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Buttress plate fixation of coronoid process fractures via a medial approach 被引量:12
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作者 Kelvin Kah Ho Lor Dong Hao Toon Andy Teck Huat Wee 《Chinese Journal of Traumatology》 CAS CSCD 2019年第5期255-260,共6页
Purpose:To assess the clinical and radiographic outcomes of coronoid process fractures surgically managed with buttress plate fixation via a medial approach.Methods:A retrospective review of all coronoid fractures sur... Purpose:To assess the clinical and radiographic outcomes of coronoid process fractures surgically managed with buttress plate fixation via a medial approach.Methods:A retrospective review of all coronoid fractures surgically fixed in our institution using a buttress plate technique via a medial approach between June 2012 and April 2015 by the senior author was performed.These fractures were all sizeable fractures contributing to persistent elbow instability in terrible triad or varus posteromedial rotatory instability injury patterns.A prospective telephone questionnaire was conducted to assess patient outcomes using the disabilities of the arm,shoulder and hand(DASH)score and Mayo hlbow performance score(MEPS).Results:Twelve patients were included in the study,comprising 10 males and 2 females with an average age of 39 years(range,19-72 years).Mean follow-up was 16 months(range.4-18 months).The average time to radiographic union was 4 months(range.3-7 months).Range of motion measurements at final follow-up were obtained in 11 out of 12 patients,with one patient defaulting follow-up.All 11 patients displayed a functional elbow range of motion of at least 30°-130°.with an average arc of motion of 130°(range.110°-140°).mean elbow flexion of 134°(range.110°-140°)and mean flexion contracture of 3°(range.0°-20°).The mean DASH score was 16(range.2.5-43.8)and the mean MEPS was 75(range.65-100).Complications observed included one patient with a superfic ial wound infection which resolved with a course of oral antibiotics and one patient with radiographic evidence of heterotopic ossification which was conservatively managed.No residual elbow instability was observed and no reoperations were performed.Conclusion:Buttress plate fixation via a medial approach of coronoid process fractures that contribute to persistent elbow instability represents a reliable method of treatment that produces satisfactory and predictable outcomes. 展开更多
关键词 Coronoid process anteromedial FACET fracture Complex ELBOW INSTABILITY Terrible TRIAD injury
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Irreducible anteromedial radial head dislocation without fracture caused by transposed biceps tendon in an adult:A case report and literature review
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作者 Ming-Fu Fu Hai-Ning Zuo +2 位作者 Tao Sun Ming-Zhang Mu Zhi-Yong Zhou 《Chinese Journal of Traumatology》 CAS CSCD 2024年第3期180-186,共7页
