Background:Regional anaesthesia has been proposed to reduce intraoperative blood loss,duration of hospital stay and in-hospital complications with improved postoperative pain control.General anaesthesia is advantageou...Background:Regional anaesthesia has been proposed to reduce intraoperative blood loss,duration of hospital stay and in-hospital complications with improved postoperative pain control.General anaesthesia is advantageous for prolonged surgeries.We hypothesized that combined regional and general anaesthesia would offer advantages of both in pelvi-acetabular fracture surgeries.Methods:We identified 71 patients who underwent open reduction and internal fixation of pelvi-acetabular fractures from May 2012 to 2013 in our trauma centre.We excluded patients with incomplete records(n=4)and other injuries operated along(n=8).Hence,59 patients were divided into three groups:G group(general anaesthesia),R group(regional anaesthesia)and GR group(combined regional and general anaesthesia).Main outcome measurements studied were intraoperative blood loss,duration of hospital stay,duration of surgery and intraoperative and postoperative complications.Results:No differences were obtained in between the groups in terms of age,gender,Injury Severity Score,number of comorbidities,or duration from injury to surgery.No significant differences were found between the three groups for intraoperative blood loss,days of hospital stay and duration of surgery.Intraoperative and postoperative complications were also comparable between the groups(p>0.05).Conclusions:There is no specific significant advantage of the technique of anaesthesia on the observed perioperative complications in pelvi-acetabular fracture surgeries.展开更多
目的：探讨带翼加强杯在Ⅰ期全髋关节置换治疗髋臼骨折合并同侧股骨颈骨折中的应用。方法对12例合并同侧股骨颈骨折的髋臼骨折行Ⅰ期全髋关节置换术（total hip arthroplasty，THA）。伤后5~18 d 接受 THA，12例均采用带翼加强杯合并自...目的：探讨带翼加强杯在Ⅰ期全髋关节置换治疗髋臼骨折合并同侧股骨颈骨折中的应用。方法对12例合并同侧股骨颈骨折的髋臼骨折行Ⅰ期全髋关节置换术（total hip arthroplasty，THA）。伤后5~18 d 接受 THA，12例均采用带翼加强杯合并自体植骨行髋臼侧固定，股骨侧均采用生物型固定。根据 Harris 评分和 X 线片对其临床效果进行评估。结果12例患者均得到随访，平均随访时间3年9个月（2年1个月~5年7个月）。2例出现异位骨化，无脱位，未见假体移位及透亮带，无再翻修病例。术后 Harris 评分平均90分，较术前平均改善51分。所有随访患者髋关节功能均有明显改善，随访期内未发现假体松动。结论应用带翼加强杯行Ⅰ期全髋关节置换术是治疗髋臼骨折合并同侧股骨颈骨折的有效方法，这种方法强调髋臼重建结构的稳定性，避免了切开复位内固定引起的股骨头坏死等严重髋关节并发症，能显著改善关节功能，避免多次手术，减少患者的精神和经济负担。展开更多
We describe a case of pelvic narrowing in a patient with osteogenesis imperfecta (OI) type III and complications consisting of deep venous thrombosis, hydronephrosis and faeculomas. The literature is reviewed and the ...We describe a case of pelvic narrowing in a patient with osteogenesis imperfecta (OI) type III and complications consisting of deep venous thrombosis, hydronephrosis and faeculomas. The literature is reviewed and the management is discussed. Conclusion: Monitoring of OI type III patients for pelvic narrowing and complications is recommended.展开更多
