18 Chen Ximin, Li Chenli, Zhang Bingjin, and so on. DSA diagnosis and interventional treatment of idiopathic femoral head necrosis. Radiology practice, 1988 19 Li Xidong, Fan Lijun, Li Guojiu and so on. Interventional treatment of steroidal necrosis of the femoral head. Chinese Journal of Radiology, 1998 20 Jiang Zhong servant. Interventional treatment of avascular necrosis of the femoral head. Chinese Journal of Microsurgery, 199619 (1): 34-36. 24 Yu Yongcun, Chen Jie, Liu Zongqun, et al. Recurrent dislocation of total hip articular joint. Chinese Journal of Orthopaedic Surgery, 1999, (Received: 2001-0820 Editor: Li Weinong) * Short report ° In the operation of the same side of the iliac bone self-made bone screw internal fixation for the treatment of humeral condyle fracture Hao Dacheng Liu Hongjun Liu Jianbin (Daqing People's Hospital, Heilongjiang Daqing 163311)~ In 2000, 21 patients with avulsion fractures of the humeral condyle were treated with the same side humerus.
1 Clinical data of this group of 21 patients, 13 males and 8 females; aged between 13 and 52 years, mean age 243 years; 8 cases of left knee, 13 cases of right knee, were fresh closed fractures. There were 7 cases of avulsion fractures of the humeral condyle and 14 cases of collateral ligament and meniscus injury.
2 treatment method 21 patients in this group, intraoperative supine position, under continuous epidural anesthesia or spinal anesthesia, after the knee joint internal or lateral incision revealed joints, explore the displacement of the bone, after clearing the blood clot, Take the lateral middle incision of the ipsilateral calf. After peeling off the periosteum, take a bone block of about 4.0 cm×1.0 cm×1.0 cm in the middle part of the humerus, rinse it with saline, and make a bone screw with a diameter of about 3.0 cm and a tip diameter of about 3.0 cm. After the anatomical alignment of the fracture, use an electric drill to be perpendicular to the longitudinal axis of the humerus in the center of the bone. A circular hole with a diameter of 0.5 cm is drilled to a depth of about 3.0 mm. The bone screw is antegrade along the hole and the end of the bone screw is completely buried in the cartilage. Next, after the examination is firmly fixed, if the collateral ligament or cruciate ligament injury is damaged, it can be repaired. If there is a meniscus injury, it can be removed. After the knee flexion 30* plaster support, the plaster cast is completely removed after 8 weeks. Physiotherapy and massage to restore knee function as soon as possible.
3 treatment results in this group of 21 patients with 18 patients were followed up for six months to three years, the results of evaluation 1|: 1 excellent: no complaints of pain or instability symptoms, can restore pre-injury work, and can participate in general activities, knee flexion function is affected Limited to 20*; 2 good: mild pain, limited flexion function 21 ° ~ 30 * 3 can be: moderate pain, with joint instability, can not be qualified for the original work, up and down the building has certain difficulties, knee flexion Functional limitation 31* ~40°4 Poor: Pain is heavy, and affects daily life. It is difficult to get on and off the stairs. Knee flexion is limited to 40*. Among the 21 patients, 11 cases (52.3%) are good (9 cases). 42.7%) can account for 1 case (5%), no bad cases, 95% satisfaction rate, 20 cases of negative drawer test (accounting for 952%), 1 case (48%), the results show that the humeral intercondylar fracture with self-made bone The effect of nail fixation is satisfactory.
4 Discussion of the humeral intercondylar avulsion fracture, clinically less common, and more use of steel nails or wire to fix the intercondylar humeral fracture, although the fixation is stronger than the bone nail, but requires a second operation, and the fixation is a foreign body, Increasing the economic burden and pain of patients, and self-made bone nails to fix the intercondylar uplift fractures have the following advantages: 1 In an anesthesia, the whole process of bone removal and surgical fixation is completed without expanding the scope of disinfection, and there is no need to change the body position. 2 bone nails were taken from the ipsilateral limb humerus, no foreign body rejection. 3 No need for secondary surgery to remove the fixed wire or steel nails, the patient only needs one functional exercise to reduce the burden and pain of the patient. 4 do not need to extend the operation time, old and infirm can be tolerated. 5 The use of bone nails can be fixed and bone grafted at the same time without destroying the stability of the tibia. The disadvantage is that there is no steel wire, the steel nails are firmly fixed, and the plaster can be used for external fixation after surgery. After 6 weeks, under the guidance of medical staff, the activity was slight. After 8 weeks, the plaster support was removed and physical therapy was performed for 2 weeks to help the function of the knee joint recover.
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