桡骨

If this is evident, it is prudent first to check the quality of the reduction and fixation of the coronoid fracture and radial head and the placement of the lateral ligament repair sutures.

如果这种不稳情况较明显，那么就要首先仔细检查冠状突及桡骨头复位、固定的质量及侧副韧带修复缝合的位置。

This includes (1) fixation or replacement of the radial head,(2) fixation of the coronoid fragment,(3) repair of the lateral collateral ligament complex, and (4) repair of the medial collateral ligament and/or application of a hinged external fixator for patients who demonstrate residual instability.

该方法包括：桡骨头复位或置换，冠状突骨块的复位，侧副韧带的修复以及修复内侧副韧带或对些肘关节不稳定的患者应用外固定架。

Use of our surgical protocol for elbow dislocations with associated radial head and coronoid fractures restored sufficient elbow stability to allow early motion postoperatively, enhancing the functional outcome.

应用我们外科原则治疗肘关节脱位伴桡骨头及冠状突骨折能够有效的恢复肘关节稳定，并且能够在术后早期活动，加强功能恢复效果。

Ulna coronoid process fractures need active therapy.

结论冠状突骨折需积极处理，重视软组织及韧带的检查及处理，尽量保留桡骨小头的完整性。

The principles of the operative technique are to (1) restore coronoid stability throughfracture fixation (type-II or III fractures7) or through anterior capsular repair (a type-I fracture),(2) restore radial head stability through fracture fixation or replacement with a metal prosthesis,(3) restore lateral stability through repair of the lateral collateral ligament complex and associated so-called secondary constraints such as the common extensor origin and/or the posterolateral capsule,(4) repair the medial collateral ligament in patients with residual posterior instability, and (5) apply a hinged external fixator when conventional repair does not establish sufficient joint stability to allow early motion.

外科手术的原则是：①通过骨折固定(2型骨折或3型骨折)或者经前方关节囊修复(1型骨折)恢复冠状突的稳定。②通过骨折固定或假体置换恢复桡骨头的稳定性③通过修复侧副韧带以及相关的所谓的次要限制如伸肌群起点和后外侧关节囊。④残余的后侧不稳，修复内侧副韧带⑤当传统的修复方法不能建立有效的关节稳定以便允许早期活动时，可以应用外固定器。

Methods One normal adult male was choosed, and his left elbow joint performed in pronation and extention position was scanned by spinal CT, and the two-dimensional image was dealed with Mimics 1 0 software, the three-dimensional finite element model was built up by Abaqus 6.7 software. Finite element calculation was performed to simulate the impact of 1 000 N on the elbow joint, and the stress distribution in the radial head and coronoid were analyzed.

选取1名正常成年男性为研究对象，使其左肘关节处于旋前伸直位，行螺旋CT断层扫描，得到CT数据二维图像，采用Mimics 10.0软件系统处理，利用Abaqus 6.7建立肘关节三维有限元模型，模拟施加1000 N冲击载荷，分析冠状突及桡骨小头内应力分布情况。

Materials and metheods 2.1 Experimental Animal and Model of the bone fracture New Zealand rabbits. A 3mm deossification was made in radius at distal end of mulslespronator teres as fracture healing model.

2材料与方法 2.1实验动物及建立骨折模型新西兰家兔140只，于双侧桡骨中下1／3用特制骨锯造成3mm完全骨质缺损的动物模型，不作任何固定。

Objective To evaluate the short?time results of unstable distal radius fractures treated with wrist external fixator.

目的 对腕关节外固定架治疗不稳定型桡骨远端骨折的临床疗效进行评估。

The biomechanical tests showed that two kinds of artificial bones had not significant difference on compressive strength and Young\'s modulus(P＞0.05),while the flexural strength of nano-nacre artificial bone was less than the control group(P＜0.05).3.The results of CCK-8 showed that the difference were not significant in each group,the proliferation of osteoblast reached the peak at the 5th day;7 days after being co-cultured,the total protein content of study group was higher than control group and blank group(P＜0.05),while the difference between control group and blank group was not significantP＞0.05The difference of alkaline phosphatase activities among three groups was not significant(P＞0.05The SEM view showed that osteoblast attached and grew well in two kinds of artificial bone.4.X-ray photography showed that two kinds of powder started to degrade in 2 weeks;this phenomenon became more appear in 4 weeks,nano-nacre powder degraded faster than micron-nacre powder,while the hole shadow was easy to be found;in 8 weeks,all the femoral holes recovered and returned to normal bone mineral density in all groups.Analysis of tetracycline fluorescent double marks in the hard tissue grinding slices indicated that new bone grew fastest around the bone defect area in study group,while most slowly in blank groupP＜0.05 SEM(scanning electron microscope observation showed that nano-nacre powder degraded more quickly.The same result can be found through the demineralized sections morphometric analysis,and both of the composite artificial bones made from those two kinds of nacre powder had the good connection with the adjacent tissue in rats body without apparent inflammatory response.5.X-ray photography showed that rabbit\'s bone defects healed faster in study group since NNAB implanted than in control group since MNAB implanted.At 24 weeks after operation,bone density in radial defects had nearly accessed to the normal area,while lower in control group,and turned up nonunion in blank group;The checking of BMD showed that results in study group were higher than those in control group at 8,16 and 24 week(P＜0.05), and the difference between the BMD values in study group at 24 week and those in blank group was not significant(P＞0.05).The gross specimens showed satisfactory histocompatibility both in study group and in control group,with bone tissue growing from two sides into the center of implanted materials; Normal slices in HE stain and hard tissue grinding slices in Stevenel\'s blue/Van Geison\'s picro-fuchsin stain showed that the bone growth tendency was better in study group than that in control group,and the medullary cavity had been penetrated to the implanted materials in study group at 24 week;Analysis of tetracycline fluorescent double marks in the hard tissue grinding slices indicated that new bone in both groups grew fastest 8 weeks after surgery,while slow down at 16 week.

