简介：AbstractSchatzkter type-I tibial plateau fracture is a split fracture of the lateral tibial plateau in sagittal plane, consequent to valgus impaction caused by low velocity of trauma. However, a deep understanding of the different columns of the tibial plateau and patho-mechanisms of the injury led to the unmasking of atypical fractures around the tibial plateau. We have encountered 2 cases with unusual fracture pattern of the lateral tibial condyle caused by road traffic accidents. The fracture pattern and severity of injury deviate from the original description of Schatzker type 1; in view of dual plane split, there is rotation of the posterolateral column fragment along its sagittal plane plus grade-III medial collateral ligament injury. The patients were initially treated with knee spanning external fixator and after a latency of 5 days, definitive fracture specific fixation was done, combined with repair of grade-III medial collateral ligament injury. At the 6 months follow-up both the patients achieved satisfactory knee functions (knee society score case 1:100 and case 2: 92) and returned to their jobs. The severity of fracture pattern and displacement as described should prompt for examination of associated ligament injury. Because of timely diagnosis, early and appropriate care promised an excellent function outcome even in such a severe nature of knee injury. To prompt the description of injury pattern we coined the name "dual split and dislocation" of lateral tibial plateau, as a complex injury variant of split fracture of lateral tibial plateau fracture.

简介：WeusedBastianimonoarmexternalframefixatortofixopentibialfracture,acompositeflaptransfertocoverandrepairthedefectsoftheskinandanirrigationdevicetodrainthewoundareainpatientswithinfectedopentibialfracturesinducedbyinternalfixation.Satisfactoryfunctionwasobtainedandthecosmeticresultsofboththedonerandthereceptorsiteswerealsosatisfactoryafteroperation.

简介：Objective:Toobservetheeffectofoctyl-a-cyanoacrylateuponbonehealinganditsdegradationinvitroaftermiddletibialtransversefractureinrabbits,andtoestablishtreatmentofhigherefficacywiththeapplicationofoctyl-a-cyanoacrylate.Methods:MiddletibialtransversefracturemodelofNewZealandrabbitswasestablished.Intheexperimentalgroup,internalfixationwith2mmKirschnerwireswasperformedandthebrokenendswerefixedwithoctyl-a-cyanoacrylate.Inthecontrolgroup,onlyinternalfixationwith2mmKirschnerwireswasconducted.Animalswerekilledatpresettimeintervalsof2,4,6,8,10and12weekspostoperativelyandsampleswereharvested.Results:Twoweeksafteroperation,clearfracturelineswereobservedinboththeexperimentalandthecontrolgroups.Fibroussofttissueconnectionwasnotedbetweenthebrokenendsandtherewassofttissueadhesionaroundthefracturesite.Therewasnocallusformationandthebrokenendsweresurroundedbyadhesivesofttissues.Obviousexternalcallusformationwasconfirmedat8weeksafteroperationinbothgroupswithpartialdisappearanceoffracturelines.Tenandtwelveweeksaftertheoperation,fracturelinesdisappearedcompletelyandtherewasobviousexternalcallusformationandboneunion.Inthefourthweek,fibrouscellsandchondrocyteswerefoundtogrowintothecolloidandsurrounditatthe6thweek.Theadhesivematerialwasdegradedandgraduallyabsorbedatthe8thweek.Chondrificationwasobserved.Conclusions:Twoweeksafterfixationfortibialfractureinrabbits,octyl-a-cyanoacrylatebeginsinvivodegradation.Chondrocytesandfibrocytesgraduallygrowintothedegradationareaandsurroundtheadhesivematerial,whichbrokeintopiecesat8weeks.Completedegradationanddisappearanceoftheadhesivematerialispresentbetween10and12weeks.Nobarriereffecthamperingfracturehealingisnoted.

