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Thirty-day mortality of patients with hip fracture during COVID-19 pandemic and pre-pandemic periods:A systematic review and metaanalysis 认领
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作者 Sujit Kumar Tripathy Paulson Varghese +5 位作者 Sibasish Panigrahi Bijnya Birajita Panda Sandeep Velagada Samrat Smrutiranjan Sahoo Monappa A Naik Sharath K Rao 《世界骨科杂志:英文版》 2021年第1期35-50,共16页
BACKGROUND Timely intervention in hip fracture is essential to decrease the risks of perioperative morbidity and mortality.However,limitations of the resources,risk of disease transmission and redirection of medical a... BACKGROUND Timely intervention in hip fracture is essential to decrease the risks of perioperative morbidity and mortality.However,limitations of the resources,risk of disease transmission and redirection of medical attention to a more severe infective health problem during coronavirus disease 2019(COVID-19)pandemic period have affected the quality of care even in a surgical emergency.AIM To compare the 30-d mortality rate and complications of hip fracture patients treated during COVID-19 pandemic and pre-pandemic times.METHODS The search of electronic databases on 1st August 2020 revealed 45 studies related to mortality of hip fracture during the COVID-19 pandemic and pre-pandemic times.After careful screening,eight studies were eligible for quantitative and qualitative analysis of data.RESULTS The pooled data of eight studies(n=1586)revealed no significant difference in 30-d mortality rate between the hip fracture patients treated during the pandemic and pre-pandemic periods[9.63%vs 6.33%;odds ratio(OR),0.62;95%CI,0.33,1.17;P=0.14].Even the 30-d mortality rate was not different between COVID-19 non-infected patients who were treated during the pandemic time,and all hip fracture patients treated during the pre-pandemic period(OR,1.03;95%CI,0.61,1.75;P=0.91).A significant difference in mortality rate was observed between COVID-19 positive and COVID-19 negative patients(OR,6.99;95%CI,3.45,14.16;P<0.00001).There was no difference in the duration of hospital stay(OR,-1.52,95%CI,-3.85,0.81;P=0.20),overall complications(OR,1.62;P=0.15)and incidence of pulmonary complications(OR,1.46;P=0.38)in these two-time frames.Nevertheless,the preoperative morbidity was more severe,and there was less use of general anesthesia during the pandemic time.CONCLUSION There was no difference in 30-d mortality rate between hip fracture patients treated during the pandemic and pre-pandemic periods.However,the mortality risk was higher in COVID-19 positive patients compared to COVID-19 negative patients.There was no difference in time to su 展开更多
关键词 Hip fracture Femur neck fracture Trochanter fracture MORTALITY PANDEMIC COVID-19
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第三骨块对股骨干骨折髓内钉固定后骨愈合效果的影响 认领
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作者 毛国庶 周敏 +2 位作者 李晓明 周子红 殷渠东 《中国组织工程研究》 CAS 北大核心 2021年第15期2405-2409,共5页
背景:文献报道,伴第三骨块的股骨干骨折髓内钉固定后不愈合发生率高于无第三骨块的股骨干骨折,认为第三骨块的位移或形态与骨不愈合有关。目的:探讨第三骨块对股骨干骨折髓内钉固定后骨愈合效果的影响。方法:选择2009年1月至2018年4月... 背景:文献报道,伴第三骨块的股骨干骨折髓内钉固定后不愈合发生率高于无第三骨块的股骨干骨折,认为第三骨块的位移或形态与骨不愈合有关。目的:探讨第三骨块对股骨干骨折髓内钉固定后骨愈合效果的影响。方法:选择2009年1月至2018年4月无锡市第二中医医院和无锡市人民医院收治的伴第三骨块股骨干骨折患者52例,其中男32例,女20例,年龄16-69岁,均接受髓内钉固定治疗。术后拍摄X射线片测量第三骨块的长度及远端、近端位移,根据第三骨块的长度分为:A组(1.0-3.9 cm),B组(4.0-7.9 cm)和C组(≥8 cm);根据第三骨块远端(D)或近端(P)移位分为:D1组、P1组(0-9 mm),D2、P2组(10-19 mm),D3、P3组(≥20 mm)。术后随访12个月判定骨折愈合情况,如12个月仍未愈合判定为不愈合。采用Logistic回归分析第三骨块形态对骨折愈合的影响。研究获无锡市第二中医医院和无锡市人民医院伦理委员会批准。结果与结论:①术后随访12个月,52例患者中41例骨折愈合,愈合率为79%;②A、B、C组间的第三骨块远端位移比较差异无显著性意义(P>0.05)、近端位移比较差异无显著性意义(P>0.05),3组间的骨折愈合率与骨折愈合时间比较差异无显著性意义(P>0.05);③第三骨块远端(或近端)位移越大,骨折愈合率越低、愈合时间越长,总体上3组间的骨折愈合率和愈合时间比较差异有显著性意义(P<0.05),移位<1 cm组与其他两组比较差异有显著性意义(P<0.05);④Logistic回归分析显示,第三骨块长度对骨折愈合无影响(P>0.05),第三骨块远端与近端位移对骨折愈合有影响(P<0.05);⑤第三骨块移位影响骨愈合效果,对于移位超过1 cm的第三骨块宜采用切开或闭合方式对第三骨块实施复位或固定。 展开更多
