骨关节植入物图片文章

骨关节植入物图片文章的相关文献在2013年到2013年内共计59篇,主要集中在基础医学 等领域,其中期刊论文59篇、专利文献982228篇; 骨关节植入物图片文章的相关文献由134位作者贡献,包括夏睿、孙鸿涛、李贵涛等。

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骨关节植入物图片文章

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  • 夏睿
  • 孙鸿涛
  • 李贵涛
  • 杨波
  • 陈为坚
  • 靳安民
  • 李赟罡
  • 万盛钰
  • 万磊
  • 于博
  • 期刊论文
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    • 李广伟
    • 摘要: BACKGROUND: Applying artificial hip joint replacement for the treatment of end-stage hip disease is difficult and involves multi-aspects, including the surgical approach, intraoperative osteotomy, prosthesis implantation and selection of type, There are a lot of controversies due to different scholarly opinions. OBJECTIVE: To explore the methods and clinical effects of the artificial hip joint replacement in the treatment of end-stage hip disease. METHODS: Retrospective analysis of 52 patients (57 hips) receiving artificial hip joint replacement was performed based on a long-term fol ow-up. The fol ow-up time was 14-86 months, 27 months in average. The preoperative and postoperative (last fol ow-up) visual analogue scale score and Harris hip score were recorded, analyzed and compared, and the results were statistical y analyzed. RESULTS AND CONCLUSION: The visual analogue scale score in 52 patients was decreased from preoperative (7.0±1.2) points to postoperative (2.0±0.7) points. Harris score was increased from preoperative (35.9±5.4) points to the last fol ow-up (89.7±3.1) points. The difference was statistical y significant when compared with that before operation (P < 0.05). Al the 52 patients after surgery could walk with crutches or walker ambulation, and al of them could be able to walk independently and take self-care after 3 months. X-ray assessment showed no loosening of the prosthesis, and achieved satisfactory results. Careful preoperative preparation and scientific and rigorous operation can prevent the hip prosthesis loosening, infection and pain after operation. Rehabilitation exercise after surgery is an important measure to reduce the postoperative pain and recover the function to the maximum extent.%  背景:终末期髋关节疾病施行人工全髋关节置换难度大,涉及面多,包括置换入路、置换中截骨、假体的植入、类型的选择等,专家学者各不相同,意见不统一,争议较多。  目的:探讨人工全髋关节置换治疗终末期髋关节疾病的方法及临床效果。  方法:回顾性分析52例(57髋)人工髋关节置换患者,进行长期随访,随访时间14-86个月,平均随访时间为27个月。随访并记录置换前后(末次随访时)的目测类比评分、Harris 评分,分析比较置换前后评分并对结果进行统计学分析。  结果与结论:52例患者中目测类比评分由置换前的(7.0±1.2)分降至置换后的(2.0±0.7)分,Harris 评分从置换前的(35.9±5.4)分增加到末次随访的(89.7±3.1)分,与置换前相比差异有显著性意义(P <0.05)。52例患者置换后均可扶拐或助行器下地行走,3个月后能独立行走,生活自理,X 射线评估无假体松动,治疗效果满意。说明精心的置换前准备、科学严谨的操作技术可预防髋部假体松动、感染、疼痛等并发症,置换后科学正确的康复锻炼是减少置换后疼痛、功能最大程度恢复的重要措施。
