目的:探讨应用中药熏洗方在手屈指肌腱Ⅱ区损伤修复后肌腱粘连功能恢复中的临床疗效。方法:将手屈指肌腱Ⅱ区损伤修复后的118例随机分中药熏洗组76例和无熏洗(对照组)42例,均于肌腱修复术后3周得到手指功能恢复,两组其他治疗方法均相同。测量手指活动改善情况以评定疗效。结果:118例均得到临床随访,随访时间2~4个月,平均3.1个月。中药熏洗组术后手指功能恢复较好,肌腱粘连12例,粘连率15%;对照组肌腱粘连15例,粘连率35%。两组比较,P<0.01。结论:中药熏洗可迅速消除手指肿胀,缓解手指疼痛,改善手指功能,降低肌腱粘连率,具有良好的临床疗效。

髌骨骨折是常见的骨折,随着关节镜和空心螺钉的普遍应用,自1998年2月～2002年8月,我院对109例髌骨骨折在关节镜下以克氏针经皮撬拨复位、螺丝钉固定.取得了满意的疗效.

目的探讨腓肠神经营养血管蒂逆行岛状皮瓣的临床应用效果.方法应用腓肠神经营养血管蒂逆行岛状皮瓣修复小腿下段软组织缺损14例,皮瓣切取范围4cm×3.5cm～24cm×16cm.术中利用皮瓣远端腓肠神经与受区浅表神经的远端架接.结果12例皮瓣完全成活,2例皮瓣远端部分坏死,经换药后愈合.经6～12个月随访,皮瓣感觉神经外形良好.皮瓣传导感觉平均二点分辨率为1.5cm,随访期内未出现失神经性溃疡.结论腓肠神经营养血管蒂逆行岛状皮瓣血供丰富,不牺牲重要血管神经,手术操作简单,可较好地修复小腿下部软组织缺损.

胫骨平台骨折是膝关节的常见骨折,往往导致关节面塌陷、劈裂,严重影响膝关节功能,治疗较为棘手.我院从2001年10月～2003年4月收治胫骨平台骨折72例,其中手术治疗、关节连续被动活动(CPM)锻炼64例.经1～2.5年随访,疗效满意,现报道如下.

Objective To design an arthroscopic universal aiming device for cruciate ligament repairing and evaluate its clinical efficacy. Methods The aiming device was designed on the principle of “a line crossing any point on a spherical surface and perpendicular to it must cross the sphere center”, which enables the surgeon to locate the ligamentous attachment of cruciate ligament precisely for reconstruction. Twelve cases of PCL injuries have been treated with this method. Results The average follow up period was 12.1 months (5-19 months). According to Lysholm scoring system, the average score was improved from 59.2 points to 92.7 points, increased by 33.5 points. Lachman test turned negative in all patients, the average range of motion was 120°. Conclusion The instrument was reasonably designed for easy handling and precise orientation. It is particularly preferable to locate the tibial attachment of cruciate ligament for endoscopic reconstruction on the posteromedial approach.

Objective To introduce treatment outcome of combined tissue transplant for repair of damage injuries and function reconstruction in the hands. Methods 5 cases of hand damage injury was involved. Free second toe or second and third toe with foot dorsal flap, femoral anterolateral flap, abdominal rectus muscle flap were combined to repair major area wound in hands and reconstruction of thumb and other fingers. Results All the transplants are survival. The hand functions after reconstruction increased 40 % in average in comparison with preoperative one. Conclusions Combined tissues transplant has the advantages of both primary repair of wounds in hands and reconstruction of hand function. It is a better procedure for treatment of damage injury in hands.