关键词 骨折 内固定 股骨干骨折 第三骨块 髓内钉 骨折愈合
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Open reduction and Herbert screw fixation of Pipkin type IV femoral head fracture in an adolescent:A case report 认领
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作者 Yao Liu Jin Dai +3 位作者 Xiao-Dong Wang Zhi-Xiong Guo Lun-Qing Zhu Yun-Fang Zhen 《世界临床病例杂志》 SCIE 2021年第4期898-903,共6页
BACKGROUND Femoral head fracture is extremely rare in children.This may be the youngest patient with femoral head fracture ever reported in the literature.There are few pediatric studies that focus on cases treated wi... BACKGROUND Femoral head fracture is extremely rare in children.This may be the youngest patient with femoral head fracture ever reported in the literature.There are few pediatric studies that focus on cases treated with open reduction via the modified Hardinge approach.CASE SUMMARY A 14-year-old female adolescent suffered a serious traffic accident when she was sitting on the back seat of a motorcycle.A pelvic radiograph and computed tomography revealed a proximal femoral fracture and slight acetabular rim fracture.This was diagnosed as a Pipkin type IV femoral head fracture.An open reduction and Herbert screw fixation was performed via a modified Hardinge approach.After 1-year follow-up,the patient could walk without aid and participate in physical activities.The X-ray results showed that the fractures healed well with no evidence of complications.CONCLUSION Open reduction and Herbert screw fixation is an available therapy to treat Pipkin type IV femoral head fractures in children. 展开更多
关键词 Pipkin classification Femoral head fracture ADOLESCENT Fracture fixation Case report
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Congenital Depressed Skull Fracture Due to Maternal-Fetal Trauma 认领
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作者 Diallo Moussa Rabiou Mahaman Sani +3 位作者 Tokpa André Ouattara Dramane Diallo Oumar Kanikomo Drissa 《现代神经外科学进展(英文)》 2021年第1期1-6,共6页
The fetal head trauma is rare and seen in pregnant road accidents and during extractive maneuvers during childbirth. We have reported a case of congenital depressed skull fracture due to an innocuous fall from her own... The fetal head trauma is rare and seen in pregnant road accidents and during extractive maneuvers during childbirth. We have reported a case of congenital depressed skull fracture due to an innocuous fall from her own height of a pregnant of 35 weeks of amenorrhea. The diagnosis was made at birth, by vaginal delivery, by the discovery of a left frontal depressed skull fracture without neurological disorder. A surgical lifting of the drepressed skull fracture was made at the 2nd day of life. Outcome was good marked by a normal psychomotor development. 展开更多
关键词 FETUS Head Trauma Skull Depressed Fracture
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关节镜下利用纳米羟基磷灰石棒治疗SchatzkerⅢ型胫骨平台骨折:6个月随访 认领
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作者 范鑫超 邱长茂 +1 位作者 任中缘 李西成 《中国组织工程研究》 CAS 北大核心 2021年第10期1571-1576,共6页
背景:单纯的SchatzkerⅢ型胫骨平台骨折临床治疗方法不统一,有内固定、外固定及关节镜等治疗方法。目的:探讨关节镜下纳米羟基磷灰石棒植入治疗SchatzkerⅢ型胫骨平台骨折的疗效及影响因素分析。方法:纳入河北省人民医院2017年7月至2019... 背景:单纯的SchatzkerⅢ型胫骨平台骨折临床治疗方法不统一,有内固定、外固定及关节镜等治疗方法。目的:探讨关节镜下纳米羟基磷灰石棒植入治疗SchatzkerⅢ型胫骨平台骨折的疗效及影响因素分析。方法:纳入河北省人民医院2017年7月至2019年7月收治的36例SchatzkerⅢ型胫骨平台骨折患者,男25例,女11例,年龄20-57岁,其中观察组18例接受关节镜下纳米羟基磷灰石棒植入微创治疗,对照组18例接受传统切开接骨板螺钉内固定治疗。术后随访6个月,记录并发症发生情况与骨折愈合时间,采用目测类比评分评估疼痛情况,HSS膝关节功能评分评估膝关节功能,Lysholm膝关节评分评估治疗优良率。单因素分析观察组患者年龄、性别、有合并半月板及韧带损伤、手术时间及术中出血量等各单因素对术后膝关节疗效的影响。试验获得河北省人民医院伦理委员会批准。结果与结论:①观察组术后下肢深静脉血栓、创伤性关节炎等并发症发病率低于对照组(P <0.05);②观察组骨折愈合时间短于对照组(P <0.05),临床治疗优良率高于对照组(P <0.05);③观察组术后第1天、1周及1,3个月的目测类比评分均低于对照组(P <0.05),术后1,3,6个月的HSS膝关节功能评分均高于对照组(P <0.05);④单因素分析显示,年龄<50岁患者术后疗效优于≥50岁患者(P <0.05);⑤结果表明,关节镜下纳米羟基磷灰石棒植入微创治疗SchatzkerⅢ型胫骨平台骨折可促进骨折愈合,减轻疼痛,促进关节功能恢复,其中年龄是影响术后疗效的独立因素。 展开更多
