阳泉市第一人民医院骨科病例精解

本书包括骨科常见病和多发病的手术治疗。关节部分是对严重的膝关节与髋关节终末型疾病采用的膝关节置换术和髋关节置换术的的介绍；创伤部分包括四肢骨折及假体周围骨折等。每章节典型病例、疑难病例、罕见病例等，包含病例摘要（基本信息、体格检查、辅助检查、诊断、治疗）、病例分析以及上级医生病例点评。

陈魁胜：阳泉市第一人民医院院长，骨科主任医师，山西医科大学毕业，从事骨科专业30年，擅长骨科多发病及常见病的诊治。

\"第一章?关节疾病?.......................................................1 第一节 肩关节......................................................................................................................2 01 半肩关节置换术治疗肱骨近端粉碎性骨折1例 ...................................................2 02 组配式假体治疗肱骨近端转移瘤1例 ...................................................................4 第二节 髋关节......................................................................................................................7 03 股骨粗隆间粉碎性骨折关节置换1例 ...................................................................7 04 左髋关节术后假体周围骨折内固定1例 ...............................................................9 05 DDH全髋关节置换1例 ........................................................................................13 06 骨盆重度倾斜并发髋关节骨性关节炎1例 .........................................................15 07 老年患者髋部骨折内固定失效后全髋关节置换翻修1例 .................................18 08 小腿缺如伴股骨颈骨折治疗1例 .........................................................................19 09 复杂人工髋关节假体翻修术1例 .........................................................................21 10 股骨头髓芯减压坏死骨切除同种异体骨打压植骨治疗早期股骨头坏死 （Ⅱ～Ⅲ期）1例 ..................................................................................................24 11 肿瘤假体合并人工股骨头置换治疗股骨近端骨肿瘤1例 .................................27 第三节 膝关节....................................................................................................................30 12 牛津单髁治疗剥脱性骨软骨炎1例 .....................................................................30 目?录 13 后交叉韧带保留型假体膝关节置换1例 .............................................................33 14 膝关节置换术后感染翻修1例 .............................................................................35 15 膝骨性关节炎合并重度膝内翻膝关节置换1例 .................................................39 16 双侧膝关节置换术后假体周围骨折1例 .............................................................43 17 膝外翻全膝关节置换1例 .....................................................................................45 18 牛津单髁置换治疗膝关节前内侧骨性关节炎1例 .............................................47 第二章?运动医学?......................................................51 第一节 肩关节....................................................................................................................52 19 肱二头肌长头肌腱炎的治疗1例 .........................................................................52 20 粘连性肩关节囊炎1例 .........................................................................................54 21 巨大肩袖损伤1例 .................................................................................................56 22 关节镜下治疗肩锁关节脱位1例 .........................................................................59 第二节 膝关节....................................................................................................................62 23 青少年髌骨脱位的治疗1例 .................................................................................62 24 膝关节内侧副韧带重建1例 .................................................................................64 25 成人复发性髌骨脱位1例 .....................................................................................66 26 半月板囊肿的治疗1例 .........................................................................................69 27 关节镜治疗盘状半月板1例 .................................................................................71 28 前交叉韧带断裂的关节镜治疗1例 .....................................................................73 29 痛风性关节炎治疗1例 .........................................................................................75 30 关节镜下治疗多发韧带损伤1例 .........................................................................76 31 腘窝囊肿伴囊肿内游离体1例 .............................................................................80 32 后交叉韧带胫骨止点撕脱骨折1例 .....................................................................82 33 关节镜下治疗前交叉韧带合并关节外侧半月板损伤1例 .................................84 第三节 其他........................................................................................................................87 34 关节镜下治疗臀肌挛缩症1例 .............................................................................87 35 关节镜下行内固定物取出术1例 .........................................................................90 36 关节镜下治疗肘关节僵硬1例 .............................................................................92 37 股骨髋臼撞击症合并滑膜软骨瘤病1例 .............................................................94 第三章?