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1.
研究股骨近端空心钉锁定板内固定微创治疗青壮年股骨近端骨折的临床疗效及优点。采用透视下闭合复位应用股骨近端空心钉锁定板内固定治疗41例青壮年股骨颈基底部GardenⅠ～Ⅲ型骨折或股骨转子间EvansⅠ～Ⅱ型骨折。观察术后骨折愈合情况、髋关节功能恢复情况及股骨头坏死情况。结果显示,41例患者骨折愈合率为100%,无髋内翻及内固定失败;髋关节功能优良率90%(Harris评分标准);股骨头坏死率7.3%。结果表明,该方法具有创伤小、操作简单、固定可靠和并发症少等优点。 相似文献
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目的：分析和评价加长柄人工股骨头置换术治疗高龄股骨粗隆部不稳定骨折的方法及疗效。方法：本组15例,男10例,女5例;年龄70～90}0,平均79岁。骨折按Evans分类,ⅢA型9例,ⅢB型6例。取髋关节后外侧切口,术中注意保留股骨大、小转子部位的骨折块,用骨水泥固定,争取将其重新复位。由于股骨颈及股骨距骨缺损,在插入人工股骨柄之前可用试模测试。股骨距部位的骨缺损用骨水泥充填重塑,关节腔内置负压引流管48—72h。结果：15例患者均康复出院。住院时间16～24d,平均20d。均获得随访,平均随访时间8个月（6—12个月）,伤口均一期愈合,无感染,无假体松动,无下肢深静脉栓塞发生,无髋关节脱位或半脱位发生,无病人死于手术并发症,12例病人髋关节功能满意。结论：加长柄人工股骨头置换术是治疗高龄股骨粗隆部不稳定骨折的可靠方法,其操作可行,疗效满意,可降低死亡率、改善生活质量。 相似文献
3.
股骨颈骨折愈合率低,股骨头坏死率高。治疗方法较多,效果各不相同。我院应用缝匠肌骨瓣加双端加压螺纹钉治疗股骨颈骨折20例,效果较好,治疗体会如下。 1 临床资料 1.1 一般资料 本组共20例,男12例,女8例;年龄20～48岁,平均34岁;20～32岁6例。32～48岁16例。骨折至手术时间2～21d,平均6.6d。骨折类型按骨折部位分类:头颈型5例,经颈型12例,头下型3例。 1.2 治疗方法 病人入院后即作胫骨结节骨牵引,复位满意后一次完成内固定和肌蒂骨瓣植骨术。手术方 相似文献
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目的:阐述老年新鲜股骨颈骨折的手术治疗方法及疗效评价.方法:通过C型臂X光机透视下牵引复位后空心加压螺纹钉内固定术治疗老年新鲜股骨颈骨折的结果及随访记录.结果:26例手术,疗效优良.结论:空心加压螺纹钉内固定术是治疗老年新鲜股骨颈骨折的首选方法之一,手术适应证,疗效佳. 相似文献
5.
髋关节置换术的护理 总被引：3，自引：0，他引：3
人工关节是指用生物相容性与机械性能良好的金属材料制成的一种类似人体骨关节的假体 ,利用手术方法将人工关节置换被疾病或损伤所破坏的关节面 其目的是切除病灶、清楚疼痛 ,恢复关节的活动与原有功能 2 0 0 1年 8月至今收治 2 0例行髋关节置换的病例 ,均取得满意效果 1 临床资料 2 0例病例 1例为男性 ,其余均为女性 ,年龄 30至 73岁 ,临床表现为股骨颈骨折 15例 ,髋关节炎 2例 ,股骨头坏死 3例 2 护理2 1 术前护理2 1 1 心理护理与健康教育 :病人对于髋关节置换顾虑较多 ,应向病人及家属解释手术方法、效果 ,消除病人顾虑 ,… 相似文献
6.
