目的：探讨钩骨体部骨折的临床分型和治疗策略。方法报告41例钩骨体部骨折病例的临床分型与治疗效果。根据骨折线的方位和对钩骨-掌骨关节稳定性的影响进行分型：横行骨折（I型）和纵行骨折（ II型），后者进一步分为三个亚型，II A型为钩骨冠状面劈裂骨折；II B型骨折线为斜形，涉及钩骨关节面背侧较大部分；II C型为钩骨背侧撕脱骨折。本组I型骨折2例，II A型骨折9例， II B型骨折21例，II C型9例。根据骨折类型选择治疗方案，保守治疗6例，手术治疗35例。结果本组患者随访4～48个月，平均（21.2±12.2）个月。至最后一次随访，所有患者对治疗的主观评价为满意或非常满意。骨折愈合率100%，术后握力双侧对比差异无统计学意义，患侧平均握力（40.41±6.18） kg，健侧平均握力（40.26±5.13） kg，P＝0.613。没有出现感染、肌腱粘连和神经损伤等并发症。结论钩骨体部骨折预后较好，II A型和II B型骨折由于稳定性差，一般需要手术治疗，II C型骨折则需评估合并损伤情况和腕掌关节复位后的稳定性来决定是否手术。

Objective To investigate the clinical classiifcation and therapeutical strategy of fractures of the body of the hamate. Methods The clinical classiifcation and therapeutic effects of 41 cases of fractures of the body of the hamate were reported. The fractures of the body of the hamate were classiifed into 2 major groups and 3 subgroups based on the orientation of the fracture line and the effects on the stability of the hamatometacarpal joint. Type I referred to the traverse fracture, and type II referred to the longitudinal fracture. Type II A represented coronal splitting fractures of the hamate, type II B represented oblique fractures with a major part of the dorsal hamate joint involved, and type II C represented avulsion fractures of the dorsal hamate. There were 2 cases of type I, 9 cases of type II A, 21 cases of type II B and 9 cases of type II C in this group. The therapeutical strategy was chosen based on the type of fractures, and the conservative treatment was performed on

目的：探讨钉钩内固定系统峡部植骨治疗青少年腰峡部裂的手术方法及疗效。方法自从2007年以来，我院对17例腰椎峡部裂患者采用钉钩内固定系统峡部植骨治疗，并对手术结果进行分析。结果所有患者均获得随访，随访时间12～26个月，平均17个月。术前JOA评分为15.06±2.35，最后随访评分为26.18±0.25，差异有统计学意义，所有患者峡部裂融合处获得骨性愈合。结论采用钉钩内固定系统峡部植骨治疗青少年腰椎峡部裂，对腰椎的运动功能干扰及手术创伤均较小，是有效的治疗方法。

Objective To explore the surgical method and clinical results of the pedicle screw-lamina hook plus isthmic bone grafting in the treatment of the lumbar spondylolysis. Methods Since 2007,seventeen cases with lumbar spondylolysis had been treated with the pedicle screw-lamina hook plus isthmic bone grafting,and the surgical results were analyzed. Results All the patients were followed up for 12-26 months,average 17 months. Preoperative JOA score was 15.06±2.35,and that was 26.18±0.25 at the final follow-up,the difference was statistically significant (P<0.05). The bone fusion was roentgenologically observed in all patients. Conclusion The pedicle screw-lamina hook plus isthmic bone grafting is a single-fixation,and this operation is technically simple and no sacrifices of lumbar motion ranges,and it is proved to be effective.

