Duan Z_2009_J Orthop Res

塌陷型胫骨平台骨折的填塞植骨治疗进展江亚;卞育俊;段延明【摘要】@@ 胫骨平台骨折是膝关节创伤中最常见的关节内骨折之一,目前常用的分型是Schatzker分类:外侧平台劈裂,无关节面塌陷;②外侧平台劈裂压缩骨折;③外侧平台单独压缩;④内侧平台骨折;⑤平台骨折伴不同程度关节面塌陷和髁的移位;⑥平台骨折伴干骺分离.常伴有内外侧半月板前后交叉韧带及侧副韧带损伤,处理不当都可能造成膝关节畸形、力线或稳定问题,导致关节功能的障碍.对于SchatzkerⅢ-Ⅵ型骨折,骨折移位明显,关节面破坏严重,常合并较重软组织损伤,半月板、交叉韧带、侧副韧带的损伤是复杂的胫骨平台骨折.【期刊名称】《河北医学》【年(卷),期】2011(017)006【总页数】3页(P818-820)【关键词】塌陷型胫骨平台骨折;填塞;植骨【作者】江亚;卞育俊;段延明【作者单位】安徽省合肥市第三人民医院骨科,安徽,合肥,230022;安徽省合肥市第三人民医院骨科,安徽,合肥,230022;安徽省合肥市第三人民医院骨科,安徽,合肥,230022【正文语种】中文胫骨平台骨折是膝关节创伤中最常见的关节内骨折之一，目前常用的分型是Schatzker分类:①外侧平台劈裂，无关节面塌陷;②外侧平台劈裂压缩骨折;③外侧平台单独压缩;④内侧平台骨折;⑤平台骨折伴不同程度关节面塌陷和髁的移位;⑥平台骨折伴干骺分离。

常伴有内外侧半月板前后交叉韧带及侧副韧带损伤，处理不当都可能造成膝关节畸形、力线或稳定问题，导致关节功能的障碍。

对于SchatzkerⅢ－VI型骨折，骨折移位明显，关节面破坏严重，常合并较重软组织损伤，半月板、交叉韧带、侧副韧带的损伤是复杂的胫骨平台骨折。

目前对胫骨平台骨折的治疗多以良好的固定维持助于解剖复位，辅以良好的固定保障及完整的关节软骨面及关节附属结构满足功能恢复需要，其中正确有效的内固定是解剖复位和功能恢复的关键。

对于塌陷型胫骨平台骨折，牵引、外固定、单纯关节镜下手术，均难以达到关节面复位和受损韧带修复，易形成较严重的创伤性关节炎、关节不稳定等并发症，需行开放性手术治疗，根据不同的分型采用不同的固定方式，通过切开复位尽可能精确的关节面复位。

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老年股骨转子间不稳定性骨折3种手术固定方法的疗效比较黄文显;刘颗星;胡建辉;邓颂波;曾日祥;李干【摘要】目的比较应用InterTAN、股骨近端防旋髓内钉(PFNA)、Gamma钉3种固定方法治疗老年股骨转子间不稳定骨折的疗效差异.方法回顾性分析南方医科大学珠江医院2007年3月至2017年3月收治的194例老年股骨转子间不稳定骨折患者的临床资料,其中64例行InterTAN内固定(InterTAN组)、64例行PFNA内固定(PFNA组)、66例行Gamma钉内固定(Gamma钉组),对3组手术时间、术中出血量、骨折愈合时间、术后并发症、Harris髋关节评分进行比较.结果 InterTAN组术中出血量明显低于PFNA组和Gamma钉组,差异有统计学意义(P<0.05);3组骨折愈合时间、术后髋关节Harris评分优良率,差异无统计学意义;InterTAN组并发症发生率最低,但3组比较差异不明显(P>0.05).结论InterTAN、PFNA和Gamma钉3种内固定方式治疗老年股骨转子间不稳定骨折均可获得良好的治疗效果,但InterTAN创伤更小,与传统PFNA和Gamma钉比较似乎更具优势.【期刊名称】《中国骨科临床与基础研究杂志》【年(卷),期】2018(010)003【总页数】5页(P152-156)【关键词】股骨转子间骨折;不稳定骨折;骨折固定术,髓内;骨板;骨钉;手术后并发症;老年人【作者】黄文显;刘颗星;胡建辉;邓颂波;曾日祥;李干【作者单位】516300 广东,惠东县人民医院骨科;516300 广东,惠东县人民医院骨科;516300 广东,惠东县人民医院骨科;516300 广东,惠东县人民医院骨科;516300 广东,惠东县人民医院骨科;510282 广州,南方医科大学珠江医院关节骨病外科【正文语种】中文【中图分类】R683.421;R687.33老年股骨转子间骨折发病率近年来有上升趋势。

（收稿 ：２０１０—０６—２８ 编辑 ：李强 ）
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应 用 地 塞 米 松 导 致 频 繁 呃 逆 患 者 ２５ 服 胃复安 １０ ｍｇ，每 天 ３次 ，同 时加 服 收缩力。（３）使 胃酸、胃蛋白酶分泌增加 ，
例 ，现总结报告如下 。
雷尼 替 丁胶 囊 ０．１５ ｇ，每 天 ２次 ．硫 糖 抑制 胃黏液分泌 ．降低 胃肠 黏膜 的抵抗
１ 临 床 资 料
铝片 １ ｇ，每天 ３次 ，１—２ ｄ后呃逆 消 力 ［２］，进而 刺激 胃肠 道 的迷 走神 经 ，反
１．１ 一 般资料 ２５例 均为 门诊患 者 。 失 ：４例患者 Ｉ＝Ｉ服效 果不佳 ．加用氯 丙 射性 引起膈 肌 收缩 。地塞 米松作 用广
６ 参 考 文 献 ［１］ Ｂｕｔｌｅｒ Ｄ．Ｔｒａｎｓｌａｔｉｏｎａｌ ｒｅｓｅａｒｃｈ：ｃｒｏｓｓｉｎｇ ｔｈｅ ｖａｌｌｅｙ ｏｆ ｄｅａｔｈ［Ｊ］．Ｎａｔｕｒｅ，２００８，４５３（７１９７）：８４０—８０２． ［２］ Ｍａｒｉｎｃｏｌａ ＦＭ．ＴｒａｎｓｌａｔｉｏｎａｌＭｅｄｉｃｉｎｅ：Ａｔｗｏ．ｗａｙ ｒｏａｄ［Ｊ］．ＪＴｒａｎｓｌＭｅｄ，２００３，１（１）：１． ［３］ Ｃｒｏｗｌｅｙ Ｗ ＦＪｒ， Ｓｈｅｒｗｏｏｄ Ｌ， Ｓａｌｂｅｒ Ｐ， ｅｔ ａ１． Ｃｌｉｎｉｃａｌ ｒｅｓｅａｒｃｈ ｉｎ ｔｈｅ Ｕｎｉｔｅｄ Ｓｔａｔｅｓ ａｔ ａ Ｃ／ＯＳＳｒｏａｄｓ： ｐｒｏｐｏｓａ ｌ ｆｏｒ ａ ｎｏｖｅｌ ｐｕｂｌｉｃ—ｐｒｉｖａｔｅ