肱骨

From October 2006 to March 2007, 31 shoulders (13 men and 18 women with average age of 54.3) with subacromial impingement syndrome, from our department, were selected to form the patient group, An age and gender-matched of 40 asymptomatic shoulders (18 men and 22 women with average age of 52.8) formed the control group. The acromion index was measured on the Grashey view. The distance from the glenoid plane to the lateral border of the acromion was divided by the distance from the glenoid plane to the lateral aspect of the humeral head to calculate the acromion index.

方法］对本科2006年10月~2007年3月就诊的肩峰下撞击综合征患者31肩（平均年龄54.3岁，男13肩，女18肩）的G rashey位片，计算肩峰指数即肩峰最外侧缘至肩关节盂平面的距离与肱骨近端最外侧缘至肩关节盂平面的距离的比值，通过肩峰指数对肩峰肱骨头相对位置进行定量评估，与正常人群40肩（平均年龄52.8岁；男18肩，女22肩进行比较、分析。

The larger the acromion index, the higher the ascending force component during active abduction and the higher of the pressure in the subacromial space. The situation may cause the subacromial impingement syndrome.

在较大的肩峰指数所反映的肩峰肱骨头位置关系中，外展时三角肌对肱骨头向上的分力大，肩峰下间隙内压力高，易引发肩峰下撞击综合征。

Typically, capitellar fractures are divided into 3groups3,21: type 1, the Hahn-Steinthal fracture, is characterized by a single, large capitellar fragment; type 2, the Kocher-Lorenz or Mouchet fracture, involves the articular cartilage and a thin layer of subchondral bone; type 3 was originally described by Broberg and Morrey and characterizes a comminuted or compression fracture of the capitellum.

肱骨小头骨折可典型地分为3种：1，Hahn-Steinthal骨折，特点为单个、大块小头骨折片；2，Kocher-Lorenz 或 Mouchet骨折，涉及到软骨和软骨下骨骨折；3，此类骨折最初为Broberg和Morrey所描述，特点为肱骨小头粉碎性或压缩性骨折。

［Objective］ To observe the clinical experience of artificial caput humeri substitution to senile humerus proximal fracture.

：［目的］介绍高龄肱骨近端骨折患者人工肱骨头置换的临床经验。

Objective To approach the operation treatment curative about condyle of humerus comminuted fracture effect .

目的 探讨肱骨髁间粉碎性骨折的手术治疗疗效。方法对19例肱骨髁沟粉碎性骨的的。

In recent years, In view of the reason of occurrence of cubitus varus, we design the therapy of casts splint fixation in elbow extension to treat supracondylar fracture of humerus.

近年来，我们针对肱骨髁上骨折并发肘内翻的原因，制定了伸肘外翻位石膏固定治疗肱骨髁上伸直型骨折。

The main pathological changes of complicated fracture of proximal humerus of the elderly people are osteoporosis and bone defect of fracture site,bone graft pedestaling in cavitas medullaris and internal fixation can recover or reconstruct the normal anatomy of proximal humerus,also make for bone union and function recovery of shoulderjoint,which is an effective approach for treatment of complicated fracture of proximal humerus for the elderly people.

老年人肱骨近端复杂骨折，其主要病理变化是骨质疏松和骨折部位骨缺损，髓内支撑植骨内固定能够恢复或重建肱骨近端正常解剖关系，有利于骨折愈合和肩关节功能恢复，是老年肱骨近端复杂骨折有效治疗方法。

Results The anterior bundle of ulnar collateral ligament originates from the inferior aspect of the medial epicondyle and inserts immediately adjacent to the joint surface on the ulna near the sublimis tubercle. The posterior bundle originates from the medial epicondyle slightly posterior to its most inferior portion and inserts broadly on the olecranon process. The lateral collateral ligament arises from the inferior aspect of the lateral epicondyle. Two types of conjoined lateral collateral and annular ligamentous insertions on the ulna were observed. Type Ⅰ(61.2％) was bilobate and type Ⅱ(38.8％) was a single broad conjoined type with insertion on the ulna. The anterior band of anterior bundle was more tighten than the posterior band as the elbow flexed less than 60°. When the elbow flexed over 60°, the two parts of anterior bundle were equally tightened. The posterior bundle was tightened as the elbow was flexed more than 90°. The lateral collateral ligament was tightened gradually as the elbow moved in flexion.