    • 黄若昆; 谢鸣; 余嘉; 任义军; 勘武生; 黄雯洁
    • 摘要: 背景:髋部骨折的病情较复杂,临床医师选择适当治疗方案和手术入路的主要依据来源于影像学检查,常难以准确判断空间立体关系。n  目的:探讨基于64排螺旋 CT 扫描数据对髋部骨折进行虚拟手术设计的可行性和临床应用价值。n  方法:将髋部骨折患者.dicom 格式 CT 数据导入 Mimics 软件,进行图像分割,建立骨折三维模型并进行虚拟复位,将.stl 格式复位模型导入 Imageware12.0,根据钢板放置位置选择合适长度钢板,螺钉固定。并快速成型形成实体与导航模板。n  结果与结论:重建三维可视模型可准确反映出骨折特点、骨折移位方向和程度,并可进行任意旋转观察,实现了内固定手术模拟。可见术前应用计算机辅助虚拟现实手术设计可以制定合理的个体化手术方案,有很好的临床应用价值。%BACKGROUND: The hip fractures are difficult to treat because of its complexity. Clinicians select appropriate treatment options and surgical approaches according to imaging studies, which are difficult to accurately determine the spatial three-dimensional relationship. n OBJECTIVE: To study the feasible and clinical value of computer-assisted preoperative design for hip fractures based on 64-slice spiral CT scanning data. n METHODS: CT data in .dicom format from the patients with hip fractures were imported into Mimics. In segmentation process, the three-dimensional model of fracture was built to perform simulated reduction. The reduced model in .stl format was transferred into Imageware 12.0 to determine an appropriate dynamic hip screw in a suitable place and fixed with screw. And then using rapid prototyping, the entity and navigation template were formed. n RESULTS AND CONCLUSION: The three-dimensional reconstructed visualization model could reflect the features of fractures, and the direction and degree of fracture displacement. And the fracture models could be rotated in any direction and space for observation which could simulate the internal fixation surgery. Preoperative computer-assisted virtual reality surgery can help to make a reasonable individualized surgical option, which has good clinical value.
    • 金文杰; 沈康平; 陶海荣; 吴玉杰; 朱超; 刘兴振
