目的探讨内侧加背外侧双柱90°解剖型钢板内固定治疗肱骨远端C3型骨折手术方法及临床疗效。方法回顾性研究淮南市第一人民医院2016年1月至2018年5月期间15例肱骨远端骨折病人,术前经三维重建CT(Computed Tomography)确诊为AO/OTA(Ar...目的探讨内侧加背外侧双柱90°解剖型钢板内固定治疗肱骨远端C3型骨折手术方法及临床疗效。方法回顾性研究淮南市第一人民医院2016年1月至2018年5月期间15例肱骨远端骨折病人,术前经三维重建CT(Computed Tomography)确诊为AO/OTA(Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation)分型C3型骨折,均采用肘关节后侧经尺骨鹰嘴截骨入路,直接内侧加背外侧双柱90°解剖型钢板内固定治疗。末次随访时使用Mayo评分标准评估肘关节功能。结果病人术后无切口感染、骨折均愈合并获得随访,随访时间范围为6~18个月,随访时间(11.67±3.89)个月。末次随访未见术后内固定松动、断裂及其它严重并发症。采用Mayo肘关节功能评分标准评价:优6例,良9例,优良率100%。结论经尺骨鹰嘴截骨内侧加背外侧双柱90°解剖型钢板内固定治疗肱骨远端C3型骨折,骨折固定可靠,可进行早期肘关节功能锻炼从而获得良好的远期肘关节功能。展开更多
Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-ol...Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.展开更多
目的：探讨角稳定原则结合关节面下支撑治疗关节面粉碎的尺骨鹰嘴骨折的疗效。方法回顾性分析2008年11月至2012年6月，采用Synthes解剖锁定加压钢板结合关节面下克氏针固定治疗13例关节面粉碎的尺骨鹰嘴骨折患者资料，男7例，女6例；年...目的：探讨角稳定原则结合关节面下支撑治疗关节面粉碎的尺骨鹰嘴骨折的疗效。方法回顾性分析2008年11月至2012年6月，采用Synthes解剖锁定加压钢板结合关节面下克氏针固定治疗13例关节面粉碎的尺骨鹰嘴骨折患者资料，男7例，女6例；年龄20~77岁，平均52岁；左侧9例，右侧4例。Mayo分型：ⅡB型11例，ⅢB型2例；Schatzker-Schmeling分型：A2型2例，C型9例，D型2例，其中C型骨折中1例伴Ⅰ型冠状突骨折（Regan和Morrey分型）。使用Mayo肘关节评分指数（Mayo elbow performance index, MEPI）和简化的臂肩手功能障碍评估表（the shortened disabilities of the arm, shoulder and hand, Quick-DASH）评价患者的术后功能，同时行满意度调查和X线片随访。结果13例患者均获得随访，随访时间8~41个月，平均20.2个月。肘关节屈伸活动65°~140°，平均112°，前臂旋转活动150°~180°，平均170°。MEPI评分85~100分，平均96分，其中优12例，良1例，优良率为100%。Quick-DASH量表得分0~16.7分，平均6.2分。满意度评价，8例为非常满意，4例为满意，1例为一般。骨折均完全愈合，愈合时间11~24周，平均12.7周；无一例发生内外翻畸形、不稳定、感染、尺神经损伤等并发症。术后5例诉内固定刺激引起轻度不适，其中3例屈伸活动度＜100°，被诊断为关节僵硬（1例取出内固定，1例取内固定同时行内侧副韧带松解，1例拒绝治疗）。结论 Synthes解剖锁定加压钢板螺钉角稳定结合克氏针关节面下支撑治疗关节面粉碎的尺骨鹰嘴粉碎性骨折固定确实，有利于肘关节早期活动，临床应用效果优良。展开更多
文摘目的探讨内侧加背外侧双柱90°解剖型钢板内固定治疗肱骨远端C3型骨折手术方法及临床疗效。方法回顾性研究淮南市第一人民医院2016年1月至2018年5月期间15例肱骨远端骨折病人,术前经三维重建CT(Computed Tomography)确诊为AO/OTA(Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation)分型C3型骨折,均采用肘关节后侧经尺骨鹰嘴截骨入路,直接内侧加背外侧双柱90°解剖型钢板内固定治疗。末次随访时使用Mayo评分标准评估肘关节功能。结果病人术后无切口感染、骨折均愈合并获得随访,随访时间范围为6~18个月,随访时间(11.67±3.89)个月。末次随访未见术后内固定松动、断裂及其它严重并发症。采用Mayo肘关节功能评分标准评价:优6例,良9例,优良率100%。结论经尺骨鹰嘴截骨内侧加背外侧双柱90°解剖型钢板内固定治疗肱骨远端C3型骨折,骨折固定可靠,可进行早期肘关节功能锻炼从而获得良好的远期肘关节功能。
文摘Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.
文摘目的：探讨角稳定原则结合关节面下支撑治疗关节面粉碎的尺骨鹰嘴骨折的疗效。方法回顾性分析2008年11月至2012年6月，采用Synthes解剖锁定加压钢板结合关节面下克氏针固定治疗13例关节面粉碎的尺骨鹰嘴骨折患者资料，男7例，女6例；年龄20~77岁，平均52岁；左侧9例，右侧4例。Mayo分型：ⅡB型11例，ⅢB型2例；Schatzker-Schmeling分型：A2型2例，C型9例，D型2例，其中C型骨折中1例伴Ⅰ型冠状突骨折（Regan和Morrey分型）。使用Mayo肘关节评分指数（Mayo elbow performance index, MEPI）和简化的臂肩手功能障碍评估表（the shortened disabilities of the arm, shoulder and hand, Quick-DASH）评价患者的术后功能，同时行满意度调查和X线片随访。结果13例患者均获得随访，随访时间8~41个月，平均20.2个月。肘关节屈伸活动65°~140°，平均112°，前臂旋转活动150°~180°，平均170°。MEPI评分85~100分，平均96分，其中优12例，良1例，优良率为100%。Quick-DASH量表得分0~16.7分，平均6.2分。满意度评价，8例为非常满意，4例为满意，1例为一般。骨折均完全愈合，愈合时间11~24周，平均12.7周；无一例发生内外翻畸形、不稳定、感染、尺神经损伤等并发症。术后5例诉内固定刺激引起轻度不适，其中3例屈伸活动度＜100°，被诊断为关节僵硬（1例取出内固定，1例取内固定同时行内侧副韧带松解，1例拒绝治疗）。结论 Synthes解剖锁定加压钢板螺钉角稳定结合克氏针关节面下支撑治疗关节面粉碎的尺骨鹰嘴粉碎性骨折固定确实，有利于肘关节早期活动，临床应用效果优良。