关键词 材料 骨折 关节镜 纳米 羟基磷灰石 胫骨平台骨折
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空心螺钉和钢板内固定修复移位型跟骨关节内骨折:基于15篇随机对照试验的Meta分析 认领
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作者 胡凯 乔晓红 +2 位作者 张永红 王栋 秦泗河 《中国组织工程研究》 CAS 北大核心 2021年第9期1465-1470,共6页
目的:移位的跟骨关节内骨折是跟骨骨折最常见的类型。目前常用的为空心钉与钢板内固定两种术式,但其疗效差异尚不清楚。因此,文章对比经皮空心钉与钢板内固定对跟骨关节内骨折的修复效果。方法:计算机检索PubMed,Cochrane Library,Embas... 目的:移位的跟骨关节内骨折是跟骨骨折最常见的类型。目前常用的为空心钉与钢板内固定两种术式,但其疗效差异尚不清楚。因此,文章对比经皮空心钉与钢板内固定对跟骨关节内骨折的修复效果。方法:计算机检索PubMed,Cochrane Library,Embase,Web of Science和中国知网数据库中关于空心螺钉与切开复位钢板内固定对跟骨骨折治疗效果的随机对照试验研究,检索时限为建库至2019年12月。按入选与排除标准筛选文献,逐一评价纳入研究的质量,提取有效结果数据,采用RevMan 5.3软件进行Meta分析。结果:共纳入15篇随机对照研究,跟骨骨折患者总计1438例,对纳入的文献进行风险偏倚评价,结果显示整体文献质量为中等偏上。Meta分析结果显示:①钢板内固定组在术后Bohler’s角(MD=0.69,95%CI:0.27-1.10,P=0.001)、术后Gissane’s角(MD=0.95,95%CI:0.16-1.74,P=0.02)方面显著优于空心钉固定组(P<0.05);②空心钉固定组在手术时间(MD=-23.92,95%CI:-25.40至-22.44,P<0.00001),术后并发症(OR=0.28,95%CI:0.19-0.41,P<0.00001)方面少于钢板内固定组(P<0.05);③但两组在跟骨高度(MD=0.43,95%CI:-0.17-1.03,P=0.16),术后AOFAS评分(MD=0.61,95%CI:-0.35-1.58,P=0.21)方面差异无显著性意义。结论:上述数据说明钢板内固定修复的跟骨骨折患者术后Bohler’s角及Gissane’s角优于空心钉固定组,但空心钉内固定技术具有手术时间短、并发症发生率低等优点。 展开更多
关键词 骨折 跟骨 关节内骨折 螺钉 内固定 钢板 META分析
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Experience in surgical treatment of typeⅡodontoid fractures:A report of two cases and review of the literature 认领
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作者 Sen Yang Yi-Jie Liu Wei-Min Jiang 《中华创伤杂志:英文版》 CAS CSCD 2021年第1期57-62,共6页
Two cases of typeⅡodontoid fractures were reported to share our experience in surgery treatment of such cases.A 33-year-old woman with comminuted typeⅡodontoid fracture and a 42-year-old man with fracture end harden... Two cases of typeⅡodontoid fractures were reported to share our experience in surgery treatment of such cases.A 33-year-old woman with comminuted typeⅡodontoid fracture and a 42-year-old man with fracture end hardened typeⅡodontoid fracture received surgical treatment in our hospital.Though imaging examination suggested that these two patients were suitable for anterior screw fixation,we encountered difficulties during the operation.The two patients eventually underwent posterior C1–C2 fusion surgery and recovered well.According to the experience of these two cases,we found that the fracture line angle and the degree of comminution are two important factors affecting surgical decision-making.Although anterior screw fixation is the ideal choice for typeⅡodontoid fractures with anterior superior to posterior inferior fracture line,it may not be the best choice for comminuted or fracture end hardened typeⅡodontoid fractures. 展开更多
关键词 Bone screws Fracture fixation Odontoid fracture
新型股骨颈内固定系统治疗不稳定性股骨颈骨折的有限元分析 认领
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作者 范智荣 苏海涛 +4 位作者 周霖 黄晖达 周俊德 江涛 刘子桃 《中国组织工程研究》 CAS 北大核心 2021年第15期2321-2328,共8页
背景:股骨颈骨折的治疗策略包括空心螺钉固定、动力髋螺钉固定、髓内钉固定、锁定钢板固定和髋关节置换等,然而目前对于PauwelsⅢ型股骨颈骨折的最佳治疗方法仍存在争议。目的:通过采用三维有限元方法分析新型股骨颈内固定系统(femoral ... 背景:股骨颈骨折的治疗策略包括空心螺钉固定、动力髋螺钉固定、髓内钉固定、锁定钢板固定和髋关节置换等,然而目前对于PauwelsⅢ型股骨颈骨折的最佳治疗方法仍存在争议。目的:通过采用三维有限元方法分析新型股骨颈内固定系统(femoral Neck System,FNS)治疗不稳定性股骨颈骨折生物力学特征。方法:选择1名岁青年健康志愿者的股骨CT影像学资料,并将其导入到医学三维重建软件Mimics 21.0中,得到原始股骨三维模型;将模型输出为STL格式文件并导入到Geomagic Wrap 2017软件中进行优化,构建股骨皮质骨与松质骨结构;将优化后的模型导入至Solidworks 2017软件中,通过布尔运算重建PauwelsⅢ型股骨颈骨折三维模型,Pauwels角度分别设定为50°,60°和70°;使用Solidworks2017软件,按照临床上应用的内固定尺寸大小建模,建立3种内部固定模型(股骨颈内固定系统、正三角形空心螺钉、倒三角形空心螺钉);最后使用Abaqus 2017软件进行网格划分、施加载荷和数据计算,分析各模型股骨与内固定的应力分布、应力峰值和最大位移。结果与结论:①无论是何种角度的骨折,3种内固定模型中的股骨近端应力主要分布在内侧股骨距附近,并向四周扩散,其中倒三角形空心螺钉组的应力最大,股骨颈内固定系统组最小;②无论是何种角度的骨折,3种内固定模型中的内固定装置应力主要分布在骨折线附近螺钉中间表面,其中倒三角形空心螺钉组的应力最小,股骨颈内固定系统组最大;③无论是何种角度的骨折,3种内固定模型中的股骨位移峰值主要集中在股骨头顶端,其中倒三角形空心螺钉组的位移峰值最大,股骨颈内固定系统组最小;④无论是何种角度的骨折,3种内固定模型中的内固定装置位移峰值主要在螺钉顶部,其中正三角形空心螺钉组位移峰值最大,股骨颈内固定系统组最小;⑤结果表明,股骨颈内固定 展开更多
