关节内的

Methods Ten fresh-frozen foot specimens, three-dimensional kinematics of talonavicular joint were determined in the case of neutral position, dorsiflexion, plantoflexion, adduction, abduction, inversion and eversion motion by means of three-dimensional coordinate instrument （Immersion MicroScribe G2X） before and after calcaneocuboid arthrodesis under non-weight with moment of couple, bending moment, equilibrium dynamic loading.

方法10只新鲜尸体足标本，通过建立非负重位尸体足模型，结合力偶矩、弯矩及平衡加载方法，应用三维坐标仪测量分析跟骰关节融合前、后距舟关节在大体足背屈、跖屈、内收、外展、内翻及外翻运动中的三维运动度变化。

METHODS From January 1998 to February 2001, 4 ml of sodium hyaluronate injection was injected into the knee joint of the 134 cases at the end of arthroscope operation, or the 91 cases undergoing open operation of the knee at the time when the drain tube was removed. Five days after operation, the hydrarthrosis was removed and 2 ml of sodium hyaluronate was injected into the knee joint. According to the patient's condition, injection of sodium hyaluronate was performed once a week for several weeks. Clinical evaluation was made by evaluating pain visual analog scale and painless range of movement of the joint at every definite point of time.

1998年 1月～ 2 0 0 1年 2月，对关节镜手术 134例于手术结束时，以及膝关节开放手术 91例于术后 2 4小时拔引流管时，分别在关节腔内注射透明质酸钠 4ml ；术后第 5天抽出关节积液，再注入透明质酸钠注射液 2 ml；每周 1次，连续 5周为一个疗程，根据病情注射1～ 2个疗程，观察各时间点疼痛 VAS评分和达到最大无痛活动度的时间。

Make a cured incision 5 cm long on the medial aspect of the joint (Fig. 1-24, A). Begin it just proximal to the interphalangeal joint, cure it oer the dorsum of the metatarsophalangeal joint medial to the extensor hallucis longus tendon, and end it on the medial aspect of the first metatarsal 2.5 cm proximal to the joint.

于关节内侧做一5cm弧形切口(图1-24，A)，切口起自趾间关节近端，弧形延伸至拇趾跖趾关节的背侧，拇长伸肌腱内侧，终止于跖趾关节近侧2.5 cm处的第一跖骨内侧面。

Results: For normal living body. extensor hallucis longus was about (44±4.26)mm lateral to tibialis anterior muscle at the transverse striation of ankle,(2.00±2.22)mm lateral to the middle point of tarsometatarsal joint,(1.32±1.46)mm lateral to the middle point of metatarsophalangeal joint, and it inserted into the center of the base of distal phalanx with the range of (2.22±2.42) mm.

结果：正常长伸肌腱的位置在踝横纹处位于胫骨前肌外侧(9.44±4.26)mm，在跖附关节中点外侧(2.00±2.22)mm，跖趾关节中点外侧(1.32±1.46)mm，止点位于末节趾骨基底中点(2.22±2.42)mm范围内，长屈肌腱在跖趾关节中点外侧(0.44±2.42)mm。

Dissect the fascia from the dorsum down to the bursa over the medial aspect of the metatarsal head. Then make a curved incision through the bursa and capsule of the joint Fig. 1-24,; begin the incision over the dorsomedial aspect of the joint, continue it proximally dorsal to the metatarsal head and then plantarward and distalward around the joint, and end it distally on the medioplantar aspect of the metatarsophalangeal joint.

然后弧形切开滑囊及跖趾关节囊图1-24，，切口起自关节背内侧，自跖骨头背侧向近端延长，然后转向跖侧，再转向远瑞，环绕关节而行，最后在远端终止于跖趾关节的跖内侧面，此切口形成一椭圆形网球拍状组织瓣，连接于近节趾骨的基底部

Flexor pollicis longus muscle tendon was about (0.44±2.42)mm lateral to the center of metatarsophalangeal joint. For cases of HV, extensor hallucis longus was about (9.32±3.46)mm lateral to tibialis anterior muscle at ankle transverse striation,(3.00±2.22)mm lateral to the center of tarsometatarsal joint.

