简介：Objective:ToinvestigatethediagnosticvalueofmultidetectorspiralCT(MSCT)inacutethoracolumbarspinalfractureandfracture-dislocation.Methods:CTimagingfilesof152consecutivetraumaticpatientswiththoracolumbarfractureswereretrospectivelyreviewed.MSCTscanningswereperformedwithacollimationof3-5mmandapitchof5.5.Thepostprocessingincludedsagittalandcoronalmultiplannarreconstruction,and3-Dreconstruction.Result:Therewere88casesofcompressionfracture,54casesofburstfractureand10casesoffracasdislocation.TransverseimagesofMSCTcouldvisualizeallfracturesdirectlyanddeterminewhetherspinalcanalwasintact.Postprocessingimagewashelpfulindepictingthedisplacementoffragmentandorientationofdislocation.Conclusions:MSCTplaysanimportantroleindiagnosisandmanagementofacutethoracolumbarspinalfractureandfracture-dislocation.

简介：与ipsilateral联系的臀部的创伤的以后的脱臼代替了大腿骨的颈骨折是稀罕损害。而且，如此的病人的管理唤起考虑主要代替或保存大腿骨的头的强壮的看法。我们与如此的损害介绍了年轻成年人的一个盒子。他被操作在之上与大腿骨的颈的脱臼和固定的减小，在cancellous的帮助下的骨折拧紧。二年以后，破裂联合起来，病人是无征状的。我们进一步为如此的破裂建议了损害的机制并且在发展中的世界的变化损伤情形讨论了管理。

简介：手掌的perilunate破裂脱臼是极其稀罕的腕骨损害，但是与ipsilateral索引和中指的metacarpophalangeal关节脱臼联系从来没被报导过。我们报导跟随一处高精力的损伤的一个28岁的人的一个案例。在执行metacarpophalangeal关节损害的关上的减小以后，通过手掌的途径的手腕损害的开的减小被做，并且K电线固定被用来稳定舟骨破裂和lunotriquetral关节。在16月的后续时期以后，没有症状，手腕重获全套运动，并且折断的骨头在一个好位置被加强。

简介：AbstractPurpose:Posterior fracture-dislocation of shoulder is an infrequent traumatic event; however, most orthopaedic surgeons may face the challenge of treating it. The aim of this study is to review and summarise systematically the current principles of the management of this complex injury, and create a treatment algorithm.Methods:Both PubMed and Scopus Databases were systematically searched for the terms "posterior shoulder fracture-dislocation" or "posterior glenohumeral fracture-dislocation" or "posterior glenoid fracture-dislocation" for articles written in English and published in the last decade.Results:A total of 900 articles were identified, of which 13 were retained for analysis. A total of 153 patients (161 shoulders) were identified. These patients were treated either with open reduction and internal fixation, modified McLaughlin procedure, allograft/autograft humeral head reconstruction or shoulder arthroplasty. The mean age was 40.15 years. The mean postoperative Constant score in cases treated by open reduction and internal fixation was 86.45, whereas by bone graft was 84.18. Further, the mean postoperative Constant score was between 79.6 and 67.1 in those that were managed by modified McLaughlin and arthroplasty procedure, respectively.Conclusion:The management of posterior shoulder fracture-dislocation may be challenging, and the best surgical option depends on many variables such as the chronicity of the injury, the presence of a fracture at the level of the surgical neck or tuberosities and the extend of the Hill-Sachs lesion if any. A treatment algorithm is proposed, based on the current literature in an effort to create a consensus for these injuries. For the acute shoulder fracture-dislocations, an open reduction should be performed. For the chronic fracture/dislocations in the elderly low-demand patients, conservative treatment should be performed. For the rest of the patients, depending on the severity of the Hill-Sachs lesion different surgical options are available such as the McLaughlin technique, the use of an allograft, osteotomy or arthroplasty.

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简介：AbstractSchatzkter type-I tibial plateau fracture is a split fracture of the lateral tibial plateau in sagittal plane, consequent to valgus impaction caused by low velocity of trauma. However, a deep understanding of the different columns of the tibial plateau and patho-mechanisms of the injury led to the unmasking of atypical fractures around the tibial plateau. We have encountered 2 cases with unusual fracture pattern of the lateral tibial condyle caused by road traffic accidents. The fracture pattern and severity of injury deviate from the original description of Schatzker type 1; in view of dual plane split, there is rotation of the posterolateral column fragment along its sagittal plane plus grade-III medial collateral ligament injury. The patients were initially treated with knee spanning external fixator and after a latency of 5 days, definitive fracture specific fixation was done, combined with repair of grade-III medial collateral ligament injury. At the 6 months follow-up both the patients achieved satisfactory knee functions (knee society score case 1:100 and case 2: 92) and returned to their jobs. The severity of fracture pattern and displacement as described should prompt for examination of associated ligament injury. Because of timely diagnosis, early and appropriate care promised an excellent function outcome even in such a severe nature of knee injury. To prompt the description of injury pattern we coined the name "dual split and dislocation" of lateral tibial plateau, as a complex injury variant of split fracture of lateral tibial plateau fracture.