简介：Objective:Toevaluatetheclinicalresultsoftreatmentofmidshafttibialfracturewithexpandableintramedullarynailscomparedwithinterlockingintramedullarynails.Methods:FromJune2003toAugust2005,46patients(27malesand19females,aged20-74years,mean=38.4years)withmidshafttibialfractureweretreatedsurgicallyinourdepartment.Thecausesoffracturesweretrafficinjuryin21patients,fallinjuryin6,tumblinginjuryin11andcrushinginjuryin8.AccordingtoAO/ASIFclassification,TypeAfracturewasfoundin16patients,TypeBin11,TypeC_1in5,andTypeC_2in2.Openfractureswerefoundin12patients,accordingtoGustiloclassification,TypeⅠin9patientsandTypeⅡin3patients.Basedonthepatients'consent,24patientsweretreatedwithexpandableintramedullarynails(GroupA)and22withinterlockingintramedullarynails(GroupB).Theoperationtime,bloodlossduringoperation,X-rayfluoroscopictimes,hospitalizationtime,weightbearingtimeafteroperation,healingtimeoffractureandcomplicationsofallthepatientswererecorded.TheclinicaleffectsofallthecaseswereevaluatedaccordingtothecriteriaofJohner-Wruhs.Results:Allthepatientswerefollowedupfor12-34months(mean=16.2months).Thetimeofoperation,thebloodloss,X-rayfluoroscopictimes,hospitalizationtimeandhealingtimeoffractureofGroupAsignificantlydecreased(P<0.05)comparedwiththoseofGroupB,butthetimeforweightbearingafteroperation,theJohner-WruhsdegreeofclinicaleffectsandcomplicationshadnosignificantdifferencebetweenGroupAandGroupB(P>0.05).Conclusions:Expandableintrameduilarynailcanshortenoperationtime,decreasebloodlossandreduceinvasion,whichisasafeandeffectivetreatmentmethodfortibialmidshaftfracture.

简介：胫骨的高原不属于工会的Intraarticular是稀罕的。在文学，仅仅9个病人被发现为不属于工会的胫骨的高原和他们得到了改变结果的intraarticular被对待。与骨头grafting一起的内部固定在所有情况中作为标准治疗被做。我们对待intraarticular的4个不同侧面案例在我们由4个不同方法的机构不属于工会的胫骨的高原。我们与骨头接枝，有K钉子的arthrodesis和全部的膝代替一起与巴黎扔的、内部固定的灰浆对待这些案例。大小写1与当病人拒绝了外科，扔的巴黎(流行音乐)的灰浆被对待。破裂被统一，尽管有外翻足malalignment，病人充分对运动的完整的范围满意。大小写2与开的减小被管理与骨头grafting一起的内部固定。病人有一个好工会并且在膝关节得到了运动的完整的范围。大小写3由于她的老年与全部的膝关节造形术被对待并且得到了令人满意的结果。大小写4是一感染不属于工会。Arthrodesis被做，病人能与忍受independently.We的完整的重量走断定与骨头grafting一起的那内部固定不能在胫骨的高原不属于工会的intraarticular的所有情况中是合适的。不属于工会的、现在的状况的原因和膝关节的运动的范围都应该被考虑，治疗应该根据每种patient’s状况是individualised。

简介：

简介：AbstractPurpose:Tibial plateau fracture (TPF) is a devastating injury as it shatters lower articular surface of the largest joint. Apart from bony injury, TPF can lead to great soft tissue envelope compromise which affects the treatment plan and outcome. In the present study, clinical results were assessed in cases of high energy TPFs treated in staged manner.Methods:Twenty-three (20 males and 3 females) patients of high energy communited TPFs (Schatzker type V and VI) were consecutively treated.1 All the patient had compromise of overlying skin conditions. They were all successively scheduled for staged treatment plan which comprised of application of bridging knee external fixator on the first day of admission and definitive internal fixation after skin and soft tissue overlying the fracture were healed. Schatzker type I, II, III and IV were excluded from the study. Primary survey was done and patient who had head injury, chest and abdominal injury, pelvic injury and contralateral limb injury and open fractures were excluded from the study. The patients were also evaluated in terms of wound complications, axial and rotary alignment of limb, fixation failure, articular congruity and range of motion of the knees and post injury employment. Statistical analysis was done using SPSS software.Results:Maximum follow-up period was 13 months. All the fractures were united at final follow-up. Clinical evaluation was done with the Tegner Lysholm knee scoring scale.2 Excellent results were found in 78% cases and good and fair results in 22% cases. There was significant correlation between range of motion and the Tegner Lysholm knee score (p < 0.001, Pearson correlation coefficient = 0.741). The correlation between the score and the radiographical union duration was significant (p = 0.006, Pearson correlation coefficient =-0.554).Conclusion:A staged treatment plan allows healing of soft tissue envelope, with avoidance of dreadful complications such as compartment syndrome and chronic infection. In addition, a staged treatment strategy does not hamper the fracture reduction, bony union and the functional results.

