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  humeral
The indications for primary arthroplasty included: humeral head fracture (20), osteoarthritis (14), posttraumatic avascular head necrosis (11), cuff tear arthropathy (6) and rheumatoid arthritis (1).
      
Intraoperatively, disorders were identified and attributed to pathology present on the humeral side related to bone loss or failure (38 %), soft tissue injury (29 %), implant failure (21%) or infection (12 %).
      
On the humeral side good outcomes resulted in cases that were revised for implant failures.
      
We report about our experience using elastic stable intramedullary nailing for markedly displaced proximal humeral fractures Type III and IV in children.
      
The following complications occurred: one nail perforated the humeral head, one nail was placed in the wrong position, two problems occurred with the removal of the nail.
      
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Objective To evaluate the application of prosthetic replacement in limb salvage treatment of bone tumors. Methods 50 patients with bone tumors treated with en bloc resection and prosthetic replacement were reviewed. Their survivorship, limb function, complication and the management were analysed. There were 22 malignant tumors including 11 osteosarcomas, 5 chondrosarcomas, 2 malignant fibrous histocytomas, and one each of malignant osteoblastoma, alveolar sarcoma, rhabdomyosarcoma, malignant giant cell tumor...

Objective To evaluate the application of prosthetic replacement in limb salvage treatment of bone tumors. Methods 50 patients with bone tumors treated with en bloc resection and prosthetic replacement were reviewed. Their survivorship, limb function, complication and the management were analysed. There were 22 malignant tumors including 11 osteosarcomas, 5 chondrosarcomas, 2 malignant fibrous histocytomas, and one each of malignant osteoblastoma, alveolar sarcoma, rhabdomyosarcoma, malignant giant cell tumor of bone. 28 benign tumors included 27 giant cell tumors of bone and 1 benign fibrous histocytoma. The types of the prostheses were as follows: 26 hinged knee prostheses, 7 proximal femoral prostheses, 7 proximal tibial biofixation prosthesis, 7 proximal humeral prostheses, 2 hinged elbow, 1 artificial scapula. Results In the patients with malignant bone tumors, local recurrence was seen in 18.1% ; the 5- year survival rate were 38.8% , final limb salvage rate was 81.9% . No prosthesis related complications were seen. In patients with giant cell tumor of bone, the rate of local recurrence and mortality were 3.7% ; complications occurred in 40.7% of the patients, and the final limb salvage rate was 84.8% . 1 patient with benign fibrous histocytoma in scapula has survived 16 years with good function. In all of the prostheses, the function of the proximal tibial biofixation prosthesis, proximal humeral prostheses, hinged elbow and artificial scapula were better than others, then followed by proximal femoral prostheses; the hinged knee had the highest rate of complications. Conclusion Prosthetic replacement can be used in the limb salvage surgery of patients with malignant or aggressive benign bone tumors; further improvements in design, fixation and soft tissue reconstruction technique of the prostheses are needed for reducing the complications.

目的 探讨人工假体在骨肿瘤保肢术中的应用价值。方法 分析 50例骨肿瘤患者进行人工假体置换术后的效果、生存情况、功能、并发症及处理。肿瘤类型 :恶性肿瘤 22例,其中骨肉瘤 11例,软骨肉瘤 5例,恶性纤维组织细胞瘤 2例,恶性骨母细胞瘤、腺泡状肉瘤、横纹肌肉瘤、骨巨细胞肉瘤各 1例;良性肿瘤 28例,其中骨巨细胞瘤 27例,良性纤维组织细胞瘤 1例。肿瘤部位 :股骨远端 24例,股骨近端 7例,股骨干 2例,胫骨近端 7例,肱骨近端 7例,肱骨远端 2例,肩胛骨 1例。假体类型 :铰链式膝关节 26例,股骨近端假体 7例,生物固定式胫骨近端假体 7例,肱骨近端假体 7例,铰链式肘关节 2例,人工肩胛骨 1例。结果 22例恶性骨肿瘤 :局部复发率为 18.1%,五年生存率为 38.8%,最终保肢率为 81.9%,未见假体并发症。 27例骨巨细胞瘤 :复发率及死亡率均为 3.7%,并发症发生率为 40.7%,最终保肢率为 84.8%。 1例肩胛骨良性纤维组织细胞瘤术后 16年功能良好。在所有关节中,生物固定式胫骨上端假体、铰链式肘关节、人工肱骨头功能较好,人工股骨头功能稍差,铰链式膝关节功能最差,并发症高。结论...

