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简介：手由五籽骨组成。他们中的二个在metacarpophalangeal(MCP)是在场的姆指的关节。姆指的籽骨骨头的骨折是稀罕损害，光线的方面上的文学很少被报导。我们在姆指的MCP关节与光线的籽骨的破裂报导了一个病人的一个案例以便关于这类损害增加注意。一个44岁的男、高级体操的训练员，当他向右姆指的MCP关节汇报了一处伸直过度损伤时，在锻练期间正在帮助他的运动员之一。在损伤以后的一个星期，他介绍了给在它的手掌的方面上在MCP联合水平抱怨痛苦的姆指的手外科医生。标准A-P和侧面的X光揭示了光线的籽骨的破裂，破裂与一根藤条被对待3个星期。他对有能力6个星期在损害以后恢复了他的全部工作。籽骨破裂伸直过度损害并且有时的大小的指示物与MCP关节的手掌的板系带的眼泪被联系。并且认出系带损害的失败可以在拧上导致长期的伸直过度不稳定性。

简介：AbstractPurpose:Tibial plateau fracture (TPF) is a devastating injury as it shatters lower articular surface of the largest joint. Apart from bony injury, TPF can lead to great soft tissue envelope compromise which affects the treatment plan and outcome. In the present study, clinical results were assessed in cases of high energy TPFs treated in staged manner.Methods:Twenty-three (20 males and 3 females) patients of high energy communited TPFs (Schatzker type V and VI) were consecutively treated.1 All the patient had compromise of overlying skin conditions. They were all successively scheduled for staged treatment plan which comprised of application of bridging knee external fixator on the first day of admission and definitive internal fixation after skin and soft tissue overlying the fracture were healed. Schatzker type I, II, III and IV were excluded from the study. Primary survey was done and patient who had head injury, chest and abdominal injury, pelvic injury and contralateral limb injury and open fractures were excluded from the study. The patients were also evaluated in terms of wound complications, axial and rotary alignment of limb, fixation failure, articular congruity and range of motion of the knees and post injury employment. Statistical analysis was done using SPSS software.Results:Maximum follow-up period was 13 months. All the fractures were united at final follow-up. Clinical evaluation was done with the Tegner Lysholm knee scoring scale.2 Excellent results were found in 78% cases and good and fair results in 22% cases. There was significant correlation between range of motion and the Tegner Lysholm knee score (p < 0.001, Pearson correlation coefficient = 0.741). The correlation between the score and the radiographical union duration was significant (p = 0.006, Pearson correlation coefficient =-0.554).Conclusion:A staged treatment plan allows healing of soft tissue envelope, with avoidance of dreadful complications such as compartment syndrome and chronic infection. In addition, a staged treatment strategy does not hamper the fracture reduction, bony union and the functional results.

简介：与ipsilateral联系的Hoffa骨折大腿骨的柄骨折是很稀罕的。损害的这种稀罕类型的三个盒子回顾地被考察。大腿骨的柄破裂和Hoffa破裂的地点被记录。所有大腿骨的柄破裂与内部固定被管理。为Hoffa破裂的错误诊断的率被记录。影响的膝的功能在二年后续为特殊外科(HSS)分数根据修改医院被评估。大腿骨的破裂在所有三个盒子中横向或合成。IpsilateralHoffa破裂在一种情况中在二种情况，和侧面的髁中发生在中间的髁。一仅仅Hoffa破裂外科手术前地被识别。所有大腿骨的柄破裂太平无事地愈合了。在其Hoffa骨折正确地被诊断的病人，修改HSS分数是94。在另一个病人，其Hoffa断裂，被第二个手术对待，修改HSS分数是93。并且在第三个盒子中，为Hoffa破裂拒绝了另外的操作，修改HSS分数仅仅是70。决定性地大腿骨的柄骨折能与ipsilateralHoffa骨折被联系，特别在摩托车事故。这类损害是很稀罕的，错误诊断是普通的。

简介：目的将由解剖学习和临床的申请探索paraspinal途径的优点和指示。解剖数据和27个盒子的临床的实践被分析探索在paraspinal肌肉和周围的纸巾的结构之间的精确途径的方法，以及paraspinal的临床的申请的结果来临。操作时间，血损失，切口长度，X光线照相术的结果(Cobb角度，vertebrae的前面的边的高度)与在传统的途径对待的24种情况中的那些相比。结果完成方面的暴露能被识别在multifidus和longissimus肌肉之间的自然劈开飞机容易执行。自然肌肉发达的劈开是(1.47

