To explore the clinical classification of hamate hook fracture and the treatment strategy for different type of fractures,12 patients who suffered from hamate hook fractures were followed up retrospectively.According ...To explore the clinical classification of hamate hook fracture and the treatment strategy for different type of fractures,12 patients who suffered from hamate hook fractures were followed up retrospectively.According to the fracture sites and the prognosis,we classified the hamate hook fractures into 3 types.Type Ⅰ referred to an avulsion fracture at the tip of hamate hook,type Ⅱ was a fracture in the middle part of hamate hook,and type Ⅲ represented a fracture at the base of hamate hook.By the classification,in our series,only 1 fell into type Ⅰ,7 type Ⅱ,and 4 type Ⅲ.The results were evaluated with respect to the functional recovery,recovery time and the association among the clinical classification,pre-operative complications and treatment results.The average follow-up time of this group was 8.4±3.9 months.Two cases were found to have fracture non-union and both of them were type Ⅱ fractures.Six patients had complications before operation.Five cases were type Ⅱ fractures and 1 case type Ⅲ fracture.All the patients were satisfied with the results at the time of the last follow-up.Their pain scale and grip strength improved significantly after treatment.All the pre-operative complications were relieved.The recovery time of hamate hook excision was significantly shorter than that of the other two treatments.The incidences of both pre-operative complications and non-union in type Ⅱ fractures were higher than those in type Ⅰ and type Ⅲ fractures.It was concluded that,generally,the treatment effects with hamate hook fracture are quite good.The complication incidence and prognosis of the fracture are closely related to the clinical classification.Early intervention is critical for type Ⅱ fractures.展开更多
目的 探讨指骨侧方放置微型钛板治疗中节、近节指骨骨折的技术要点和临床疗效.方法 2011年12月至2015年4月,采用手指侧方入路切开复位微型钛板内固定治疗闭合性指骨骨折患者56例（64指）,男48例,女8例;年龄17～65岁,平均36.3岁.中节指...目的 探讨指骨侧方放置微型钛板治疗中节、近节指骨骨折的技术要点和临床疗效.方法 2011年12月至2015年4月,采用手指侧方入路切开复位微型钛板内固定治疗闭合性指骨骨折患者56例（64指）,男48例,女8例;年龄17～65岁,平均36.3岁.中节指骨骨折25指,近节指骨骨折39指.中节指骨髁部骨折12指,中节指骨骨干7指,中节指骨基底6指,近节指骨髁部10指,近节指骨骨干22指,近节指骨基底7指;横行骨折13指,短斜行骨折9指,长斜行骨折11指,螺旋形骨折6指,粉碎性骨折25指.术中均采用手指侧方入路,其中近节指骨骨折需切除该侧侧腱束和斜行纤维以充分暴露骨折端,骨折复位后微型钛板放置于指骨侧方固定.采用臂肩手功能障碍评估表（the disabilities of the arm,shoulder and hand,DASH）、患侧和健侧手指各关节活动范围（range of motion,ROM）及手指总的主动活动度（total active motion,TAM）评价术后功能,同时拍摄患指正、侧位X线片观察骨折愈合情况.结果 56例患者均获得随访,随访时间9～47个月,平均（14±6）个月;指骨骨折完全愈合,愈合时间7～14周,平均（8.8±2.4）周.末次随访时,DASH评分1.7～7.5分,平均（4.8±2.2）分.术后患指活动功能优者（患侧手指TAM大于健侧手指TAM的90％）为51.5％（33/64指）,良（患侧手指TAM为健侧手指的75％～90％）为46.9％（30/64指）,可（患侧手指TAM为健侧50％～75％）为1.6％（1/64指）,优良率为98.4％.握拳时手指无交叉畸形和偏斜畸形.结论 中节、近节指骨不稳定骨折采用手指侧方入路切开复位微型钛板内固定术,对伸肌腱装置干扰小,术中骨折端暴露充分,术后骨折愈合及手指活动度好,是治疗中节、近节指骨骨折有效的手术方法.展开更多