创伤?..........................................................99 第一节 上肢创伤..............................................................................................................100 38 老年肱骨髁上骨折的治疗1例 ...........................................................................100 39 尺骨冠突骨折1例 ...............................................................................................103 40 闭合复位髓内钉治疗肱骨干骨折1例 ...............................................................105 第二节 下肢创伤..............................................................................................................107 41 左下肢股骨病理性骨折的治疗1例 ...................................................................107 42 股骨头骨折脱位（PipkinⅣ型）1例 ................................................................110 43 胫骨平台骨折的微创治疗1例 ...........................................................................112 44 纵向骨搬移治疗胫骨骨不连及骨髓炎1例 .......................................................115 45 髓内钉治疗股骨粗隆下粉碎性骨折1例 ...........................................................117 46 加长髓内钉治疗股骨粗隆间粉碎性骨折1例 ...................................................120 47 切开复位双钢板治疗胫骨平台粉碎性骨折1例 ...............................................121 48 “漂浮膝”髓内钉微创手术治疗1例 ...............................................................123 49 股骨远端骨折逆行髓内钉手术治疗1例 ...........................................................125 50 胫骨平台后缘骨折手术治疗1例 .......................................................................127 第三节 足踝外科创伤......................................................................................................129 51 跟骨骨折（经跗骨窦入路）治疗1例 ...............................................................129 52 三踝骨折治疗1例 ...............................................................................................131 53 外翻矫形术1例 ...............................................................................................133 54 横向骨搬移治疗糖尿病足1例 ...........................................................................135 55 跖跗关节骨折治疗1例 .......................................................................................138 56 踝关节外侧副韧带损伤1例 ...............................................................................140 第四节 骨盆创伤..............................................................................................................141 57 骨盆骨折的手术治疗1例 ...................................................................................141 58 肿瘤切除骨水泥填充克氏针内固定治疗髋臼转移瘤1例 ...............................143 第五节 手外科创伤..........................................................................................................145 59 断腕再植1例 .......................................................................................................145 60 游离股前外侧皮瓣联合异体肌腱治疗手背部皮肤肌腱缺损1例 ...................148 61 游离股前外侧皮瓣联合“Masquelet技术”治疗前足骨髓炎1例 ..................150 62 肌腱转位治疗桡神经损伤垂拇垂指畸形1例 ...................................................152 63 臀大肌肌皮瓣修复骶尾部压疮1例 ...................................................................154 第六节 小儿创伤..............................................................................................................156 64 儿童肱骨髁上骨折的微创手术治疗1例 ...........................................................156 65 儿童股骨干骨折弹性髓内针治疗1例 ...............................................................158 66 儿童掌骨颈骨折的髓内针微创手术治疗1例 ...................................................160 67 儿童先天性肌性斜颈的手术治疗1例 ...............................................................162 第四章?脊柱疾病?.....................................................165 第一节 颈椎.....................................................................................................................166 68 颈前路椎间盘切除植骨融合术治疗神经根型颈椎病1例 ...............................166 69 颈后路双开门椎管成形大术治疗混合型颈椎病1例 .......................................168 70 前路齿状突螺钉内固定治疗Ⅱ型C2齿状突骨折1例 ......................................170 71 后路椎管减压部分肿瘤切除椎弓根侧块螺钉内固定治疗C3椎体转移瘤1例 .............................................................................................................................172 72 颈前路椎体次全切除减压植骨融合术治疗脊髓型颈椎病合并后纵韧带骨化症 1例 .......................................................................................................................175 73 脊髓型颈椎病及颈椎后纵韧带骨化症（连续型）1例 ...................................177 74 自发性寰枢椎半脱位伴不全瘫1例 ...................................................................180 第二节 胸椎......................................................................................................................182 75 Wilste入路治疗胸椎爆裂骨折1例 ....................................................................182 76 后路经椎弓根截骨矫形融合治疗陈旧性胸腰段后凸畸形1例 .......................185 77 后路全椎板黄韧带切除减压内固定治疗胸椎黄韧带骨化症1例 ...................187 第三节 腰椎......................................................................................................................191 78 斜外侧入路椎间融合术治疗腰椎不稳1例 .......................................................191 79 后路全椎体切除人工椎体植入治疗腰椎转移瘤1例 .......................................193 80 应用S2AI螺钉治疗腰椎减压内固定术后腰椎不稳症1例 ..............................197 81 老年性骨质疏松病理性骨折1例 .......................................................................199 第四节 脊柱微创..............................................................................................................201 82 全内镜下椎间孔成形减压术治疗伴钙化的腰椎间盘突出症1例 ...................201 83 全内镜下单侧入路双侧减压融合固定治疗腰椎管狭窄症1例 .......................204 84 经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症1例 ...................................208 85 单侧双通道内镜下腰椎间融合术治疗腰椎失稳症1例 ...................................211\"