简介：AbstractBackground:Mallet fracture is avulsion of the terminal extensor tendon from the base of the distal phalangeal bone with a bony fragment. This study was performed to evaluate the anatomical characteristics of mallet fractures, investigate a new mallet fracture classification system using anatomical and imaging methods, and discuss the treatment schemes for different types of mallet fracture.Methods:Sixty-four fresh cadaveric fingers were divided into four groups, and models of different types of mallet fracture with distal interphalangeal joint instability were established by dissecting 25%, 50%, 75%, and 100% of the bilateral collateral ligaments. The effect of mallet fractures on the stability of the distal interphalangeal joint was then observed. The lateral radiographs of mallet fractures in 168 patients were analyzed and classified according to the involvement of the joint surface in the fracture, the thickness of fracture, the untreated time after injury, and the complication of distal interphalangeal joint palmar subluxation. Forty-seven patients were surgically treated by reconstruction of extensor tendon insertion, the Ishiguro method, or single Kirschner wire fixation.Results:The established mallet fracture model showed that the distal interphalangeal joint was stable when the bilateral collateral ligaments were cut off by 25% (t= -0.415, P = 0.684) and significantly unstable when this range was ≥50% (50% transection: t= -6.363, P < 0.001; 75% transection: t= -17.036, P < 0.001; 100% transection: t = -30.977, P < 0.001, respectively). The mallet fractures were divided into Types I, II, and III (fracture involving <20%, 20%-50%, and >50% of the joint surface, respectively). Type II was further divided into Types IIa and IIb according to whether the course of injury was < or ≥2 weeks, respectively. The mean post-operative flexion of the distal interphalangeal joint was 63.4° ± 7.9°, and the mean extension lag was 6.7°± 4.6°.Conclusions:The lateral collateral ligament is the main factor that maintains the stability of the distal interphalangeal joint. Classification that combines the involvement of the joint surface in the fracture, the thickness of the fracture, and the untreated time after injury is reasonable and will help to choose an appropriate operational method.

简介：手由五籽骨组成。他们中的二个在metacarpophalangeal(MCP)是在场的姆指的关节。姆指的籽骨骨头的骨折是稀罕损害，光线的方面上的文学很少被报导。我们在姆指的MCP关节与光线的籽骨的破裂报导了一个病人的一个案例以便关于这类损害增加注意。一个44岁的男、高级体操的训练员，当他向右姆指的MCP关节汇报了一处伸直过度损伤时，在锻练期间正在帮助他的运动员之一。在损伤以后的一个星期，他介绍了给在它的手掌的方面上在MCP联合水平抱怨痛苦的姆指的手外科医生。标准A-P和侧面的X光揭示了光线的籽骨的破裂，破裂与一根藤条被对待3个星期。他对有能力6个星期在损害以后恢复了他的全部工作。籽骨破裂伸直过度损害并且有时的大小的指示物与MCP关节的手掌的板系带的眼泪被联系。并且认出系带损害的失败可以在拧上导致长期的伸直过度不稳定性。

简介：目的介绍一种治疗Mallet骨折的新方法。方法自2003年3月至2007年7月，采用远侧指间（DIP）关节背侧切口，将1枚克氏针从甲床与指骨间顺行自指尖穿出，骨块复位后，过伸DIP关节将克氏针逆行打入中节指骨，然后屈曲DIP关节，弯曲的克氏针压迫骨折块，使之维持复位状态。共治疗Mallet骨折17例。结果17例骨折均于术后4周临床愈合，9例得到随访，随访时间4～54个月（平均16个月），采用Crawford法进行疗效评定：优2例，良4例，可3例，差0例。结论该方法不损伤关节软骨，避免了骨块碎裂，简单易行、疗效可靠，是治疗Mallet骨折的较好方法。

简介：与ipsilateral联系的Hoffa骨折大腿骨的柄骨折是很稀罕的。损害的这种稀罕类型的三个盒子回顾地被考察。大腿骨的柄破裂和Hoffa破裂的地点被记录。所有大腿骨的柄破裂与内部固定被管理。为Hoffa破裂的错误诊断的率被记录。影响的膝的功能在二年后续为特殊外科(HSS)分数根据修改医院被评估。大腿骨的破裂在所有三个盒子中横向或合成。IpsilateralHoffa破裂在一种情况中在二种情况，和侧面的髁中发生在中间的髁。一仅仅Hoffa破裂外科手术前地被识别。所有大腿骨的柄破裂太平无事地愈合了。在其Hoffa骨折正确地被诊断的病人，修改HSS分数是94。在另一个病人，其Hoffa断裂，被第二个手术对待，修改HSS分数是93。并且在第三个盒子中，为Hoffa破裂拒绝了另外的操作，修改HSS分数仅仅是70。决定性地大腿骨的柄骨折能与ipsilateralHoffa骨折被联系，特别在摩托车事故。这类损害是很稀罕的，错误诊断是普通的。

