目的比较弹性带锁髓内钉与解剖型锁定钢板治疗锁骨中段骨折的疗效。方法回顾性分析2014年1月至2016年12月手术治疗47例锁骨骨折患者资料。其中23例采用弹性带锁髓内钉固定(髓内钉组),男14例,女9例;年龄19~85岁,平均55.26岁;左侧14例,右...目的比较弹性带锁髓内钉与解剖型锁定钢板治疗锁骨中段骨折的疗效。方法回顾性分析2014年1月至2016年12月手术治疗47例锁骨骨折患者资料。其中23例采用弹性带锁髓内钉固定(髓内钉组),男14例,女9例;年龄19~85岁,平均55.26岁;左侧14例,右侧9例;根据AO/OTA分型,2A型6例,2B型17例。24例采用解剖型锁定钢板固定(钢板组),男18例,女6例;年龄15~71岁,平均51.25岁;左侧16例,右侧8例;根据AO/OTA分型,2A型9例,2B型15例。比较两组患者的手术时间、术中出血量、皮肤切口长度、骨折愈合时间、内固定取出时间、Constant-Murley肩关节评分、臂肩手功能障碍(disabilities of the arm, shoulder, and hand, DASH)评分以及并发症等。结果47例患者均顺利完成手术。两组患者均获得随访,髓内钉组随访时间14~23周,平均19.35周;钢板组随访时间28~76周,平均53.13周。髓内钉组手术时间(20.78±7.71)min、术中出血量(13.26±9.72)ml、切口长度(1.57±1.24)cm、骨折愈合时间(10.39±2.39)周、内固定取出时间(13.17±2.37)周、Constant-Murley肩关节评分(99.09±1.86)分、DASH评分(1.20±2.47)分;钢板组手术时间(57.79±11.56)min、术中出血量(69.17±46.24)ml、切口长度(9.67±2.90)cm、骨折愈合时间(14.21±4.05)周、内固定取出时间(47.38±10.46)周、Constant-Murley肩关节评分(98.00±2.17)分、DASH评分(0.89±1.65)分。与钢板组比较,髓内钉组手术时间短(t=12.856,P=0.000)、术中出血量少(t=5.791,P=0.000)、切口长度明显短(t=12.549,P=0.000)、骨折愈合时间短(t=3.566,P=0.002)、内固定取出时间明显早(t=15.603,P=0.000);以上各指标比较差异均有统计学意义。髓内钉组和钢板组Constant-Murley肩关节评分[(99.09±1.86)分和(98.00±2.17)分]、DASH评分[(1.20±2.47)分和(0.89±1.65)分]比较差异无统计学意义。术后3~6周,髓内钉组6例发生尾端皮肤刺激及滑囊炎,经换药及取内固定后症状消失。钢板组延迟愈合2例,经�展开更多
Osteoporosis,a global age-related health problem in both male and female elderly,insidiously deteriorates the microstructure of bone,particularly at trabecular sites,such as vertebrae,ribs and hips,culminating in frag...Osteoporosis,a global age-related health problem in both male and female elderly,insidiously deteriorates the microstructure of bone,particularly at trabecular sites,such as vertebrae,ribs and hips,culminating in fragility fractures,pain and disability.Although osteoporosis is normally associated with senescence and estrogen deficiency,diabetes mellitus(DM),especially type 1 DM,also contributes to and/or aggravates bone loss in osteoporotic patients.This topic highlight article focuses on DM-induced osteoporosis and DM/ osteoporosis comorbidity,covering alterations in bone metabolism as well as factors regulating bone growth under diabetic conditions including,insulin,insulin-like growth factor-1 and angiogenesis.Cellular and molecular mechanisms of DM-related bone loss are also discussed.This information provides a foundation for the better understanding of diabetic complications and for development of early screening and prevention of osteoporosis in diabetic patients.展开更多
文摘目的比较弹性带锁髓内钉与解剖型锁定钢板治疗锁骨中段骨折的疗效。方法回顾性分析2014年1月至2016年12月手术治疗47例锁骨骨折患者资料。其中23例采用弹性带锁髓内钉固定(髓内钉组),男14例,女9例;年龄19~85岁,平均55.26岁;左侧14例,右侧9例;根据AO/OTA分型,2A型6例,2B型17例。24例采用解剖型锁定钢板固定(钢板组),男18例,女6例;年龄15~71岁,平均51.25岁;左侧16例,右侧8例;根据AO/OTA分型,2A型9例,2B型15例。比较两组患者的手术时间、术中出血量、皮肤切口长度、骨折愈合时间、内固定取出时间、Constant-Murley肩关节评分、臂肩手功能障碍(disabilities of the arm, shoulder, and hand, DASH)评分以及并发症等。结果47例患者均顺利完成手术。两组患者均获得随访,髓内钉组随访时间14~23周,平均19.35周;钢板组随访时间28~76周,平均53.13周。髓内钉组手术时间(20.78±7.71)min、术中出血量(13.26±9.72)ml、切口长度(1.57±1.24)cm、骨折愈合时间(10.39±2.39)周、内固定取出时间(13.17±2.37)周、Constant-Murley肩关节评分(99.09±1.86)分、DASH评分(1.20±2.47)分;钢板组手术时间(57.79±11.56)min、术中出血量(69.17±46.24)ml、切口长度(9.67±2.90)cm、骨折愈合时间(14.21±4.05)周、内固定取出时间(47.38±10.46)周、Constant-Murley肩关节评分(98.00±2.17)分、DASH评分(0.89±1.65)分。与钢板组比较,髓内钉组手术时间短(t=12.856,P=0.000)、术中出血量少(t=5.791,P=0.000)、切口长度明显短(t=12.549,P=0.000)、骨折愈合时间短(t=3.566,P=0.002)、内固定取出时间明显早(t=15.603,P=0.000);以上各指标比较差异均有统计学意义。髓内钉组和钢板组Constant-Murley肩关节评分[(99.09±1.86)分和(98.00±2.17)分]、DASH评分[(1.20±2.47)分和(0.89±1.65)分]比较差异无统计学意义。术后3~6周,髓内钉组6例发生尾端皮肤刺激及滑囊炎,经换药及取内固定后症状消失。钢板组延迟愈合2例,经�
文摘Osteoporosis,a global age-related health problem in both male and female elderly,insidiously deteriorates the microstructure of bone,particularly at trabecular sites,such as vertebrae,ribs and hips,culminating in fragility fractures,pain and disability.Although osteoporosis is normally associated with senescence and estrogen deficiency,diabetes mellitus(DM),especially type 1 DM,also contributes to and/or aggravates bone loss in osteoporotic patients.This topic highlight article focuses on DM-induced osteoporosis and DM/ osteoporosis comorbidity,covering alterations in bone metabolism as well as factors regulating bone growth under diabetic conditions including,insulin,insulin-like growth factor-1 and angiogenesis.Cellular and molecular mechanisms of DM-related bone loss are also discussed.This information provides a foundation for the better understanding of diabetic complications and for development of early screening and prevention of osteoporosis in diabetic patients.