在外翻的患者中，长伸肌腱在踝横纹处位于胫骨前肌外侧(9.32±3.46)mm，在跗跖关节中点外侧(3.00±2.22)mm，跖趾关节中点外侧(4.22±2.26)mm，止点位于末节趾骨基底中点(2.02±2.32)mm范围内，长屈肌腱在跖趾关节中点外侧(3.24±2.32)mm。

The human cartilages are composed of chondrocyte and extracellular matrix,the form of chondrocytes are hypertrophy and the quantity are less;the ECM of cartilage are compised of type II collagen and proteoglycan. Articular cartilages are all hyaline with little fibers. Trauma and arthritis are the main cause of cartilage injury,the ommilayer injury ofcartilage can be recovered by marrow,but because of without stimulation mechanism,the new tissues are merely fibrocartilages,they can not be coincide with hyaline cartilage in menchanics;the purely damage of articular cartilage can not stimulate chondrocyte to regenerate because of without blood circulation,thus,the plerosis of articular catilage can not depend on the proliferation of local chondrocyte.Ever since,people tried their best to find a way to reconstruct articular cartilage.

造成人体关节软骨损伤的原因主要为创伤和关节炎，关节软骨全层损伤可由于骨髓中间充质干细胞的高速增殖修复，但这种修复由于缺乏相应的刺激机制，只能形成纤维软骨，而不能形成符合关节生理、力学要求的透明软骨；单纯软骨部分损伤软骨组织内无血管，软骨细胞迁移迟缓，无法使损伤区域软骨细胞再生，因此，关节炎及关节创伤后的软骨修复不能依赖于软骨细胞的增殖和迁移。

The human cartilages are composed of chondrocyte and extracellular matrix , the form of chondrocytes are hypertrophy and the quantity are less; the ECM of cartilage are compised of type Ⅱ collagen and proteoglycan. Articular cartilages are all hyaline with little fibers. Trauma and arthritis are the main cause of cartilage injury, the ommilayer injury ofcartilage can be recovered by marrow, but because of without stimulation mechanism, the new tissues are merely fibrocartilages, they can not be coincide with hyaline cartilage in menchanics; the purely damage of articular cartilage can not stimulate chondrocyte to regenerate because of without blood circulation, thus, the plerosis of articular catilage can not depend on the proliferation of local chondrocyte.

造成人体关节软骨损伤的原因主要为创伤和关节炎，关节软骨全层损伤可由于骨髓中间充质干细胞的高速增殖修复，但这种修复由于缺乏相应的刺激机制，只能形成纤维软骨，而不能形成符合关节生理、力学要求的透明软骨；单纯软骨部分损伤软骨组织内无血管，软骨细胞迁移迟缓，无法使损伤区域软骨细胞再生，因此，关节炎及关节创伤后的软骨修复不能依赖于软骨细胞的增殖和迁移。

Results:Fractures were demonstrated definitely with transaxial imaging,SSD and MPR in all patients.The length,shape,direction and displacement of fractures,the appearance,size and space location of detached bone fragments,and dislocation of joint were displayed stereoscopically by SSD.Joint disruption and detached bone fragments within joint could be best viewed by MPR.

结果：所有病例CT横断面、SSD和MPR像均明确地显示了骨折，SSD像立体地显示了骨折线的长短、形态、走向，碎骨片的形态、大小、空间位置以及骨折的移位和关节对位状况，跨关节MPR像显示关节受累和关节腔内游离碎骨片更佳。

All the patients returned to normal daily life after a mean time of 5.3 months (3 to 11 months) Conclusions Tarsometatarsal joint injuries can be treated well by close reduction and percutaneous screw fixation with less operative lesion and lower incidence of soft tissue complications. Reduction of the middle column with screw insertion along the direction of the Lisfranc ligament is the key to reestablishment of the stability of the tarsometatarsal joint complex.

闭合复位经皮螺钉内固定手术创伤小，软组织并发症低，能有效治疗跖跗关节复合体损伤；中间柱复位并沿Lisfranc韧带方向插入螺钉内固定是重建跖跗关节复合体稳定性的关键。

For a big chunk of credit-card losses; the number of filings (and thus charge-off rates) would be rising again, whether

年美国个人破产法的一个改动使得破产登记急速下降，而后引起了信用卡大规模的亏损。

Eph. 4:23 And that you be renewed in the spirit of your mind

弗四23 而在你们心思的灵里得以更新