内上髁

Objective To evaluate clinical effect of treatment of humeral supracondylar fracture with crossing Kirschner wire internal fixation.

目的探讨儿童肱骨髁上骨折采用克氏钢针交叉内固定治疗的临床效果。

To research effective treatment for humerus upper condylar fracture and reduce the happening rate of elbow turn inside.

目的 研究有效的肱骨髁上骨折治疗方法和如何降低肘内翻的发生率。

Methods: twenty rabbits with fracture of the femur diaphysis were treated by intramedullary nailing of femur with composites rod of resorbable dl polylactic acid calcium metaphosphate. the animals were sacrificed at 2, 4, 8 and 12 weeks after surgery. the fracture healing, the material degradation and mechanical properties were studied with x ray films, macroscopic, microscopic and electron microscopic observations.

用生物可吸收性聚乳酸/偏磷酸钙复合物棒对20只兔股骨髁上实验性骨折行髓内固定，术后2， 4， 8和12 wk分别经x线摄片、肉眼、光镜和电镜对骨折的愈合、材料的降解性能和力学性能进行观察。

METHODS: Twenty rabbits with fracture of the femur diaphysis were treated by intramedullary nailing of femur with composites rod of resorbable DL polylactic acid calcium metaphosphate.

用生物可吸收性聚乳酸/偏磷酸钙复合物棒对 2 0只兔股骨髁上实验性骨折行髓内固定，术后 2 ，4 ，8和 1 2wk分别经X线摄片、肉眼、光镜和电镜对骨折的愈合、材料的降解性能和力学性能进行观察。

The results indicate that the fixation methods for supracondylar fractureshould b that:(1) The fixation with the flexion angle of 9O°in the pronator position is adopted if the medial side presents displacement and the lateral periosteum is broken and the "hinge"of the medial periosteum remained unbroken.

表明肱骨髁上骨折的固定方法宜采用：①若内侧移位，外侧骨膜破裂，内侧骨膜"铰链"完整，则采用屈曲90°旋前位固定；②若外侧移位，内侧骨膜破裂，外侧骨膜"铰链"完整，则采用屈90°旋后位固定；③若内外侧骨膜完全破裂，不论是内侧移位，还是外侧移位，宜采用旋后位固定。

Large cancellous and corticocancellous grafts may be obtained from the anterosuperior iliac crest and the posterior iliac crest. Small cancellous grafts may be obtained from the greater trochanter of the femur, femoral condyle, proximal tibial metaphysis, medial malleolus of the tibia, olecranon, and distal radius. At least 2 cm of subchondral bone must remain to aoid collapse of the articular surface.

大块的松质骨或皮质-松质骨复合植骨块，可取自髂前上棘或髂后棘，小块松质骨块可以取自股骨大粗隆、股骨髁、胫骨近侧干骺端、内踝、尺骨鹰嘴及桡骨远端，但至少要保留2cm的软骨下骨以防止关节面的塌陷。

Large cancellous and corticocancellous grafts may be obtained from the anterosuperior iliac crest and the posterior iliac crest. Small cancellous grafts may be obtained from the greater trochanter of the femur, femoral condyle, proximal tibial metaphysis, medial malleolus of the tibia, olecranon, and distal radius. At least 2 cm of subchondral bone must remain to avoid collapse of the articular surface.

大块的松质骨或皮质-松质骨复合植骨块，可取自髂前上棘或髂后棘，小块松质骨块可以取自股骨大粗隆、股骨髁、胫骨近侧干骺端、内踝、尺骨鹰嘴及桡骨远端，但至少要保留2cm的软骨下骨以防止关节面的塌陷。

Cuneiform osteotomy ,interal fixation with assimilable thread and exteral fixation with plaster.

行肱骨髁上改良楔形截骨，可吸收缝线内固定加上肢石膏托外固定治疗。

BACKGROUND: Fracture of humeral ectocondyle is a kind of articular epiphyseal fracture. It is one of the most prevalent disorder of cubital articulation. The occurrence of fracture and the mechanical mechanism of treatment is not very well cognized in clinic.

背景：肱骨外侧髁骨折是最易发生的肘部损伤之一，属关节内骨骺骨折，临床上对其骨折发生和其治疗的力学机制并不完善。

The accessory measures included: 1 To break iliopsoas and adductor, to tractate femur condyle; 2 femoral shortening and derotational osteotomy; 3人-shaped plaster fixation of single coxa ; 4 early movement of the hip joint after operation and was allowed ambulatory late; 5 the hip joint was mobilized passively. Results The complete reduction rate of the hip joint was 100%.

辅助手段包括：(1)髂腰肌及内收肌切断，股骨髁上骨牵引；(2)股骨粗隆下旋转加短缩截骨；(3)单髋人字石膏制动；(4)髋关节早活动，晚负重；(5)术后被动活动髋关节加主动功能锻炼。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。