    • 摘要: 背景:脊椎后路植骨融合是常见的脊椎术式,人工骨可以很好地辅助植骨融合,但是由于软组织可能对人工骨存在一定的反应,人工骨目前很少应用于脊椎后路植骨中。目的:拟通过兔的脊椎后路植骨实验,探讨如何降低脊椎手术中软组织对人工骨反应。方法:36只成年公兔随机分为可吸收止血纱布组和对照组,于L2-3去皮质的椎板表面上,植入β-磷酸三钙人工骨,以可吸收止血纱布隔离背侧软组织为可吸收止血纱布组,无隔离物为对照组。检测植骨后不同时间点,兔血液中的C-反应蛋白表达,记录植骨后1周和12周皮肤愈合和皮下组织愈合情况以及局部炎症反应,CT检查记录植骨后不同时间点的人工骨爬行替代情况。结果与结论:1周时,可吸收止血纱布组所有兔的背侧筋膜愈合完整;对照组9只中7只筋膜愈合完整,2只背侧筋膜愈合欠佳。12周时,可吸收止血纱布组9只中8只背侧筋膜愈合良好,1只愈合欠佳;对照组9只中6只愈合良好,2只愈合欠佳,1只轻度感染。1周时两组肌肉组织都存在一定充血,部分炎性细胞浸润,可吸收止血纱布组炎性细胞浸润较少,局部充血相对较少。12周时两组肌肉组织都存在一定的肉芽组织增生,可吸收止血纱布组炎性细胞浸润略少,对照组部分动物可见较明显的坏死组织。植骨后即刻,植骨后1周,4周时血液中的C-反应蛋白表达在两组间差异无显著性意义。植骨后12周时,CT检查显示靠近骨面的人工骨吸收明显,靠近软组织的人工骨无明显吸收,人工骨吸收情况在两组间无明显区别。结果提示,人工骨放置应尽量与植骨面多接触,这可促进人工骨尽早吸收,并降低软组织反应。减少人工骨和软组织接触,可以降低软组织对人工骨的反应。可吸收止血纱布的早期生物隔离和组织修复作用能一定程度减少组织对人工骨的反应。
    • 李广伟
    • 摘要: 背景:终末期髋关节疾病施行人工全髋关节置换难度大,涉及面多,包括置换入路、置换中截骨、假体的植入、类型的选择等,专家学者各不相同,意见不统一,争议较多。目的:探讨人工全髋关节置换治疗终末期髋关节疾病的方法及临床效果。方法:回顾性分析52例(57髋)人工髋关节置换患者,进行长期随访,随访时间14-86个月,平均随访时间为27个月。随访并记录置换前后(末次随访时)的目测类比评分、Harris评分,分析比较置换前后评分并对结果进行统计学分析。结果与结论:52例患者中目测类比评分由置换前的(7.0±1.2)分降至置换后的(2.0±0.7)分,Harris评分从置换前的(35.9±5.4)分增加到末次随访的(89.7±3.1)分,与置换前相比差异有显著性意义(P 〈 0.05)。52例患者置换后均可扶拐或助行器下地行走,3个月后能独立行走,生活自理,X射线评估无假体松动,治疗效果满意。说明精心的置换前准备、科学严谨的操作技术可预防髋部假体松动、感染、疼痛等并发症,置换后科学正确的康复锻炼是减少置换后疼痛、功能最大程度恢复的重要措施。
    • 戴胡明; 方诗元; 夏睿; 王叙进; 孙建皖; 徐磊
    • 摘要: 背景:胸腰椎骨折治疗上多采用椎弓根螺钉棒系统固定,传统后正中入路广泛剥离椎旁肌,部分患者在治疗后出现腰背疼痛。目的:观察经椎旁肌间隙入路与传统入路治疗胸腰段骨折的疗效及对多裂肌影响。方法:选择安徽医科大学附属省立医院骨科2010年6月至2012年6月收治的45例胸腰段骨折患者,依据Denis骨折分型,压缩型骨折11例,爆裂型骨折34例,并且椎管占位小于1/3,后柱均完整,ASIA分级均为E级,无神经症状。随机分为椎旁肌间隙入路21例和传统正中入路24例,比较两组患者围手术期参数及影像学指标,治疗后进行目测类比评分系统评分以及6个月随访腰背痛日本骨科协会(JOA)评分,比较两组治疗前及治疗后1,3,5 d肌酸激酶水平,随访时行多裂肌肌内静息肌电图评估。结果与结论:治疗后两组在Cobb角恢复上差异无显著性意义,椎旁肌间隙入路组手术时间、术中出血量、术后引流量、肌酸激酶水平及术后目测类比评分低于传统正中入路组,两组比较差异有显著性意义(P 〈 0.05)6个月随访腰背痛JOA评分椎旁肌间隙入路组低于传统正中入路组,但差异无显著性意义(P 〉 0.05)。6个月随访行多裂肌肌电图检查,椎旁肌间隙入路组出现失神经纤颤电位少于传统正中入路组,差异有显著性意义(P 〈 0.05)。结果可见经椎旁肌间隙入路疗效确切,具有创伤小、出血少,手术时间短等优点。
    • 秦洪; 梁爱军; 钱文亮; 黄夕斌; 宋雅伟
    • 摘要: BACKGROUND: Simple plaster external fixation for the treatment of distal radius fracture is difficult to obtain the good reduction and fixation, and in recent years, traction splint has better treatment effect. n OBJECTIVE: To comparatively analyze the effect of rubber band stretching and stress relaxation on the treatment of distal radius fracture with traction splint through biomechanical methods. n METHODS: Total y 236 cases of distal radius comminuted fractures were divided into treatment group and control group according to the treatment method. The patients in the treatment group were treated with traction splints and the patients in the control group were treated with manipulative therapy and splints external fixation. The X-ray films were taken regularly to