股骨颈骨折是指股骨头下端至股骨基底部之间的骨折,多发生于巾老年人群．与骨质疏松引起的骨质量下降有关,当遭受轻微扭转力即可发生骨折。老年股骨颈骨折可导致行动障碍．使患者的活动能力和生活自理能力大力降低。我科自2008年1月至2010年1月共收治150例伴有不同程度并发症的老年股骨颈骨折患者．通过采用有针对性的护理及术后功能锻炼．取得了良好的效果,现报告如下。 相似文献
7.
老年髋关节置换患者的健康教育路径 总被引：1，自引：0，他引：1
目的：探讨将健康教育路径应用于对老年人工髋关节置换患者进行健康教育的实施效果。方法：将74例老年髋部骨折行人工髋关节置换患者随机分成2组,对照组采用传统方法进行健康教育,观察组采用健康教育路径进行健康教育,2组比较效果。结果：观察组健康教育内容知晓率和对护理工作满意度均高于对照组（p〈0.05）。结论：将健康教育路径应用于对老年人工髋关节置换患者的健康教育,对患者更好地掌握健康教育知识,密切护患关系,提高护理满意度起到了积极作用。 相似文献
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9.
目的：总结三枚斯氏针闭合经矩穿针微创法治疗股骨颈骨折的经验．方法：采用下肢牵引复位器复位固定，在放射诊视床上，闭合经矩用三枚斯氏针交叉固定股骨颈骨折．结果：经1—3a的随访，20例患者除2例外均达到骨性愈合，髋关节功能恢复正常．术后20例均达到解剖复位．结论：闭合经矩三枚斯氏针交叉内固定治疗股骨颈骨折具有微创、感染率低、内固定坚强、愈合快等优点，是一种简单有效的方法． 相似文献
10.
季敏 《河北北方学院学报(医学版)》2003,20(4):33-34
股骨颈骨折系指自股骨头以下至股骨颈基部之间的骨折 ,主要由于扭转应力使股骨颈抵于髋臼后缘而引起 ,多因老年人的骨质疏松、肌力减退、动作迟缓和稳定度差所致。骨折发生后 ,久难治愈 ,可能发生多种并发症 ,因此做好老年性股骨颈骨折患者的临床护理非常重要。1 临床资料我院自 1997～ 2 0 0 2年 ,共收治 38例老年性股骨颈骨折患者 ,患者的年龄自 6 0～ 85岁 ;其中男性患者2 5例 ,女性患者 13例 ;手术治疗 2 0例 (在持硬麻醉下行人工股骨头置换术 14例、加压螺纹钉固定 4例、鹅颈钉钢板固定 2例 ) ,单纯行骨牵引治疗 12例 ,“丁”字鞋治疗… 相似文献
11.
目的:探讨逆行交锁髓内钉在治疗股骨髁上骨折中的应用.方法:从2003.1～2003.5月,应用逆行交锁髓内钉治疗23例股骨髁上骨折.结果:随访5～18个月,骨折均愈合.结论:逆行交锁髓内钉是治疗股骨髁上骨折的良好方法之一,其提供的力学固定有利于骨折愈合和膝关节功能的康复. 相似文献
12.
Objective： The aim of this retrospective investigation was to explore the influence of femoral osteoporosis on short-term curative effects ofcementless hip arthroplasty and to evaluate the femoral metaphyseal bone mineral density （BMD） for femoral osteoporosis in order to guide prosthesis choice and rehabilitation. Methods： We performed 127 total arthroplasty operations between June 1999 to February 2003 and investigated 49 cementless hip replacements with the Metalcancellous cementless Lubeck Ⅱ system being used in all hips. There were twenty men and twenty-nine women whose mean age at the time of the operation was 60 years （range, 52-81 years）. The patients were divided into osteoporosis or normal groups according to the femoral metaphyseal BMD measured preoperatively. The average duration of follow-up was 30 months （range, 8-52 months）. We evaluated all of the patients from a clinical standpoint with use of a standard-terminology questionnaire with respect to the short-term curative effects and patients＇ satisfaction. Hip pain status and functional ability were important indicators of treatment efficacy. Results： Harris hip score and patients＇ satisfaction in femoral osteoporosis patients who underwent noncemented hip arthroplasty were lower （P=0.004, P=0.03） while the incidence of thigh pain was higher （P=0.03） than the patients with non-osteoporosis. Conclusion： The higher incidence of pain, as well as the decrease in function experienced by the patients in osteoporosis group, supports the case that cementless arthroplasty is not a better choice for those patients and that we had better select prosthesis based on the femoral metaphyseal BMD. 相似文献
13.