关键词 内固定 骨折 股骨颈 股骨颈骨折 内固定系统 有限元分析 生物力学
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腰椎骨盆矢状面参数对骨质疏松椎体压缩骨折球囊扩张椎体后凸成形后继发邻椎骨折的影响 认领
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作者 张乐 潘彬 +1 位作者 阮如昕 郭开今 《中国组织工程研究》 CAS 北大核心 2021年第15期2370-2374,共5页
背景:近年来,部分学者认为经皮球囊扩张椎体后凸成形术后继发邻椎骨折可能与腰椎骨盆序列改变引起的矢状面失衡有关。目的:探讨腰椎骨盆矢状面参数对骨质疏松性腰椎压缩骨折患者行经皮球囊扩张椎体后凸成形术后继发相邻椎体骨折的影响... 背景:近年来,部分学者认为经皮球囊扩张椎体后凸成形术后继发邻椎骨折可能与腰椎骨盆序列改变引起的矢状面失衡有关。目的:探讨腰椎骨盆矢状面参数对骨质疏松性腰椎压缩骨折患者行经皮球囊扩张椎体后凸成形术后继发相邻椎体骨折的影响。方法:回顾性分析2017年1月至2019年1月徐州医科大学附属医院收治的单节段骨质疏松性腰椎压缩骨折患者67例的病历资料,所有患者均接受经皮球囊扩张椎体后凸成形治疗,其中术后继发邻椎骨折32例,未继发椎体骨折35例。根据术后拍摄的腰椎正、侧位X射线片,对比继发邻椎骨折组与未继发椎体骨折组的腰椎前凸角、骨盆入射角、骨盆倾斜角、骶骨倾斜角、骶骨骨盆角、骶骨骨盆后角,同时分析继发邻椎骨折组腰椎参数与骨盆参数之间的相关性。试验获得徐州医科大学附属医院伦理委员会批准。结果与结论:①两组均获得1年以上的随访;②继发邻椎骨折组的腰椎前凸角、骨盆入射角、骶骨倾斜角、骶骨骨盆角、骶骨骨盆后角均小于对照组(P<0.05),两组的骨盆倾斜角比较差异无显著性意义(P>0.05);③Pearson相关分析显示,腰椎前凸角与骨盆入射角、骶骨骨盆角及骶骨骨盆后角有相关性(P<0.01),与骨盆倾斜角、骶骨倾斜角无相关性(P>0.05);④结果表明,较小的腰椎前凸角、骶骨倾斜角可增加单节段骨质疏松性腰椎压缩骨折患者行经皮球囊扩张椎体后凸成形术后继发邻椎骨折的风险,较大的骨盆入射角、骶骨骨盆角和骶骨骨盆后角是单节段骨质疏松性腰椎压缩骨折患者行经皮球囊扩张椎体后凸成形术后继发邻椎骨折的保护性因素。 展开更多
关键词 骨折 骨质疏松 矢状面参数 椎体后凸成形 邻椎骨折
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迷你锁定钛板系统内固定治疗腕舟骨骨折 认领
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作者 吴胜祥 刘园 陆帅 《中国组织工程研究》 CAS 北大核心 2021年第12期1874-1878,共5页
背景:腕舟骨骨折治疗的基本原则是即刻刚性固定,恢复生物力学性能,重建解剖结构和血供,由于其独特的解剖特点和血供,容易出现漏诊和骨不连。目的:探讨采用迷你锁定钛板系统内固定治疗腕舟骨骨折的效果,分析其临床应用前景。方法:纳入腕... 背景:腕舟骨骨折治疗的基本原则是即刻刚性固定,恢复生物力学性能,重建解剖结构和血供,由于其独特的解剖特点和血供,容易出现漏诊和骨不连。目的:探讨采用迷你锁定钛板系统内固定治疗腕舟骨骨折的效果,分析其临床应用前景。方法:纳入腕舟骨骨折患者40例,随机分为2组,试验组采用迷你锁定钛板系统固定,对照组采用双螺纹空心埋头钛钉固定,每组20例。观察围术期指标(手术时间、术中透视次数、术后住院时间),每月临床随访时记录骨折愈合时间,术前和术后3,8,12个月时评估患者的局部疼痛目测类比评分和腕关节功能评分(Mayo评分)。结果与结论:(1)两组患者均完成12个月以上随访,对照组留置内固定,试验组在术后6个月时取出内固定进行康复训练;(2)两组围术期指标中,试验组在手术时间和术中透视次数方面均具有优势(P<0.05),在术后住院时间方面两组差异无显著性意义(P>0.05);(3)在骨折愈合时间方面,试验组骨折愈合时间短(P<0.05);(4)术后1年随访时,两组的目测类比评分、Mayo腕关节功能评分相比,差异无显著性意义(P>0.05);(5)提示采用迷你锁定钛板系统进行腕舟骨的内固定治疗具有一定的临床可行性,其较为稳定的固定系统可以实现骨折的解剖复位,抗旋能力强,骨折愈合时间短,临床疗效肯定;而且在直视下的手术操作,可减少手术的操作难度和透视次数。 展开更多
关键词 腕舟骨 骨折 锁定钛板 内固定 腕关节功能 骨折愈合
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桥接组合式内固定系统与锁定钢板治疗锁骨中段骨折的Meta分析 认领
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作者 吴桐 熊鹰 +5 位作者 李焕龙 陈勇 刘璐赟 张珑 秦晶 Md Ariful Haque 《中国组织工程研究》 CAS 北大核心 2021年第18期2923-2929,共7页
目的:目前临床上治疗锁骨中段骨折最常用的是锁定钢板,桥接组合式内固定系统是一种新型内固定器械,其用于治疗锁骨中段骨折时间并不长,但是国内许多学者已经发表了很多篇临床研究来比较两者的疗效,但是尚无统一意见。文章对桥接组合式... 目的:目前临床上治疗锁骨中段骨折最常用的是锁定钢板,桥接组合式内固定系统是一种新型内固定器械,其用于治疗锁骨中段骨折时间并不长,但是国内许多学者已经发表了很多篇临床研究来比较两者的疗效,但是尚无统一意见。文章对桥接组合式内固定系统和锁定钢板治疗锁骨中段骨折的临床疗效进行Meta分析。方法:应用计算机检索PubMed、Medline、The Cochrane Library、迈特思创FMRS外文医学信息平台、OVID医学期刊全文数据库、维普、中国知网和万方数字化期刊平台,收集2010年1月至2020年4月发表的对比桥接组合式内固定系统和锁定钢板治疗锁骨中段骨折的临床对照试验。根据纳入标准和排除标准筛选文献,采用Jadad量表和MINORS评分表进行文献质量评估,对纳入的研究进行质量评价以及数据提取,选择手术时间、术中出血量、骨折愈合时间、并发症及术后1年肩关节功能评分作为Meta分析的评价指标,利用Cochrane协作网提供的RevMan 5.2软件对纳入研究结果进行Meta分析。结果:①文章纳入了中文及外文文献共9篇,其中随机对照试验3篇,非随机对照试验6篇,共计613例锁骨中段骨折的患者,其中桥接组280例,钢板组333例;②通过Meta分析可得:两种方法在术后肩关节功能(MD=3.23,95%CI:0.13-6.33,P=0.04)方面差异无显著性意义,但桥接组在手术时间(MD=-4.62,95%CI:-9.08至-0.16,P=0.04)、术中出血量(MD=-15.29,95%CI:-15.81至-14.47,P<0.00001)、骨折愈合时间(MD=-2.88,95%CI:-3.10至-2.65,P<0.00001)和总体并发症(OR=0.21,95%CI:0.09-0.48,P=0.0002)方面均优于钢板组。结论:桥接组合式内固定系统与锁定钢板两种内固定技术治疗锁骨中段骨折,均能达到预期的治疗效果,两种修复方法在术后肩关节功能方面无显著差异,桥接组合式内固定系统在手术时间、术中出血量、骨折愈合时间及总体并发症方面较锁定钢板有一定优势。但� 展开更多
关键词 锁骨 骨折 肩关节 内固定 钢板 中段骨折 META分析
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可吸收螺钉联合爱昔邦缝线固定长螺旋投弹骨折的有限元分析 认领