observe the healing of the fracture, and the wrist function was assessed with Dienst assessment standards. Instron Electronic Universal Material Testing Machine 3367 was used to detect the rubber band stretching and stress relaxation of the traction rubber band in order to test the rubber band maximum stress. n RESULTS AND CONCLUSION: According to the intent-to-treat analysis, al the patients were involved in the final analysis. Al the patients were fol owed-up for more than 5 months, and longest for 13 months. Dienst functional assessment showed in the treatment group, excel ent in 68 cases, good in 42 cases and the excel ent and good rate was 93.2%; the excel ent and good rate of the control group was 52.6%, the excel ent and good rate of the treatment group was significantly higher than that of the control group. Traction splint for the treatment of distal radius fracture has the advantages of simple operation and reliable clinical efficacy. Rubber band stretching and stress relaxation results showed that the maximum stress of the rubber band was 46.97 N and it was maintained at 20.60 N, thereby achieving the traction effect in the reduction treatment of distal radius comminuted fractures.%  背景:单纯石膏外固定治疗桡骨远端粉碎性骨折难以实现良好复位和固定,近年来以牵引式夹板治疗的效果较好。n  目的:运用生物力学的研究方法,对比分析牵引式夹板治疗桡骨远端粉碎性骨折时橡皮筋拉伸及应力松弛与效果的关系。n  方法:236例桡骨远端粉碎性骨折患者按治疗方法分为治疗组和对照组,治疗组实行牵引式夹板治疗,对照组实行单纯手法整复夹板外固定。治疗后定期拍摄 X 射线片观察骨折愈合情况,腕关节功能采用Dienst 评估标准进行评定。采用 Instron 电子万能材料试验机3367对牵引的橡皮筋进行橡皮筋拉伸和应力松弛实验,测试橡皮筋的最大应力。n  结果与结论:按意向性处理分析,全部进入结果分析。患者随访均超过5个月,最长随访13个月。Dienst功能评估:治疗组优68例,良42例,优良率93.2%,对照组优良率52.6%,治疗组优良率显著高于对照组。证实采用牵引式夹板治疗桡骨远端粉骨折,操作简单方便,临床疗效可靠。橡皮筋拉伸和应力松弛实验结果显示,橡皮筋的最大应力为46.97 N,最终应力保持在20.60 N,能够达到桡骨远端粉骨折复位治疗的牵引作用。
    • 卢吴宁; 潘诗农
    • 摘要: 背景:肘关节的结构和功能复杂,对调节上肢的活动具有重要的作用。目的:评价不同影像学方法评价肘关节骨折的诊断作用。方法:分析肱骨内外髁骨折、肱骨髁上和髁间骨折、桡骨小头骨折和尺骨冠突骨折以及周围韧带、肌腱等软组织损伤的X射线影像评价、CT影像评价以及MRI影像评价的诊断作用,重点分析肘关节创伤常见的“恐怖三联征”的影像学评价。结果与结论:X射线可以清晰显示肘关节骨折的骨折线以及骨折断端移位情况,还能够显示肘后三角的位置关系。CT扫描对骨折的检测效果优于X射线,不仅能够显示无移位骨折、微小移位骨折以及关节腔内的微小骨折碎片,还能显示骨折的部位、范围、数目、大小、移位情况、粉碎情况等。MRI主要用于评价肘关节骨折时周围软组织的损伤。
    • 殷渠东; 田小武; 郑祖根
    • 摘要: 背景:骨质疏松患者置入椎弓根螺钉后,易发生螺钉松动和复位矫正丢失等固定不稳现象,因此,骨质疏松被认为是椎弓根螺钉的相对禁忌证。目的:观察骨质疏松患者提高椎弓根螺钉稳定性方法的临床应用效果。方法:34例骨质疏松患者行椎弓根螺钉内固定,术中采用了提高椎弓根螺钉稳定性方法。骨折患者14例(骨折组),骨病患者20例。20例骨病患者和5例骨折患者行脊柱后外侧或椎间植骨融合(融合组)。骨质疏松按Jikei分级,初级8例,Ⅰ级11例,Ⅱ级8例,Ⅲ级7例。对19例初级和Ⅰ级骨质疏松患者,采用较粗和较长螺钉,同时结合采用螺钉与连接棒强直性连接,且有两根横向连接装置,左右、上下椎弓根螺钉分别在水平面和矢状面以较大成角置入螺钉等方法提高螺钉固定相对稳定性对15例Ⅱ级和Ⅲ级骨质疏松患者,钉道注入骨水泥以提高螺钉固定绝对稳定性。结果与结论:随访9-26个月,平均14个月,无螺钉断裂,骨折组仅2例Jikei Ⅰ级患者固定后五六个月时发生螺钉松动、部分复位矫正丢失等固定不稳,但无明显其他不良影响。骨折组复位矫正丢失平均5%,融合组植骨融合率100%。对于骨质疏松患者,根据骨质梳松程度采用不同的提高螺钉固定稳定性方法,可以减少螺钉松动和复位矫正丢失等固定不稳并发症。