Irreducible anteromedial radial head dislocation(IARHD)caused by transposed biceps tendon is rare.Delayed diagnosis and surgical failure often occur.A 46-year-old fisherman presented with 10 days history of painful sw... Irreducible anteromedial radial head dislocation(IARHD)caused by transposed biceps tendon is rare.Delayed diagnosis and surgical failure often occur.A 46-year-old fisherman presented with 10 days history of painful swelling and restricted movement of his right elbow due to strangulation injury by a fishing boat cable.On examination,the images of the right elbow reveals in a"semi-extended and pronated"elastic fixation position.Radiography and 3-dimensional reconstruction CT reveals an isolated anteromedial radial head dislocation with extreme protonation of the radius and the bicipital tuberosity towards the posterior aspect of the elbow joint,and MRI shows biceps tendon wrapping around the radial neck,similar to umbilical cord wrapping seen in newborns.The Henry approach was applied for the first time to reduce the biceps tendon.The patient achieved a good functional recovery at 26 months,which represents the first reported case of IARHD without fracture caused by biceps tendon in an adult.In treatment of IARHD,attention should be paid to the phenomenon of biceps tendon transposition.Careful clinical examination,comprehensive imaging modalities,and appropriate surgical approach are the keys to successful management. 展开更多
关键词 Biceps tendon Henry approach IRREDUCIBLE anteromedial dislocation Radial head ELBOW ADULT
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三入路关节镜技术治疗踝关节前外侧撞击征 被引量:6
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作者 邓宇 桂鉴超 +2 位作者 蒋逸秋 邢麟子 陆一鸣 《中国骨与关节损伤杂志》 2012年第10期905-907,共3页
目的探讨三入路关节镜技术治疗踝关节前外侧撞击征的临床疗效。方法常规建立前内侧、前外侧入路,然后建立前下外人路,通过这3个人路进行关节镜手术治疗躁关节前外侧撞击征26例。术后随访采用Meislin评分和美国足踝外科协会(AOFAS)... 目的探讨三入路关节镜技术治疗踝关节前外侧撞击征的临床疗效。方法常规建立前内侧、前外侧入路,然后建立前下外人路,通过这3个人路进行关节镜手术治疗躁关节前外侧撞击征26例。术后随访采用Meislin评分和美国足踝外科协会(AOFAS)踝关节评分系统。结果每例踝关节前外侧撞击征关节镜下可以发现以下1-5个病变:局限性滑膜炎、瘢痕组织增生、半月板样病变、距腓前韧带(ATFL)部分撕裂、前下胫腓联合韧带(AITFL)远侧束、骨赘、游离体、附属小骨、软骨损伤。其中最多的是软骨损伤(18例),其次是瘢痕组织增生(17例)和局限性滑膜炎(14例)。所有患者均获得18—36个月(平均24.5个月)随访,AOFAS评分术前为(70.3±8.2)分,末次随访时(92.0±5.3)分,t=11.3,P〈O.01;采用Meislin评分:优10例,良1l例。可5例,优良率8018%。’结论三人路关节镜技术能够到达前外侧沟的任何部位,可以明确诊断踝关节前外侧撞击征的病因,同时具有手术操作简单、安全性好、疗效佳的优点。 展开更多
关键词 踝关节撞击征 关节镜 前内侧 前外侧 前下外侧 入路
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过伸内翻型胫骨平台骨折新型钢板的设计及有限元分析
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作者 梁钟帅 王仁崇 +4 位作者 张璐 胡居正 石展英 谢友 毛春华 《中国组织工程研究》 CAS 北大核心 2024年第33期5283-5288,共6页
背景:目前尚无适用于前内侧平台的解剖型锁定钢板,因此通常采用胫骨平台内侧锁定钢板偏前放置来固定过伸内翻损伤导致的前内侧压缩骨折。由于锁定螺钉无法实现对骨折线的垂直固定,再加上髌韧带的影响,临床效果仍不尽人意。目的:通过有... 背景:目前尚无适用于前内侧平台的解剖型锁定钢板,因此通常采用胫骨平台内侧锁定钢板偏前放置来固定过伸内翻损伤导致的前内侧压缩骨折。由于锁定螺钉无法实现对骨折线的垂直固定,再加上髌韧带的影响,临床效果仍不尽人意。目的:通过有限元分析比较新型钢板与传统内固定方式治疗胫骨平台前内侧骨折的生物力学性能。方法:收集20例内翻型胫骨平台前内侧骨折的CT数据,并对其形态学特征,如前内侧胫骨平台后倾角、骨折面角度、骨折块表面积、高度和角度等进行测量。选择1位24岁、身高175 cm、体质量65 kg的男性志愿者,将其胫骨CT数据导入Mimics 21.0软件生成三维模型。在SolidWorks 2017软件中导入内固定模型,根据测量的形态学数据建立新型钢板、内侧锁定钢板、后内侧锁定钢板和6.5 mm拉力螺钉固定数据模型。使用Ansys17.0软件对4种固定模型进行应力加载,比较其生物力学性能。结果与结论:①随着轴向载荷的增加,不同内固定模型的应力峰值近似同比增大,500 N时应力峰值:螺钉组(6.9737 MPa)<新型钢板组(14.733 MPa)<内侧钢板组(16.445 MPa)<后内侧钢板组(25.199 MPa);②500 N时骨折块的应力峰值:螺钉组(3.6579 MPa)<新型钢板组(4.5108 MPa)<内侧钢板组(5.2259 MPa)<后内侧钢板组(6.1812 MPa);③随着轴向载荷的增加,骨折块和内固定位移也近似等比增大,位移分布特征无明显变化;500 N时钢板位移:新型钢板组(1.0307 mm)<内侧钢板组(1.503 mm)<螺钉组(2.0965 mm)<后内侧钢板组(2.2582 mm);500 N时骨折块位移:新型钢板组(0.2128 mm)<内侧钢板组(0.31154 mm)<螺钉组(0.42779 mm)<后内侧钢板组(0.45498mm);④提示在治疗过伸内翻型胫骨平台骨折时,新型钢板的稳定性和力学性能优于传统内固定方式。 展开更多
关键词 胫骨平台 骨折固定术 过伸损伤 新型钢板 前内侧 有限元分析
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后外侧入路联合后内侧入路治疗KlammerⅡ、Ⅲ型后侧Pilon骨折的疗效 被引量:5
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作者 刘太福 黄涛 +3 位作者 杨延兵 杨永兵 许春友 张俊 《实用医院临床杂志》 2020年第5期56-59,共4页
