关节固定术

RESULTS: A total of 199 patients were included in the present study; 106 patients (53%) underwent arthroplasty, whereas ninety-three (47%) underwent arthrodesis.

结果：共199名入选患者，其中106例（53%）行关节成形术，93例(47%)行关节固定术。

Four patients had undergone a combined anterior-posterior, and 4 had a posterior-only spine arthrodesis.

有4个病人经历了前后路联合脊柱关节固定术，另有4个病人则经历了单独后路脊柱关节固定术。

Methods: We conducted a retrospective study of sixty-eight consecutive patients (mean age , 68 ± 6 years) in whom a total of seventy-two irreparable rotator cuff tears had been treated arthroscopically with biceps tenotomy or tenodesis.

我们回顾性的研究了68例连续的患者，平均年龄68 ± 6 岁，其中72例不可自身修复的肩袖撕裂使用关节镜行二头肌肌腱切除术或者腱固定术进行修复。

The purpose of this study was to evaluate the clinical and radiographic outcomes of isolated arthroscopic biceps tenotomy or tenodesis as treatment for persistent shoulder pain and dysfunction due to an irreparable rotator cuff tear associated with a biceps lesion.

本研究的目的是评价关节镜下二头肌肌腱切除术或者腱固定术来治疗由于肩袖撕裂及其二头肌肌腱病变导致的肩部疼痛或者功能丧失。

Deliver the fixed skill of lock inner nail and fix within fibulare.

交锁髓内钉内固定术及腓骨内固定对小腿持重、维持足关节的结构功能及小腿下1/3应力平衡有重要作用。

Ten patients with temporal bone fracture and trauma of ear,whose CT scan of temporal bone showed that Malleoincudal joint irregular shape in the axial view and incudostapedial joint dislocation in the coronal view,were included in this study,Virtual endoscopy showed Malleoincudal joint separation,incudostapedial joint dislocation and interruption,ossicular chain disruptio...

虚拟耳镜示锤砧关节分离，砧镫关节脱位，听骨链中断。手术经颞线下开放上鼓室，保留完整的外耳道后上壁，充分暴露上、后鼓室和听骨链，检查并行听骨链成形术。结果：砧骨长脚骨折1耳，将砧骨改型后行锤-镫连接术；锤砧和砧镫关节脱位6耳，砧骨完全脱落3耳，行砧骨复位双关节固定术。10耳均行上鼓室进路鼓室探查术，术后语频听力平均提高25~50dB。结论：完壁式上鼓室进路鼓室探查术治疗外伤性听骨链中断疗效满意。

Solves this symptom method to divide into the surgery and the non-surgery treats, the non-surgery treats for example the physical property treatment and the pharmacological treatment, the effect is not often good, the surgery treats may divide into the traditional surgery and micro creates the surgery two kinds, the traditional surgery method is in the lumbar vertebra fusion the pexia, although this method excised has created the lumbar vertebra narrow yellow ligament and the small surface joint, but the surgery time was long, the wound was big as well as although the lumbar vertebra fusion and fixed has removed the pathological change stage abnormal movement, but the neighbor stage's abnormal movement increased, between the awl in plate's pressure elevated obviously, the small articular process exceptionally drew back changes with the fixed stage bone quantityThe loss, causes the fixed stage vertical motion stage to draw back changes ASD[1], but new micro creates the surgery is opens a small wound in the back, and implants the interspinal to open, then solution lumbar vertebra narrow sickness question.

解决此种症状的方法分为手术及非手术治疗，非手术治疗例如物理性治疗和药物治疗，往往效果不佳，手术治疗又可分为传统手术和微创手术二种，传统手术方法就是腰椎融合内固定术，虽然此种方法切除了造成腰椎狭窄的黄韧带和小面关节，但手术时间长，伤口大以及腰椎的融合和固定虽去除了病变节段的异常活动，但邻近节段的异常活动增加，锥间盘内的压力明显升高，小关节突的异常退变和固定节段的骨量丢失，导致固定节段上下运动节段的退变ASD[1]，而新型的微创手术是在背部开一个小伤口，并植入棘突间撑开器，进而解决腰椎狭窄症的问题。

Method］from january 2003 to may 2006,32 patients were corrected with qin si-he's orthotics devices on the ilizarov principle of tension-stress,which involved 15 males and 17 females,the age ranged from 10 to 25 years.among these patients,2 were caused by peroneal nerve injury,l by tumor in the vertebral canal,5 by meningocele,11 were caused by poliomyelitis,13 by congenital talipes equino-varus.in accordance with deformities,external fixator and limitied operative methods were dertermined.the limited release of soft tissue were performed in 7 patients,limited osteotomy in 25 patients.the dynamic muscle balance operation were performed in 9 patients with imbalance of muscle strength.according to the ilizarov technique,the fixative rods were installed.the telescopic rods on the apparatus were rotated one week after the operation,the divices had corrective function in three-dimensional directions.the deformity of talipes equinovarus,internal rotation and drooping of the forefoot were gradually corrected,and the patients could bear weight and walked on the deformed foot.the mean duration of traction were 42 days,then removed the external fixator maintained with plaster for a site time.

方法］2003年1月～2006年5月，根据ilizarov张力应力法则，应用秦泗河改良的外固定矫形器，遵循ilizarov穿针固定的基本原则，共手术治疗马蹄内翻足32例，男15例，女17例；年龄10～25岁，平均17岁。病因：腓总神经损伤2例，腰椎管内肿瘤1例，硬脊膜膨出5例，小儿麻痹后遗症11例，先天性马蹄内翻足13例。术前用足掌的前外缘负重行走者11例，用足的外缘或足背外侧负重者21例。根据马蹄内翻足畸形程度、性质和患者年龄，确定实施有限矫形手术的方法和外固定矫形器治疗。本组7例同期实施有限的软组织松解术，25例同期实施了有限的截骨术和跗骨间关节融合术，9例合并踝关节内外翻肌力明显失衡者，同期行足部肌腱转移的肌力平衡术。然后安装外固定矫形器。术后按作者制定的管理程序，7 d开始旋转相应的螺纹牵拉杆，对器械进行三维空间的缓慢调整，先矫正前足内收和后足内翻，后矫正足下垂畸形，直至达到矫形要求的标准。在矫形的过程中定期进行x线检测，以防止发生踝关节前后移位，治疗期间允许患足负重行走。术后平均牵伸42 d，拆外固定器后患足再上石膏固定适当时间。

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

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。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。