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作者 覃万安 蔡洲瑜 +1 位作者 韦葛堇 林舟丹 《中国组织工程研究》 CAS 北大核心 2021年第24期3855-3859,共5页
背景:目前治疗长螺旋投弹骨折的方法有很多,如悬垂石膏固定的保守治疗方法,以及使用锁定钢板、螺钉、髓内钉等内植物的手术治疗方法,但使用可吸收螺钉联合爱昔邦缝线内固定进行治疗为此课题组首次报道。目的:应用有限元分析方法,评价可... 背景:目前治疗长螺旋投弹骨折的方法有很多,如悬垂石膏固定的保守治疗方法,以及使用锁定钢板、螺钉、髓内钉等内植物的手术治疗方法,但使用可吸收螺钉联合爱昔邦缝线内固定进行治疗为此课题组首次报道。目的:应用有限元分析方法,评价可吸收螺钉联合爱昔邦缝线固定长螺旋投弹骨折的骨折稳定性,为临床应用提供参考。方法:收集中国人民解放军联勤保障部队923医院骨科1例志愿者的肱骨CT数据,分别建立钢板(钢板组)、可吸收螺钉(螺钉组)、可吸收螺钉联合爱昔邦缝线(联合组)固定长螺旋投弹骨折的有限元模型,设置3种工况:①固定肱骨头,向肱骨远端施加300 N纵向压缩载荷;②固定肱骨头和肱骨远端,向肱骨中段施加350 N弯曲载荷;③固定肱骨头,向肱骨远端施加15 N·m旋转载荷。评价3种工况下各组模型骨折面最大位移、骨折面平均等效应力与可吸收螺钉最大等效应力等指标。结果与结论:①在压缩、弯曲、旋转工况下,螺钉组骨折面最大综合位移分别为0.52,0.27,0.544 mm,联合组骨折面最大综合位移分别为0.51,0.25,0.396 mm,钢板组骨折面最大位移分别为0.495,0.234,0.393 mm;②螺钉组骨折面平均等效应力分别为5.964,4.512,24.176 MPa,联合组骨折面平均等效应力分别为5.651,4.601,21.465 MPa,钢板组骨折面平均等效应力分别为1.210,4.048,13.537 MPa;③对比可知,钢板组骨折面位移最小,联合组骨折面位移接近钢板组;联合组、螺钉组骨折面平均有效应力均高于钢板组;④结果证实,根据该有限元分析试验结果,可吸收螺钉联合爱昔邦缝线固定长螺旋投弹骨折具有良好的骨折稳定性,同时应力遮挡效应小于钢板固定,有利于骨折愈合、避免局部骨质疏松。 展开更多
关键词 肱骨 骨折 可吸收螺钉 有限元分析 骨折面 载荷 等效应力 综合位移
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Review of Management of Type-2 Odontoid Fracture in Elderly 认领
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作者 Jagodish Chandra Ghosh 《矫形学期刊(英文)》 2021年第1期12-21,共10页
Odontoid fracture accounts for 15%<span> - 20% of all cervical spine injuries. Among the odontoid fracture, type-2 fracture </span><span>is</span><span> the most commo... Odontoid fracture accounts for 15%<span> - 20% of all cervical spine injuries. Among the odontoid fracture, type-2 fracture </span><span>is</span><span> the most common variety. This injury is associated with a high incidence of morbidity, mortality and nonunion in </span><span>the </span><span>elderly irrespective of mode of treatment. Management of odontoid fracture cannot be standardized till to date and ideal treatment for type-2 odontoid fractures still ha</span><span>s</span><span> some controversial issues. Objective of this review is to find </span><span>a </span><span>controversial aspect of management along with opinion to find out a standard guideline by searching the literature in Pubmed and Google scholar databases with key words</span><span>: </span><span>odontoid, fracture, type-2, management, nonoperative and operative management. Nonoperative treatment with halo vest is associated with very high rate of complication in elderly patient. When conservative treatment of this fractures is indicated that should be carried out with hard cervical collar or cervicothoracic orthosis. Current studies suggest that surgical management of odontoid fractures may offer a protective benefit but it is limited to patients younger than 75 years of age. Though surgical treatment has </span><span>a </span><span>better outcome</span><span>, it </span><span>is also limited by the co-mobidities and hazards of anesthesia and surgery in elderly patients. Conservative treatment of this fracture in </span><span>the </span><span>elderly should preferably be carried out with hard collar or avoiding halo vest. Surgical treatment is associated with little advantage but should be selected with proper attention to age, comorbidities, fracture geometry and it is better to individualize the treatment strategy.</span> 展开更多
关键词 ODONTOID FRACTURE Type-2 MANAGEMENT REVIEW
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Hammering Sound Frequency Analysis to Fix an Acetabular Cup during Total Hip Arthroplasty: Clinical Trials and Biomechanical Studies 认领
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作者 Rina Sakai Katsufumi Uchiyama +3 位作者 Kensuke Fukushima Naonobu Takahira Kazihiro Yoshida Masanobu Ujihira 《生物医学工程(英文)》 2021年第1期14-20,共7页
