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胫骨上段大型骨化性纤维瘤切除后修复一例

Femoral Neck Fracture Treated with Close Reduction plus Cannulated Screw Fixation with Quadratus Femoris Muscle Pedicle Bone Grafting

目的 目前对青壮年有移位新鲜股骨颈骨折患者的治疗仍存在许多争议，被认为尚未完全解决难题之一，股骨颈骨折内固定术后常导致骨折不愈合股骨头缺血性坏死。 方法 2003年1月-2008年6月，收治青壮年新鲜移位股骨颈骨折患者12例，年龄17~55岁，平均36.3 岁。所有患者在受伤后1周内采用牵引下闭合复位空心钉内固定加股方肌骨瓣移植术治疗。术后随访1~5年，平均3.5年。 结果 12例患者均达骨性愈合，随访期内未出现股骨头缺血性坏死；术后采用Harris 髋关节评分标准进行评估，获优良10例，一般1例，差1例。 结论 青壮年新鲜有移位股骨颈骨折患者，采用牵引下闭合复位空心钉内固定加股方肌骨瓣转移术治疗效果良好，均能达到骨折愈合，且无股骨头缺血性坏死发生。

THE CLINICAL APPLICATION OF ILIAC BONE GRAFT WITH ASCENDING BRANCH OF LATERAL CIRCUMFLEX FEMORAL VESSEL

Since 1984, the authors have used the iliac bone graft with ascending branch of lateral circomflex femoral vessel for treatment of bone defect, nonunion, and avascular necrosis of femoral head in 88 cases. Seventy-two patients were followed from one to six years. Seventy cases were successful with 2 failure. The applied anatomy and clinical application of the iliac bone graft, and the operative principles were discused in this article.

带旋髂深血管蒂髂骨瓣联合空心加压螺钉内固定治疗青壮年股骨颈骨折的疗效分析

目的 总结带旋髂深血管蒂髂骨瓣联合松质骨空心加压螺钉内固定治疗青壮年股骨颈骨折的疗效。 方法 2006 年1 月－ 2008 年12 月，采用带旋髂深血管蒂髂骨瓣联合松质骨空心加压螺钉内固定治疗23 例外伤致股骨颈骨折患者。其中男17 例，女6 例；年龄19 ～ 47 岁，平均31.4 岁。骨折按Garden 分型：Ⅱ型3 例，Ⅲ型14 例，Ⅳ型6 例。受伤至手术时间1 ～ 9 d，平均5 d。 结果 术后患者切口均Ⅰ期愈合。23 例均获随访，随访时间13 ～ 36个月，平均15.3 个月。骨折愈合时间9 ～ 15 个月。术后15 个月Harris 评分为73 ～ 92 分，其中优5 例，良16 例，中2 例，优良率91.3%。1 例术后33 个月发现股骨头缺血性坏死（avascular necrosis of femoral head，ANFH），其余患者无ANFH及股骨头晚期塌陷等并发症发生。所有患者无神经损害并发症，无术区感染；1 例术后伴供骨区疼痛，12 个月后疼痛自行消失。 结论 带旋髂深血管蒂髂骨瓣联合松质骨空心加压螺钉内固定治疗青壮年股骨颈骨折手术操作简便、安全，可获得较好疗效。

CONVERSED TRANSPLANT OF RADIAL STYLOID BONE FLAP WITH FASCIAL PEDICLE IN OLD FRACTURE OF CARPAL SCAPHOID BONE

Since October 1984, we have designed a method of conversed transplant of radial styloid bone flap with fascial pedicle in the treatment of 22 patients with non-united waist fractures of carpal scaphoid. The results from follow-up of 2-7 years were satisfactory.This article introduced the design of the bone flap, the operative procedure and the advantages of the bone flap.

The Use and Effect of Large Trauma Craniotomy on Severe Traumatic Brain Injury

ObjectiveTo investigate the effects of large trauma craniotomy on severe traumatic brain injury. MethodsA total of 132 cases of severe traumatic brain injury adopted large trauma craniotomy between July 2008 and August 2013, and the clinical data were retrospectively analyzed. ResultsAccording to the results of GOS assessment at discharge, 67 patients (50.75%) were satisfied, 26 (19.70%) were mildly disable, 10 (7.58%) were severely disable, 12 (9.09%) were in vegetative state, and 17 (12.88%) were dead. ConclusionCorrect use of large trauma craniotomy on severe brain injury cases will help to improve the treatment outcome, reduce complications and improve quality of survival.

空心钉内固定加股直肌骨瓣移植治疗青壮年股骨颈骨折23 例

探讨一种治疗青壮年股骨颈骨折的方法。 方法 2000 年5 月－ 2005 年10 月，采用空心钉内固定加股直肌骨瓣治疗青壮年股骨颈骨折23 例。男16 例，女7 例；年龄21 ～ 45 岁，平均31.3 岁。车祸伤18 例，高处坠落伤5 例。左侧10 例，右侧13 例。骨折部位：头下型10 例，头下经颈型13 例。Garden 分型：Ⅲ型15 例，Ⅳ型8 例。 结 果 23 例患者术后获随访16 ～ 52 个月，平均26 个月。术后无感染、退钉、骨瓣松动等发生。22 例术后4 ～ 6 个月X 线片示骨折愈合；1 例术后8 个月X 线片示骨折未愈合，术后16 个月CT 及ECT 示股骨头坏死。髋关节功能按Harris 评分标准：优13 例，良8 例，差2 例，优良率91%。 结论 空心钉内固定加股直肌骨瓣移植能有效减少青壮年股骨颈骨折的骨折不愈合和股骨头坏死的几率。

TRANSPLANTATION OF SARTORIUS MUSCULO-SKELETAL GRAFT THROUGH GREATER TROCHANTER IN THE TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD IN ADULTS

Eight cases(10 hips) of avascular necrosis of femoral head in adults were treated with transplantation of sartorius musculo-skeletal graft through the greater trochanter since August 1990. The patients were followed up for 12 to 20 months,with disappearance of pain in 7 cases. The degree of hip motion was markedly increased. The good results rated 87.5 percent.

带旋股外侧升支蒂髂骨治疗中青年股骨头缺血坏死

TRANSFERRING OF THE PEDICLED SECOND METATARSAL BASE FOR REPAIRING BONE DEFECT OFLATERAL MALLEOLUS

Objective To study the method and effect of transferring the pedicled second metatarsal base for repairing bone defect of lateral malleolus. Methods Thirty lower limb specimens were anatomized to observe the morphology, structure and blood supply of the second metatarsal bone . Then transferring of thepedicled second metatarsal base was designed and used in 6 patients clinically.All cases were male, aged from 24 to 48 years old, and the area of bone defect was 3-4 cm. Results Followed up for 3-11 months, all patients healed primarily both in donor and recipient sites. There were excellent results in 4 cases and good results in 2 cases . The morphology and function of the malleoli were satisfactory. Conclusion Transferring of the pedicled second metatarsal base for repairing bone defect of lateral malleolus is an effective and reliable operative method.