目的探讨后外侧入路联合后内侧入路治疗KlammerⅡ、Ⅲ型后侧Pilon骨折的疗效。方法我院行择期内固定手术的100例KlammerⅡ、Ⅲ型后侧Pilon骨折患者,其中行后外侧入路联合后内侧入路内固定治疗45例(研究组),行后外侧入路内固定治疗55例(... 目的探讨后外侧入路联合后内侧入路治疗KlammerⅡ、Ⅲ型后侧Pilon骨折的疗效。方法我院行择期内固定手术的100例KlammerⅡ、Ⅲ型后侧Pilon骨折患者,其中行后外侧入路联合后内侧入路内固定治疗45例(研究组),行后外侧入路内固定治疗55例(对照组)。对比两组围术期相关指标,术后1年骨折复位效果,术后1年踝关节功能恢复情况,术前、术后1年生活质量(SF-36评分)差异,并记录术后1年内并发症出现情况。结果研究组手术时间、术后1周VAS评分、住院时间均低于对照组(P<0.05)。术后1年,研究组骨折复位效果、踝关节功能恢复优于对照组,术后并发症发生率低于对照组;两组SF-36评分较术前均上升,且研究组高于对照组(P<0.05)。结论对于KlammerⅡ、Ⅲ型后侧Pilon骨折患者,应用后外侧入路联合后内侧入路治疗效果显著,不仅可缩短手术及住院时间,有效降低术后疼痛,骨折效果较好,促进患者踝关节功能恢复,提升患者的生活质量,且术后并发症较少,具有较好的应用价值。 展开更多
关键词 后侧Pilon骨折 踝关节 改良 前内侧 后外侧 疗效
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Technical note: Anterior cruciate ligament reconstruction in the presence of an intramedullary femoral nail using anteromedial drilling 被引量:1
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作者 Matthew Lacey Joseph Lamplot +2 位作者 Kempland C Walley Joseph P De Angelis Arun J Ramappa 《World Journal of Orthopedics》 2017年第5期379-384,共6页
AIM To describe an approach to anterior cruciate ligament(ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary(IM) femoral nail.METHODS Once preop... AIM To describe an approach to anterior cruciate ligament(ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary(IM) femoral nail.METHODS Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware(locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology. The ACL remnant and lateral wall soft tissues are removed from the intercondylar, to provide adequate visualization of the ACL footprint. Femoral tunnel placement is performed using a transportal ACL guide with desired offset and the knee flexed to 2.09 rad. The Beath pin is placed through the guide starting at the ACL's anatomic footprint using arthroscopic visualization and/or fluoroscopic guidance. If resistance is met while placing the Beath pin, the arthroscopy should be discontinued and the obstructing hardware should be removed under fluoroscopic guidance. When the Beath pin is successfully placed through the lateral femur, it is overdrilled with a 4.5 mm Endobutton drill. If the Endobutton drill is obstructed, the obstructing hardware should be removed under fluoroscopic guidance. In this case, the obstruction is more likely during Endobutton drilling due to its larger diameter and increased rigidity compared to the Beath pin. The femoral tunnel is then drilled using a best approximation of the graft's outer diameter. We recommend at least 7 mm diameter to minimize the risk of graft failure. Autologous hamstring grafts are generally between 6.8 and 8.6 mm in diameter. After reaming, the knee is flexed to 1.57 rad, the arthroscope placed through the anteromedial portal to confirm the femoral tunnel position, referencing the posterior wall and lateral cortex. For a quadrupled hamstring graft, the gracilis and semitendinosus tendons are then harvested in the standard fashion. The tendons are whip stitched, quadrupled and shaped to match th 展开更多
关键词 anteromedial DRILLING INTRAMEDULLARY FEMORAL NAIL Anterior CRUCIATE ligament reconstruction RETAINED hardware
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Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures 被引量:1
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作者 Yin-Feng Zheng Jun-Lin Zhou +2 位作者 Xiao-Hong Wang Lei Shan Yang Liu 《Chinese Medical Journal》 SCIE CAS CSCD 2016年第15期1850-1855,共6页