高屈曲人工全膝关节表面置换术临床研究 总被引：1，自引：0，他引：1
目的:探讨应用高屈曲型假体行人工全膝关节置换术的早期临床效果。方法:2002.12~2006.3月间,对125例(213膝)患者用LPS-FLEX高屈曲型假体行TKA。其中男36例(62膝),女89例(151膝),年龄51~85岁,平均68.1岁。骨性关节炎90例(149膝),类风湿性关节炎35例(64膝)。所有病人均行常规髌骨置换,假体均采用骨水泥固定。结果:术后第一天即开始康复训练,伤口均一期愈合。随访12~52个月,平均34个月。2例因早期屈曲不佳(<90°)于术后6周在连续硬膜外麻醉下行手法松解后获得满意屈曲度,2例发生感染,其余均疗效优良。随访X线片结合临床均无感染、假体松动、假体周围骨折、骨吸收及脱位发生。HSS评分由术前30~65分,平均48分,提高至术后85~98分,平均91分。结论:LPS-FLEX高屈曲型假体在高屈曲位时仍在胫骨上保持面接触,且胫骨CAM始终在股骨SPINE的基部,从而在获得最大屈曲的同时保持了良好的稳定性。 相似文献
14.
目的：介绍弹性钛制髓内钉治疗儿童股骨干骨折的护理方法。方法：通过对43例弹性钛制髓内钉治疗儿童股骨干骨折的护理。结果：43例皆获骨性愈合,优良率为100％。结论：该方法是一种损伤小、对骨折处生理影响小、住院时间短、易于护理、并发症少的手术,同时做好手术前后护理、术后康复训练是患儿全面恢复的重要保证。 相似文献
15.
吴立东 《浙江大学学报(A卷英文版)》2004,5(10):1270-1278
Objective: To observe the accuracy of femoral preparation and the position of the cementless prosthesis in femoral cavity, and to compare the results between the computer-assisted surgical group (CASPAR) and the conventional group. Methods: Ten femoral components were implanted either manually or by CASPAR in cadaver femurs. The specimens were cut to 3 mm thick slices. Microradiograms of every slice were sent to a computer for analysis with special software (IDL). The gaps and the medullary cavities between component and bone, the direct bone contact area of the implant surface,the gap width and the percentage of gap and bone contact area were measured in every slice. Results: In the proximal implant coated with HA of the CASPAR group, the average percentage of bone contact reached 93.2% (ranging from 87.6% to 99.7%); the average gap percentage was 2.9% (ranging from 0.3% to 7.8%); the maximum gap width was 0.81 mm and the average gap width was only 0.20 mm. While in the conventional group, the average percentage of bone contact reached 60.1% (ranging from 49.2% to 70.4%); the average gap percentage was 32.8% (ranging from 25.1% to 39.9%); the maximum gap width was 2.97 mm and the average gap width was 0.77 mm. The average gap around the implant in the CASPAR group was only 9% of that in the manual group; the maximum and average gap widths were only about 26% of those in the manual group. On the other hand, the CASPAR group showed 33% higher bone contact than the manual group. Conclusion: With the use of robotics-assisted system, significant progress can be achieved for femoral preparation in total hip arthroplasty. 相似文献
16.
