关节内的

Objective Creating a 3D finite element model of a full pelvis with sacroiliac joint fracture. Comparing the biomechanical properties of the model where the fracture part was fixated by using a new sacroliliac anatomy type Bar-plate internal fixation system to iliosacral screw fixation and front reconstruction plate fixation.

目的 建立使用新型的骶髂关节解剖型棒-板内固定系统对骶髂关节骨折脱位进行固定的三维有限元模型，并与骶髂关节螺钉、和前路重建钢板固定进行对比，验证和分析其力学性能。

Isolated rotatory dislocation is very rare in adults.11–13 Few cases of AARFs have been reported in adults, perhaps because the cause may often be a severe trauma associated with lethal injuries.3,4,12,14 –19 The mechanisms underlying persistent displacement in traumatic AARF include infolding of the synovial folds into the C1–C2 joints, muscle spasm, subsequent ligamentous contracture, articular cartilage damage, or facet fracture.1,11

离体旋转脱位在成人也很少见[11-13]。关于成人AARF病例的报道甚少，可能与严重创伤通常与高致死性损害相关[3，4，12，14 –19]。创伤性AARF持续移位的主要原因包括滑膜襞内折入C1-C2关节、肌肉痉挛、继发韧带孪缩、关节软件损伤或关节突骨折[1，11]。

Objective: To clarify the technical parameters in posterior atlanto-occipital transarticular screw fixation and discuss the clinical significance of occipitocervical junction fixation with transarticular screws.

目的：明确后路寰枕关节经关节螺钉固定的技术参数；探讨枕颈部经关节螺钉内固定技术的临床意义。

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.

中文题名人骨髓基质干细胞成软骨诱导及多孔复合材料作为细胞载体的体外实验研究副题名外文题名 Cartilage induction of human mesenchymal stem cells and experiment on compound porous materials as cells' scaffold in vitro 论文作者刘晓岚导师周江南学科专业外科学研究领域\研究方向学位级别博士学位授予单位中南大学学位授予日期2003 论文页码总数68页关键词骨组织工程软骨细胞骨髓基质干细胞壳聚糖高分子外消旋聚乳酸馆藏号BSLW /2003 /R68 /10 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。

Collar-bone hook nickelclad utilizes the lever principle and the intensity of nickelclad itself to oppose the traction force of sternomastoid muscle and avoid prolapse.As not damaging the acromioclavicular facet,it can avoid and reduce the traumatic arthritis caused by devices such as Kirschner wire ect.This method characterized by little wound,fixation firmly and moving the joint early is a effective method to cure distal collar bone fracture and acromioclavicular dislocation.

锁骨钩钢板利用杠杆原理和钢板自身的强度对抗胸锁乳突肌的牵引力，可以避免内固定物体的松动脱出，由于术中不损伤肩锁关节面，能够避免或减少克氏针固定等经关节手术所造成的继发性创伤骨关节炎，该方法创伤小、固定牢固，能早期活动肩关节，是治疗锁骨远端骨折和肩锁关节脱位行之有效的方法。

The patients can get painless free-running.Conclusion Collar-bone hook nickelclad utilizes the lever principle and the intensity of nickelclad itself to oppose the traction force of sternomastoid muscle and avoid prolapse.As not damaging the acromioclavicular facet,it can avoid and reduce the traumatic arthritis caused by devices such as Kirschner wire ect.This method characterized by little wound,fixation firmly and moving the joint early is a effective method to cure distal collar bone fracture and acromioclavicular dislocation.

锁骨钩钢板利用杠杆原理和钢板自身的强度对抗胸锁乳突肌的牵引力，可以避免内固定物体的松动脱出，由于术中不损伤肩锁关节面，能够避免或减少克氏针固定等经关节手术所造成的继发性创伤骨关节炎，该方法创伤小、固定牢固，能早期活动肩关节，是治疗锁骨远端骨折和肩锁关节脱位行之有效的方法。

The patients can get painless free-running.Conclusion Collar-bone hook nickelclad utilizes the lever principle and the intensity of nickelclad itself to oppose the traction force of sternomastoid muscle and avoid prolapse.As not damaging the acromioclavicular facet,it can avoid and reduce the traumatic arthritis caused by devices such as Kirschner wire ect.

锁骨钩钢板利用杠杆原理和钢板自身的强度对抗胸锁乳突肌的牵引力，可以避免内固定物体的松动脱出，由于术中不损伤肩锁关节面，能够避免或减少克氏针固定等经关节手术所造成的继发性创伤骨关节炎，该方法创伤小、固定牢固，能早期活动肩关节，是治疗锁骨远端骨折和肩锁关节脱位行之有效的方法。

Conclusion］The pristine cases could receive significant curative effects through open reduction and internal fixation, the late cases could also receive significant curative effects through instep re-establishment and tarsometatarsal joints Fusion.

结论］早期陈旧性跖跗关节骨折脱位可行切开复位内固定术，疗效满意，而晚期的陈旧性跖跗关节骨折脱位，行足弓重建跖跗关节原位融合术，也可取得较好的治疗效果。

Evaluate MRI representation:(1) segregation condition: transfixation band, segregation between cartilage and bone, segregation between bone and bone;(2) four stages of pathologic classification based on MRI signal character;(3) texture in weight bearing zone;(4) add Bone Marrow Edema score and joint effusion score as stasis index.

术前MRI评估：(1)股骨头内分离情况：贯穿带、软骨与骨分离，软骨下骨与骨分离；(2)股骨头内信号的病理分期；(3)冠状正中位的髋臼负重区下结构；(4)将股骨头骨髓水肿评分和关节积液评分相加记为关节的瘀积指数。

objective to investigate the treatment effect of wolter crook plate on distal clavicle fracture and acromioclavicular dislocation.methods thirty two patients underwent surgical repairs with wolter crook plate.results twenty seven cases were followed up for 12 months.according to karlsson,the excellent result was found in 19 cases;good in 8 cases;poor in 0 case.no complications such as infection,non union,plate failure,or redislocation after removal of the plate was found.conclusion the implant of wolter crook plate provides sufficient stability to allow active shoulder exercises immediately after surgery,which is worthy of clinical practice.

对32例锁骨远端骨折及肩锁关节脱位患者采用wolter钢板内固定治疗。结果本组27例获得随访，平均随访时间12个月，根据karlsson疗效评定标准：优19例；良8例；差0例。未出现感染、骨不连、钢板断裂以及内固定取出后再脱位等并发症。结论 wolter钢板固定能提供足够的生物力学稳定性，可允许患者进行早期功能锻炼，且肩关节功能恢复较好，有一定的临床推广应用价值。

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