Failure during total hip arthroplasty may lead to bedridden of the elderly. Since the acetabulum cup fix in an anatomically deep region, failures, such as loosening and fracture, occur three times more frequently comp... Failure during total hip arthroplasty may lead to bedridden of the elderly. Since the acetabulum cup fix in an anatomically deep region, failures, such as loosening and fracture, occur three times more frequently compared with failures of the stem fix in the femur. We investigated the possibility of evaluating whether fixation was acquired by frequency analysis of the hammering sound of implanting a cup into the acetabulum. The subjects were 11 patients (11 joints) who underwent total hip arthroplasty, biomechanical test materials, and orthopedic models. Surgeries and experiments were performed by orthopedists specialized in the hip. A system was constructed with a tablet PC and directional microphone, the peak frequency at which the amplitude reached the maximum was determined, and judgment processing (stable, unstable) of cup fixability was performed in real time. The stable maximum peak frequency observed in the clinical trials was 4.42 ± 4.02 kHz. The mean stable maximum peak frequency in the biomechanical tests was 4.46 ± 1.19 kHz in biomechanical test materials and 4.56 ± 2.02 kHz in orthopaedicmodels. When hammering was continued, the frequency leading to fracture decreased in both biomechanical test materials and orthopaedicmodels. In conclusion, in clinical trials and biomechanical studies, variation of the maximum peak frequency decreased when fixation was acquired and the frequency stabilized. It was suggested that this method can serve as a fixability evaluation method of acetabular cups because analysis can be performed in real time during surgery, for which prevention of intraoperative fracture can be expected. 展开更多
关键词 Total Hip Arthroplasty Hammering Sound Frequency Analysis Intraoperative Fracture LOOSENING
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基于正演模拟的车排子地区石炭系裂缝响应特征研究 认领
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作者 于晓东 马永强 +2 位作者 王昱翔 谢玮 胡守旺 《物探化探计算技术》 CAS 2021年第2期186-193,共8页
车排子地区石炭系裂缝性油气藏富集,为了更好地预测裂缝发育区带,需要使用正演模拟的手段分析不同情况下裂缝地质体的地震响应特征。首先简述了交错网格有限差分数值模拟的原理,其次根据工区实际地震剖面和油藏剖面,建立裂缝模型对比裂... 车排子地区石炭系裂缝性油气藏富集,为了更好地预测裂缝发育区带,需要使用正演模拟的手段分析不同情况下裂缝地质体的地震响应特征。首先简述了交错网格有限差分数值模拟的原理,其次根据工区实际地震剖面和油藏剖面,建立裂缝模型对比裂缝发育区、裂缝中等发育区以及非裂缝发育区的响应特征,最后结合实际工区从地震剖面反射特征、地震多属性分析以及关联维属性分析对比了裂缝发育区和裂缝欠发育区的特征。 展开更多
关键词 裂缝 正演模拟 裂缝预测
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Estimation of Fatigue Strength of Reinforced Complete Upper Denture Using a Newly Designed Testing Machine: A Laboratory Research Project 认领
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作者 Anthony E. Prombonas Nikolas A. Poulis Evangelos A. Prombonas 《生物医学工程(英文)》 2021年第2期48-63,共16页
In the present study, an aero pneumatic fatigue testing machine for complete dentures was designed, fabricated, and tested for the evaluation of the fatigue life of reinforced complete upper denture (CUD). On completi... In the present study, an aero pneumatic fatigue testing machine for complete dentures was designed, fabricated, and tested for the evaluation of the fatigue life of reinforced complete upper denture (CUD). On completion and testing, it was observed that the machine has the potential of generating reliable number of cyclic data. The machine’s performance was evaluated using test specimens of identical CUDs that were machined in conformity with standard procedures. The fatigue machine compressed the lower dental arch over the upper denture-specimen in centric occlusion, in the same way that the two masticatory muscles pull the lower jaw over the upper jaw during chewing. The incorporation of glass fibres into the CUD using