1、 g ? y Z E 4张世琼 裴福兴 黄富国nullK 1 “ 探讨几种手术方法,重建拇指对掌功能的手术效果。Z E 通过5个不同的动力肌腱移位及1,2掌骨间植骨的6种重建方法和三种滑车(腱扭)制作位置和方法的不同,按优、良、可、差进行评定。 T null 动力腱选用结果按优到差的顺序为:尺侧腕屈肌腱、环指指浅屈肌腱、掌长肌肌腱、桡侧腕屈肌肌腱、小指外展肌、1, 2掌骨间植骨。null滑车选用结果按优到差的顺序:腕横韧带上建滑车、绕尺侧腕屈肌腱下部作滑车、尺侧腕屈肌腱下部腱瓣环作滑车。 动力肌的选择和滑车的位置及制作方法的不同,直接影响手术疗效,但术前适应症、术中操作要领及术后注意事项的掌握
2、仍不可忽视。1 o M 屈肌腱 滑车 关节囊 动力腱 对掌功能 m s | R622+ . 2 D S M ASelection of thesurgical approachs forreconstruction of thumb opposing functionZhang Shiqiong, Pei Fuxing,Huang Fuguo. Department of Orthopedic Surgery, the First University Hospital of West China University of MedicalSciences,Chengdu, 610041Abs
3、tractObjctiveTo compare the effects of sveral different surgical approaches to reconstruction of thumbopposing function.Methods 58 patients with dysfunction of thumb opposing were admitted to this study.Among them ,there were 54 males and 4 females; the ages ranged from 22 to 55 years. In operation,
4、 five different tendons weretransferred alternatively as dynamic tendon and three different positions were adopted alternatively as trochlearreconstruction position.Besides these dynamic methods, bone grafting between the first and second intermetacarpal wasalso used as a static reconstruction metho
5、d. After operation, all the patients were followed up and the functionalrestoration was divided into four grades:excellent, good,fairoand poor.Results1. The dynamic tendons on the prioritylist for selection were arranged as: flexor carpi ulnaris, flexor digit superficialis of ring finger , palmaris
6、longus, flexorcarpi radialis,abductor digit minimi,j intermetacarpal bone grafting. 2.The trochlear positions on the priority listfor selection were arranged as: on the superior of flexor retinaculum,around the inferior of flexor carpi ulnaris, throughthe inferior tendonous flap ring of flexor carpi
7、 ulnaris. Conclusion The effect of operation depends on the selection ofdynamic muscle and trochlear position mainly;flexor carpi ulnaris and superior of flexor retinaculum were recommendedas the dynamic muscle and trochlear position respectively. Equally important are the operative indications, ope
8、rativetechniques and post-operative rehabilitation that should not be overlooked.KeywordsFlexor muscle tendonTrochleaJoint capsuleDynamic tendonThumb opposing function 30 M , 1 g ? y m Z E m B % “ 5 1 s c . b 58 h - % ,V ? C B t Y r ,7 $ j y bC / b1 “ 5 1. 1B S V 1981 M 4 j1998 M11 W 58 g ? y m b 3
9、54 , o 4 , M - 22j55 b1. 2 m n V 1b1. 3 m Z E1. 3.1 M y EM m :null 1j4E , ( - D g / 1/ 3T M g , ,N M g V y , ? 3 ? p , m = % A 1 b | a% ,1 # H 7 S ? , l r n , 1j2? 8 % ? E s 1 ,1 ib ? ,i ,48l H 5 $ (CPM) 7 S 1 , 1 ? bc380c + D 2000 M 5 21 ( 5 )SichuanMedicalJournal, 2000,Vol 21,No. 5T : D S v B D (6
10、10041) , V v = M 7 , M g A M s ! y g g b 0 y M , M g , 1 Z T B : M g M g ) T 1j2 M g ,V 1 0.5cm ) M ,V + M g G - D ! bnull E :l Z M :A, l T B M g ,A a , M , B L ,L_ S ,N ) V A * 5 ,A l F bB, g 1 y T B oLp M g ,A y 1 5 bC,V S g 1 M g ,T B z / ,5 | V , 1 5 # Z , % 3j4 bV 1 F h T # rm Z E TV 9 y null 1
11、4 8 4 2 0 20+ null 6 y 6 3 1 1 16 y null 5 1 2 1 1 8+ null y 3 0 1 2 0g null 5 2 1 1 1 8g null y 3 0 0 0 3 0 y null 9 4 2 2 1 13null 6 y 4 1 1 1 1l Z 4 1 2 1 0 41, 2g W 5 0 2 2 1 5 9 58 20 16 13 9 58M y : g 1 T ojpM g ,A y 1 5 T M b y = T :null y b g 0. 5cm ) T B d bnull M y / T , Z , / s 1.5cm B d