结果(1)尺侧副韧带前束起于肱骨内上髁的前下方，止于尺骨冠突内侧的小结节；后束起于肱骨内上髁的内下方，止于尺骨鹰嘴内侧的骨面；(2)桡侧副韧带起于肱骨外上髁的外下方，其纤维部分止于环状韧带，部分止于尺骨冠突的外下方；桡侧副韧带和桡骨环状韧带在尺骨上的止点有两种类型：Ⅰ型占61.2％，桡侧副韧带的部分纤维汇于环状韧带的尺骨止点，另一部分纤维单独止于稍远的尺骨上；Ⅱ型占38.8％，桡侧副韧带和环状韧带形成一宽的纤维止于尺骨上；(3)在肘关节屈曲60°以前，尺侧副韧带前束的外侧部紧张而内侧部较松弛，肘关节屈曲超过60°后，前束内外侧处于同程度的紧张状态；尺侧副韧带的后束在肘关节屈曲超过90°后才被拉紧；(4)桡侧副韧带在肘关节不同屈曲状态时其紧张度逐渐增加，当肘关节屈曲超过90°时，桡侧副韧带被明显拉长。

Results:The anterior bundle of the UCL starts from anterior inferior part of the medial condyle,and ends on the sublimis tubercle in front of the coronoid process of ulna,locating in the deep layer of the flexor carpal ulnar muscle.The distance between ulnar nerve and UCL is (0.9±0.1)cm in the center of cubital tunnel,and (0.6±0.3)cm in the distal foramen of cubital tunnel.The distance from the point of ulnar nerve entering the flexor carpi ulnar muscle to the medial epicondyle is (3.7±0.8)cm.The distance between the closest branch innervated flexor muscle of the median nerve and the approach is (1.6±0.5)cm at the level of medial epicondyle,and (0.9±0.4)cm at the level of ulnar tubercle.

结果：UCL前束起于肱骨内侧髁的前下方，止于尺骨冠突内侧的小结节，UCL前束位于尺侧腕屈肌肱头、尺头之间的深层；尺神经在肘管中部与尺侧副韧带前束的平均距离为(0.9±0.1)cm，在肘管的远侧出口，距尺侧副韧带的尺骨止点(0.6±0.3)cm；尺神经至尺侧腕屈肌尺头肌支的入肌点距肱骨内侧髁的距离为(3.7±0.8)cm；正中神经最靠近切口的分支距切口的距离，在肱骨内侧髁和尺骨结节水平分别为(1.6±0.5)cm和(0.9±0.4)cm。

For supracondylar fracture of humerus with obvious displacement,it is easy to make reduction,but the fixation and the maintenance of reduction is not easy; manual reduction with plaster or splint immobilization,though as the first-chosen method,has such shortcomings as infirm or loosening fixation of plaster or splint which may cause injury to blood vessels or nerves; open reduction may lead to further trauma to soft tissues and tissue adhesion,and to joint stiffness; the closed reduction with cross Kirschners wires under C-arm X-ray can avoid the above mentioned shortcomings and it is easy in operation.

移位明显的肱骨髁上骨折，复位容易，但固定及维持复位困难，手法复位石膏或夹板外固定虽是首选治疗方法，但石膏或夹板固定不牢固，易出现松动甚至可造成血管及神经损伤，而切开复位更易进一步造成软组织创伤，组织粘连，最终导致关节僵直功能障碍。本组C臂下闭合复位交叉克氏针治疗移位明显的肱骨髁上骨折避免了上述缺点，而且方法简单。肱骨髁上骨折；经皮克氏针固定；儿童；闭合复位

However, as the name（read－only memory）implies, CD disks cannot be written onorchanged in any way.

然而，正如其名字所指出的那样，CD盘不能写，也不能用任何方式改变其内容。

Galvanizes steel pallet is mainly export which suits standard packing of European Union, the North America. galvanizes steel pallet is suitable to heavy rack. Pallet surface can design plate type, corrugated and the gap form, satisfies the different requirements.

镀锌钢托盘多用于出口，替代木托盘，免薰蒸，符合欧盟、北美各国对出口货物包装材料的法令要求；喷涂钢托盘适用于重载上货架之用，托盘表面根据需要制作成平板状、波纹状及间隔形式，满足不同的使用要求。