目的总结以相关解剖学标志指导全髋关节置换术中髋臼假体精准置入的研究进展。方法在中国知网、万方数据、PubMed等中、英文数据库,以“解剖学标志”“全髋关节置换”“髋臼假体置入”以及“anatomical mark”“total hip arthroplasty...目的总结以相关解剖学标志指导全髋关节置换术中髋臼假体精准置入的研究进展。方法在中国知网、万方数据、PubMed等中、英文数据库,以“解剖学标志”“全髋关节置换”“髋臼假体置入”以及“anatomical mark”“total hip arthroplasty”“acetabular prothesis implant”等为关键词,检索1999年1月—2019年9月有关骨盆及相关解剖标志指导全髋关节置换的相关文献,共检索到9881篇文献,排除内容不相符、无法获取全文、质量较低、证据等级不高、重复研究的文献,最终纳入文献43篇,对其进行总结、分析。结果全髋关节置换术中常见的指导髋臼假体置入的解剖学标志包括髋臼横韧带、卵圆窝及髋臼切迹、骨盆参考平面、髋臼切迹角、“通道线”以及髋臼外展角顶区等,通过识别、参照以上解剖学标志,有助于精准置入髋臼假体。骨盆参考平面、髋臼切迹角相对抽象,髋臼横韧带、“通道线”以及髋臼外展角顶区适用于髋臼解剖相对正常的患者,卵圆窝及髋臼切迹指导髋臼假体精准置入的方法有待进一步深入研究。数字化科技的发展有利于进一步提高髋臼假体置入的精准性。结论全髋关节置换术中根据患者髋臼的解剖形态特点,正确认识、选择和参照合适的骨盆及相关解剖学标志,结合数字骨科技术,有利于实现髋臼假体个性化的精准置入,减少术后并发症,促进患者快速康复。展开更多
文摘Background:Regional anaesthesia has been proposed to reduce intraoperative blood loss,duration of hospital stay and in-hospital complications with improved postoperative pain control.General anaesthesia is advantageous for prolonged surgeries.We hypothesized that combined regional and general anaesthesia would offer advantages of both in pelvi-acetabular fracture surgeries.Methods:We identified 71 patients who underwent open reduction and internal fixation of pelvi-acetabular fractures from May 2012 to 2013 in our trauma centre.We excluded patients with incomplete records(n=4)and other injuries operated along(n=8).Hence,59 patients were divided into three groups:G group(general anaesthesia),R group(regional anaesthesia)and GR group(combined regional and general anaesthesia).Main outcome measurements studied were intraoperative blood loss,duration of hospital stay,duration of surgery and intraoperative and postoperative complications.Results:No differences were obtained in between the groups in terms of age,gender,Injury Severity Score,number of comorbidities,or duration from injury to surgery.No significant differences were found between the three groups for intraoperative blood loss,days of hospital stay and duration of surgery.Intraoperative and postoperative complications were also comparable between the groups(p>0.05).Conclusions:There is no specific significant advantage of the technique of anaesthesia on the observed perioperative complications in pelvi-acetabular fracture surgeries.
文摘目的：探讨带翼加强杯在Ⅰ期全髋关节置换治疗髋臼骨折合并同侧股骨颈骨折中的应用。方法对12例合并同侧股骨颈骨折的髋臼骨折行Ⅰ期全髋关节置换术（total hip arthroplasty，THA）。伤后5~18 d 接受 THA，12例均采用带翼加强杯合并自体植骨行髋臼侧固定，股骨侧均采用生物型固定。根据 Harris 评分和 X 线片对其临床效果进行评估。结果12例患者均得到随访，平均随访时间3年9个月（2年1个月~5年7个月）。2例出现异位骨化，无脱位，未见假体移位及透亮带，无再翻修病例。术后 Harris 评分平均90分，较术前平均改善51分。所有随访患者髋关节功能均有明显改善，随访期内未发现假体松动。结论应用带翼加强杯行Ⅰ期全髋关节置换术是治疗髋臼骨折合并同侧股骨颈骨折的有效方法，这种方法强调髋臼重建结构的稳定性，避免了切开复位内固定引起的股骨头坏死等严重髋关节并发症，能显著改善关节功能，避免多次手术，减少患者的精神和经济负担。
文摘We describe a case of pelvic narrowing in a patient with osteogenesis imperfecta (OI) type III and complications consisting of deep venous thrombosis, hydronephrosis and faeculomas. The literature is reviewed and the management is discussed. Conclusion: Monitoring of OI type III patients for pelvic narrowing and complications is recommended.