目的研究先天性复拇合并三指节拇指畸形的一个家系的临床表现及致病原因。方法在患者家系调查的基础上，应用聚合酶链反应（PCR）技术对极化活性区（zone of polarizing activlty，ZPA）调控序列进行扩增和测序分析。结果体检发现，患...目的研究先天性复拇合并三指节拇指畸形的一个家系的临床表现及致病原因。方法在患者家系调查的基础上，应用聚合酶链反应（PCR）技术对极化活性区（zone of polarizing activlty，ZPA）调控序列进行扩增和测序分析。结果体检发现，患者存在单侧或双侧拇指的复拇合并三指节拇指畸形，部分患者还可合并轴前和轴后的多指畸形。病因研究提示，在所有患者ZPA调控序列的第105位碱基对上发现了C→G的点突变。结论复拇合并三指节拇指畸形家系患者由ZPA调控序列的第105位碱基对上C→G的点突变所致。展开更多
基金supported by a grant from the Beijing Senior Health Care Elite Training Project(No.2009-3-17)
文摘To explore the clinical classification of hamate hook fracture and the treatment strategy for different type of fractures,12 patients who suffered from hamate hook fractures were followed up retrospectively.According to the fracture sites and the prognosis,we classified the hamate hook fractures into 3 types.Type Ⅰ referred to an avulsion fracture at the tip of hamate hook,type Ⅱ was a fracture in the middle part of hamate hook,and type Ⅲ represented a fracture at the base of hamate hook.By the classification,in our series,only 1 fell into type Ⅰ,7 type Ⅱ,and 4 type Ⅲ.The results were evaluated with respect to the functional recovery,recovery time and the association among the clinical classification,pre-operative complications and treatment results.The average follow-up time of this group was 8.4±3.9 months.Two cases were found to have fracture non-union and both of them were type Ⅱ fractures.Six patients had complications before operation.Five cases were type Ⅱ fractures and 1 case type Ⅲ fracture.All the patients were satisfied with the results at the time of the last follow-up.Their pain scale and grip strength improved significantly after treatment.All the pre-operative complications were relieved.The recovery time of hamate hook excision was significantly shorter than that of the other two treatments.The incidences of both pre-operative complications and non-union in type Ⅱ fractures were higher than those in type Ⅰ and type Ⅲ fractures.It was concluded that,generally,the treatment effects with hamate hook fracture are quite good.The complication incidence and prognosis of the fracture are closely related to the clinical classification.Early intervention is critical for type Ⅱ fractures.
文摘目的 探讨指骨侧方放置微型钛板治疗中节、近节指骨骨折的技术要点和临床疗效.方法 2011年12月至2015年4月,采用手指侧方入路切开复位微型钛板内固定治疗闭合性指骨骨折患者56例（64指）,男48例,女8例;年龄17～65岁,平均36.3岁.中节指骨骨折25指,近节指骨骨折39指.中节指骨髁部骨折12指,中节指骨骨干7指,中节指骨基底6指,近节指骨髁部10指,近节指骨骨干22指,近节指骨基底7指;横行骨折13指,短斜行骨折9指,长斜行骨折11指,螺旋形骨折6指,粉碎性骨折25指.术中均采用手指侧方入路,其中近节指骨骨折需切除该侧侧腱束和斜行纤维以充分暴露骨折端,骨折复位后微型钛板放置于指骨侧方固定.采用臂肩手功能障碍评估表（the disabilities of the arm,shoulder and hand,DASH）、患侧和健侧手指各关节活动范围（range of motion,ROM）及手指总的主动活动度（total active motion,TAM）评价术后功能,同时拍摄患指正、侧位X线片观察骨折愈合情况.结果 56例患者均获得随访,随访时间9～47个月,平均（14±6）个月;指骨骨折完全愈合,愈合时间7～14周,平均（8.8±2.4）周.末次随访时,DASH评分1.7～7.5分,平均（4.8±2.2）分.术后患指活动功能优者（患侧手指TAM大于健侧手指TAM的90％）为51.5％（33/64指）,良（患侧手指TAM为健侧手指的75％～90％）为46.9％（30/64指）,可（患侧手指TAM为健侧50％～75％）为1.6％（1/64指）,优良率为98.4％.握拳时手指无交叉畸形和偏斜畸形.结论 中节、近节指骨不稳定骨折采用手指侧方入路切开复位微型钛板内固定术,对伸肌腱装置干扰小,术中骨折端暴露充分,术后骨折愈合及手指活动度好,是治疗中节、近节指骨骨折有效的手术方法.
文摘目的研究先天性复拇合并三指节拇指畸形的一个家系的临床表现及致病原因。方法在患者家系调查的基础上，应用聚合酶链反应（PCR）技术对极化活性区（zone of polarizing activlty，ZPA）调控序列进行扩增和测序分析。结果体检发现，患者存在单侧或双侧拇指的复拇合并三指节拇指畸形，部分患者还可合并轴前和轴后的多指畸形。病因研究提示，在所有患者ZPA调控序列的第105位碱基对上发现了C→G的点突变。结论复拇合并三指节拇指畸形家系患者由ZPA调控序列的第105位碱基对上C→G的点突变所致。