Background: Open reduction and internal fixation with plate and screws are the gold standard for the surgical treatment of humeral shaft fractures, this study was to compare the mechanical properties ofanteromedial, ... Background: Open reduction and internal fixation with plate and screws are the gold standard for the surgical treatment of humeral shaft fractures, this study was to compare the mechanical properties ofanteromedial, anterolateral, and posterior plating for humeral shaft fractures. Methods: A distal third humeral shaft fracture model was constructed using fourth-generation sawbones (#3404, composite bone). A total of 24 sawbones with a distal third humeral shaft fracture was randomly divided into three Groups: A, B, and C (n = 8 in each group) for anteromedial, anterolateral, and posterior plating, respectively. All sawbones were subjected to horizontal torsional fatigue tests, horizontal torsional and axial compressive fatigue tests, four-point bending fatigue tests in anteroposterior (AP) and mediolateral (ML) directions and horizontal torsional destructive tests. Results: In the horizontal torsional fatigue tests, the mean torsional angle amplitude in Groups A, B, and C were 6.12°, 6.53°, and 6.81°. In horizontal torsional and axial compressive fatigue tests, the mean torsional angle amplitude in Groups A, B, and C were 5.66°, 5.67°, and 6.36°. The mean plate displacement amplitude was 0.05 mm, 0.08 mm, and 0.10 mm. Group A was smaller than Group C (P 〈 0.05). In AP four-point bending fatigue tests, the mean plate displacement amplitude was 0.16 ram, 0.13 ram, and 0.20 mm. Group B was smaller than Group C (P 〈 0.05). In ML lbur-point bending fatigue tests, the mean plate displacement amplitude were 0.16 mm, 0.19 ram, and 0.17 ram. In horizontal torsional destructive tests, the mean torsional rigidity in Groups A, B, and C was 0.82, 0.75, and 0.76 N·m/deg. The yielding torsional angle was 24.50°, 25.70°, and 23.86°. The mean yielding torque was 18.46, 18.05. and 16.83 N·m, respectively. Conclusions: Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolat 展开更多
关键词 anteromedial Plating BIOMECHANICS Compressive Plate Fracture Model Humeral Shaft Fracture
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不同入路手术方法治疗胫骨平台骨折临床疗效观察 被引量:2
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作者 陈亮 张德光 +2 位作者 陈小光 刘福全 任占国 《创伤与急危重病医学》 2022年第1期74-76,共3页
目的探讨不同入路手术方法治疗胫骨平台骨折的临床疗效。方法选取自2016年4月至2020年4月首都医科大学附属北京友谊医院平谷医院收治的104例胫骨平台骨折接受手术治疗的患者作为研究对象。根据手术不同入路方式分为前内+前外侧组(n=34)... 目的探讨不同入路手术方法治疗胫骨平台骨折的临床疗效。方法选取自2016年4月至2020年4月首都医科大学附属北京友谊医院平谷医院收治的104例胫骨平台骨折接受手术治疗的患者作为研究对象。根据手术不同入路方式分为前内+前外侧组(n=34)、前内+前外+后外侧组(n=36)及后内侧+外侧腓骨头上入路组(n=34)。比较3组患者术中出血量和手术时间。对患者进行为期半年的随访,并在随访第3、6个月比较3组患者的美国纽约外科医院(HSS)评分。比较3组患者的临床疗效、不良反应。结果与前内+前外侧组和前内+前外+后外侧组比较,后内侧+外侧腓骨头上入路组术中出血量更低,手术时间更短,差异有统计学意义(P<0.05);后内侧+外侧腓骨头上入路组手术后第3、6个月HSS评分均显著升高,差异有统计学意义(P<0.05);后内侧+外侧腓骨头上入路组临床总有效率较高,差异有统计学意义(P<0.05)。3组患者随访期间不良反应比较,差异无统计学意义(P>0.05)。结论与前内+前外侧、前内+前外+后外侧入路方式比较,后内侧+外侧腓骨头上入路手术的术中出血量较低,手术时间较短,患者的膝关节功能恢复较快,疗效佳且安全性较高。 展开更多
关键词 胫骨平台骨折 前内侧 前外侧 后外侧 后内侧 外侧腓骨头上入路 不良反应
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Anteromedial Plating of Humerus—An Easier and Effective Approach
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作者 L. Senthil N. Jambu B. Samuel Chittranjan 《Open Journal of Orthopedics》 2015年第10期305-310,共6页
