骨关节伤筋油治疗急性软组织损伤442例疗效观察

目的探讨骨关节伤筋油治疗急性软组织损伤的临床疗效。方法将急性软组织损伤患者442例随机分为两组,采用单盲法进行对照观察,治疗组402例运用骨关节伤筋油治疗,对照组40例运用正红花油治疗,均以10 d为1个疗程,用药1个疗程后观察疗效。结果两组治疗方法对急性软组织损伤均有良好的治疗作用,两组治愈率和总有效率比较差异有统计学意义(P<0.01、P<0.05),治疗组优于对照组。结论骨关节伤筋油治疗急性软组织损伤具有良好的凉血清热、活血化瘀、消肿止痛、舒筋通络作用,特别值得临床基层医院推广使用。

99Tcm-MDP显像对运动性骨关节伤早期定位诊断价值以及护理干预效果

目的:探讨99Tcm-MDP显像对运动性骨关节伤早期定位诊断价值以及护理干预效果。方法:将我院收治的60例运动性骨关节伤早期患者(入院时间为2017年1月—2019年1月)作为临床研究对象,将其随机分为两组,每组患者30例。其中观察组采用99Tcm-MDP显像对骨关节伤早期定位进显像结果分析,对照组患者进行局部X线检查以及局部SPECT/CT断层融合检查,对比两组患者显像定位结果,并对其护理干预效果进行对比。结果:观察组干预后的总有效率明显优于对照组的,差异具有统计学意义(P<0.05)。结论:对于运动性骨关节伤早期定位选择99Tcm-MDP显像对患者的初诊有较快较准确的显像,对于后期的护理干预也有较好的效果。

高速公路交通事故中多发骨关节损伤的误漏诊分析

目的 :探讨高速公路交通事故伤中多发骨关节损伤发生的原因。方法 :对 2 0 6例多发骨关节损伤临床资料进行回顾性分析 ,对其漏诊病历进行统计分析。结果 :误、漏诊 45例 ( 2 1.8% )。漏诊原因主观因素占主位。结论 :高速公路交通事故伤中骨关节损伤的误、漏诊发生率高 ,临床上应对患者诊断要有全面的认识。

浅谈“骨关节损伤的康复护理”教学设计

切合课程内容和学生实际的教学设计可获得良好的教学效果，尤其是以情境、活动和创新教学为关键的教学设计可以达到主体性教学和素质教育的目的。现代的教学设计主要是让学生学什么，即解决目标问题；为达到目标，需要使用什么教学资源和采取什么教学策略，即解决资源和策略问题；如何评价教学效果，即教学效果的评价问题。在此种理念的引导下，笔者在康复护理学教学中运用这样的教学设计原则。现将“骨关节损伤的康复护理”的教学设计作一介绍。

小儿骨关节损伤常见部位及原因分析

目的:对小儿骨关节损伤的常见多发部位、发病原因以及临床症状进行探讨分析,从而丰富临床诊治经验。方法选择于2010年12月~2013年5月在我院接受治疗的小儿骨关节损伤患儿203例作为研究对象,研究观察小儿骨关节损伤的与年龄性别之间的关系同时了解骨关节损伤的常见多发部位、发病原因以及临床症状。结果造成小儿骨关节损伤的主要原因包括坠落、交通事故、体育活动以及同一平面摔倒;男性患儿由于体育活动、坠落以及同一平面摔倒原因造成骨关节损伤的比例明显高于女性患儿,差异显著(P<0.05),且随着年龄的增长患儿的发病率上升,主要集中在8~11岁,与其它年龄段比较差异显著(P<0.05);另外小儿骨关节损伤的常见多发部位主要集中在四肢部位,少部分发生在躯干、头颈部,其中四肢骨折包括肱骨髁上骨折、尺桡骨骨折、肱骨内外髁骨折、股骨骨折及胫腓骨骨折,其中部分患儿合并脑震荡、神经损伤。结论多种原因会造成小儿骨关节损伤的损伤,且损伤部位多样,因此需要及时了解损伤的原因并且诊断损伤部位给予针对性的治疗。

