颈前路减压植骨方法的改进

自1997年我们在颈椎前路切除脊髓前方致压物后采用嵌锁式植骨方法治疗45例脊髓型颈椎病,疗效满意.报告如下.

内置法骨移植

将自体骨或骨代用品移植于腔隙中的植骨方法。

造釉细胞瘤下颌骨部分切除植骨围手术期护理

目的 探讨造釉细胞瘤下颌骨围手术期护理。方法 主要有术前的心理护理，术前准备及术后并发症的观察及护理。结果 26例造釉细胞瘤下颌骨部分切除的患者均无并发症发生，治愈出院。结论 做好下颌骨部分切除的围手术期护理，对帮助患者适应新生活，改善生活质量有重要的意义。

牵张成骨在口腔种植术中的临床与基础研究进展

口腔种植学是20世纪30年代发展起来的一门独立学科。种植义齿以其美观、舒适、咀嚼功能好、不损伤邻牙等一系列优点逐渐被越来越多的缺牙患者所接受。为保证种植成功率，种植术对骨质和骨量有着极高的要求。临床上由于多种原因造成牙槽骨萎缩甚至缺失，致骨宽度和高度不足，限制了种植术的应用。为此，在骨量不足或拔牙术后即刻种植的情况下需要采取一系列增骨方法以增加骨量，提高种植成功率。传统的植骨方法不可避免地会产生排异反应、植骨区骨吸收以及供骨区功能障碍等一系列并发症。牵张成骨术（distraction osteogenesis，DO）是利用骨的自身愈合来增加新骨的一种方法。该技术通过牵张装置，使骨切开处的骨组织受到缓慢而稳定的牵引和张力，从而达到增长或伸直骨骼的目的。由于其避免了植骨术的缺点，并经过多年临床验证，逐步被应用于口腔种植术中，取得了满意的疗效，本文就牵张成骨在口腔种植术中的临床与基础研究进展综述如下。

皮质外骨桥固定特制假体置换治疗肢体骨肿瘤

[目的]确定采用特制假体及特殊植骨方法固定后,假体与骨交界区能否有效形成皮质外骨桥,皮质外骨桥能否起到有效的辅助固定作用,皮质外骨桥的形成和重建有何规律.[方法]44例患者行皮质外骨桥加强固定,带有1～4 cm多孔表面区的特制假体置换.31例患者资料可供分析,以了解植入后固定的效果以及骨桥形成和重建的规律.[结果]31例患者中有25例(81%)形成了有效的骨桥固定,骨桥在股骨后侧和内侧的压应力区形成更为丰富.[结论]在假体与骨端交接区的珍珠面和骨皮质之间良好植骨可有效构建骨桥;骨桥的重建与应力和血运有关;髓内固定、珍珠面、皮质外植骨有利于形成有效的骨桥固定.

胸腰段椎体骨折后路内固定术后角度丢失评价

目的 评价胸腰段椎体骨折早期后路内固定术后中远期临床效果。方法 回顾性分析胸腰椎骨折并早期行后路内固定术 37例患者临床资料 ,并对不同的植骨方法与内固定拆除后脊柱生理曲度的丢失进行相关比较 ,通过影像学结果进行指标的观察与比较。结果 随访时间平均 2 .5年。Harrington棒断裂、脱钩 3例 ,椎弓根钉断裂 2例。无固定物断裂 ,内固定物取出后 16例发生了不同程度的角度丢失。结论 胸腰段椎体骨折后路内固定术内固定物取出后脊柱角度的丢失是其较为常见的并发症。术中正确的横突间融合及经椎弓根植骨方法可能是预防术后脊柱角度丢失较好的选择。

加压螺钉及自体骨植骨治疗腕舟骨陈旧性骨折

腕舟骨骨折临床上较常见，尤以年轻人多见，治疗方法及内固定方式多种多样。2006年8月-2009年3月，我院采用加压螺钉及取自体桡骨远端松质骨植骨方法治疗腕舟骨陈旧性骨折14例，术后疗效满意。

Treatment of femoral neck fracture with muscle-bone flap of both tensor fasciae latae and sartorius

Objective: To evaluate the effect of muscular pedicle bone grafts with sartorius or tensor fasciae latae and sartorius in fresh transcervical or subcapital fractures of the femoral neck. Methods: Thirty cases of fresh transcervical and subcapital fractures of the femoral neck were treated by the tail breakable screws and sartorius pedicle bone grafts (single muscular pedicle, SMP group). The other 23 cases were treated by cannulated pressure screws and bone grafts with the muscular pedicles of both sartorius and tensor fasciae latae (double muscular pedicles, DMP group). Results: Fifty-two cases were followed up for 3 to 5 years (mean, 4 years). In SMP group, ten cases showed poor therapeutic results. Excellent therapeutic effects were achieved in all cases of DMP group. Conclusions: The transcervical or subcapital fractures of the femoral neck can be treated by double muscular pedicles bone graft. The bone graft with double muscular pedicles is more effective than single sartorius muscular pedicles for fresh transcervical and subcapital fractures of the femoral neck during short and medium terms.

External fixation and bone grafting for collapsed and comminuted distal radius fracture

Objective: To study the therapeutic effect of collapsed and comminuted distal radius fracture. Methods: Twenty-six patients with collapsed and comminuted distal radius fracture were hospitalized from July 1998 to June 2003. All fractures were treated by the methods of open reduction, sustained bone grafting and passing joint external fixator to restore the anatomic shape of distal radius. Results: All 26 cases were followed up, and the results showed that the fractures have been united radiographically. The joint surfaces were intact and there was no length discrepancy occurred in patient’s radius. The average volar tilt was 6° to 15° and the average ulnar tilt was 18° to 25°. According to the Dieust criterion, 19 cases were rated as excellent and 7 as good. Conclusions: The method that applying passing joint external fixator and bone grafting for the treatment of collapsed and comminuted distal radius fracture could maintain the stability of fracture and restore the length of radius and the intact of joint surface.