简介：Objective:ToinvestigatethediagnosticvalueofmultidetectorspiralCT(MSCT)inacutethoracolumbarspinalfractureandfracture-dislocation.Methods:CTimagingfilesof152consecutivetraumaticpatientswiththoracolumbarfractureswereretrospectivelyreviewed.MSCTscanningswereperformedwithacollimationof3-5mmandapitchof5.5.Thepostprocessingincludedsagittalandcoronalmultiplannarreconstruction,and3-Dreconstruction.Result:Therewere88casesofcompressionfracture,54casesofburstfractureand10casesoffracasdislocation.TransverseimagesofMSCTcouldvisualizeallfracturesdirectlyanddeterminewhetherspinalcanalwasintact.Postprocessingimagewashelpfulindepictingthedisplacementoffragmentandorientationofdislocation.Conclusions:MSCTplaysanimportantroleindiagnosisandmanagementofacutethoracolumbarspinalfractureandfracture-dislocation.

简介：Objective:Tointroducetheexperienceoftreatingfractureofbothtibiaandfibulawithmicro-invasivepercutaneousplateinternalfixationthroughfracturesiteapproach.Methods:Thedataof15patients(11malesand4females),including14adults(aged22-73years,mean=40years)and1child(aged10years),withfractureofbothtibiaandfibulawerestudiedretrospectivelyinthisstudy.Asmallincisionwasmadeatthefracturesiteoftibia.Thenrepositionwasmadeunderdirectvision,andinternalfixationwasemployedwithsteelplatesinsertingthroughthesmallincision.Results:Anatomicalreductionwasobtained.Nocomplicationwasfound.Unionoccurredontimein14patients.Onecasehealedafterasecondoperation.Conclusions:Micro-invasivepercutaneousplateinternalfixationisbeneficialtothehealingofboneandsofttissues.WithoutX-rayexamination,itisalsoeasytoreachanatomicalreductionandmaketibialinternalfixationwithbothplateswithmicro-invasivepercutaneousplateinternalfixation.

简介：Objective:Toexploretheinjurymechanismandtreatmentprincipleofopensupracondylarfractureofhumerus.Methods:Thedataof32patientswithopensupracondylarfractureofhumerushospitalizedinourdepartmentintherecent20yearswereanalyzedretrospectively.Onanaverage,theywerefollowedupfor30months.Therelationshipbetweenthefracturetype,situationofwounds,operatingtime,operatingmethodandtimeforpostoperativefunctionalexerciseandfinalfunctionofelbowjointwereevaluatedwithFlynnscoringstandard.Results:Excellenttherapeuticeffectwasfoundin14cases,goodin12andbadin6,withthepercentageoffinetherapeuticeffectof81.25%.Conclusions:Forthepatientswithopensupracondylarfractureofhumerus,debridementandinternalfixationshouldbemadeasearlyaspossible,forthoroughdebridementandcorrectinternalfixationarethekeypointstoimprovetheprognosis.

简介：异乎寻常并且‘non-lethal’武器现在定期在人群控制正在被使用。这些手臂的使用不是无风险的。在2010的起军事辅助作用的力量在克什米尔为人群控制使用了老式的弹弓。年轻男性从一个弹弓由于云石受不了远侧的肱骨的破裂。他被清创术和灰浆splintage管理。为人群控制的显然无害的武器的使用不没有风险，当从他们开除的射弹能完成高速度并且引起重要损坏。

简介：AbstractThe Hoffa fracture is an uncommon fracture. There is a lot of confusion about its diagnosis and management with several conflicting reports in literature. We reported a 25-year-old patient with non-union of Hoffa fracture, and meanwhile tried to develop an algorithm-based treatment for Hoffa fractures. A systematic review of the available literature was performed. Medline, Embase, the Cochrane Library and PubMed were searched for relevant articles. Fifty-five articles were reviewed, and the clinical knowledge base was summarized. The understanding of the mechanism of trauma has become more nuanced. The literature has also evolved to classify the fracture with the purpose of surgical management in mind. This can be used to plan approach and fixation with preservation of blood supply. Classification can also prognosticate the outcomes in Hoffa fracture.

简介：WeusedBastianimonoarmexternalframefixatortofixopentibialfracture,acompositeflaptransfertocoverandrepairthedefectsoftheskinandanirrigationdevicetodrainthewoundareainpatientswithinfectedopentibialfracturesinducedbyinternalfixation.Satisfactoryfunctionwasobtainedandthecosmeticresultsofboththedonerandthereceptorsiteswerealsosatisfactoryafteroperation.