定量磁共振成像在关节软骨中的应用研究进展

在临床上,关节软骨损伤是一种常见病,其发生发展可由外伤、骨性关节炎(osteoarthritis, OA)以及剥脱性骨软骨炎等原因造成,而且这种损坏发生后很难修复。关节软骨损伤主要表现为关节疼痛及功能障碍,关节软骨的损伤以及退变都不同程度地发生在老年人及长期剧烈运动的人群中。关节镜检查被认为是诊断关节软骨病变的金标准。但由于其有创检查的性质,对检查者的技术水平要求很高,且无法深入了解软骨的内部情况。定量磁共振成像(quantitative magnetic resonance imaging, qMRI)既可显示软骨形态学变化,又可以定量评估软骨的生化成分,由于该技术具有无创、良好的软组织分辨力、多参数、多平面成像的优势,它能以非侵入性的定量测量来敏感地监测软骨的微细变化,提供可靠和可重复的成像生物标志物。

骨关节型严重多发伤的治疗及损害控制

目的：探讨骨关节型严重多发伤患者救治过程中应用损害控制的临床意义。方法：回顾我院2006年10月-2010年12月，我科收治的50例骨关节型严重多发伤患者临床资料，总结损害控制应用于患者救治过程中的临床经验，并研究进行损害控制的时机与方法。结果：50例患者均获得成功救治，其中有35例患者能够返回原来的工作岗位，有11例患者生活能够自理，另外4例患者尚需进行进一步的治疗。结论：第一，严重多发伤患者ISS评分应≥17分，而骨关节型的严重多伤患者中，ISS90评分应以骨与关节的损伤为主，并≥16分。第二，对骨关节型严重多发伤患者进行损害控制能够提高救治的成功率，尤其对患者四肢与骨盆骨折的外固定器进行临时性的固定，可以有效进行控制损害。

Application of Huangqi Guizhi Wuwu Decoction in Orthopaedics and Traumatology

The Huangqi Guizhi Wuwu Decoction(HQGZWWT)is composed of Huangqi(Astragali Radix),Shaoyao(Paeoniae Radix Alba),Guizhi(Cinnamomi Ramulus),Shengjiang(Zingiberis Rhizoma Recens),and Dazao(Jujubae Fructus)which has various pharmacological anti-inflammatory,analgesic,antioxidant,antitumor,lipid-lowering,and immunity-regulating activities.It has certain advantages in the treatment of orthopaedic diseases,such as cervical spondylosis,scapulohumeral periarthritis,lumbar disc herniation,knee osteoarthritis,rheumatoid arthritis,myofascial pain syndrome,etc.,with outstanding clinical efficacy,few adverse reactions,and high patient compliance.However,modern pharmacological researches on the whole prescription of HQGZWWT are insufficient and the therapeutic targets are not clear which needs further exploration.Besides,this prescription cannot treat ll orthopaedic diseases,so we should adhere to the thinking of four diagnostics in traditional Chinese medicine(TCM),select prescriptions based on syndrome differentiation,closely follow the pathogenesis,innovate and expand its scope of application,reflect the application advantages of this prescription in orthopaedics and traumatology and improve the total clinical efficiency.

全国首届骨折固定会议在渝召开

全国首届骨折固定专题座谈会暨中华骨科学会骨关节伤学组成立大会于1987年11月5日在重庆第三军医大学举行。到会正式代表53名,其中有老一辈的骨科专家,但更多的是中年骨科工作者。座谈会由中华外科杂志、中华骨科杂志和创伤杂志主办,会期三天,分六个专题:骨折一期愈合与二期愈合;坚强固定与弹性固定;骨折愈合的生物力学;外固定的评价;

Effects of low-intensity pulsed ultrasound in repairing injured articular cartilage