简介：Inthispaper,anonlocaltheoryoffractureforbrittlematerialshasbeensystematicallydevel-oped,whichiscomposedofthenonlocalelasticstressfieldsofGriffithcracksofmode-Ⅰ,ⅡandⅢ,theasymptoticformsofthestressfieldsattheneighborhoodofthecracktips,andthemaximumtensilestresscriterionforbrittlefracture.Asanapplicationofthetheory,thefracturecriteriaofcracksofmode-Ⅰ,Ⅱ,ⅢandmixedmodeⅠ-Ⅱ,Ⅰ-Ⅲaregivenindetailandcomparedwithsomeexperimentaldataandthetheoreticalresultsofminimumstrainenergydensityfactor.

简介：目的将由解剖学习和临床的申请探索paraspinal途径的优点和指示。解剖数据和27个盒子的临床的实践被分析探索在paraspinal肌肉和周围的纸巾的结构之间的精确途径的方法，以及paraspinal的临床的申请的结果来临。操作时间，血损失，切口长度，X光线照相术的结果(Cobb角度，vertebrae的前面的边的高度)与在传统的途径对待的24种情况中的那些相比。结果完成方面的暴露能被识别在multifidus和longissimus肌肉之间的自然劈开飞机容易执行。自然肌肉发达的劈开是(1.47

简介：Objective:ToinvestigatethediagnosticvalueofmultidetectorspiralCT(MSCT)inacutethoracolumbarspinalfractureandfracture-dislocation.Methods:CTimagingfilesof152consecutivetraumaticpatientswiththoracolumbarfractureswereretrospectivelyreviewed.MSCTscanningswereperformedwithacollimationof3-5mmandapitchof5.5.Thepostprocessingincludedsagittalandcoronalmultiplannarreconstruction,and3-Dreconstruction.Result:Therewere88casesofcompressionfracture,54casesofburstfractureand10casesoffracasdislocation.TransverseimagesofMSCTcouldvisualizeallfracturesdirectlyanddeterminewhetherspinalcanalwasintact.Postprocessingimagewashelpfulindepictingthedisplacementoffragmentandorientationofdislocation.Conclusions:MSCTplaysanimportantroleindiagnosisandmanagementofacutethoracolumbarspinalfractureandfracture-dislocation.

简介：Objective:Tointroducetheexperienceoftreatingfractureofbothtibiaandfibulawithmicro-invasivepercutaneousplateinternalfixationthroughfracturesiteapproach.Methods:Thedataof15patients(11malesand4females),including14adults(aged22-73years,mean=40years)and1child(aged10years),withfractureofbothtibiaandfibulawerestudiedretrospectivelyinthisstudy.Asmallincisionwasmadeatthefracturesiteoftibia.Thenrepositionwasmadeunderdirectvision,andinternalfixationwasemployedwithsteelplatesinsertingthroughthesmallincision.Results:Anatomicalreductionwasobtained.Nocomplicationwasfound.Unionoccurredontimein14patients.Onecasehealedafterasecondoperation.Conclusions:Micro-invasivepercutaneousplateinternalfixationisbeneficialtothehealingofboneandsofttissues.WithoutX-rayexamination,itisalsoeasytoreachanatomicalreductionandmaketibialinternalfixationwithbothplateswithmicro-invasivepercutaneousplateinternalfixation.

简介：Objective:Toexploretheinjurymechanismandtreatmentprincipleofopensupracondylarfractureofhumerus.Methods:Thedataof32patientswithopensupracondylarfractureofhumerushospitalizedinourdepartmentintherecent20yearswereanalyzedretrospectively.Onanaverage,theywerefollowedupfor30months.Therelationshipbetweenthefracturetype,situationofwounds,operatingtime,operatingmethodandtimeforpostoperativefunctionalexerciseandfinalfunctionofelbowjointwereevaluatedwithFlynnscoringstandard.Results:Excellenttherapeuticeffectwasfoundin14cases,goodin12andbadin6,withthepercentageoffinetherapeuticeffectof81.25%.Conclusions:Forthepatientswithopensupracondylarfractureofhumerus,debridementandinternalfixationshouldbemadeasearlyaspossible,forthoroughdebridementandcorrectinternalfixationarethekeypointstoimprovetheprognosis.

