果,减少或避免并发症的发生。我科自2002年6月~2010年6月,应用钢板螺钉内固定手术治疗跟骨关节内骨折72例,临床效果满意。现报道如下。1资料和方法1.1一般资料