| 1 | 髋臼四方区组合钢板治疗髋臼双柱骨折显示文摘目的 探讨髋臼四方区组合钢板治疗髋臼双柱骨折的临床有效性和可靠性。方法 回顾性分析2016年6月至2017年8月采用髋臼四方区组合钢板治疗15例髋臼双柱骨折患者资料,男9例,女6例;年龄26~68岁,平均42.8岁;均为Letournel-Judet分型的髋臼双柱骨折,其中4例合并无后脱位机制后壁骨折。术前均采集患者DICOM格式骨盆CT薄层扫描数据,采用3D打印技术打印患者骨盆模型,充分了解骨折情况及特点,并将健侧半骨盆进行镜像打印,然后在镜像打印半骨盆模型上,模拟髋臼四方区组合钢板安放,钢板塑形备用。手术采用高位髂腹股沟入路,满意复位后依次置入预弯好的弓状缘内侧钢板(主板)、耻坐钢板、髂坐钢板,分别固定前、中、后三柱,其中耻坐钢板、髂坐钢板分别与主板相组合。结果 手术时间100~240 min,平均150 min;术中出血量600~1 500 ml,平均850 ml;手术切口长度9~13 cm,平均11 cm;术中骨折满意复位后,置入预弯钢板,钢板与钢板、钢板与骨面均贴服良好。术后骨折复位按Matta标准评价,15例患者中,优9例,良4例,可2例,优良率86.7%(13/15)。15例患者均获得随访,随访时间6~12个月,平均10个月。末次随访时髋关节功能按Matta改良的Merle d'Aubigne和Postel评分系统评分,为12~18分,平均16.4分,其中优8例,良4例,可2例,差1例,优良率80.0%(12/15)。结论 髋臼四方区组合钢板治疗髋臼双柱骨折,一方面可阻挡四方区内侧移位,另一方面可牢靠固定完全漂浮的后柱及坐骨体;该钢板为多维度框架固定,安全有效,临床疗效满意。 | 陈开放 杨帆 郭晓东 熊泽康 姚升 朱丰照 Drepaul Deepak 孙亭方 姬彦辉 | 2018 | 中华骨科杂志2018，38，5： | 11 |
| 2 | Effects of durotomy versus myelotomy in the repair of spinal cord injury显示文摘Current management for spinal cord injury aims to reduce secondary damage and recover sensation and movement.Acute spinal cord injury is often accompanied by spinal cord compartment syndrome.Decompression by durotomy and/or myelotomy attempts to relieve secondary damage by completelyrelieving the compression of the spinal cord,removing the necrotic tissue,decreasing edema,reducing hemorrhage,and improving blood circulation in the spinal cord.However,it is controversial whether durotomy and/or myelotomy after spinal cord injury are beneficial to neurological recovery.This review compares the clinical effects of durotomy with those of myelotomy in the treatment of spinal cord injury.We found that durotomy has been performed more than myelotomy in the clinic,and that durotomy may be safer and more effective than myelotomy.Durotomy performed in humans had positive effects on neurological function in 92.3% of studies in this review,while durotomy in animals had positive effects on neurological function in 83.3% of studies.Myelotomy procedures were effective in 80% of animal studies,but only one clinical study of myelotomy has reported positive results,of motor and sensory improvement,in humans.However,a number of new animal studies have reported that durotomy and myelotomy are ineffective for spinal cord injury.More clinical data,in the form of a randomized controlled study,are needed to understand the effectiveness of durotomy and myelotomy. | Dionne Telemacque Feng-Zhao Zhu Zheng-Wei Ren Kai-Fang Chen Deepak Drepaul Sheng Yao Fan Yang Yan-Zheng Qu Ting-Fang Sun Xiao-Dong Guo | 2020 | Neural Regeneration Research2020，15，10： | 7 |
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