目的椎弓根螺钉、椎板钩加峡部植骨术治疗腰椎峡部不连手术5年疗效随访研究。方法 2006-2008,我院收治20例单纯腰椎峡部不连患者采用椎弓根螺钉、椎板钩加峡部植骨固定治疗术后5年随访。结果术前及术后5年随访VAS评分有明显统计学意义(P0.05);患者术后5年CT断扫峡部裂植骨均骨性愈合。20例患者均未发生脱钩及临近节段退变(椎间隙高度丢失);2例诉腰椎活动度较术前轻度受限;6例出现腰椎间盘退变。结论与多节段固定融合术相比,椎弓根螺钉、椎板钩加峡部植骨术治疗腰椎峡部不连是对腰椎正常生理活动范围干扰小、临近节段退变率低的一种可靠、有效的单椎体动态固定术式。

Objective To observe the effect of pedicle screw-lamina hook plus isthmic bone grafting on the lumbar spondylolysis through a 5-year follow-up study. Methods From 2006 to 2008,20 cases with lumbar spondylolysis who had been treated with the pedicle screw-lamina hook plus isthmic bone grafting were selected in the present study,and the patients were followed up for 5 years. Results The VAS score of postoperative 5 years was significantly different from that pre-operation (P<0.05).The bone fusion was observed in all patients after 5-year follow-up. None of them had detachmented the pedicle screw-lamina hook and intervertebral altitude loss. Only 2 cas-es felt lumbar restricted movement. 6 cases had degeneration of lumbar intervertebral disc. Con-clusion Compared with the multi-segmental fixation and interbody fusion,the pedicle screw-lamina hook plus isthmic bone grafting is a single-fixation,and this operation is technically simple and no sacrifices of lumbar motion ranges,and it is pro

目的：NeerⅡ（1）型锁骨远端骨折为不稳定性骨折，探讨应用锁骨钩钛板治疗效果。方法：本组39例病人均给予锁骨钩钛板手术治疗。结果：39例病人均骨折愈合，没有出现骨不连及内固定断裂现象，但有11例出现肩周疼痛，肩关节功能障碍现象，按Lazzcano标准评定，优28例，良11例。临床效果满意。结论：应用锁骨钩钛板治疗锁骨远端骨折是目前比较可靠的治疗方法。

objective :NeeⅡ(1)type distal clavicle is not stable fractures ,the clavicular hook titanium plate treatment is a reliable treatment method .Fracture healing in this group of 39 patients,no nonunion fracture and internal fixation phenomen .However,11patients had shoulder pain ,shoulder dysfunction phenomenon ,under Lazzcano standard assessment results :excellent in 28 cases,good in 11 cases, satisfactory clinical results .

目的比较头帽-J钩与微种植钉压低上颌切牙时的临床疗效。方法选择上颌前部牙槽骨发育过度的成年患者21例,分J钩组9例,种植组12例,分别使用头帽-J钩和微种植钉压低切牙,比较2组压入术前后头颅定位侧位片相关指标及矫治时间。结果 2组U1-PP均明显减少(P0.01),种植组减少量大于头帽-J钩组(P0.01);U1-Sv种植组增大(P0.01),头帽-J钩组减少(P0.01);U1/PP角种植组增大(P0.01),头帽-J钩组变化不明显(P0.05);U6-PP2组变化均无统计学差异(P0.05);U6-Sv种植组增大(P0.01),J钩组变化无统计学差异(P0.05);压低时间种植组小于头帽-J钩组(P0.01)。结论微种植螺钉和头帽-J钩均可以很好的压低切牙,微种植螺钉压入效果优于头帽-J钩,并用时少,但会引起切牙唇倾加重后牙支抗负担。

Objective To evaluate the treatment effects of J hook headgear and micro-screwson intrusionof upper incisor.Methods 21 adult patients with overgrown maxillary alveolar were chosen and divided into two groups:J hook headgear group(n =9),and mi-cro-screws group(n =12),using J hook headgear and micro-screwsto lowerupper incisor respectively.Cephalometric analysis was per-formedbefore and after treatment,and cephalometric indicatorschangesand treatment time of two groups were compared.ResultsU1 -PP of the two groups were significantly reduced(P 0.05);U6-PP both groups had no statistically significantchange(P > 0.05 );as for U6-Sv,micro-screws group increased(P 0.05);the treatment time of micro-screws group was less than that of J hook headgear group(P <0.01 ).Conclusions Both J hook headgear and micro-screwshave effect onthe intrusion of incisors, and micro-screws is more effective than J hook headgear with less time,but it will cause anterior teeth labial inclination and increas