简介：异乎寻常并且‘non-lethal’武器现在定期在人群控制正在被使用。这些手臂的使用不是无风险的。在2010的起军事辅助作用的力量在克什米尔为人群控制使用了老式的弹弓。年轻男性从一个弹弓由于云石受不了远侧的肱骨的破裂。他被清创术和灰浆splintage管理。为人群控制的显然无害的武器的使用不没有风险，当从他们开除的射弹能完成高速度并且引起重要损坏。

简介：为在受到飞机紧张条件的一个盘子中的一个中央裂缝的一个问题被调查。我击碎装载的模式被从裂缝在大距离使用的动态压力脉搏创造。为振幅的某个联合和使用的脉搏的持续时间，传给样品的能量有强烈显著的最小，这被发现，意味着与移动离开最佳的价值的脉搏振幅或持续时间，最小的能量为生长很快增加的快克的开始要求了。获得的结果显示优化不同工业过程的能量消费的可能性与骨折连接了。大部分能被获得在例如，钻或跳能量输入在哪儿说明这进程的最大的部分的岩石花费了。观察的效果的大概进一步的调查能使预言节省参数的最佳的能量可能，即为工业设备，例如讨厌的人，磨擦用机器制造的影响的频率和振幅，并且显著地因此减少过程费用。预言能基于折断的媒介的参数被给(材料参数，流行裂缝长度和取向，等等)。

简介：摘要目的评估Ishiguro法微创治疗训练伤所致的可复性陈旧Mallet骨折的远期临床疗效。方法选择2012年9月至2016年12月火箭军特色医学中心骨科收治的28例训练所致的可复性陈旧Mallet骨折官兵，采用Ishiguro法进行微创手术治疗，末次随访时间24.0～64.0个月，平均随访时间(38.4±13.3)个月，采用Dargan标准进行功能评定。结果28例可复性陈旧Mallet骨折中，24例取得骨性愈合，采用Dargan法进行功能评定：28指中9指优，10指良，5指可，4指差，优良率为67.9%。结论Ishiguro法可作为可复性陈旧Mallet骨折的有效治疗方法之一，便于在基层部队推广。

简介：AbstractThe Hoffa fracture is an uncommon fracture. There is a lot of confusion about its diagnosis and management with several conflicting reports in literature. We reported a 25-year-old patient with non-union of Hoffa fracture, and meanwhile tried to develop an algorithm-based treatment for Hoffa fractures. A systematic review of the available literature was performed. Medline, Embase, the Cochrane Library and PubMed were searched for relevant articles. Fifty-five articles were reviewed, and the clinical knowledge base was summarized. The understanding of the mechanism of trauma has become more nuanced. The literature has also evolved to classify the fracture with the purpose of surgical management in mind. This can be used to plan approach and fixation with preservation of blood supply. Classification can also prognosticate the outcomes in Hoffa fracture.

简介：WeusedBastianimonoarmexternalframefixatortofixopentibialfracture,acompositeflaptransfertocoverandrepairthedefectsoftheskinandanirrigationdevicetodrainthewoundareainpatientswithinfectedopentibialfracturesinducedbyinternalfixation.Satisfactoryfunctionwasobtainedandthecosmeticresultsofboththedonerandthereceptorsiteswerealsosatisfactoryafteroperation.

简介：客观：为王牌探索起作用的指示和主要全部的新潮的关节造形术的起作用的方法平坦骨折并且观察临床的药品effect.Methods：我们回顾地总结了并且分析创伤的条件，破裂类型，复杂并发症，起作用的时间，起作用的技术，和11patients的短期的药品效果(10男性和1女性，与42的吝啬的年龄。4年)与王牌平坦骨折经历了主要全部的新潮的关节造形术。结果；病人被跟随在上面为6-45月(吝啬的=28月)。他们手术后的新潮的关节的普通哈里斯分数是78。结论：指示的Understrict控制，有平坦骨折可以经历的王牌的病人主要全部的新潮的关节造形术，而是稳定的王牌平坦部件应该被做。

简介：Fracturetoughnessisoneofthecrucialmechanicalpropertiesofbrittlematerialssuchasglassesandceramicswhichdemonstratecatastrophicfailuremodes.Conventionalstandardizedtestingmethodsadoptedforfracturetoughnessdeterminationrequirelargespecimenstosatisfytheplanestraincondition.Asforsmallspecimens,indentationisapopular,sometimesexclusivetestingmodetodeterminefracturetoughnessforitcanbeperformedonasmallflatareaofthespecimensurface.Thisreviewfocusesonthedevelopmentofindentationfracturetheoriesandtherepresentativetestingmethods.Crackingpatterndependentonindentergeometryandmaterialpropertyplaysanimportantroleinmodeling,andisthemainreasonforthediversityofindentationfracturetheoriesandtestingmethods.Alongwiththesimplicityofspecimenrequirementisthecomplexityofmodelingandanalysiswhichaccountsforthesemi-empiricalfeaturesofindentationfracturetests.Someunresolvedissuesshapingthegapbetweenindentationfracturetestsandstandardizationarealsodiscussed.更多还原