纳米珍珠层/消旋聚乳酸复合人工骨与微米珍珠层/消旋聚乳酸复合人工骨分别与成骨细胞共培养后，其各时间点CCK-8法检测值与空白对照无显著差异(P＞0.05)，成骨细胞均在第5天达到增殖高峰期；培养7天后，实验组细胞蛋白含量高于对照组及空白组(P＜0.05)，后两者之间则无显著差异P＞0.05碱性磷酸酶活性在三组间均无显著差异(P＞0.05电镜下可见成骨细胞在两种人工骨上都有良好生长贴附能力。4.X-ray显示两种粉体在大鼠股骨骨洞植入第2周时都开始出现了降解，第4周时更为明显，纳米珍珠层粉较之微米珍珠层粉降解更快，而空白对照组骨洞阴影仍可见，至8周时，则所有组骨洞均己闭合修复，X-ray下已不可见原钻孔痕迹，恢复正常骨质密度；硬组织磨片四环素荧光双标记结果显示纳米珍珠层粉植入组较其余两组在骨缺损区周围新骨生长速度更快，空白组速度最慢P＜0.05电镜观察及常规脱钙切片亦可见到纳米粉体降解较快；由以上两种原材料制得的纳米珍珠层/消旋聚乳酸复合人工骨与微米珍珠层/消旋聚乳酸复合人工骨在大鼠体内均与周围组织结合良好，无明显炎症反应。5.X-ray显示纳米珍珠层/消旋聚乳酸复合人工骨植入兔桡骨缺损区后其骨愈合速度较对照组微米珍珠层/消旋聚乳酸复合人工骨植入的快，至植入术后24周，实验组骨缺损区接近正常骨密度，对照组骨缺损区密度较低，空白组则呈现骨不连状态；骨密度测量结果显示术后8周、16周、24周实验组的骨密度值高于对照组(P＜0.05，24周实验组的骨密度值与术前所测得的正常值无显著性差异P＞0.05动物取材大体所见均显示组织相容性良好，骨组织逐渐由植入材料两端向中央生长；常规切片HE染色及硬组织磨片Stevenel\'s blue/Van Geison\'s picro-fuchsin联合染色均可见实验组骨缺损区长势优于对照组，至术后24周，实验组骨髓腔与材料已呈相交通状；硬组织磨片荧光显微镜下观察，两组材料在术后8周处于骨生长最快速时期，16周时速度开始减慢，术后4、8、16周时实验组的新骨生长速度均较对照组的快

From April 2003 to February 2008, a total of 36 patients (39 limbs) suffered from refractory bone nonunion were studied, there were 22 males and 14 females with an average age of 51.5 years (range, 15~71 years). The nonunion occurred in 19 tibia, 9 humeri, 7 femora, and 4 radius or ulnae. The nonunion experienced operation for 1 to 4 times (average, 2. 5 times). The fracture gaps were4.5~36 mm (average, 16.5 mm) according to X-rays measurement before operation. The shortened length of lower limb was 5-40 mm (average, 21 mm).

方法］2003年4月－2008年2月，共收治四肢难治性骨不连36例39肢，男22例，女14例；年龄15~71岁，平均51.5岁；胫骨19肢，肱骨9肢，股骨7肢，尺、桡骨4肢；治疗骨不连手术次数1~4次，平均2.5次；术前X线片骨不连骨断端距离：4.5~36mm，平均16.5mm；下肢短缩距离：5~40mm，平均21mm。

With Death guitarist Schuldiner adopting vocal duties, the band made a major impact on the scene.

随着死亡的吉他手Schuldiner接受主唱的职务，乐队在现实中树立了重要的影响。

But he could still end up breakfasting on Swiss-government issue muesli because all six are accused of nicking around 45 million pounds they should have paid to FIFA.

不过他最后仍有可能沦为瑞士政府&议事餐桌&上的一道早餐，因为这所有六个人都被指控把本应支付给国际足联的大约4500万英镑骗了个精光。