简介：客观：为王牌探索起作用的指示和主要全部的新潮的关节造形术的起作用的方法平坦骨折并且观察临床的药品effect.Methods：我们回顾地总结了并且分析创伤的条件，破裂类型，复杂并发症，起作用的时间，起作用的技术，和11patients的短期的药品效果(10男性和1女性，与42的吝啬的年龄。4年)与王牌平坦骨折经历了主要全部的新潮的关节造形术。结果；病人被跟随在上面为6-45月(吝啬的=28月)。他们手术后的新潮的关节的普通哈里斯分数是78。结论：指示的Understrict控制，有平坦骨折可以经历的王牌的病人主要全部的新潮的关节造形术，而是稳定的王牌平坦部件应该被做。

简介：Objective:Toevaluatetheeffectofosteoporosisonfracturehealingthroughobservingthehistomorphologicalchanges,bonemineraldensityofcallusandexpressionanddistributionoftransforminggrowthfactorbeta1(TGF-β1),basicfibroblastgrowthfactor(bFGF)andbonemorphogeneticprotein-2(BMP-2)inovariectomizedrats.Methods:SixtyfemaleSprague-Dawleyrats(aged12weeksandweighing235gonaverage)wererandomlydividedintoanovariectomized(OVX)group(n=30)andasham-operated(SO)group(n=30).OvariectomywasperformedintheOVXratsandsameincisionwasmadeintheSOrats.Threemonthslater,fractureoffemoralshaftwasmadeonalltherats.Thentheywerekilledatdifferenttimepoints.Callusformationwasobservedwithhistologicalandimmunohistochemicalmethods.Results:AreductionincallusandbonemineraldensityinthehealingfemurandadecreaseofosteoblastsexpressingTGF-β1nearthebonetrabeculawereobservedintheOVXrats3-4weeksafterfracture.HistomorphologicalanalysisrevealedahighercontentofsoftcallusintheOVXratsthanthatintheSOrats.ImmunohistochemistryresultsshowedthatnoremarkabledifferenceinexpressionanddistributionofBMP-2andbFGFbetweentheOVXandSOgroupswasfound.Conclusions:Osteoporosisinfluencesthequantityandqualityofcallusduringtheearlyperiodoffracturehealing.TheeffectofosteoporosisonfracturehealinghasnorelationshipwiththeexpressionofBMP-2orbFGF.ThedecreasedexpressionofTGF-β1inosteoblastsmaycauseadecreaseinqualityoffacturehealingafterosteoporosis.

简介：大腿骨的髁的孤立的花冠破裂在成年人是稀罕的并且Hoffa骨折不属于工会被报导仅仅在文学的一些时间。我们分析了六个案例在三年的一个时期上的Hoffa破裂不属于工会。三个病人保存地被对待，三个病人有固定失败。表示的延期是到一年的2个月。治疗协议与膝arthrolysis一起由开的减小，pseudoarthrosis的切除，骨头grafting和内部固定组成了。联合在平均数16星期在所有病人被完成。治疗Hoffa破裂不属于工会要求小心的外科手术前的计划和过细的外科的技术。关于在破裂管理和外科的技术的争吵的文学被考察。

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简介：客观：为了调查与外部fixator在处理期间测量主要axials火车的不同方法并且发现，合适的压缩在一个早阶段由外部fixator装载了。方法：十八只健康大耳朵的兔子随机根据不同测量方法被划分成二个组：组织A和组B。在组A，一个紧张计量器与502胶水在外部胫骨的外皮被加，并且在组B，一个骨头cement-coatedstrain计量器在内部胫骨的外皮上被安装。组A和B被划分成二亚群A1，A2和B1，B2，分别地根据一半并且与身体重量一样的压力。Z塑造左中间柄的胫骨的截骨术被externalfixator执行并且修理。结果：组A的sealer曲线在早阶段期间戏剧性地变化了。当后者紧张价值比前者高时，内部、外部的外皮的Thetrendlines在到达稳定的阶段以后一致地去了。到达最稳定的年龄的组B的时间是短的，但是它的绝对紧张价值是不到组A的。在他们被贴在稳定的阶段以前，当亚群B1和B2的结果是一样的时，亚群A1的拒绝的速度比SubgroupA2的慢慢地是更多。在它衰退了以后，当时，组A有一个上升趋势组Bdidn“t。在他们到达了稳定的阶段，两亚群A1和A2had以后一个衰退趋势当亚群A2比亚群A1快速是更多时，当亚群B2波动时，亚群B1在明确的水平被保留。结论：在外部fixatorcan下面的轴的紧张被骨头水泥测量在vivo的涂紧张的计量器。数据可以建议身体重量负担的那一半对外部fixator合适。