Plate osteosynthesis of humeral shaft fractures is an established surgical procedure. Iatrogenic radial nerve palsy appears to be common complication in treating these fractures. A case series of 20 fracture shafts of... Plate osteosynthesis of humeral shaft fractures is an established surgical procedure. Iatrogenic radial nerve palsy appears to be common complication in treating these fractures. A case series of 20 fracture shafts of humerus were treated with anteromedial plating through anterolateral approach. There was no radial nerve palsy in any of the cases and all achieved fracture union. 展开更多
关键词 anteromedial PLATING Antero Lateral Approach HUMERUS SHAFT FRACTURES Radial NERVE PALSY
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Redislocation Following Zigzag Osteotomy Combined with Fibular Allograt for Dislocation of the Hip in Children
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作者 Nguyen Ngoc Hung 《Open Journal of Orthopedics》 2016年第4期86-97,共12页
We have reviewed 17 patients (18 hips) who required repeated open reduction for recurrent or persistent dislocation after a previous attempt at zigzag osteotomy combined with fibular allowgraft for developmental dyspl... We have reviewed 17 patients (18 hips) who required repeated open reduction for recurrent or persistent dislocation after a previous attempt at zigzag osteotomy combined with fibular allowgraft for developmental dysplasia of the hip (DDH). The purposes of this study were to examine predictors of redislocation and to evaluate the long-term outcomes after revision surgery. The mean age at primary open reduction was 24 months (13 to 36). The median time to the recognition of failure was 4.6 months. The second reduction was performed at a mean age of 26.3 months (17 to 42) and the mean age at final follow-up was 79.7 months (58 to 105) and the mean time follow-up was 42.4 months (37 to 76). We treated the hips with a new open reduction through an anteromedial approach. A constricted anteromedial capsule was always found as the main factor;all had an intact anteromedial capsule, and there was an inverted transverse ligament in five cases and a very tight psoas tendon in another four cases, eversion of the limbus in six cases, densing anterior capsule in five cases. We perform with the condition that all hips were cleared of scar tissue;five hips had adductor tenotomy;four hips required release of the psoas tendon, five eversion of the limbus. Release of the transverse ligament was required in five cases each. All hips with Kirschner wire through the femoral head into the acetabulum. Three hips required femoral shortening (average of 1.5 cm);a derotation varus osteotomy was performed in two hips from ten and twelve weeks after repeated open reduction. Postoperative results according to modified McKay criteria for clinical: excellent: 3 of 18 hips (16.7%);good: 8 of 18 hips (44.4%);fair: 6 of 18 hips (33.3%);and poor: 1 of 18 hips (5.6%). We suggest that technical failure is usually the cause for redislocation with all that has an intact anteromedial capsule. There was an inverted transverse ligament, tight psoas tendon, eversion of the limbus, and densing anterior capsule. We believe that abnormal femoral version and f 展开更多
关键词 DDH Redislocation anteromedial Approach Salter Innominate Osteotomy Femoral Shortening
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两种钢板内固定治疗肱骨中下段骨折临床分析 被引量:2
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作者 徐火荣 徐文强 涂少龙 《中国实用医药》 2014年第19期18-19,共2页
