目的:观察前内及前外侧联合入路钢板内固定结合骨伤复原汤口服治疗复杂过伸型胫骨平台骨折的临床疗效和安全性。方法:2014年2月至2022年8月,采用前内及前外侧联合入路钢板内固定结合骨伤复原汤口服治疗复杂过伸型胫骨平台骨折患者23例。...目的:观察前内及前外侧联合入路钢板内固定结合骨伤复原汤口服治疗复杂过伸型胫骨平台骨折的临床疗效和安全性。方法:2014年2月至2022年8月,采用前内及前外侧联合入路钢板内固定结合骨伤复原汤口服治疗复杂过伸型胫骨平台骨折患者23例。男15例,女8例。年龄22~61岁,中位数40岁。均为闭合性胫骨平台骨折。按照胫骨平台骨折Schatzker分型标准,Ⅳ型4例、Ⅴ型9例、Ⅵ型10例。按照罗从风三柱分型方法,双柱骨折7例、三柱骨折16例。均无重要血管、神经损伤。合并后外侧复合体损伤4例,后交叉韧带损伤3例,内侧半月板损伤4例,外侧半月板损伤2例。受伤至手术时间5~16 d,中位数7 d。随访观察切口愈合、骨折复位、骨折愈合及并发症发生情况。分别于术后即刻及术后6个月,拍摄膝关节正侧位X线片,测量胫骨平台内翻角和后倾角。术后6个月,采用Rasmussen放射学评分标准评价胫骨平台骨折复位情况。末次随访时,采用美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分标准评价膝关节功能。结果:所有患者均获随访,随访时间10~21个月,中位数17个月。切口均甲级愈合。骨折均达到解剖复位。骨折均愈合,愈合时间12~21周,中位数17周。胫骨平台后倾角,术后即刻12.6°±1.8°、术后6个月11.8°±1.2°;胫骨平台内翻角,术后即刻3.6°±1.2°、术后6个月3.3°±1.1°。术后6个月,Rasmussen放射学评分(15.8±2.2)分,优13例、良8例、差2例。末次随访时,HSS膝关节评分(88.1±6.6)分,优10例、良12例、可1例;膝关节屈曲133.6°±7.2°,膝关节伸直均可达0°。均无感染、神经损伤等并发症发生。结论:采用前内及前外侧联合入路钢板内固定结合骨伤复原汤口服治疗复杂过伸型胫骨平台骨折,骨折复位和愈合好,有利于膝关节功能的恢复,且安全性较高。展开更多
The study of sedimentary mélanges holds pivotal importance in understanding orogenic processes and unveiling geodynamic mechanisms.In this study,we present findings on zircon U-Pb isotopes and whole-rock elementa...The study of sedimentary mélanges holds pivotal importance in understanding orogenic processes and unveiling geodynamic mechanisms.In this study,we present findings on zircon U-Pb isotopes and whole-rock elemental data concerning the recently uncovered Zongzhuo Formation sedimentary mélanges within the Dingri area.Field observations reveal the predominant composition of the Zongzhuo Formation,characterized by a matrix of sandstone-mudstone mixed with sand-conglomerates within native blocks exhibiting soft sediment deformation.Moreover,exotic blocks originating from littoral-neritic seas display evidence of landslide deformation.Our study identifies the depositional environment of the Zongzhuo Formation in Dingri as a slope turbidite fan,with its provenance traced back to the passive continental margin.Notably,this contrasts with the Zongzhuo Formation found in the Jiangzi-Langkazi area.Based on existing data,we conclude that the Zongzhuo Formation in the Dingri area was influenced by the Dingri-Gamba fault and emerged within a fault basin of the passive continental margin due to Neo-Tethys oceanic subduction during the Late Cretaceous period.Its provenance can be attributed to the littoral-neritic sea of the northern Tethys Himalaya region.This study holds significant implications for understanding the tectonic evolution of Tethys Himalaya and for reevaluating the activity of the Dingri-Gamba fault,as it controls the active deposition of the Zongzhuo Formation.展开更多
文摘目的:观察前内及前外侧联合入路钢板内固定结合骨伤复原汤口服治疗复杂过伸型胫骨平台骨折的临床疗效和安全性。方法:2014年2月至2022年8月,采用前内及前外侧联合入路钢板内固定结合骨伤复原汤口服治疗复杂过伸型胫骨平台骨折患者23例。男15例,女8例。年龄22~61岁,中位数40岁。均为闭合性胫骨平台骨折。按照胫骨平台骨折Schatzker分型标准,Ⅳ型4例、Ⅴ型9例、Ⅵ型10例。按照罗从风三柱分型方法,双柱骨折7例、三柱骨折16例。均无重要血管、神经损伤。合并后外侧复合体损伤4例,后交叉韧带损伤3例,内侧半月板损伤4例,外侧半月板损伤2例。受伤至手术时间5~16 d,中位数7 d。随访观察切口愈合、骨折复位、骨折愈合及并发症发生情况。分别于术后即刻及术后6个月,拍摄膝关节正侧位X线片,测量胫骨平台内翻角和后倾角。术后6个月,采用Rasmussen放射学评分标准评价胫骨平台骨折复位情况。末次随访时,采用美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分标准评价膝关节功能。结果:所有患者均获随访,随访时间10~21个月,中位数17个月。切口均甲级愈合。骨折均达到解剖复位。骨折均愈合,愈合时间12~21周,中位数17周。胫骨平台后倾角,术后即刻12.6°±1.8°、术后6个月11.8°±1.2°;胫骨平台内翻角,术后即刻3.6°±1.2°、术后6个月3.3°±1.1°。术后6个月,Rasmussen放射学评分(15.8±2.2)分,优13例、良8例、差2例。末次随访时,HSS膝关节评分(88.1±6.6)分,优10例、良12例、可1例;膝关节屈曲133.6°±7.2°,膝关节伸直均可达0°。均无感染、神经损伤等并发症发生。结论:采用前内及前外侧联合入路钢板内固定结合骨伤复原汤口服治疗复杂过伸型胫骨平台骨折,骨折复位和愈合好,有利于膝关节功能的恢复,且安全性较高。
基金supported by the Geological Survey Project of the China Geological Survey(Grant No.DD20211547)the Basic Survey Project of the Command Center of Natural Resources Comprehensive Survey(Grant No.ZD20220508)。
文摘The study of sedimentary mélanges holds pivotal importance in understanding orogenic processes and unveiling geodynamic mechanisms.In this study,we present findings on zircon U-Pb isotopes and whole-rock elemental data concerning the recently uncovered Zongzhuo Formation sedimentary mélanges within the Dingri area.Field observations reveal the predominant composition of the Zongzhuo Formation,characterized by a matrix of sandstone-mudstone mixed with sand-conglomerates within native blocks exhibiting soft sediment deformation.Moreover,exotic blocks originating from littoral-neritic seas display evidence of landslide deformation.Our study identifies the depositional environment of the Zongzhuo Formation in Dingri as a slope turbidite fan,with its provenance traced back to the passive continental margin.Notably,this contrasts with the Zongzhuo Formation found in the Jiangzi-Langkazi area.Based on existing data,we conclude that the Zongzhuo Formation in the Dingri area was influenced by the Dingri-Gamba fault and emerged within a fault basin of the passive continental margin due to Neo-Tethys oceanic subduction during the Late Cretaceous period.Its provenance can be attributed to the littoral-neritic sea of the northern Tethys Himalaya region.This study holds significant implications for understanding the tectonic evolution of Tethys Himalaya and for reevaluating the activity of the Dingri-Gamba fault,as it controls the active deposition of the Zongzhuo Formation.