简介：AbstractBackground:Although there are few studies mentioned there may be some relationship between psoriatic arthritis (PsA) and osteoporosis, clinical data in real world still need to be clarified in China. The aim of this study was to assess the areal and volumetric bone mineral density (BMD), frequency of fracture, and risk factors in patients with PsA.Methods:A total of one hundred PsA patients who visited Peking University First Hospital and one hundred age- and sex-matched healthy controls with DXA data were enrolled in the study. Patients with clinical fractures confirmed by X-ray during follow-up were also recorded. Clinical characteristics of the patients were recorded and compared between the abnormal BMD group and the normal BMD group, as well as between the fracture and non-fracture groups. Risk factors for fracture and low BMD were analyzed.Results:Mean BMD at the total hip and femoral neck was significantly lower in PsA patients than that in healthy controls (0.809 ± 0.193 vs. 0.901 ± 0.152 g/cm2, P = 0.041; 0.780 ± 0.146 vs. 0.865 ± 0.166 g/cm2, P = 0.037, respectively). Moreover, lumbar spine BMD was negatively correlated with psoriasis duration, swollen joint count and DAS28-CRP (r = -0.503, -0.580, -0.438; P < 0.05). Total hip BMD and femoral neck BMD were negatively correlated with HAQ (r = -0.521, -0.335; P < 0.05). Fractures occurred in 29 patients during the follow-up period. Logistic regression analysis showed that older age (OR 1.132 [95% CI: 1.026-1.248), P < 0.05], higher HAQ score (OR 1.493, 95%CI: 1.214-1.836, P < 0.01), higher disease activity index for psoriatic arthritis (OR 1.033, 95% CI: 1.002-1.679, P < 0.05) and hip joint involvement (OR 6.401, 95% CI: 4.012-44.180, P < 0.05) were risk factors for fracture in the multivariate model.Conclusions:Increased risks of osteoporosis and fracture were found in PsA patients compared to healthy controls. Besides age, high disease activity and hip joint involvement were risk factors for decreased BMD and fracture.

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简介：AbstractBackground:Mallet fracture is avulsion of the terminal extensor tendon from the base of the distal phalangeal bone with a bony fragment. This study was performed to evaluate the anatomical characteristics of mallet fractures, investigate a new mallet fracture classification system using anatomical and imaging methods, and discuss the treatment schemes for different types of mallet fracture.Methods:Sixty-four fresh cadaveric fingers were divided into four groups, and models of different types of mallet fracture with distal interphalangeal joint instability were established by dissecting 25%, 50%, 75%, and 100% of the bilateral collateral ligaments. The effect of mallet fractures on the stability of the distal interphalangeal joint was then observed. The lateral radiographs of mallet fractures in 168 patients were analyzed and classified according to the involvement of the joint surface in the fracture, the thickness of fracture, the untreated time after injury, and the complication of distal interphalangeal joint palmar subluxation. Forty-seven patients were surgically treated by reconstruction of extensor tendon insertion, the Ishiguro method, or single Kirschner wire fixation.Results:The established mallet fracture model showed that the distal interphalangeal joint was stable when the bilateral collateral ligaments were cut off by 25% (t= -0.415, P = 0.684) and significantly unstable when this range was ≥50% (50% transection: t= -6.363, P < 0.001; 75% transection: t= -17.036, P < 0.001; 100% transection: t = -30.977, P < 0.001, respectively). The mallet fractures were divided into Types I, II, and III (fracture involving <20%, 20%-50%, and >50% of the joint surface, respectively). Type II was further divided into Types IIa and IIb according to whether the course of injury was < or ≥2 weeks, respectively. The mean post-operative flexion of the distal interphalangeal joint was 63.4° ± 7.9°, and the mean extension lag was 6.7°± 4.6°.Conclusions:The lateral collateral ligament is the main factor that maintains the stability of the distal interphalangeal joint. Classification that combines the involvement of the joint surface in the fracture, the thickness of the fracture, and the untreated time after injury is reasonable and will help to choose an appropriate operational method.

简介：与ipsilateral联系的臀部的创伤的以后的脱臼代替了大腿骨的颈骨折是稀罕损害。而且，如此的病人的管理唤起考虑主要代替或保存大腿骨的头的强壮的看法。我们与如此的损害介绍了年轻成年人的一个盒子。他被操作在之上与大腿骨的颈的脱臼和固定的减小，在cancellous的帮助下的骨折拧紧。二年以后，破裂联合起来，病人是无征状的。我们进一步为如此的破裂建议了损害的机制并且在发展中的世界的变化损伤情形讨论了管理。