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Surgical treatment is effective for the treatment of the complex acetabular fracture,It is a good choice that the complex acetabular fracture is treated through extensile acetabular approach.

手术治疗是复杂髋臼骨折的有效治疗方法,扩展型髂股入路对复杂髋臼骨折手术治疗是一个良好的选择。

Donclusion Surgical treatment is effective for the treatment of the complex acetabular fracture,It is a good choice that the complex acetabular fracture is treated through extensile acetabular approach.

手术治疗是复杂髋臼骨折的有效治疗方法,扩展型髂股入路对复杂髋臼骨折手术治疗是一个良好的选择。

According to LetournelJudet classification,there were 2 transverse and posterior wall fractures,8 Tshaped fractures,3 anterior fractures accompanying posterior hemitransverse fractrures and 13 both column fractures.these patients were all treated through extensile acetabular approach.The reconstructive plates and compression screws were used for internal fixation basing on different classification.

回顾性总结了2002年至2005年收治的资料完整的手术治疗髋臼骨折26 例,按照LetournelJudet分型:横行伴后壁骨折2 例,T型骨折8 例,前方伴后方半横行骨折3 例和完全双柱骨折13 例,均采用扩展型的髂股切口手术治疗,根据不同骨折类型采用重建钢板和拉力螺钉固定。

According to Letournel Judet classification,there were 2 transverse and posterior wall fractures,8 T shaped fractures,3 anterior fractures accompanying posterior hemitransverse fractrures and 13 both column fractures.these patients were all treated through extensile acetabular approach.The reconstructive plates and compression screws were used for internal fixation basing on different classification.

回顾性总结了2002年至2005年收治的资料完整的手术治疗髋臼骨折26 例,按照Letournel Judet分型:横行伴后壁骨折2 例,T型骨折8 例,前方伴后方半横行骨折3 例和完全双柱骨折13 例,均采用扩展型的髂股切口手术治疗,根据不同骨折类型采用重建钢板和拉力螺钉固定。

The self-centering mechanism design of bipolar endoprosthesis has advocated the use of offset centers of rotation between the inner and outer joint bearing surfaces to generate a self-centering moment on loading to prevent impingement of polyethylene rim and stem neck or cup fixed at wrong place. The design was used popularly, but the function of self-centering mechanism was discussed in very few papers. Three bipolar endoprosthesis were evaluated: UNIQHIP system, UHR system, and AML system.

双极式半人工髋关节的离心复位机构,是利用髋臼外帽的球心与股小球的球心两者在不同点,来防止发生髋臼外帽固定於髋臼中某角度卡住不动,而使股骨柄颈部固定磨损超高分子聚乙烯内衬之一边缘,进而加速超高分子聚乙烯内衬之磨耗,造成骨溶蚀与人工髋关节的松脱。

Spine specimens were fixed to the biomechanical elongation tester (Shimazu AGS-J, Japan) with the upper clipping at the vertebra dentata, T1 and T12 vertebra, the lower clipping at the superior part of thigh bone. Under the different states, keeping or removing psoas muscle, the extended stress (N/mm^2 )of different segments of spine at the flexed and extended positions of hip joint were measured respectively.

上端十字头分别夹枢椎、第1胸椎和第12胸椎,下端十字头夹股骨上部;分别作有腰大肌状态下和切断腰大肌状态下,股髋自屈曲位到过伸带动脊柱自屈曲位到过伸位拉伸试验,测定两种不同状态下脊柱各节段的伸展应力。

Methods On the basis of the three-dimensional computed tomography, 75 cases of complex acetabular fractures were diagnosed and classified according to Letournel classification. They were treated through the anterior, posterior, combined anterior-posterior and the improved iliofemoral approaches. All the fractures were fixed with screws and AO reconstruction plates.

75例Letournel分型复杂髋臼骨折,术前经骨盆CT三维重建明确诊断分型后,分别采用前、后入路,前后联合入路及笔者改良的髂股入路显露并复位,AO重建钢板内固定。

RESULTS: There were three functions of hamstring in gait cycle: decelerating the concentric contraction of the iliopsoas at bending hipbone; decelerating the concentric contraction of the quadriceps at knee bending; as well as making the lower limbs under the knee get certain angular momentum at toe-off, by eccentric contraction.

结果:腘绳肌在跑步周期中的作用有3个:在屈髋时通过离心收缩拮抗髂肌;在伸膝时通过离心收缩拮抗股四头肌;在支撑阶段通过向心收缩为膝关节提供动态稳固作用和使小腿和足获得一定的角动量。

Methods A wet hip joint's sample from corpse was scaned by CT and all images of every cross-section hip joint's layer was obtained, and an hip joint's model was contructed with Unigraphics NX 2.0 and Solid Works 2006 SP 0.0 software. The models were assembled when simulated total hip arthroplasty after total hip joint prosthetic and ischiofemoral ligament model had been constructured. Analysis was done on von Mises stress distribution and amount of total hip component when simulated seated leg-crossing manuver. The bone and metal components were meshed as rigid bodies, composed of three-dimensional, all-quadrilateral rigid body elements, and hip joint capsule ligament was fully three-dimensional, hexahedral continuum elements representations. Results The current form of this ischiofemoral ligament's reconstruction finite element model provided for multi-body contact, large displacement interfacial sliding, large deformation capsule ligament representation, and clearly reflected the real ischiofemoral ligansent's anatomy and biomechanical behavior. The maximum on Mises stresses at the joint interface was more than that fur an otherwise identical hardware-only construct.

选择成人尸体髋关节行CT成像得到髋关节每层横截面图像,提取边界坐标,利用有限元分析软件Unigraphics NX 2.0和Solid-Works 2006 SP0.0构建出髋关节三维有限元模型及人工髋关节假体,并模拟全髋置换术进行装配,将坐股韧带按其术中重建位置进行构建骨骼与金属模型采用三维十节点四面体实体单元进行网格划分,关节囊六面体连接单元划分,模拟坐位腿交叉动作载荷获取假体撞击过程的角活动度和相应的von Mises应力分布情况结果所构建的多体连接、大界面划移、大变形的坐股韧带重建有限元模型,客观反映坐股韧带真实解剖形态及生物力学行为,增加坐股韧带重建的模型其关节面的最大主应力值大于仅有金属的模型。

Methods 38 cases with 53 hips of ANFH treated with the method of thrombolysis and opening catheterizing and perfusing medial and lateral circumflex arteries.Those drugs are Urokinase 200 thousand Units,Danshen Root 20 ml and Ligustrazine 20 mg. Retention catheter was held in the target vessels and infused the same drugs besides Heparin 4500u in 3 days. To evaluate therapeutic effect ,the DSA of the femoral artery and x-ray plain film and/or CT/MRI of the femoral head were performanced. Results All cases were followed up 1~16 (mean 9.5) months.

方法对38例ANFH患者的53髋先常规行股动脉DSA,后在股骨头的供血动脉旋股内、外侧动脉内灌注溶栓、扩血管药物,即在每支血管内注入稀释后的尿激酶 20万u、丹参10 ml及川芎嗪20 mg;术后保留导管于动脉内,经导管每日注入同剂量的药物及肝素钠4500 u,连用3天后拔管,治疗后复行股动脉DSA检查及行股骨头X线平片及/或CT、MR随访以评估疗效。

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