简介：AbstractWe reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse racing. We examined the injury mechanism based upon the patients’ diagnostic images and video footage of races, in which the accidents occurred. Admission imaging of patient 1 (a 42 years old male) revealed T5 burst fracture with bony retropulsion of 7 mm causing complete paralysis below T5/6. There existed 22° focal kyphosis at T5/6, anterolisthesis of T5 relative to T6, T5/6 disc herniation, cord edema and epidural hemorrhage from T4 through T6, and cord injury from C3 through C6. Admission imaging of patient 2 (a 23 years old male) revealed T4/5 fracture/dislocation causing incomplete paralysis below spinal level. There existed compression fractures at T5, T6, and T7; 4 mm anterior subluxation of T4 on T5; diffuse cord swelling from T3 through T5; comminuted fracture of the C1 right lateral mass; right frontal traumatic subarachnoid hemorrhage; and extensive diffuse axonal injury. The injuries were caused by high energy flexion-compression of the mid-thoracic spine with a flexed posture upon impact. Our results suggest that substantially greater cord compression occurred transiently during trauma as compared to that documented from admission imaging. Video footage of the accidents indicated that the spine buckled and failed due to abrupt pocketing and deceleration of the head, neck and shoulders upon impact with the ground combined with continued forward and downward momentum of the torso and lower extremities. While a similar mechanism is well known to cause fracture/dislocation of the cervical spine, it is less common and less understood for mid-thoracic spine injuries. Our study provides insight into the etiology of fracture/dislocation patterns of the mid-thoracic spine due to falls during horse racing.

简介：手由五籽骨组成。他们中的二个在metacarpophalangeal(MCP)是在场的姆指的关节。姆指的籽骨骨头的骨折是稀罕损害，光线的方面上的文学很少被报导。我们在姆指的MCP关节与光线的籽骨的破裂报导了一个病人的一个案例以便关于这类损害增加注意。一个44岁的男、高级体操的训练员，当他向右姆指的MCP关节汇报了一处伸直过度损伤时，在锻练期间正在帮助他的运动员之一。在损伤以后的一个星期，他介绍了给在它的手掌的方面上在MCP联合水平抱怨痛苦的姆指的手外科医生。标准A-P和侧面的X光揭示了光线的籽骨的破裂，破裂与一根藤条被对待3个星期。他对有能力6个星期在损害以后恢复了他的全部工作。籽骨破裂伸直过度损害并且有时的大小的指示物与MCP关节的手掌的板系带的眼泪被联系。并且认出系带损害的失败可以在拧上导致长期的伸直过度不稳定性。

简介：Weinvestigatetheelasticfieldinducedbyanedgedislocationinamultilayeredlaminatedcompositecomposedof(N—2)thinbondedelasticlayerssandwichedbetweentwosemi-infiniteelasticmedia.Asimpleclosed-formsolutionisobtainedwhenallthephaseshaveequalshearmodulusbutdifferentPoisson'sratios,andwhenthedislocationislocatedintheuppersemi-infinitephase.Theimageforceactingonthedislocationduetoitsinteractionwiththemultilayeredstructureisalsoderived.Severalspec...

简介：与ipsilateral联系的Hoffa骨折大腿骨的柄骨折是很稀罕的。损害的这种稀罕类型的三个盒子回顾地被考察。大腿骨的柄破裂和Hoffa破裂的地点被记录。所有大腿骨的柄破裂与内部固定被管理。为Hoffa破裂的错误诊断的率被记录。影响的膝的功能在二年后续为特殊外科(HSS)分数根据修改医院被评估。大腿骨的破裂在所有三个盒子中横向或合成。IpsilateralHoffa破裂在一种情况中在二种情况，和侧面的髁中发生在中间的髁。一仅仅Hoffa破裂外科手术前地被识别。所有大腿骨的柄破裂太平无事地愈合了。在其Hoffa骨折正确地被诊断的病人，修改HSS分数是94。在另一个病人，其Hoffa断裂，被第二个手术对待，修改HSS分数是93。并且在第三个盒子中，为Hoffa破裂拒绝了另外的操作，修改HSS分数仅仅是70。决定性地大腿骨的柄骨折能与ipsilateralHoffa骨折被联系，特别在摩托车事故。这类损害是很稀罕的，错误诊断是普通的。

简介：一条一般热力学的变化途径被使用在边脱臼上学习力量，它驱使脱臼爬。我们的注意集中于为脱臼负责的物理机制爬。在一个材料元素的脱臼由于空缺从脱臼核心扩散进或外面爬，与充当为在材料元素的空缺散开的来源或一个水池的脱臼。为脱臼的基本管理方程爬并且脱臼上的climb力量由于现在的热力学的变化途径自然地被获得。