目的探究两种钢板内固定方法治疗肱骨中下段骨折的临床效果分析。方法肱骨中下段骨折60例患者,随机分为前内侧钢板组(A组)和前外侧钢板组(B组)。每组30例患者。对两组患者进行随访跟踪调查。结果两组患者的手术时间、愈合时间、肘关节... 目的探究两种钢板内固定方法治疗肱骨中下段骨折的临床效果分析。方法肱骨中下段骨折60例患者,随机分为前内侧钢板组(A组)和前外侧钢板组(B组)。每组30例患者。对两组患者进行随访跟踪调查。结果两组患者的手术时间、愈合时间、肘关节评分差异均无统计学意义(P>0.05)。前外侧钢板组(B组)的患者桡神经功能异常的并发症明显高于前内侧钢板组(A组),差异有统计学意义(P<0.05)。结论肱骨中下段骨折的患者应用前内侧钢板固定的方法可以有效预防桡神经损伤等后遗症的发生。 展开更多
关键词 肱骨中下段骨折 前内侧 前外侧 桡神经损伤
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Outcome of posterior wall blowout in anterior cruciate ligament (ACL) reconstruction via anteromedial portal approach: A retrospective research in 20 patients with 6 years follow-up 被引量:1
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作者 Xu-Dong Jiang Han-Long Zheng Yu-Ping Yang 《Chinese Journal of Traumatology》 CAS CSCD 2019年第1期24-28,共5页
Purpose: To evaluate the clinical outcome in patients who received anterior cruciate ligament (ACL) rec on structi on via an teromedial portal with or without posterior wall blowout. Methods: Twenty patients w让h rupt... Purpose: To evaluate the clinical outcome in patients who received anterior cruciate ligament (ACL) rec on structi on via an teromedial portal with or without posterior wall blowout. Methods: Twenty patients w让h ruptured ACL, who have received ACL reconstruction via anteromedial portal between Apr 2012 and Oct 2013 were enrolled. According to the conditions of posterior wall, the patients were divided into 2 groups: posterior wall blowout group (10 patients) and posterior wall intact group (10 patients). The median follow up time were 63 (range 19-75) months and 60.5 (range 25—64) months in the 2 groups respectively. The clinical outcome was evaluated by knee joint physical examinati on, mag netic resonance imaging (MRI), the Inter national Knee Docume ntation Comm 让 tee (IKDC) 2000 subjective score, Lysholm score. Ten ger score, difference of thigh circumfere nee, KT-2000 and Biodex isokinetic dynamometer system. Results: No significant differences were found in terms of the IKDC score, Lysholm score, Tegner score, Lachman test positive rate or Pivot Shift test positive rate between the two groups. In KT-2000 and Biodex isokinetic dynamometer tests, the differenee of muscle strength between affected knees and unaffected knees in posterior wall blowout group was not significant less than that of posterior wall intact group (p > 0.05). In addition, there is no statistical difference between the two groups in signal/ noise quotient (SNQ) of the graft (p > 0.05) in post operative MRI. Conclusion: Blowout of posterior wall in ACL reconstruction via anteromedial portal does not affect the clinical outcome as long as reliable fixation has been taken intraoperatively. 展开更多
关键词 Anterior CRUCIATE LIGAMENT ARTHROSCOPY RECONSTRUCTION anteromedial PORTAL Posterior wall BLOWOUT
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Regulation of Cued Fear Expression via Corticotropin-ReleasingFactor Neurons in the Ventral Anteromedial Thalamic Nucleus 被引量:1
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作者 Yin Lv Peng Chen +3 位作者 Qing-Hong Shan Xin-Ya Qin Xiu-Hong Qi Jiang-Ning Zhou 《Neuroscience Bulletin》 SCIE CAS CSCD 2021年第2期217-228,共12页
