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  股骨远端骨折
    BIOMECHANICAL STUDY AND CLINICAL APPLICATION OF FIXING DISTAL FEMORAL FRACTURE USING INTRAMEDULLARY SUPRACONDYLAR NAIL (LMSC)
    股骨远端骨折采用股骨髁上交锁髓内钉固定的生物力学研究与临床应用
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    Objective: To provide morphologic basis for treating distal femoral fracture with retrograde interlocking intramedullary nail.
    目的:为带锁髓内钉治疗股骨远端骨折提供形态学基础。
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  distal femoral fracture
We present in this case report of an elderly patient with comminuted distal femoral fracture who had Primary total knee arthroplasty as an alternative to internal fixation.
      
The study suggests that locked intramedullary nailing of a distal femoral fracture in osteoporotic bone gives more secure fracture retention than fixation with a 95° AO/ASIF condylar plate.
      
Massive callus formation after distal femoral fracture in association with trisomy 2
      
Retrograde Nailing of Distal Femoral Fracture - Clear and Potential Indications
      
To our knowledge, there is no report of patients sustaining distal femoral fracture at the in situ IMN tip in a second high-velocity trauma.
      
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Objective Quantitative biomechanical compairson of different internal fixation methods for distal femoral fractures provides theoretical basis for clinic curing. Method Performing theoretical and experimental stress analysis for fixing Y type femora fracture by using three different internal fixation methods. Results Under the same load condition Intramedullary supracondylar nail method is the best while for comprssed plate method the femoral condyle strength and origidity is worse (P<0.05)....

Objective Quantitative biomechanical compairson of different internal fixation methods for distal femoral fractures provides theoretical basis for clinic curing. Method Performing theoretical and experimental stress analysis for fixing Y type femora fracture by using three different internal fixation methods. Results Under the same load condition Intramedullary supracondylar nail method is the best while for comprssed plate method the femoral condyle strength and origidity is worse (P<0.05). Conclusion Intramedullary Supracondylar nail Method is the best method among different internal fixation methods. It deserves to be put into application and populatization.

目的:对股骨远端骨折不同内固定方法进行定量生物力学评价,为临床治疗提供理论依据。方法:从理论和实验上对股骨Y形骨折,应用三种不同内固定方法加以固定,进行实验应力分析。结果:发现在受同等载荷条件下,髁上交锁髓内钉固定方法最佳,而采用加压钢板固定的股骨髁强刚度较差(P<0.05)。结论:采用股骨髁上交锁髓内钉固定方法优于其它内固定方法,值得临床推广应用。

Objective By evaluating quantitative biomechanical comparison of four internal fixation methods for distal femoral fractures, to choose suitable clinical internal fixation method according to the experimental data. Methods The models of fracture of femoral condyle were made on 16 fresh cadaver femurs (C1 of AO classification) and fixed by supracondylar intramedullary interlocking nail, dynamic condyle screw plate, L shaped condyle plate and Ender's nail fixation respectively. To compare the...

Objective By evaluating quantitative biomechanical comparison of four internal fixation methods for distal femoral fractures, to choose suitable clinical internal fixation method according to the experimental data. Methods The models of fracture of femoral condyle were made on 16 fresh cadaver femurs (C1 of AO classification) and fixed by supracondylar intramedullary interlocking nail, dynamic condyle screw plate, L shaped condyle plate and Ender's nail fixation respectively. To compare the four different methods by experimental stress analysis and theoretical analysis of finite element method. Results Under the same load condition, the supracondylar intramedullary interlocking nail absorbed more energy during axial loading compared with the other constructs(P<0.01). The dynamic condyle screw plate had the greatest torsional stiffness (P<0.01). There were no significant differences in torsional stiffness between GSHN and DCS. Conclusion Using supracondylar intramdullary interlocking nail and the dynamic condyle screw plate are better than the other internal fixation methods and deserve to be put into clinical application and populatization.

目的 对股骨髁上骨折 4种内固定方法进行生物力学测试评估 ,为临床治疗提供较全面、客观的依据。方法 取 1 6具新鲜尸体股骨标本 ,造成股骨髁上骨折模型 (AO分类的C1型 ) ,分别用股骨髁上逆行交锁髓内钉 (GSHN)、动力髁螺钉 (DCS)、L形髁钢板 (L -CCP)、Ender钉固定 ,利用实验应力分析和有限元分析方法对股骨髁上骨折和内固定系统的力学性能进行比较研究。结果 在轴向应力实验中 ,GSHN固定优于DCS、L -CCP和Ender钉内固定 ( P <0 .0 1 ) ;在扭转实验中 ,GSHN和DCS优于L -CCP和Ender钉 (P <0 .0 1 ) ,尤以DCS为最佳。结论 采用GSHN和DCS内固定生物力学强刚度最佳 ,优于其它内固定方法 ,值得临床推广应用。

Objective: To provide morphologic basis for treating distal femoral fracture with retrograde interlocking intramedullary nail. Methods: ①Medial condyle, lateral condyle, medial epicondyle, lateral epicondyle and intercondylat fossa of 30 adults' dry femurs were measured and analyzed. ②Descending genicular artery and its branches, distribution of infrapatellar branch of saphenous nerve and its relationship with the former were observed on 20 sides low limbs specimen. Results: ①The shape of intercondylar...

Objective: To provide morphologic basis for treating distal femoral fracture with retrograde interlocking intramedullary nail. Methods: ①Medial condyle, lateral condyle, medial epicondyle, lateral epicondyle and intercondylat fossa of 30 adults' dry femurs were measured and analyzed. ②Descending genicular artery and its branches, distribution of infrapatellar branch of saphenous nerve and its relationship with the former were observed on 20 sides low limbs specimen. Results: ①The shape of intercondylar fossa was "U" (35%) or "V"(65%), the largest transverse diameter of intercondylar fossa was (1.98±0.36) cm (left) and (2.06±0.29) cm (right); The width of the back of articular surface of medial surface of lateral condyle was (2.28±0.31) cm (left) and (2.34±0.29) cm (right); The distance from medial epicondyle to lateral epicondyle was (7.30±0.60) cm (left) and (7.43±0.57)cm(right) respectively. ② The infrapatellar branch of descending genicular artery accompanied closely with saphenous nerve. The saphenous nerve sent out the upper and lower branch at the intersection point of 1/3 of the middle section and the lower section of sartorius, which distributed to the front area and the exterior area of knee joint. Conclusions: For preventing from damaging nerve, blood vessels and the happening of complication in the operation, anatomic characteristics as above should be concerned.

目的:为带锁髓内钉治疗股骨远端骨折提供形态学基础。方法:①选用30例成人干燥股骨测量股骨内外侧髁、内外上髁、髁间窝有关数据进行统计分析。②20侧下肢标本解剖观测膝降动脉及隐神经髌下支的分支、分支等及两者的关系。结果:髁间窝呈U型占35%,V型占65%,此窝最宽处横径:左侧(1.98±0.36)cm, 右侧(2.06±0.29) cm;内侧髁后关节面宽,左侧(2.21±0.23) cm,右侧(2.34±0.29) cm;内、外上髁的距离,左侧(7.30±0.60)cm,右侧(7.43±0.57)cm。膝降动脉髌下支和隐神经髌下支呈紧密的伴行关系。隐神经在缝匠肌中下1/3交界点穿出,有上、下两支分布到膝关节前外侧皮肤。结论:术中注意这些解剖位置特点,避免损伤神经和血管,减少手术出血,防止并发症。

 
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