Objective To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic va-lue of different imaging methods. Methods One hundred and fourteen patients with 120 thoracolumbar b...Objective To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic va-lue of different imaging methods. Methods One hundred and fourteen patients with 120 thoracolumbar burst fractures were retrospectively reviewed. Pl-ain radiographs were available in all cases; CT scans and MRI were obtained in 96 and 74 cases, respectively. Results A total of 27 burst fractures were misdiagnosed as other types of fractures on radiographs alone, and accounted for 22.5% of all fractures. The results indicated that plain radiographs often fail to delineate the pathological features of thor-acolumbar burst fractures, leading to delay in diagnosis. Conclusion In regard to thoracolumbar injury diagnosis, burst fractures should be differentiated from compression frac-tures. CT should be routinely indicated and MRI examination, when necessary, may be simultaneously considered.展开更多
OBJECTIVE: To investigate the mechanism associated with thoracolumbar burst fractures. METHODS: Stress distribution of the spine in the upright, flexion and extension positions was analyzed using a three-dimensional f...OBJECTIVE: To investigate the mechanism associated with thoracolumbar burst fractures. METHODS: Stress distribution of the spine in the upright, flexion and extension positions was analyzed using a three-dimensional finite element model of the spinal motion segment. RESULTS: Stress concentration was noted at the pedicle and posterosuperior part of the vertebral body near the pedicle. CONCLUSION: Stress concentration of the spine may be implicated in the biomechanical mechanism underlying thoracolumbar burst fractures.展开更多
Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: ...Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: (1) Two small incisions, a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid, were made instead of a conventional large arc incision from the acromion to coracoid. (2) The foreign body in the acromioclavicular joint was cleared out. The chondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired. (3) The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4) the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament. Results: The follow up duration in 30 patients of the series was from 6 to 72 months (mean 41 months). Functional assessment was carried out by the criteria delineated previously by Karkson, in which Grade A was in 24 cases, Grade B in 4cases, and C in 2. Conclusions: This modified technique, having less postoperative complications and less injuries to tissues and according well with the requirement of biomechanics, can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and therefore is preferable to use clinically on a large scale.展开更多
文摘Objective To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic va-lue of different imaging methods. Methods One hundred and fourteen patients with 120 thoracolumbar burst fractures were retrospectively reviewed. Pl-ain radiographs were available in all cases; CT scans and MRI were obtained in 96 and 74 cases, respectively. Results A total of 27 burst fractures were misdiagnosed as other types of fractures on radiographs alone, and accounted for 22.5% of all fractures. The results indicated that plain radiographs often fail to delineate the pathological features of thor-acolumbar burst fractures, leading to delay in diagnosis. Conclusion In regard to thoracolumbar injury diagnosis, burst fractures should be differentiated from compression frac-tures. CT should be routinely indicated and MRI examination, when necessary, may be simultaneously considered.
基金supported by the National Natural Science Foundation of China(No3880785)
文摘OBJECTIVE: To investigate the mechanism associated with thoracolumbar burst fractures. METHODS: Stress distribution of the spine in the upright, flexion and extension positions was analyzed using a three-dimensional finite element model of the spinal motion segment. RESULTS: Stress concentration was noted at the pedicle and posterosuperior part of the vertebral body near the pedicle. CONCLUSION: Stress concentration of the spine may be implicated in the biomechanical mechanism underlying thoracolumbar burst fractures.
文摘Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: (1) Two small incisions, a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid, were made instead of a conventional large arc incision from the acromion to coracoid. (2) The foreign body in the acromioclavicular joint was cleared out. The chondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired. (3) The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4) the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament. Results: The follow up duration in 30 patients of the series was from 6 to 72 months (mean 41 months). Functional assessment was carried out by the criteria delineated previously by Karkson, in which Grade A was in 24 cases, Grade B in 4cases, and C in 2. Conclusions: This modified technique, having less postoperative complications and less injuries to tissues and according well with the requirement of biomechanics, can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and therefore is preferable to use clinically on a large scale.
