简介：AbstractPurpose:In the surgical treatment of paediatric forearm fractures, plate-screw and titanium elastic nails are used. During the transformation of ligamento-osseous structures from adolescence form into adult form, more stable fixation is required. The aim of this study was to evaluate the results of locked intramedullary nail fixation in adolescent forearm fractures.Methods:A retrospective examination was made on 36 adolescent patients who underwent surgery with locked intramedullary nail fixation due to a forearm fracture. The included patients were in the adolescent age group (12-17 years), did not meet conservative follow-up criteria and had unstable fractures (>10° angulation and <50% cortex continuity after plaster casting). Patients were excluded from the study if they were aged >18 years or <12 years, had Gustilo-Anderson type 2/3 open fractures, multi-trauma, history of physeal injuries or could not be contacted during follow-up. Patients’ age, gender, body mass index, affected side, and the pronation and supination values during follow-up were noted. Functional evaluation of the patients was performed with disabilities of the arm, shoulder and hand score and the surgical outcomes were evaluated according to the Price criteria. The time to union, infection during follow-up, re-fracture and vascular nerve damage were also examined. Data were analyzed using SPSS 22 Windows package program software.Results:The patients comprised 30 males and 6 females (ratio, 5:1) with a mean age of (14.7 ± 2.1) years (range, 12-18 years). According to the Price criteria, the results of 33 patients were excellent, 3 were good and there were no moderate or poor cases. The mean disabilities of the arm, shoulder and hand score was 11.2 ± 6.1 (range, 4-28). The mean time to union was (8.7 ± 2.2) weeks (range, 6-14 weeks), while patients aged >15 years had prolonged time to union ([11.1 ± 1.8] weeks). There were no non-unions, re-fractures or infections. No complications were observed during implant removal. None of the patients had sensorial radial nerve injury or tendon damage.Conclusion:The locked intramedullary nailing technique, which is minimally invasive and provides biological fixation, was found to be successful and safe in the treatment of adolescent forearm fractures.

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简介：Assessmentofchildandadolescentpsychiatricdisorders(Figure1)focusesonfourkeyquestions.

简介：AbstractSubcutaneous emphysema is commonly associated with infection caused by gas-producing organisms. In this case report, we describe a rare instance of traumatic subcutaneous emphysema of the hand and forearm caused by a puncture injury to the first web space of the hand. Our objective is to increase awareness of the potential for seemingly minor trauma to cause entrapment of significant air in subcutaneous tissues, thereby decreasing the likelihood that a clinically benign-appearing patient will be started down an unnecessarily aggressive treatment pathway.A 16-year-old, otherwise healthy white female, presented to the pediatric emergency room with an impressive amount of subcutaneous emphysema that developed over a 12-h period after sustaining an accidental laceration to the first web space of her right hand. She appeared nontoxic and had a clinically benign presentation. A comprehensive work-up was performed. She was splinted by the orthopedic surgery resident on call, and was admitted to the Pediatric Intensive Care Unit for overnight monitoring. She received tetanus vaccination and broad-spectrum antibiotics. The patient was discharged 2 days after admittance, with a splint applied to her right hand and forearm. She undertook home-based physical and occupational therapy. She had a pain-free range-of-motion in the right wrist, elbow and shoulder. The swelling in the right hand subsided completely.Although initially alarming, traumatic subcutaneous emphysema in an otherwise healthy patient from minor wounds (as featured in this case) does not necessarily mean one ought to proceed down an aggressive treatment algorithm. Careful evaluation of the patient's history, clinical examination findings, and determination of the Laboratory Risk Indicator for Necrotizing Fasciitis score can help guide physicians in the management of traumatic subcutaneous emphysema and potentially avoid unnecessary and costly interventions.

