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长骨骨折支架骨外固定与第三种骨折愈合方式
1989年徐莘香[1]报道应用梯形钢板治疗长骨骨折的动物实验及临床应用研究中发现并提出第三种骨折愈合方式的新概念,认为这是一种优化的骨愈合方式,按此方式骨折修复为理想.我们自1993年10月~1996年10月应用于仲嘉式单侧多功能外固定支架治疗长骨骨折62例,从X线片及临床均发现这一现象,报告如下.
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神经生长因子在骨创伤愈合中的作用
骨创伤愈合是一个复杂的过程,受到多层面、多途径的调节,神经因素在骨折愈合过程中具有重要作用,近来发现正常骨组织和骨折骨痂中有神经生长因子及其受体的表达,局部给予外源性神经生长因子对骨折修复具有促进作用,具体机制不明.本文就神经生长因子在骨创伤愈合中的作用作一综述.
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近端髓内钉与锁定加压钢板治疗股骨反转子间的临床分析
目的:探讨近端髓内钉与锁定加压钢板治疗股骨反转子间骨折治疗中应用效果的观察。方法回顾我院在2010年07月至2013年10月收治的120例股骨反转子骨折患者,随机分为观察组组和对照组两组,每组60例。观察组采用近端髓内钉进行治疗,对照组则采用锁定加压钢板进行治疗。且分别对两组患者的术中失血量、手术时间、骨折愈合时间和髋关节功能进行回顾性分析。结果观察组(近端髓内钉)的术中失血量、手术时间、骨折愈合时间和髋关节功能等评价均优于对照组,且两组差异具有显著性,具有统计学意义,P<0.05。结论近端髓内钉治疗股骨反转子间骨折具有术中出血少、功能恢复快、提高患者的术后生活质量等优点,且可以取得显著的临床疗效的,值得临床推广应用。
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股骨干骨折和膝部损伤术后的康复
Background:Joint activity directly affect limbs function.Early continual passive motion(CPM) can improve fracture healing and regeneration and repair of intraarticular cartilage,effectively prevent joint adhesion and recover limbs function.
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小针刀加金葡液治疗老年退变性膝关节病的临床观察
1997年10月~1998年10月,我们应用小针刀加金葡液综合疗法治疗老年退变性膝关节病118个关节,同时设对照Ⅰ、Ⅱ组,分别为98、97个关节.疗程结束及半年后随访,结果显示小针刀加金葡液疗法的临床近、远期疗效均优于单纯小针刀治疗及小针刀加盐酸曲安缩松(康宁克通)悬浊液治疗.现将临床结果报道如下.
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成纤维细胞生长因子促进骨折愈合的作用及机制
FGF的生物学特性成纤维细胞生长因子(fibroblast growth factor,FGF)初从牛脑垂体提取液中分离获得,距今已有半个多世纪,但FGF与同源FGF特异结构与功能之间的相互作用直到近10~15年才被确认[1],不过FGF对中胚层细胞、神经外胚层细胞的促有丝分裂及促血管生成活性已经证实.
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外固定器刚度对骨折愈合的影响
骨折治疗中实施有效的骨折固定,以维持骨连续性,保证骨折愈合生物学反应,促进骨折愈合,避免骨迟延愈合、骨不愈合及再骨折等并发症的发生.合理的固定刚度相当重要,外固定器为骨折提供的固定刚度有别于其他固定方法,可以针对骨折的病理特点、治疗要求,在不同阶段,根据骨再生进程的生物学特征,实施坚强固定、加压固定、轴向弹性固定、综合弹性固定等与骨再生所需理想生物力学环境相符的适应性刚度,使骨折愈合的生物学过程按照骨胚胎原始发育方式完成骨再生与功能重建,直至实现正常骨力学强度.
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Objective: To evaluate the therapeutic effects of retrograde interlocking intramedullary nailing under arthroscopy on supracondylar femoral fractures. Methods: From June 1999 to December 2000, 17 patients with supracondylar femoral fracture were treated with arthroscopically assisted implantation of retrograde interlocking intramedullary nail and close reduction. Results: More than 6-month follow-up study after operation in 11 patients revealed that the average healing time was 3 months. Average range of the knee motion for all the patients was more than 90 degrees. There was no implant breakage and infection. Conclusions: This new method, combining the advantage of arthroscope and retrograde interlocking intramedullary nail, can provide a stable and reliable fixation, and meanwhile is less invasive to the soft tissue and knee, less operative time and blood loss, minimal disruption of the blood supply in fracture site. It is conducive to the fracture healing and the functional recovery of the knee joint and worthwhile to be recommended.
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The mechanical environment is known to influence fracture healing. We speculated that connexin43 (Cx43) gap junctions, which impact skeletal homeostasis, fracture healing and the osteogenic response to mechanical load, may play a role in mediating the response of the healing bone to mechanical strain. Here, we used an established rat fracture model, which uses a 2 mm osteotomy gap stabilized by an external fixator, to examine the impact of various cyclical axial loading protocols (2%, 10%, and 30%strain) on osteotomy healing. We examined the presence of Cx43 in the osteotomy-healing environment and assessed how mechanical strain modulates Cx43 expression patterns in the callus. We demonstrated that increased cyclical axial strain results in increased radiographic and histologic bone formation. In addition, we show by immunohistochemistry that Cx43 is abundantly expressed in the healing callus, with the expression most robust in samples exposed to increased cyclical axial strain. These data are consistent with the concept that an increase in Cx43 expression by mechanical load may be part of the mechanisms by which mechanical forces enhances fracture healing.