Objective: To observe the accuracy of femoral preparation and the position of the cementless prosthesis in femoral cavity, and to compare the results between the computer-assisted surgical group (CASPAR) and the conventional group. Methods: Ten femoral components were implanted either manually or by CASPAR in cadaver femurs. The specimens were cut to 3 mm thick slices. Microradiograms of every slice were sent to a computer for analysis with special software (IDL). The gaps and the medullary cavities between component and bone, the direct bone contact area of the implant surface, the gap width and the percentage of gap and bone contact area were measured in every slice. Results: In the proximal implant coated with HA of the CASPAR group, the average percentage of bone contact reached 93.2% (ranging from 87.6% to 99.7%); the average gap percentage was 2.9% (ranging from 0.3% to 7.8%); the maximum gap width was 0.81 mm and the average gap width was only 0.20 mm. While in the conventional group, the average 相似文献
17.
Sheng-yong Wu Hui-hui Jia Didier Hans Jing Lan Li-ying Wang Jing-xue Li Yue-zeng Cai 《Journal of Zhejiang University. Science. B》2009,10(7):499-504
Objective: To demonstrate the validity and reliability of volumetric quantitative computed tomography (vQCT) with multi-slice computed tomography (MSCT) and dual energy X-ray absorptiometry (DXA) for hip bone mineral density (BMD) measurements, and to compare the differences between the two techniques in discriminating postmenopausal women with osteoporosis-related vertebral fractures from those without. Methods: Ninety subjects were enrolled and divided into three groups based on the BMD values of the lumbar spine and/or the femoral neck by DXA. Groups 1 and 2 consisted of postmenopausal women with BMD changes ＜-2SD, with and without radiographically confirmed vertebral fracture (n=11 and 33, respectively).Group 3 comprised normal controls with BMD changes ≥-1SD (n=46). Post-MSCT (GE, LightSpeed16) scan reconstructed images of the abdominal-pelvic region, 1.25 mm thick per slice, were processed by OsteoCAD software to calculate the following parameters: volumetric BMD values of trabecular bone (TRAB), cortical bone (CORT), and integral bone (INTGL) of the left femoral neck, femoral neck axis length (NAL), and minimum cross-section area (mCSA). DXA BMD measurements of the lumbar spine (AP-SPINE) and the left femoral neck (NECK) also were performed for each subject. Results: The values of all seven parameters were significantly lower in subjects of Groups 1 and 2 than in normal postmenopausal women (P＜0.05, respectively).Comparing Groups 1 and 2, 3D-TRAB and 3D-INTGL were significantly lower in postmenopausal women with vertebral fracture(s) [(109.8±9.61) and (243.3±33.0) mg/cm3, respectively] than in those without [(148.9±7.47) and (285.4±17.8) mg/cm3,respectively] (P＜0.05, respectively), but no significant differences were evident in AP-SPINE or NECK BMD. Conclusion: the femoral neck-derived volumetric BMD parameters using vQCT appeared better than the DXA-derived ones in discriminating osteoporotic postmenopausal women with vertebral fractures from those without, vQCT might be useful to evaluate the effect of osteoporotic vertebral fracture status on changes in bone mass in the femoral neck. 相似文献
18.
周庆琳 《孝感职业技术学院学报》2006,9(3):108-109
目的:分析股部刺伤与肠系膜动脉栓塞的关系,为防止临床上今后发生类似误诊提供参考;方法:结合临床误诊病例,联系基础医学理论进行分析并行开腹探查;结果:开腹探查证实该例股部刺伤患者急性腹痛乃因肠系膜下动脉的分支———乙状结肠动脉栓塞、乙状结肠坏死所致;结论:股部外伤,尤其是严重刺伤导致大血管破裂并脂肪组织严重损伤时可能引起其他器官脂肪栓塞。 相似文献