The ventral part of the anteromedial thalamic nucleus(AMv)is in a position to convey information to the cortico-hippocampal-amygdalar circuit involved in the processing of fear memory.Corticotropin-releasing-factor(CR... The ventral part of the anteromedial thalamic nucleus(AMv)is in a position to convey information to the cortico-hippocampal-amygdalar circuit involved in the processing of fear memory.Corticotropin-releasing-factor(CRF)neurons are closely associated with the regulation of stress and fear.However,few studies have focused on the role of thalamic CRF neurons in fear memory.In the present study,using a conditioned fear paradigm in CRF transgenic mice,we found that the c-Fos protein in the AMv CRF neurons was significantly increased after cued fear expression.Chemogenetic activation of AMv CRF neurons enhanced cued fear expression,whereas inhibition had the opposite effect on the cued fear response.Moreover,chemogenetic manipulation of AMv CRF neurons did not affect fear acquisition or contextual fear expression.In addition,anterograde tracing of projections revealed that AMv CRF neurons project to wide areas of the cerebral cortex and the limbic system.These results uncover a critical role of AMv CRF neurons in the regulation of conditioned fear memory. 展开更多
关键词 Corticotropin-releasing-factor neurons Ventral anteromedial thalamic nucleus Cued fear expression Chemogenetics
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Internal fixation and unicompartmental knee arthroplasty for an elderly patient with patellar fracture and anteromedial osteoarthritis:A case report
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作者 Shao-Kui Nan Hai-Feng Li +2 位作者 Dong Zhang Jian-Ning Lin Li-Sheng Hou 《World Journal of Clinical Cases》 SCIE 2021年第16期3919-3926,共8页
BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patient... BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee. 展开更多
关键词 Patellar fracture anteromedial osteoarthritis Open reduction and internal fixation Unicompartmental knee arthroplasty Elderly patient Case report
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股骨转子间骨折的稳定性重建概念演化与研究进展 被引量:27
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作者 张世民 胡孙君 +1 位作者 杜守超 张立智 《中国修复重建外科杂志》 CAS CSCD 北大核心 2019年第10期1203-1209,共7页
目的总结近年来股骨转子间骨折在稳定性重建方面的概念演化与研究进展。方法查阅国内外相关文献并结合自身经验,从股骨转子间骨折的解剖特点、稳定型骨折与不稳定型骨折分类、稳定性复位与不稳定性复位、术中加压初始稳定与术后滑动二... 目的总结近年来股骨转子间骨折在稳定性重建方面的概念演化与研究进展。方法查阅国内外相关文献并结合自身经验,从股骨转子间骨折的解剖特点、稳定型骨折与不稳定型骨折分类、稳定性复位与不稳定性复位、术中加压初始稳定与术后滑动二次稳定、内固定术后稳定性评估、早期下地站立负重等方面进行总结分析。结果股骨转子间骨折发生于股骨颈干骺端转换区,具有天然的内翻不稳定倾向。骨折复位质量是影响后续内固定物安放的最重要前提因素。判断骨折复位质量有对线和对位两方面,对线采用Garden指数;在对位方面,随着皮质对位理念(正性、中性、负性)的提出,特别强调前内侧皮质的相互砥住支撑(解剖、正性),是获得骨折稳定性复位的关键,而不再强调后内侧小转子骨块的作用。术后影像学的稳定性评分为早期下地站立负重提供了量化指标。但术中的前内侧皮质支撑复位,在术后头颈骨块滑动获得二次稳定的过程中,仍有皮质对位丢失现象,需研究其危险因素和防范措施。结论股骨转子间骨折在取得良好对线的基础上,只要获得了前内侧皮质的相互砥住和支撑,并用内固定器械维持住,就获得了术后稳定性。术后稳定性评分优良者,可以安全地早期下地负重、站立行走活动。 展开更多
关键词 股骨转子间骨折 骨折复位质量 稳定性 皮质支撑 前内侧皮质
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不稳定股骨转子间骨折前内侧皮质支撑复位的影像学研究 被引量:22
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作者 杜守超 张世民 +4 位作者 张英琪 胡孙君 马卓 熊文峰 姚喜洲 《中国矫形外科杂志》 CAS CSCD 北大核心 2018年第18期1633-1638,共6页
[目的]不稳定股骨转子间骨折(31A2型)均伴有分离的后内侧小转子骨块,获得前内侧皮质复位是重建骨折稳定性的关键。本研究比较前内侧皮质对位关系的术中透视影像与术后三维CT(3D-CT)立体影像,探讨二者的一致性和变化因素。[方法]回顾性分... [目的]不稳定股骨转子间骨折(31A2型)均伴有分离的后内侧小转子骨块,获得前内侧皮质复位是重建骨折稳定性的关键。本研究比较前内侧皮质对位关系的术中透视影像与术后三维CT(3D-CT)立体影像,探讨二者的一致性和变化因素。[方法]回顾性分析2016年1月~2017年10月,本院采用头髓钉治疗A2型不稳定股骨转子间骨折患者,收集具有完整术中透视和术后3D-CT影像资料的病例共63例,男22例,女41例,平均年龄(82.34±6.85)岁。术中侧位透视将前侧皮质对位关系分为3种:正性支撑、中性支撑和负性支撑。正性支撑指头颈骨块前侧皮质位于骨干前侧皮质的前方(髓腔外),中性支撑指头颈骨块前侧皮质与骨干前侧皮质获得平滑的完全对位;负性支撑指头颈骨块前侧皮质位于骨干前侧皮质的后方(髓腔内,即前侧皮质无支撑)。术后3D-CT旋转立体观察,能反映真正的皮质对位情况,将头颈骨块与骨干前内侧角皮质的关系分为有接触有抵住和无接触未抵住两种类型。将术中透视影像与术后CT影像进行对比,计算各种皮质对位类型的例数、百分比及术后改变。[结果]术中侧位透视皮质对位为负性者23例,术后3D-CT观察仅5例(21.74%)获得真正的前内侧皮质支撑。术中侧位透视为中性或正性者40例,术后3D-CT观察32例(80.00%)获得前内侧皮质支撑,两者差异有统计学意义(P<0.05)。术中侧位透视为正性者仅4例,术后3D-CT观察全部获得前内侧皮质支撑(100.00%)。[结论]术中侧位透视前侧皮质对位关系为正性或中性者,术后头颈骨块容易获得稳定的前内侧角皮质接触支撑,而负性对位关系则意味着头颈骨块容易失去前内侧皮质的接触。 展开更多
