儿童桡骨远端骨骺损伤致尺骨撞击征一例报告

尺骨撞击综合征是由于腕尺侧月骨、三角骨与尺骨头撞击所引起的腕部创伤性关节病，其病理过程早期为软骨改变、骨髓水肿，晚期可导致不可逆性骨坏死及骨关节炎，导致严重的功能障碍[1]。随着临床医生对该病的认识不断提高，国内外相关报道也逐渐增多，但仍有部分临床医生及影像科医生对此征的认识不足，导致诊治不及时等情况发生。尤其是儿童桡骨远端骨骺损伤的患儿，伤后缺少远期随访，使其因骨骺生长停滞导致桡骨短缩，进而形成尺骨与桡骨生长不同步，尺骨较桡骨长而撞击腕骨，导致尺腕关节骨性关节病甚至骨坏死，给患者造成极大的痛苦。对该病早期诊断及治疗可明显降低致残率。

Objective: To study the effects of two epiphyseal stimulating procedures on local growth of long bone in rabbits.Methods: Osteotomy was performed in the metaphysis near the proximal tibial epiphyseal plate and hemicircumferential periosteal excision was made on the proximal tibial epiphysis. Tibia roentgenography, tetx, acycline labelling, histological method and electron microscopy were used.Results: The local stimulating effect following the hemicircumferential periosteal excision was more remarkable than the osteotomy.Conclusions: Periosteal excision is a better treatment for children's knee deformity.

Long-Term Trend of Bone Development in the Contemporary Teenagers of Chinese Han Nationality

Objective To further improve the accuracy of bone age identification using the time of secondary ossification center appearance and epiphyseal fusion of 7 joints to estimate the age of living individuals.Methods DR films were taken from 7 parts including sternal end of clavical and the left side of shoulder,elbow,carpal,hip,knee and ankle joints of 1709 individuals who came from eastern China,central China and southern China,whose ages were between 11.0 and 20.0 years.From those 7 joints 24 osteal loci were selected as bone age indexes,which could better reflect age growth of teenagers.The characteristics of secondary ossification center appearance and epiphyseal fusion were observed,and the mean and age range of secondary ossification center appearance and epiphyseal fusion were calculated.Results The fusion time of the 24 epiphyses were advanced at different degrees,the most obvious epiphyses the sternal end of clavicle,scapular acromial end,distal end of the radius,distal end of the ulna,iliac crest,ischial tuberosity,the upper and lower end of tibia and fibula.The appearance time of sternal end of clavicle,scapular acromial end,iliac crest and ischial tuberosity epiphyses were all found to be after the age of 12,and the female's age,approximately 1year ahead of schedule in comparison with the male's.Conclusion The relevant forensic information and data for bone age identification should be updated every 10-15 years so as to provide accurate and objective evidence for court testimony,conviction and sentencing.