简介：对学习客观解剖并且cadaveric前臂的interosseous膜(马恩岛)的biomechanical特征。十radius-IOM-ulna结构从新鲜结冰死尸被收获测量马恩岛的腱的部分的长度，宽度和厚度的方法。然后，腱的部分与腱在测量以后属于的尺骨、光线的结束一起被孤立。半径的近似部分和尺骨的远侧的部分在牙齿的基础丙烯酸的树脂粉末被嵌入并且修理。嵌入的标本被MTS为全部张力的测试用10000N负担房间夹钳并且修理858测试机器。马恩岛以50mm/min的速度被拉长直到它被破裂。负担排水量曲线与一台计算机和最大的负担被描绘，僵硬同时被记录。结果前臂的马恩岛由三部分组成：中央腱的织物，膜的织物和背面的隶属于的倾斜的绳索。马恩岛在一个中立位置被拉长，并且在内转和旋后位置弯曲。当最大的负担的点到达了N到1021.50时，马恩岛的腱的部分在6个标本被撕碎吗？

简介：手由五籽骨组成。他们中的二个在metacarpophalangeal(MCP)是在场的姆指的关节。姆指的籽骨骨头的骨折是稀罕损害，光线的方面上的文学很少被报导。我们在姆指的MCP关节与光线的籽骨的破裂报导了一个病人的一个案例以便关于这类损害增加注意。一个44岁的男、高级体操的训练员，当他向右姆指的MCP关节汇报了一处伸直过度损伤时，在锻练期间正在帮助他的运动员之一。在损伤以后的一个星期，他介绍了给在它的手掌的方面上在MCP联合水平抱怨痛苦的姆指的手外科医生。标准A-P和侧面的X光揭示了光线的籽骨的破裂，破裂与一根藤条被对待3个星期。他对有能力6个星期在损害以后恢复了他的全部工作。籽骨破裂伸直过度损害并且有时的大小的指示物与MCP关节的手掌的板系带的眼泪被联系。并且认出系带损害的失败可以在拧上导致长期的伸直过度不稳定性。

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简介：AbstractEtiology of adolescent idiopathic scoliosis (AIS), a complicated three-dimensional spinal deformity with early-onset, receives continuous attention but remains unclear. To gain an insight into AIS pathogenesis, this review searched PubMed database up to June 2019, using key words or medical subject headings terms including "adolescent idiopathic scoliosis," "scoliosis," "pathogenesis," "etiology," "genetics," "mesenchymal stem cells," and their combinations, summarized existing literatures and categorized the theories or hypothesis into nine aspects. These aspects include bone marrow mesenchymal stem cell studies, genetic studies, tissue analysis, spine biomechanics measurements, neurologic analysis, hormone studies, biochemical analysis, environmental factor analysis, and lifestyle explorations. These categories could be a guidance for further etiology or treatment researches to gain inspiration.

简介：AbstractPurpose:Secondary displacement represents a frequent complication of conservative treatment of fractures, particularly of the distal radius. The gap space between skin and cast may lead to a certain degree movements and this increased mobility might favor redisplacement. The aim of this study was to develop a new 3D method, to measure the gap space in all 3 geometrical planes, and to validate this new technique in a clinical setting of distal radius fractures.Methods:This study applies 3D imaging to measure the space between plaster and skin as a potential factor of secondary displacement and therefore the failure of conservative treatment. We developed and validated a new methodology to analyze and compare different forearm casts made of plaster of Paris and fiberglass. An unpaired t-test was performed to document differences between the investigated parameters between plaster of Paris and fiberglass casts. The significance level was set at p< 0.05.Results:In a series of 15 cases, we found the width of the gap space to average 4 mm, being slightly inferior on the radial side. Comparing the two different casting materials, plaster of Paris and fiberglass, we found a significantly larger variance of space under casts made of the first material (p=0.39). A roughness analysis showed also a markedly significantly higher irregularity of the undersurface of plaster of Paris as compared with fiberglass.Conclusion:This study allows for a better understanding of the nature of the "gap space" between cast and skin and will contribute to develop and improve new immobilization techniques and materials.