a sandwich technique quadruples the lifespan of the denture (<em>P</em> = 0.004). The low standard deviation, along with the low coefficient of variation (CV) of the group of unreinforced dentures shows the repeatability of the results and the reliability of the machine. The high standard deviation and coefficient of variation of reinforced dentures was expected, since a high variation of results is usually recorded in fibre reinforcement cases. This research confirmed the view that the crack during denture fracture initiates in the anterior palatal area and propagates to the posterior. 展开更多
关键词 Fatigue Testing Machine Complete Upper Denture Crack Initiation Crack Propagation Fatigue Fracture
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Is traumatic meniscal lesion associated with acute fracture morphology changes of tibia plateau? A series of arthroscopic analysis of 67 patients 认领
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作者 Yan-Dong Chen Shu-Xiang Chen +4 位作者 Hong-Guang Liu Xiang-Sheng Zhao Wen-Huan Ou Huan-Xi Li Hong-Xing Huang 《世界临床病例杂志》 SCIE 2021年第1期81-90,共10页
BACKGROUND Computed tomography(CT)has become a routine preoperative examination for tibial plateau fractures(TPFs).Assessing the location of the fragment and intercondylar eminence fracture can provide clinicians with... BACKGROUND Computed tomography(CT)has become a routine preoperative examination for tibial plateau fractures(TPFs).Assessing the location of the fragment and intercondylar eminence fracture can provide clinicians with valuable information;however,the evaluation of traumatic meniscal lesion(TML)and arthroscopic management are controversial.AIM To predict TML by three-dimensional skeletal anatomy changes in unilateral TPF and bilateral TPF on preoperative thin layer CT.METHODS Acute fracture of tibial plateau patients undergoing arthroscopic surgery between December 2017 and December 2019 were included in this retrospective study.The type,zone,and location of TMLs were diagnosed based on the operation records and/or arthroscopic videos.Measurement of three-dimensional fracture morphology included the following:Frontal fragment width of plateau,sagittal fragment subsiding distance(FSD),sagittal fracture line distance,sagittal posterior tibial slope,and transversal area ratio of fragment area)on preoperative CT three-dimensional plane.The correlation of TML with skeletal values was calculated according to unicondylar TPFs and bicondylar TPFs.RESULTS A total of 67 patients were enrolled in this study,among which 30 patients had TMLs,lateral/medial(23/7).FSD was a particularly positive factor to predict TML,with odds ratio of 2.31(1.26-5.63).On sagittal view of CT,FSD degree of 8 mm and posterior tibial slope exceeding 11.74°implied enhanced risk of TML in bicondylar TPFs.On coronal view,once fragment width of plateau surpassed 3 cm,incidence of TML reached 100%.On transverse view,area ratio of fragment as enhanced risk of 5.5%and FSD>4.3 mm for predicting TML were observed in unicondylar TPFs.CONCLUSION TML can be predicted by different parameters on preoperative CT views according to unicondylar fractures and bicondylar TPFs. 展开更多
关键词 Traumatic meniscal lesion KNEE Three-dimensional computerized tomography Posterior tibial slope Unicondylar fracture Bicondylar fracture
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膝关节骨性关节炎老年股骨转子间骨折行股骨近端防旋髓内钉内固定评价 认领 被引量:1
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作者 吕家兴 白磊鹏 +6 位作者 杨朝昕 苗岳松 金宇 李哲宏 孙广普 徐莹 张擎柱 《中国组织工程研究》 CAS 北大核心 2021年第3期391-396,共6页