Objective: To investigate the effects of low-intensity pulsed ultrasound in repairing injured articular cartilage. Methods: Ten adult New Zealand rabbits with bilateral full-thickness osteochondral defects on the cartilage surface of intercondylar fossas were used in this study. The wounds in the left knees were treated with low-intensity pulsed ultrasound as the experimental group. The right knees received no treatment as the control group. All the animals were killed at 8 weeks after injury and the tissues in the wounds were collected for gross appearance grading, histological grading and proteoglycan quantity. Results: The scores of the gross appearance grades, histological grades and the optical density of toluidine blue of the tissues in the experimental group were significantly higher than those of the controls at 8 weeks after injury (P<(0.05)). Conclusions: Low-intensity pulsed ultrasound can accelerate the repair of injured articular cartilage.

Posterior dislocation of the hip with ipsilateral displaced femoral neck fracture

Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had united and the patient was asymptomatic. We further proposed the mechanism of injury for such a fracture and discussed the management in the changing trauma scenario of the developing world.

Traumatic anterior hip dislocation in a 12-year-old child

Hip dislocation in children can occur congenitally in isolation or in conjunction with other con- genital abnormalities. Traumatic hip dislocations in children are relatively uncommon and anterior dislocation of hip joint is even rarer. We report such a case following unusual mode of injury in a 12-year-old child. The patient underwent suc- cessful emergent closed reduction of left hip. The clinicalcourse and follow-up assessment of the patient was other- wise uneventful. At 2 years＇ follow-up there was no evi- dence of osteoarthritis, coxa magna, heterotrophic calcification, in congruency of the joints or avascular ne- crosis of the head of femur.

Irreducible traumatic posterior hip dislocation with entrapment and a buttonhole effect

The authors reported the case of a 27- year-old man who sustained an irreducible postero-lateral traumatic dislocation of the hip with capsular and labral entrapment. Initial X-rays showed only a small acetabular fragment. After two attempts to reduce the hip with muscle paralysis under general anaesthesia failed, the patient was treated by immediate open reduction through a posterolateral approach. Surgical exploration of the hip revealed a small osteochondral fragment attached to a large piece of labrum and capsule, clogging the acetabulum. The femoralhead crossed over the torn capsule with a buttonhole effect. These elements were relieved, the bone fragment was fixed with a 2 mm screw and the capsule was repaired. At the 10- year follow-up, the functional outcome was excellent with a Harris score of 100 points and no signs of necrosis or osteoarthritis. The authors propose a literature review of this uncommon lesion.

The effects of sodium hyaluronate on mRNA expressions of matrix metalloproteinase-1,-3 and tissue inhibitor of metalloproteinase-1 in cartilage and synovium of traumatic osteoarthritis model

Objective: To observe the influence of intra-articular injection of sodium hyaluronate (HA) on the mRNA expressions of matrix metalloproteinase-1,-3 (MMP-1,-3) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in cartilage and synovium of traumatic osteoarthritis (OA).Methods: Sixteen white rabbits underwent unilateral anterior cruciate ligament transection (ACLT) were divided into 2 groups randomly 5 weeks after transection. The experimental group rabbits received 0.3 ml of 1% HA by intra-articular injection once a week. Animals in the control group were treated under the same conditions using physiological saline. Ten weeks following surgery, cartilage and synovium were harvested. The mRNA expressions of MMP-1, MMP-3 and TIMP-1 were analyzed using reverse transcription-polymerase chain reaction (RT-PCR).Results: In synovium, the mRNA expression of MMP-3 was suppressed in the HA injection group. HA treatment had no effect on the MMP-3 expression in cartilage. No significant difference of MMP-1 and TIMP-1 expressions in cartilage and synovium was found between the HA injection group and the control group.Conclusions: One of the mechanisms of the therapeutic effect of HA may be the inhibition of expression of MMP-3 in synovium during early stage of traumatic OA.