简介：与ipsilateral联系的Hoffa骨折大腿骨的柄骨折是很稀罕的。损害的这种稀罕类型的三个盒子回顾地被考察。大腿骨的柄破裂和Hoffa破裂的地点被记录。所有大腿骨的柄破裂与内部固定被管理。为Hoffa破裂的错误诊断的率被记录。影响的膝的功能在二年后续为特殊外科(HSS)分数根据修改医院被评估。大腿骨的破裂在所有三个盒子中横向或合成。IpsilateralHoffa破裂在一种情况中在二种情况，和侧面的髁中发生在中间的髁。一仅仅Hoffa破裂外科手术前地被识别。所有大腿骨的柄破裂太平无事地愈合了。在其Hoffa骨折正确地被诊断的病人，修改HSS分数是94。在另一个病人，其Hoffa断裂，被第二个手术对待，修改HSS分数是93。并且在第三个盒子中，为Hoffa破裂拒绝了另外的操作，修改HSS分数仅仅是70。决定性地大腿骨的柄骨折能与ipsilateralHoffa骨折被联系，特别在摩托车事故。这类损害是很稀罕的，错误诊断是普通的。

简介：OnMarch13th,2011,theReleaseof2010SurveyReportonAdolescentHealthyPersonalityProjectandCeremonyfortheFoundationofYouthVolunteerUnionwereheldinBeijing.Thesurveyreportrevealsthatstudyitselforgettinghighmarksarethefundamentalelementsforprimarystudentsfeelinghappyandproud.26.3%oftheparentsdonotofferhelp

简介：Inthispaper,anonlocaltheoryoffractureforbrittlematerialshasbeensystematicallydevel-oped,whichiscomposedofthenonlocalelasticstressfieldsofGriffithcracksofmode-Ⅰ,ⅡandⅢ,theasymptoticformsofthestressfieldsattheneighborhoodofthecracktips,andthemaximumtensilestresscriterionforbrittlefracture.Asanapplicationofthetheory,thefracturecriteriaofcracksofmode-Ⅰ,Ⅱ,ⅢandmixedmodeⅠ-Ⅱ,Ⅰ-Ⅲaregivenindetailandcomparedwithsomeexperimentaldataandthetheoreticalresultsofminimumstrainenergydensityfactor.

简介：目的将由解剖学习和临床的申请探索paraspinal途径的优点和指示。解剖数据和27个盒子的临床的实践被分析探索在paraspinal肌肉和周围的纸巾的结构之间的精确途径的方法，以及paraspinal的临床的申请的结果来临。操作时间，血损失，切口长度，X光线照相术的结果(Cobb角度，vertebrae的前面的边的高度)与在传统的途径对待的24种情况中的那些相比。结果完成方面的暴露能被识别在multifidus和longissimus肌肉之间的自然劈开飞机容易执行。自然肌肉发达的劈开是(1.47

简介：Objective:ToinvestigatethediagnosticvalueofmultidetectorspiralCT(MSCT)inacutethoracolumbarspinalfractureandfracture-dislocation.Methods:CTimagingfilesof152consecutivetraumaticpatientswiththoracolumbarfractureswereretrospectivelyreviewed.MSCTscanningswereperformedwithacollimationof3-5mmandapitchof5.5.Thepostprocessingincludedsagittalandcoronalmultiplannarreconstruction,and3-Dreconstruction.Result:Therewere88casesofcompressionfracture,54casesofburstfractureand10casesoffracasdislocation.TransverseimagesofMSCTcouldvisualizeallfracturesdirectlyanddeterminewhetherspinalcanalwasintact.Postprocessingimagewashelpfulindepictingthedisplacementoffragmentandorientationofdislocation.Conclusions:MSCTplaysanimportantroleindiagnosisandmanagementofacutethoracolumbarspinalfractureandfracture-dislocation.

简介：光谱表面EMG信号的精力分发经常被使用，但是困难地并且有效地控制人工的手足，因为光谱在手足行动的进程的精力分发变化。在这份报纸，表面EMG信号模式的一般特征第一被描绘由光谱精力变化。当他们的前臂肌肉是“疲劳”或“放松”时，13个健康题目被指示与他们的右前臂执行前臂旋后(FS)和前臂内转(FP)。所有表面EMG信号在他们的右前臂行动期间从他们的右前臂屈肌被记录。表面EMG信号的二个集合在准备舞台和代理舞台适当地从每个表面EMG信号被分割。相对小浪包精力(在准备舞台和代理舞台分别地由pnp和pna象征了，n表示第n个频率乐队)表面EMG，信号第一被计算然后，差别(Pn=Pna-Pnp)被获得。结果证明从一些频率乐队的Pn能有效地描绘表面EMG信号模式的一般特征。与在另外的频率乐队的Pn相比，P4，光谱从93.75～125Hz的精力变化，更适当地被认为是特征。