背景:股骨近端防旋髓内钉是治疗老年股骨转子间骨折常用的内固定系统,同时老年人多伴有膝关节骨性关节炎,其对股骨转子间骨折术后疗效可能会造成影响。目的:探讨骨折侧膝关节骨性关节炎对老年股骨转子间骨折股骨近端防旋髓内钉内固定术... 背景:股骨近端防旋髓内钉是治疗老年股骨转子间骨折常用的内固定系统,同时老年人多伴有膝关节骨性关节炎,其对股骨转子间骨折术后疗效可能会造成影响。目的:探讨骨折侧膝关节骨性关节炎对老年股骨转子间骨折股骨近端防旋髓内钉内固定术后疗效的影响。方法:纳入92例65岁以上股骨转子间骨折采用股骨近端防旋髓内钉内固定治疗患者,按照术前膝关节骨性关节炎X射线K-L分级分为5组:0级为A组(13例),Ⅰ级为B组(18例),Ⅱ级为C组(23例),Ⅲ级为D组(22例),Ⅳ级为E组(16例)。记录5组住院时间、术后并发症、术后下地时间、骨折愈合时间,术后1,3,6个月的髋关节Harris评分和日常生活能力Barthel指数计分。研究得到承德医学院附属医院伦理委员会批准。结果与结论:①5组住院时间比较差异无显著性意义(P>0.05);②C、D组术后下地时间及骨折愈合时间长于A、B、C组(P<0.05);③C组术后并发症发生例数多于A、B组(P<0.05),D、E组术后并发症发生例数均多于A、B、C组(P<0.05);④C、D组术后1,3,6个月的Harris及Barthel评分低于A、B组(P<0.05),E组术后1,3,6个月的Harris及Barthel评分均低于其他4组(P<0.05);⑤结果表明,膝关节骨性关节炎分级越高,对股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折患者术后疗效的影响越大,表现为术后并发症增加、术后下地时间及骨折愈合时间延长、髋关节功能及日常生活能力下降。 展开更多
关键词 内固定 植入物 骨折 股骨转子间骨折 骨性关节炎 股骨近端防旋髓内钉
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低渗砂岩储层裂缝发育及演化特征 认领
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作者 于少群 李理 +2 位作者 时光耀 曹哲 何心月 《地质科学》 CAS CSCD 北大核心 2021年第1期109-120,共12页
随着石油工业的发展,低渗透油气藏所占比例越来越大,低渗透砂岩储层中的裂缝能够起到很好的储集和导流作用,对裂缝的研究具有十分重要的意义。牛庄洼陷牛35断块沙三中发育低渗透砂岩,为主要含油层系,前人对研究区低渗砂岩储层中的裂缝... 随着石油工业的发展,低渗透油气藏所占比例越来越大,低渗透砂岩储层中的裂缝能够起到很好的储集和导流作用,对裂缝的研究具有十分重要的意义。牛庄洼陷牛35断块沙三中发育低渗透砂岩,为主要含油层系,前人对研究区低渗砂岩储层中的裂缝研究较少。运用岩心观察、镜下薄片观测及CT扫描技术对牛35块沙三中低渗致密砂岩储层裂缝的发育及演化规律进行研究,得出牛35块宏观裂缝主要发育低、高角度斜交剪切缝,长度在2~20 cm之间,分布间距大,但整体裂缝密度仅为0.27条/m,裂缝很不发育,难以构成有效的裂缝系统;微观裂缝较发育,包括粒内缝和粒间缝,改善了储层的连通性,有助于油气的储集和运移;与牛104井、河125‑1井相比,牛35井岩石矿物接触关系更加不稳定,胶结程度更低,更容易在荷载作用下产生裂缝,裂缝由上到下呈辫状发育,裂缝体积随着施加荷载的增大呈线性增加。 展开更多
关键词 裂缝 裂缝演化 低渗透储层 沙三中 牛庄洼陷
Maxillofacial Injuries at the Komfo Anokye Teaching Hospital, Kumasi, Ghana: A Preliminary Study 认领
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作者 Solomon Obiri-Yeboah Robert Nii Lamy Larmie +3 位作者 Nana Tuffour Ampem Gyimah Alexander Oti Acheampong Elijah Asomaoh Peter Donkor 《口腔学期刊(英文)》 2021年第3期133-147,共15页
<strong>Background: </strong>The aetiology and pattern of maxillofacail injuries vary in different parts of the world and even the same country. The purpose of the study was to determine the epidemiology o... <strong>Background: </strong>The aetiology and pattern of maxillofacail injuries vary in different parts of the world and even the same country. The purpose of the study was to determine the epidemiology of maxillofacial injuries at a tertiary Hospital in Ghana. <strong>Methodology:</strong> This is a six-month (January to June 2015) prospective study. Information on age, sex, aetiology, injury type etc. was collected using a specialized design data collection form. Data was analyzed using the SPSS 17th version. Ethical approval was obtained. <strong>Result:</strong> The total study sample was 111 with a male to female ratio of 2.5:1. Majority (34.2%) were within the ages of 21 to 30 years. Majority of the victims were urban dwellers. Most of the injuries occurred on the highway (42.3%) and in the evening (35.2%). Only a small percentage (5.4%) of the road traffic crashes (RTC) victims were in some form of protection. Twenty-one (18.9%) of the injuries were intentional, of which 18 (85.7%) were assault. The commonest maxillofacial injury was a combination of soft and hard tissues 72 (64.7%). The commonest cause of maxillofacial soft tissue injuries was RTC, 72.8%. Laceration (55.6%) was the most common soft tissue injury recorded. Mandibular fractures constituted the commonest hard tissue injuries. <strong>Conclusion: </strong>This study has shown that road traffic crashes are the most common cause of injuries to the maxillofacial region. The mandible is the most frequent site of fracture, while the commonest soft tissue injury is laceration. Majority of the victims were young energetic males and adherence to road traffic regulations was very low. 展开更多
关键词 MAXILLOFACIAL INJURY Road Traffic Crush MANDIBULAR Le Forte FRACTURE
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