A correlative study between prevalence of chondromalacia patellae and sports injury in 4068 students

Objective: To study the prevalence of chondromalacia patella among college students and the correlation with sports injury. Methods: 354 students from gymnastic department and 429 from nongymnastic department with knee joint pain were selected. 184 students from gymnastic department and 342 from nongymnastic department were checked randomly by a surgeon. 77 patients (37 males, 40 females) from gymnastic department and 119 patients (62 males, 57 females) from nongymnastic department were diagnosed as chondromalacia patellae. The amount of exercise and the occurrence of sports injury were investigated in each student. All data were analyzed with SPSS 10.0 statistical software. Results: The prevalence of chondromalacia patella was 20.1% in female students and 11.6% in male students from gymnastic department, and 5.61% in female students and 4.92% in male students from nongymnastic department. The amount of exercise and the occurrence of sports injury to the knee joint in students from gymnastic department were greater than those from nongymnastic department. Conclusions: In both female and male students, the prevalence of chondromalacia patella is higher in gymnastic department than nongymnastic department. Sports injury is an important cause of chondromalacia patella.

Simultaneous reconstruction of anterior cruciate ligament and posterior cruciate ligament by using allogeneic patellar tendon under arthroscopy

To evaluate operative effects of a new method to reconstruct anterior crucial ligament （ ACL ） and posterior crucial ligament （PCL） simultaneously by using patellar tendon under arthroscopy. Methods： From November 1999 to November 2003, the injured ACL and PCL of 11 patients were fixated with compressed screws and reconstructed under arthroscopy with the bone-patellar tendon-bone treated with deep hypothermia and γ radiation. At the same time, 2 patients were treated with medial collateral ligament （MCL） reconstruction, 3 with lateral collateral ligament （LCL） reconstruction. 1 with meniscus suture and 4 with whole or partial resection. Results： All patients were followed up for 12-26 months （average 16.5 months ）. The Lysholm score method was employed to evaluate the knee function. The average preoperative score was 45.3 and the postoperative score was 86.4. Anterior drawer test （ADT） was positive in 11 knees preoperatively and feeble positive in one knee postoperatively. Lachman test was positive in 11 knees preoperatively and in one postoperatively, and feebly positive in two postoperatively. Posterior drawer test was positive in 11 knees preoperatively and feebly positive in 2 postoperatively. There were 2 knees with tolerable pain and 2 with knee flexion of 5°-20°. Conclusions： As for simultaneous reconstruction of ACL and PCL under arthroscopy, allogeneic bone-patellar tendon-bone can not only avoid injury and complication caused by autografting, but also help rehabilitation of the knee function.

Labeling of human insulin-like growth factor-I eukaryotic expression vector with green fluorescent protein

Objective: To label human insulin-like growth factor-I （hIGF-I） eukaryotic expression vector with green fluorescent protein （GFP） for the repair of articular cartilage defects. Methods: GFP cDNA was inserted into pcDNA3.1-hIGF-1 to construct the co-expression vector with two multiple cloning sites mammalian expression vector under two cytomegalovirus promoters/enhancers respectively. Recombinant pcGI was transfected into NIH 3T3 cells with the help of lipofectamine. Results: Enzyme digestion and agarose gel electrophoresis analysis revealed that pcGI vector contained correct GFP and hIGF-I cDNA. Expression of （hIGF-1） and GFP was confirmed in transfected NIH 3T3 cells by immunocytochemical analysis and fluorescence microscopy. Conclusions: hIGF-I eukaryotic expression vector has been successfully labeled with GFP.

Elbow dislocation with ipsilateral diaphyseal fractures of radius and ulna in an adult is it type 1 or type 2 Monteggia equivalent lesion？

Elbow dislocation with concomitant dia physeal fractures of radius and ulna has been reported rarely. This injury could be included in Monteggia equivalent le sions based on the mechanism of injury, radiographic pat tern and method of treatment as described by Bado. We report a rare case of Monteggia equivalent lesion in an adult with unclear mechanism of injury. The possible mechanismof injury, its management and the followup results were described. An attempt to solve the controversy regarding whether labeling it as type 1 or type 2 was made.