简介：AbstractFrostbite in Southwestern China has been overlooked due to its low incidence, relatively mild temperature and lack of literature published before. However, it needs to be further studied for religious diversity and distinct geomorphology. In this article, we reported an 18-year-old Tibetan girl who suffered from blizzard attack during pilgrimage. Her feet and several fingers showed mummified gangrene upon physical examination with poor movement. She was diagnosed with 3rd to 4th degree of frostbite. The girl was given oral ibuprofen, debridement and other regular treatment daily, but she was eventually amputated due to insufficient thrombolytic management in primary hospital, delayed informing consent in the referral hospital and ethnic conflict between religion and guidelines. This case enriched the experience of managing complex frostbite in Tibetan population and alarms that efforts should be integrated to protect pilgrims and mountaineers in the Tibetan region.

简介：Background:Lately,physicalactivity(PA)inyounggirlshasbeenfrequentlydiscussed,thuswewereinterestedtoexaminewhetheramentaltraininginterventioncanincreasethelevelofPAinyounggirls.Methods:Asampleof56girlsaged15.4±0.3years(mean±SD)wasassignedtoeithertheinterventionorcontrolgroup.Wethenconducteda6-weekmentalimagerytrainingprogramonyoungfemaleparticipants.PAwasevaluatedwithobjectiveaccelerometermonitors.Physicalself-conceptwasalsoassessedinallparticipants.Results:Youngfemales'PAincreasedafteracourseofmentaltrainingcomparedtofemaleparticipantsincontrolgroup.Furthermore,physicalself-conceptimprovedrelatedtomentaltrainingprogram.Conclusion:ExerciseimagerymaybeaneffectivemethodofPAincreasebesidespsychologicalenhancementinyounggirls.

简介：Objective:Tointroducetheexperienceoftreatingfractureofbothtibiaandfibulawithmicro-invasivepercutaneousplateinternalfixationthroughfracturesiteapproach.Methods:Thedataof15patients(11malesand4females),including14adults(aged22-73years,mean=40years)and1child(aged10years),withfractureofbothtibiaandfibulawerestudiedretrospectivelyinthisstudy.Asmallincisionwasmadeatthefracturesiteoftibia.Thenrepositionwasmadeunderdirectvision,andinternalfixationwasemployedwithsteelplatesinsertingthroughthesmallincision.Results:Anatomicalreductionwasobtained.Nocomplicationwasfound.Unionoccurredontimein14patients.Onecasehealedafterasecondoperation.Conclusions:Micro-invasivepercutaneousplateinternalfixationisbeneficialtothehealingofboneandsofttissues.WithoutX-rayexamination,itisalsoeasytoreachanatomicalreductionandmaketibialinternalfixationwithbothplateswithmicro-invasivepercutaneousplateinternalfixation.

简介：Objective:Toexploretheinjurymechanismandtreatmentprincipleofopensupracondylarfractureofhumerus.Methods:Thedataof32patientswithopensupracondylarfractureofhumerushospitalizedinourdepartmentintherecent20yearswereanalyzedretrospectively.Onanaverage,theywerefollowedupfor30months.Therelationshipbetweenthefracturetype,situationofwounds,operatingtime,operatingmethodandtimeforpostoperativefunctionalexerciseandfinalfunctionofelbowjointwereevaluatedwithFlynnscoringstandard.Results:Excellenttherapeuticeffectwasfoundin14cases,goodin12andbadin6,withthepercentageoffinetherapeuticeffectof81.25%.Conclusions:Forthepatientswithopensupracondylarfractureofhumerus,debridementandinternalfixationshouldbemadeasearlyaspossible,forthoroughdebridementandcorrectinternalfixationarethekeypointstoimprovetheprognosis.