目的 探讨人工假体在骨肿瘤保肢术中的应用价值。方法 分析 50例骨肿瘤患者进行人工假体置换术后的效果、生存情况、功能、并发症及处理。肿瘤类型 :恶性肿瘤 22例,其中骨肉瘤 11例,软骨肉瘤 5例,恶性纤维组织细胞瘤 2例,恶性骨母细胞瘤、腺泡状肉瘤、横纹肌肉瘤、骨巨细胞肉瘤各 1例;良性肿瘤 28例,其中骨巨细胞瘤 27例,良性纤维组织细胞瘤 1例。肿瘤部位 :股骨远端 24例,股骨近端 7例,股骨干 2例,胫骨近端 7例,肱骨近端 7例,肱骨远端 2例,肩胛骨 1例。假体类型 :铰链式膝关节 26例,股骨近端假体 7例,生物固定式胫骨近端假体 7例,肱骨近端假体 7例,铰链式肘关节 2例,人工肩胛骨 1例。结果 22例恶性骨肿瘤 :局部复发率为 18.1%,五年生存率为 38.8%,最终保肢率为 81.9%,未见假体并发症。 27例骨巨细胞瘤 :复发率及死亡率均为 3.7%,并发症发生率为 40.7%,最终保肢率为 84.8%。 1例肩胛骨良性纤维组织细胞瘤术后 16年功能良好。在所有关节中,生物固定式胫骨上端假体、铰链式肘关节、人工肱骨头功能较好,人工股骨头功能稍差,铰链式膝关节功能最差,并发症高。结论 人工假体置换术可用于恶性及侵袭性骨肿瘤的保肢治疗,但应进一步改进假体的设计、固定及软组织重建,以减少?

Objective: To evaluate the effect of allografting with interlocked intramedullary nailing on humeral massive bone defect reconstruction. Methods: The interlocked intramedullary nailing had been used on 11 patients with humeral malignant tumor by allografting. The range of follow up was 11 to 38 months. Result: 8 of 11 allograft host bone junctions healed and two were non union. 1 tumor local recurrence and the patient suffered amputation. 8 shoulders restoration were limited but functional range...

Objective: To evaluate the effect of allografting with interlocked intramedullary nailing on humeral massive bone defect reconstruction. Methods: The interlocked intramedullary nailing had been used on 11 patients with humeral malignant tumor by allografting. The range of follow up was 11 to 38 months. Result: 8 of 11 allograft host bone junctions healed and two were non union. 1 tumor local recurrence and the patient suffered amputation. 8 shoulders restoration were limited but functional range of motion and strength and the follows were poor. The rate of excellent and good was 63.6% base on the Mankin's allograft assessment system. Conclusion: Our results suggested this technique can accomplish stable fixation, allow early movement of shoulder joint.

目的 :评价肱骨内锁髓内钉复合异体骨段 (关节 )移植重建肱骨恶性肿瘤所致的大段骨缺损的临床效果。方法 :应用肱骨内锁髓内钉复合异体半关节或骨段移植治疗肱骨恶性骨肿瘤 11例 ,随访时间 11~ 3 8个月。结果 :8例植骨愈合 ,2例骨不连 ,1例肿瘤局部复发后截肢。术后总评优良率 63 .6%。植骨延迟愈合及肩关节无力是主要的并发症。结论 :肱骨内锁髓内钉固定牢固 ,复合异体骨段 (关节 )移植允许患者早期活动 ,值得推荐。

Objective: To investigate the presentation of abdominal and peripheral vascular aneurysm by color Doppler flow imaging(CDFI). Methods: Eight cases of aneurysm diagnosed by CDFI were retrospectively analyzed. Results: In eight cases, four were true aneurysms, local expansion of abdominal aorta under renal aorta level. One was abdominal aortic dissection, with true lumen and false lumen. One was humeral artery pseudo- aneurysm, and one was femoral artery pseudo - aneurysm, which connected to the artery through...

Objective: To investigate the presentation of abdominal and peripheral vascular aneurysm by color Doppler flow imaging(CDFI). Methods: Eight cases of aneurysm diagnosed by CDFI were retrospectively analyzed. Results: In eight cases, four were true aneurysms, local expansion of abdominal aorta under renal aorta level. One was abdominal aortic dissection, with true lumen and false lumen. One was humeral artery pseudo- aneurysm, and one was femoral artery pseudo - aneurysm, which connected to the artery through a rupture hole, there were the color and spectral Doppler flow signals in the mass. One was peripheral pancreas pseudo - aneurysm, with the history of pancreasitis; The CDFI displayed the local artery high velocity in the mass. All cases were confirmed by computerized tomography (CT) ,magnetic resonance (MR),vascular radiography and operation. Conclusion: CDFI can accurately diagnose the abdominal and peripheral vascular artery aneurysm. It's a safe and noninvasive method.

目的:总结腹部及周围血管动脉瘤的彩色多普勒超声表现。方法:对我科经彩色多普勒超声诊断的8例动脉瘤进行回顾性分析。结果:8例中腹主动脉真性动脉瘤4例,均位于肾动脉水平以下,表现为腹主动脉局部扩张。腹主动脉夹层动脉瘤1例,CDFI可识别夹层瘤的真腔和假腔。肱动脉及股动脉假性动脉瘤各1例,CDFI见动脉有破口与肿块相通,肿块内有彩色和频谱血流信号。胰头周围假性动脉瘤1例,有胰腺炎病史,CDFI见肿块中有局部动脉型高速血流。8例均经CT、MRA或手术证实。结论:彩色多普勒可准确诊断腹部及周围血管动脉瘤,它是首选的无创伤性的诊断方法。

 
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