关键词 股骨转子间骨折 骨折复位 皮质支撑复位 前内侧皮质 前侧皮质
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股前内侧接力穿支皮瓣修复游离股前外侧穿支皮瓣供区的临床应用 被引量:21
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作者 宋达疆 李赞 +5 位作者 周晓 彭小伟 周波 吕春柳 杨丽嫦 彭文 《中国修复重建外科杂志》 CAS CSCD 北大核心 2017年第1期52-56,共5页
目的探讨股前内侧接力穿支皮瓣修复游离股前外侧穿支皮瓣供区的临床疗效。方法 2012年2月—2015年12月,收治23例口腔癌患者。其中男21例,女2例;年龄29~74岁,平均52.6岁。舌鳞状细胞癌16例,口颊癌7例。肿瘤TNM分期:T4N0M03例,T4N1M0 5例,... 目的探讨股前内侧接力穿支皮瓣修复游离股前外侧穿支皮瓣供区的临床疗效。方法 2012年2月—2015年12月,收治23例口腔癌患者。其中男21例,女2例;年龄29~74岁,平均52.6岁。舌鳞状细胞癌16例,口颊癌7例。肿瘤TNM分期:T4N0M03例,T4N1M0 5例,T3N1M0 7例,T3N2M0 5例,T3N0M0 3例。病程6~18个月,平均8.8个月。行颈淋巴清扫和原发病灶根治性切除术后,采用游离股前外侧穿支皮瓣行口腔缺损修复,供区采用股前内侧接力穿支皮瓣移位修复。结果所有患者均确认有恒定的股前内侧穿支存在,未发现穿支缺如。术后所有皮瓣均顺利成活,供受区创面均Ⅰ期愈合。未发生血管危象、伤口裂开和明显肿胀等情况。23例均获随访,随访时间6~20个月,平均9.4个月。皮瓣供区仅遗留线性瘢痕,大腿功能未见明显影响,颜色及外观轮廓自然。结论股前内侧接力穿支皮瓣是修复游离股前外侧穿支皮瓣供区的理想选择。 展开更多
关键词 股前内侧穿支皮瓣 接力皮瓣 游离皮瓣移植 股前外侧穿支皮瓣
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股前内侧穿支皮瓣的应用解剖学研究 被引量:16
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作者 杨晓东 丁茂超 +5 位作者 梅劲 张根福 杨锦 刘杨武 丁建波 唐茂林 《中国临床解剖学杂志》 CSCD 北大核心 2011年第6期624-628,共5页
目的为股前内侧穿支皮瓣的临床应用提供解剖学基础。方法新鲜成人尸体20具(40侧),行一次性全身乳胶灌注5具,全身动脉造影15具。通过直接层次解剖,应用图像分析和测量系统Scion image,对股前内侧穿支进行定性、定量分析;螺旋CT扫描数据以... 目的为股前内侧穿支皮瓣的临床应用提供解剖学基础。方法新鲜成人尸体20具(40侧),行一次性全身乳胶灌注5具,全身动脉造影15具。通过直接层次解剖,应用图像分析和测量系统Scion image,对股前内侧穿支进行定性、定量分析;螺旋CT扫描数据以Dicom格式输入Mimics图像工作站对该区穿支皮瓣进行三维重建。结果股前内侧区共有外径≥0.5mm的穿支(21.0±4.0)支,外径(0.8±0.1)mm,蒂长(4.5±2.1)cm,穿支的平均供血面积(44±4.8)cm2。将股前内侧区分为上、中、下3区,发现三个区域均有穿支供应相应区域皮肤,中1/3区是穿支分布最集中的区域,多为肌皮穿支,主要由股动脉主干,旋股外侧动脉起始部,以及膝降动脉的穿支供血。结论股前内侧区穿支丰富,穿支蒂的来源因解剖部位而不同,在中1/3区穿支出现率较为恒定,设计股前内侧穿支皮瓣是切实可行的。 展开更多
关键词 股前内侧 穿支皮瓣 应用解剖 数字解剖 显微外科
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关节镜下前内侧束紧缩、后外侧束保残重建术治疗前交叉韧带损伤的临床疗效 被引量:14
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作者 宋洋 杜庆钧 +3 位作者 欧阳毅 邱耿韬 黄明光 曾秋涛 《广西医学》 CAS 2018年第1期44-47,64,共5页
目的探讨关节镜下前内侧束紧缩、后外侧束保残重建术治疗前交叉韧带(ACL)损伤的临床疗效。方法膝关节ACL前内侧束损伤合并后外侧束完全断裂的患者20例,在关节镜下行前内侧束紧缩、后外侧束保残重建术。比较术前和术后1年Lysholm评分、Te... 目的探讨关节镜下前内侧束紧缩、后外侧束保残重建术治疗前交叉韧带(ACL)损伤的临床疗效。方法膝关节ACL前内侧束损伤合并后外侧束完全断裂的患者20例,在关节镜下行前内侧束紧缩、后外侧束保残重建术。比较术前和术后1年Lysholm评分、Tegner运动评分、前抽屉试验、轴移试验及Lachman试验结果。结果术后1年,患者的Lysholm评分及Tegner运动评分为均高于术前(P<0.05),抽屉试验、轴移试验、Lachman试验结果均优于术前(P<0.05)。结论关节镜下行前内侧束紧缩、后外侧束保残重建术治疗ACL损伤可获得较好的近期疗效。 展开更多
关键词 前交叉韧带损伤 前内侧束 后外侧束 关节镜 保留残端 重建术
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股骨转子间骨折治疗中前内侧皮质正性支撑复位的研究进展 被引量:12
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作者 卫禛 陈时益 张世民 《中国修复重建外科杂志》 CAS CSCD 北大核心 2019年第10期1216-1222,共7页
目的介绍股骨转子间骨折内固定治疗中的前内侧皮质支撑复位理念,总结其历史、特征、生物力学及临床应用研究进展,提出存在的问题并展望研究方向。方法查阅近年来国内外针对股骨转子间骨折正性皮质支撑复位的相关研究,结合临床应用经验... 目的介绍股骨转子间骨折内固定治疗中的前内侧皮质支撑复位理念,总结其历史、特征、生物力学及临床应用研究进展,提出存在的问题并展望研究方向。方法查阅近年来国内外针对股骨转子间骨折正性皮质支撑复位的相关研究,结合临床应用经验进行归纳总结。结果股骨转子间骨折的前内侧皮质正性支撑复位,作为一种稳定的非解剖骨折复位技术,具有力学结构支撑和生物学促进愈合的双重效果。皮质支撑复位对医生来说并不增加手术操作难度,对患者而言股骨颈长度丢失少,颈干角内翻发生率低,骨盆的正常力学结构得以维持,术后器械相关并发症发生率低,肢体功能评分高。内侧皮质支撑的力学性能高于前侧皮质支撑,当两者均达到正性对位时骨折稳定性最佳。结论前内侧皮质支撑复位能分担内固定器械的力学载荷,提高股骨转子间骨折内固定术后稳定性,作为一种功能复位形式,可作为解剖复位之外的次选。 展开更多
关键词 股骨转子间骨折 骨折复位 正性皮质支撑 前内侧皮质 内固定
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