简介：Objective:Toevaluatetheeffectofosteoporosisonfracturehealingthroughobservingthehistomorphologicalchanges,bonemineraldensityofcallusandexpressionanddistributionoftransforminggrowthfactorbeta1(TGF-β1),basicfibroblastgrowthfactor(bFGF)andbonemorphogeneticprotein-2(BMP-2)inovariectomizedrats.Methods:SixtyfemaleSprague-Dawleyrats(aged12weeksandweighing235gonaverage)wererandomlydividedintoanovariectomized(OVX)group(n=30)andasham-operated(SO)group(n=30).OvariectomywasperformedintheOVXratsandsameincisionwasmadeintheSOrats.Threemonthslater,fractureoffemoralshaftwasmadeonalltherats.Thentheywerekilledatdifferenttimepoints.Callusformationwasobservedwithhistologicalandimmunohistochemicalmethods.Results:AreductionincallusandbonemineraldensityinthehealingfemurandadecreaseofosteoblastsexpressingTGF-β1nearthebonetrabeculawereobservedintheOVXrats3-4weeksafterfracture.HistomorphologicalanalysisrevealedahighercontentofsoftcallusintheOVXratsthanthatintheSOrats.ImmunohistochemistryresultsshowedthatnoremarkabledifferenceinexpressionanddistributionofBMP-2andbFGFbetweentheOVXandSOgroupswasfound.Conclusions:Osteoporosisinfluencesthequantityandqualityofcallusduringtheearlyperiodoffracturehealing.TheeffectofosteoporosisonfracturehealinghasnorelationshipwiththeexpressionofBMP-2orbFGF.ThedecreasedexpressionofTGF-β1inosteoblastsmaycauseadecreaseinqualityoffacturehealingafterosteoporosis.

简介：Mechanicalandelectricaldamagesareintroducedtostudythefracturemechanicsofpiezoelectricceramicsinthispaper.Twokindsofpiezoelectricfracturecriteriaareestablishedusingthemethodofleastsquarescombinedwithadamageanalysisofthewell-knownpiezoelectricfractureexperimentsofParkandSun's.Oneisbasedonalinearcombinationofthemechanicalandelectricaldamagesandtheotherontheirnonlinearcombination.WhenthecombineddamageDisuptoitscriticalvalueDc,piezoelectricfractureoccurs.Itisfoundfromthequalitativecomparisonofthenumericalresultswiththeexperimentaldatathatthenonlinearlycombineddamagefracturecriterioncangiveabetterpredictionofpiezoelectricfracture.Anditisconcludedfromthenonlinearlycombineddamagefracturecriterionthatanegativeelectricfieldimpedesfracturewhereastheeffectofapositiveelectricfieldonfracturedependsonitsmagnitude.

简介：大腿骨的髁的孤立的花冠破裂在成年人是稀罕的并且Hoffa骨折不属于工会被报导仅仅在文学的一些时间。我们分析了六个案例在三年的一个时期上的Hoffa破裂不属于工会。三个病人保存地被对待，三个病人有固定失败。表示的延期是到一年的2个月。治疗协议与膝arthrolysis一起由开的减小，pseudoarthrosis的切除，骨头grafting和内部固定组成了。联合在平均数16星期在所有病人被完成。治疗Hoffa破裂不属于工会要求小心的外科手术前的计划和过细的外科的技术。关于在破裂管理和外科的技术的争吵的文学被考察。

简介：Thisinvestigationdiscussesfurthertheextenttowhichanewdamagetheoryrecentlyproposedbytheauthorcanserveasaunifiedtheorytocharacter-izevariousductilefailureproblems.Ageneraldamageintegralandcorrespondingcriterionforductilefracturearepresented.Anewparameterforductilefractureisemphasized,whichisexperimentallyverifiedasamaterialconstantindependentofstressstate,hasclearphysicalmeaning,andcaneasilybedetermined.Theapplica-bilityofthistheorytoevaluationoftheductilityofweldsandengineeringmaterialsundervariousconditionsisexamined.Also,itisusedtopredicttheeffectofresid-ualstressonfailureofwelds,topredictsheetforminglimits,andtocorrelatethevariabilityofelasto-plasticfracturetoughnessvaluesJ1candδcwithdifferentspec-imengeometries.Anewconstraintcorrectionmethodisproposed,andconstraintcorrectednewtoughnessparametersJdcandδdcarerecommended.Experimentshaveshownthatthetoughnessvariationwithdifferentspecimengeometriescanef-fectivelyberemovedbyuseofthemethod.Thegeneralapplicabilityofthetheorytocharacterizationofvariousductilefailuresprovidesanewdesigntoolforengineeringcomponentsorstructures.