12、T b T Z E y 2. 5cm ) y 7 i M 1/2 ,T ; _ = b! M g y :5 v = / s iV M g / , | M V a N ,V M g , v N f , y , Z g H , L s Y 1 5 y b , % 3j4 b1. 3.21,2g W y E : null ? | 4cm2cm2cm v l 1 8 H ,i| ! bnull m 1, 2g W ,T B M g , A 1, 2g g ,i M , g , g D B d , r e , , V b| ! z H V d = , n , V B % l X f _ | H 1, 2
13、g % b % 6 , 7 S ? bX H X f , 7 S a$ M ? b1. 4 T : S : : ? l M ; : ? M ; V : ? U M ; : ? M b T n V 1b 58 , 1 , T 2 , y w 1 , 4 ( Y V Q m , 2 ,2 r V b2) Y V 5 M 1,2g W ZE y g ? 58 , q 71.4%,r T ib 8 :2. 1 4 :null 5 , y Z E n b y Y V a = / + B L , ,V 7 , Z g b 4 A y y V 1 g Y V # ? 3 T b g Z x , M 1 pb
14、 l Z Z x , 8 l , S M Z _ Z ,# r T 9 z b!1,2g W y E , y H q H , 1 z m 1 5 V | b2. 2 m i Y :null - _ A $ Z g s K , 4 1 a$ s K , 5 ? m bnull M f ,i y a Z g L ( A g 1 y i _ g h 1 5 )b 5 ? 4 M ; V _ , T P y w ,7 g T b M Y V / 1 z a L , 5 5 , T , T , Y r b!y g g x ,# 4 M | g b l Z S 1 v , c381c + D 2000 M
15、 5 21 ( 5 )Sichuan MedicalJournal, 2000,Vol 21,No.5 D ? % O |周宗科null 裴福兴null null 薛维天nullK 1 “ 评估单臂多功能外固定支架治疗不稳定性胫腓骨骨折的疗效。Z E 使用单臂多功能外固定支架治疗不稳定性胫腓骨骨折 42例。 T 骨折均愈合,患肢功能恢复良好,愈合平均时间6. 2个月。钉道感染率12%。 单臂多功能外固定支架可纵轴方向滑动,起延长加压作用,两端有球状万向关节,可做各方向调节,使用灵活和容许早期活动。单臂多功能外固定支架是治疗不稳定性胫腓骨骨折较好的方法。1 o M 胫腓骨骨折 外固定支架 治疗
16、m s | R683. 42 D S M AUnilateral multifunctionalexternal fixation apparatus forpatients with unstablefracturesofthetibiaand fibulaZhou Zongke, Pei Fuxing, Xie Weitian. Department of Orthopedic Surgery, The First Affilated Hospital, West ChinaUniversyity of Medical Sciences,Chengdu,610041AbstractObje
17、ctive To evaluate the results of unilateral multifunctional external fixation apparatus for patientswith unstable fractures of the tibiaand fibula.Methods Forty-two patients with unstablefractures of the tibiaand fibulawere treated by the unilateral multifunctional external fixation apparatus. Resul
18、ts Complete healing of fractures of allpatients was seen within an average of 6. 2 months; the function of suffering limbs was satisfactory and the rate ofinfection of pin tract was 12%.Conclusion The unilateral multifunctional external fixation apparatus can maintain thenormal limb length and allow
19、 dynamic compression by sliding in ordinate axial direction. It can be easily applied invarious directions to correct the displacement with two articulated ball joints.The patients can be permitted to exerciseearly. Unilateral multifunctional external fixation apparatus is a satisfactory method for
20、the treatment of unstablefractures of the tibia and fibula.KeywordsFractures of tibia and fibulaExternal fixatorTreatment1 1997 M 1 1999 M 1 AD 3 D ? % O | 42 , | i r b1 “ 5 1. 1B : 3 31 , o11 b M - 13j65 , ( 36 b | :P 17 , 25 b | :x 19 , 10 , | 13 b 7 b |25 , Gustilos 14 , 9 , 2 b i # | 13 b1. 2 O
21、: D ? % O 8 aC v h _ 1 F , _ 1 ? S 360 , Z _ | % 4 v 2 , 8 , V 1 % , V , P | % b1. 3 Z E : J % ,5 | i b , , l y - = | L / a ) S l M g ,s 7 a /F , P , * c,G h * c M G d , G 4mm 5mm , * 5 f / ,V y 7 , 5 ,? 3 7 ? Z m 5 b#1, 2g W :a. v a ,V P g V v ,7 ? ,V 5 ? J M , 4 r bb.1,2g ! dv l z 3 v , , z ,M ( , bc. d “ _ g , _ g , ? r Z g 7 r b ? : F % 3j4 ,1, 2 g W 6 , 7 S , a ? , 1 # ,1,2g W X r H , 9 F g ? b( l : 2000i03i01)H = 7 O 3 1 3 M bc382c + D 2000 M 5 21 ( 5 )SichuanMedicalJournal, 2000,Vol 21,No. 5null T : null D S v B D (610041); null + 8 S D (621900)