简介：Poles-apartdislocationhasbeentakingplaceinthecognitionofChina-EUrelationsandcausingvaryingjudgmentsontheorientationofthisrelationshipinbothChinaandEurope.OneviewbelievesthattheoverallstrategiccooperativepartnershipbetweenChinaandtheEuropeanUnionremains

简介：Inthispaper,anonlocaltheoryoffractureforbrittlematerialshasbeensystematicallydevel-oped,whichiscomposedofthenonlocalelasticstressfieldsofGriffithcracksofmode-Ⅰ,ⅡandⅢ,theasymptoticformsofthestressfieldsattheneighborhoodofthecracktips,andthemaximumtensilestresscriterionforbrittlefracture.Asanapplicationofthetheory,thefracturecriteriaofcracksofmode-Ⅰ,Ⅱ,ⅢandmixedmodeⅠ-Ⅱ,Ⅰ-Ⅲaregivenindetailandcomparedwithsomeexperimentaldataandthetheoreticalresultsofminimumstrainenergydensityfactor.

简介：目的将由解剖学习和临床的申请探索paraspinal途径的优点和指示。解剖数据和27个盒子的临床的实践被分析探索在paraspinal肌肉和周围的纸巾的结构之间的精确途径的方法，以及paraspinal的临床的申请的结果来临。操作时间，血损失，切口长度，X光线照相术的结果(Cobb角度，vertebrae的前面的边的高度)与在传统的途径对待的24种情况中的那些相比。结果完成方面的暴露能被识别在multifidus和longissimus肌肉之间的自然劈开飞机容易执行。自然肌肉发达的劈开是(1.47

简介：Objective:Tointroducetheexperienceoftreatingfractureofbothtibiaandfibulawithmicro-invasivepercutaneousplateinternalfixationthroughfracturesiteapproach.Methods:Thedataof15patients(11malesand4females),including14adults(aged22-73years,mean=40years)and1child(aged10years),withfractureofbothtibiaandfibulawerestudiedretrospectivelyinthisstudy.Asmallincisionwasmadeatthefracturesiteoftibia.Thenrepositionwasmadeunderdirectvision,andinternalfixationwasemployedwithsteelplatesinsertingthroughthesmallincision.Results:Anatomicalreductionwasobtained.Nocomplicationwasfound.Unionoccurredontimein14patients.Onecasehealedafterasecondoperation.Conclusions:Micro-invasivepercutaneousplateinternalfixationisbeneficialtothehealingofboneandsofttissues.WithoutX-rayexamination,itisalsoeasytoreachanatomicalreductionandmaketibialinternalfixationwithbothplateswithmicro-invasivepercutaneousplateinternalfixation.

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简介：AZener-Strohcrackinteractingwithanedgedislocationisstudied.Thecrackfacesareassumedtobetractionfree.Theapplied'generalizedloading'forcrackistheinitialdisplacementjumpandtheinterventionoftheedgedislocation.Throughdecomposingtheproblemintotwosubsimpleproblems,usingthesuperpositionprinciple,itssolutionisobtained.Todemonstrateboththevalidityofthesolutionanditspotentialapplication,twosimpleexamplesrelatedtothecrackstressintensityfactorsarepre...

简介：Inthispaper,theelasticfieldoftheinfinitehomogeneousmediumwithtwocircularcylindricalinclusionsundertheactionofascrewdislocationisin-vestigatedandthecorrespondinganalyticalsolutionisobtained.Here,theconformalmappingandthetheoremofanalyticalcontinuationareused.Fromtheresultsob-tained,itcanbeseenthattheelasticfielddependsontheshearmoduliofindividualphases,thegeometricparametersofthesystem,andthepositionandrelativeslipofthescrewdislocation.Inaddition,thecorrespondingspecificcasesarealsoconsid-eredinthispaperwhentwocircularcylindricalinclusionsaretangenttoeachotherandtheyareholesand/orrigidinclusions.Finally,numericalresultsareillustratedtoshowtheinteractionbetweenthescrewdislocationandtwocircularcylindricalinclusions.

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简介：Objective:Toexploretheinjurymechanismandtreatmentprincipleofopensupracondylarfractureofhumerus.Methods:Thedataof32patientswithopensupracondylarfractureofhumerushospitalizedinourdepartmentintherecent20yearswereanalyzedretrospectively.Onanaverage,theywerefollowedupfor30months.Therelationshipbetweenthefracturetype,situationofwounds,operatingtime,operatingmethodandtimeforpostoperativefunctionalexerciseandfinalfunctionofelbowjointwereevaluatedwithFlynnscoringstandard.Results:Excellenttherapeuticeffectwasfoundin14cases,goodin12andbadin6,withthepercentageoffinetherapeuticeffectof81.25%.Conclusions:Forthepatientswithopensupracondylarfractureofhumerus,debridementandinternalfixationshouldbemadeasearlyaspossible,forthoroughdebridementandcorrectinternalfixationarethekeypointstoimprovetheprognosis.