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    find Author "胡宏宇" 3 results
    • 陳舊性第一掌骨基底部骨折脫位的手術治療

      目的 總結手術治療陳舊性第 1 掌骨基底部骨折脫位(Bennett骨折)療效。 方法 2012 年 2 月—2015 年 3 月,采用韌帶松解聯合克氏針固定方法治療 10 例陳舊性 Bennett 骨折患者。其中男 8 例,女 2 例;年齡 24~44 歲,平均 35.3 歲。傷后至手術時間為 5~14 周,平均 7.5 周。術前拇示指捏力為 1~3 級,平均 1.8 級。術后石膏外固定 4~8 周,骨折愈合后去除克氏針,期間在康復師指導下進行功能鍛煉。 結果 術后切口均Ⅰ期愈合。10 例均獲隨訪,隨訪時間 7~16 個月,平均 12.5 個月。X 線片及 CT 檢查示第 1 腕掌關節對位好,無再脫位發生;骨折均愈合,愈合時間 2~4 個月,平均 3.5 個月。1 例傷后 14 周手術患者,術后第 1 腕掌關節仍存在持續疼痛癥狀,X 線片檢查見關節毛糙、間隙變窄,證實第 1 腕掌關節炎形成;其余患者無關節炎發生,第 1 腕掌關節處無明顯疼痛,關節穩定。末次隨訪時,拇示指捏力為 3~12 級,平均 6.8 級。根據手指關節總活動度(TAM)系統評定方法評價療效,優 7 例,良 2 例,差 1 例,優良率 90%。 結論 對于陳舊性 Bennett 骨折,通過適當松解橈背側韌帶聯合克氏針內固定治療,可取得良好療效。

      Release date:2017-06-15 10:04 Export PDF Favorites Scan
    • IN VITRO EFFECT OF ALENDRONATE ON CHONDROCYTES AND ARTICULAR CARTILAGE AND SUBCHONDRAL BONE IN RABBIT ANTERIOR CRUCIATE LIGAMENT TRANSECTION MODEL

      Objective To examine the effects of alendronate (ALN) on IL-1β-stimulated chondrocyte of rabbit in vitro and on cartilage and subchondral bone in rabbit osteoarthritis (OA) induced by anterior cruciate l igament transection (ACLT). Methods The chondrocytes from articular surface of healthy 3-month-old Japanese White rabbits were obtained by the method of enzyme digestion and cultured in vitro. The third generation chondrocytes were assigned into three groups: thechondrocytes were cultured in DMEM medium with 10 ng/mL IL-1β for 2 days, subsequently with (ALN group, group A1) orwithout (IL-1β group, group B1) 1 × 10-6 mol/L ALN for 3 days; the chondrocytes in vacant group (group C1) were cultured in DMEM medium for 5 days. The expression of Col II and MMP-13 were analyzed by immunocytochemical staining observation and real time RT-PCR test. Another twenty-four 3-month-old male Japanese White rabbits were randomized into three groups (n=8 per group). The OA model was made by ACLT in ACLT+ALN group (group A2) and ACLT group (group B2); the joint cave was sutured after exposure of ACL in sham group (group C2). After 4 days, the rabbits of group A2 received the subcutaneous injection of ALN at a dosage of 10 μg/(kg·d) for 8 weeks. Rabbits of group B2 and C2 received equal normal sal ine treatment. After 8 weeks, the rabbits were executed. The macro-pathologic changes of right knee joints were observed, so were the histological changes of femoral condyles. Expression levels of Col II and MMP-13 were detected by immunohistochemical staining. The bone histomorphometry analysis was appl ied to subchondral bone of proximal tibia. Results In vitro, the Col II immunocytochemical staining showed intensely positive staining in group C1, and the intensity of staining was sl ightly decreased in group A1, but the intensity of Col II immunocytochemical staining was extremely lower in the group B1. The integrated absorbance (IA) value for Col II in group A1 was significantly higher than that of group B1 (P lt; 0.05), but there was no significant difference between group A1 and group C1 (P gt; 0.05). Immunocytochemical detection of MMP-13 showed intense staining in group B1, and the intensity of staining was sl ightly decreased in group A1, but no MMP-13 expression was detected in the group C1. The IA value for MMP-13 in group A1 was significantly lower than that of group B1 (P lt; 0.05), but significantly higher than that of group C1 (P lt; 0.05). The real time RT-PCR analysis showed significantly higher mRNA levels of Col II in group A1 than in group B1 (P lt; 0.05), but there was no significant difference between group A1 and group C1 (P gt; 0.05). The MMP-13 mRNA level of the chondrocytes in group A1 was significantly lower than that of group B1 (P lt; 0.05), but significantly higher than that of group C1 (P lt; 0.05). In vivo, the gross appearance of surface of knee joint showed that there was no ulcer in group C2, and there was some ulcers in group A2, but many and all layers ulcers in group B2. Mankin score of group A2 was significantly lowerthan that of group B2 (P lt; 0.05), but significantly higher than that of group C2 (P lt; 0.05). Immunohistochemical staining showed that Col II in articular cartilage was intensely staining in group C2, the intensity of staining was sl ightly decreased in group A2, and the intensity of Col II immunohistochemical staining was extremely low in group B2, but there was no significant difference between group A2 and group C2 (P gt; 0.05..........

      Release date:2016-09-01 09:08 Export PDF Favorites Scan
    • 克氏針雙夾扣法固定治療遠節指骨背側基底不穩定骨折

      目的總結克氏針雙夾扣法固定治療遠節指骨背側基底不穩定骨折的療效。 方法2008年9月-2014年3月,對15例遠節指骨背側基底不穩定骨折患者采用切開復位、克氏針雙夾扣法固定。男12例,女3例;年齡18~53歲,平均32.5歲。致傷原因:戳傷8例,扭傷2例,摔傷3例,擠壓傷2例。損傷指別:示指5例,中指3例,環指2例,小指5例。受傷至手術時間2~9 d,平均3.8 d。 結果患者術后切口均Ⅰ期愈合。15例均獲隨訪,隨訪時間6~20個月,平均12.5個月。X線片示骨折均愈合,愈合時間5~8周,平均6.1周。術后8~12周,平均9.2周取出內固定物。末次隨訪時,根據總主動活動度(TAM)評價標準評定手指功能,獲優9例,良5例,中1例,優良率93.3%。 結論克氏針雙夾扣法固定治療遠節指骨背側基底不穩定骨折,可使骨折、關節復位且固定牢固,允許手指早期功能鍛煉,是一種有效治療方法。

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