    • 高延明; 张路
    • 摘要: BACKGROUND: The anti-rotation intramedul ary nail and dynamic hip screw has been widely used in the fixation treatment of intertrochanteric fracture. OBJECTIVE: To evaluate and compare the effect of anti-rotation intramedul ary nail and dynamic hip screw internal fixation for the treatment of femoral intertrochanteric fractures. METHODS: The clinical patients with femoral intertrochanteric fractures were fol owed-up, and the clinical effect of effect of anti-rotation intramedul ary nail and dynamic hip screw internal fixation for the treatment of femoral intertrochanteric fractures was comprehensively analyzed through evaluating the fracture healing, incidence of complications and joint function score. RESULTS AND CONCLUSION: Both anti-rotation intramedul ary nail and dynamic hip screw internal fixation could obtain the good effect on the treatment of femoral intertrochanteric fractures, but anti-rotation intramedul ary nail internal fixation for the treatment of femoral intertrochanteric fractures had the advantages of less bleeding, lower incidence of complications, shorter fracture healing time and higher excel ent and good rate of hip function, which is one of the preferred methods for the treatment of femoral intertrochanteric fractures.%  背景:防旋髓内钉与动力髋螺钉已被广泛应用于股骨转子间骨折的置入内固定治疗。目的:评估与比较防旋髓内钉与动力髋螺钉置入内固定治疗股骨转子间骨折的效果。  方法:对股骨转子间骨折的临床患者进行随访观察,通过评估患者骨折的愈合情况、并发症发生情况以及关节功能评分综合分析防旋髓内钉与动力髋螺钉内固定治疗股骨转子间骨折的临床效果,并对两种内固定治疗效果进行对比。  结果与结论:防旋髓内钉与动力髋螺钉置入内固定治疗股骨转子间骨折均可以获得较好的治疗效果,但是防旋髓内钉置入内固定治疗股骨转子间骨折置入内固定操作时间更短,出血量更少,并发症的发生率更低,骨折愈合时间更短,髋关节功能优良率更高,是股骨转子间骨折首选置入内固定治疗的方法之一。
    • 杨波; 方世兵; 尹飚; 宋磊; 王筋; 万盛钰; 谢景开
    • 摘要: 背景:三维重建技术已经广泛应用于椎弓根螺钉置入前规划,但是就其预测参数的准确性目前尚未见直接的分析与报道。目的:基于CT三维重建技术应用于临床,对腰椎椎弓根螺钉置入前指导作用的精确性作初步分析。方法:在Mimics软件下,随机对30例行腰椎椎弓根螺钉内固定的患者共136个椎弓根行内固定前CT三维重建,并通过内固定前模拟模块预测钉长、直径、水平面角及矢状面角度并与内固定后实际数据进行统计学比较。结果与结论:内固定前通过Mimics软件对腰椎行三维重建,设计最佳钉道并模拟置钉,预测椎弓根螺钉长、直径、水平面角及矢状面角度与通过C型臂及内固定中导航系统等方式置钉后实际数据的差异无显著性意义(P 〉 0.05),并且内固定后行CT扫描见置钉位置及长度均良好。说明通过Mimics软件对腰椎进行三维重建模拟置钉并制定置钉参数,能比较精确的指导内固定中实际置钉,提高椎弓根螺钉的置钉安全。
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