简介：AbstractPurpose:The treatment and outcome of tibial stress fractures concomitant with knee osteoarthritis (OA) are complicated. The aim of this study was to evaluate the functional and radiological outcome of total knee arthroplasty with long tibial stem as a treatment for patients having knee OA and tibial stress fracture.Methods:Patients who were diagnosed to have proximal tibia stress fracture along with knee OA at our institution between June 2013 and November 2018 were included in our study. All patients underwent total knee arthroplasty with long tibial stem. Preoperative and postoperative functional assessments were done according to range of movement of the knee joint, knee society score and knee injury and OA outcome score. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.Results:Twelve patients were included in the study. All patients were found to have stress fractures in the proximal half of tibia and extra-arthrosis. Four patients had non-union/delayed union, and 8 patients had acute fractures. The average preoperative range of movement was 88.1°, which improved to 116.3° at 3 months following surgery. It was found that the fracture has healed in all cases. Mean knee society score improved from 32.9 preoperatively to 89.3 at 1 year follow-up. Knee injury and OA outcome score improved from a mean score of 28.3 preoperatively to 81.1 at 1 year follow-up.Conclusion:Stress fractures can occur in the proximal tibia in patients with knee OA. Total knee arthroplasty with tibial stem provides a suitable solution for both conditions. Additional plating or bone graft is unlikely to be required.

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：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：

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：

简介：HowSpringFestivaliscelebratedAlthoughthedateoftheSpringFestivalwasswitchedfromthebeginningofspringtothefirstdayofthefirstlunarmonth,themainwaysofcelebratingit,frombygonedays,remainpopular.

简介：Ｔｈｅ　Ｐｏｔａｌａ　Ｐａｌａｃｅ：　Ａ　Ｐｅａｒｌ　ｏｎ　ｔｈｅ　ＰｌａｔｅａｕＴｈｅＰｏｔａｌａＰａｌａｃｅ：ＡＰｅａｒｌｏｎｔｈｅＰｌａｔｅａｕ￥／／Ｂｕｉｌｔｉｎｔｈｅ７ｔｈｃｅｎｔｕｒｙ，ｔｈｅＰｏｔａｌａＰａｌａｃｅｉｓｍｏｒｅｔｈａｎ１...

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：联锁钉的Intramedullary是为胫骨的柄破裂的治疗的一个标准答案。对损伤第二等的一根钉子弯曲是稀罕复杂并发症，它可以被遇到在愈合或unhealed胫骨的柄破裂。如此的弄弯的钉子的移动总是是挑战。我们报导了这个案例为弄弯的钉子的移动讨论各种各样的技术并且在在被同意进入我们的部门与的一个30岁的人移开一根弄弯的胫骨的intramedullary钉子分享我们的经验由于一个路边事故恰好胫骨的柄重新断裂在起始的外科的治疗以后的二年。intramedullary钉子，由30度的偏好并且在anterioposterior上以及在侧面的拍上可见，被部分切凸的墙第一削弱，然后由使用外部力量弄直，并且最后由使用标准钉子移动方法搬迁了。

简介：目的:探讨在不同表面上跑步对足底压力和胫骨加速度的影响。方法:13位男性跑步者被要求分别在水泥地、塑胶跑道、天然草地、跑步机以及配备EVA缓冲衬垫物的跑步机上以12km/h的速度进行慢跑。用足底压力测试系统和安放在胫骨粗隆的加速度计,记录和分析足底压力与胫骨冲击的特点。结果:第一和第二足底压力峰值(发生时间)、压力时间积分、峰值压力分布在混凝土、塑胶、草地和正常的跑步机的表面间没有明显差异。在5种不同测试表面下,峰值加速度正值也无显著差异。但相比于混凝土表面,在配备EVA缓冲衬垫物的跑步机上跑步能明显减小在冲击阶段的足底压力第一峰值和压力积分(p<0.05)。上述结果可进一步归因为足后跟区域峰值压力下降(P<0.05)。结论:运动表面和下肢冲击之间也许并无必然关系。然而值得注意的是,在解释足底压力的表现及将其运用到陆地表面的跑步运动中时应考虑不同跑步机表面的影响。