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1.
Radiographic evaluation of the pelvis in standing horses has been used to diagnose fractures of the pelvis, head and greater trochanter of the femur, and luxations of the coxofemoral joint. Coxofemoral luxation injuries are more common in smaller horse breeds and donkeys, but, due to their size, the standing ventrodorsal projection is not possible, as there is insufficient space to place the radiography equipment under the animal's abdomen. The objective of the study was to report the advantages and limitations of the use of an oblique radiographic projection to diagnose unilateral craniodorsal coxofemoral luxation in 3 ponies and a donkey performed with the animals standing under light sedation. All cases had severe unilateral hindlimb lameness and asymmetry of the gluteal region; 2 also had concurrent intermittent upward fixation of the patella. A standing dorsolateral 20–30° ventral oblique radiograph of the affected coxofemoral joint was performed in all cases to obtain a definitive diagnosis. Radiography of the coxofemoral joint in standing ponies and donkeys can be carried out to identify craniodorsal coxofemoral luxation avoiding the need for general anaesthesia. 相似文献
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FLORIAN GEBUREK DrMedVet ANNA K. RÖTTING DrMedVet PhD Diplomate ACVS & ECVS PETER M. STADLER Prof DrMedVet 《Veterinary surgery : VS》2009,38(3):310-317
Objective— To assess agreement between ultrasonography (transcutaneous and transrectal) and standing radiography in horses with fractures in the pelvic region and disorders of the coxofemoral joint.
Study Design— Case series.
Animals— Warmblood horses (n=23) and 2 ponies.
Methods— Medical records (1999–2008) of equids with pelvic or coxofemoral disorders that had pelvic radiography and ultrasonography were retrieved and results of both techniques compared.
Results— Radiography and ultrasonography each identified equal numbers of fractures of the tuber coxa (n=4), ilial shaft (2), ischium (3), femoral neck (2), and osteoarthritis/osis of the coxofemoral joint (6). Fractures of the ilial wing (4) were only identified by ultrasonography not by standing radiography. Of 9 acetabular fractures, 3 were identified on radiographs only, 5 were identified with both modalities. One pubic fracture was identified using ultrasonography and radiography. One acetabular and 1 pubic fracture were only diagnosed on necropsy.
Conclusions— We found reasonable agreement (73%; 24/33) between ultrasonography and standing radiography for diagnosis of pelvic–femoral disorders. Ultrasonography was more useful for ilial wing fractures and radiography for acetabular fractures.
Clinical Relevance— Ultrasonography is a rapid, safe imaging technique for detecting disorders of the pelvic region with a high diagnostic yield and is a preferred initial approach in horses with severe hindlimb lameness. 相似文献
Study Design— Case series.
Animals— Warmblood horses (n=23) and 2 ponies.
Methods— Medical records (1999–2008) of equids with pelvic or coxofemoral disorders that had pelvic radiography and ultrasonography were retrieved and results of both techniques compared.
Results— Radiography and ultrasonography each identified equal numbers of fractures of the tuber coxa (n=4), ilial shaft (2), ischium (3), femoral neck (2), and osteoarthritis/osis of the coxofemoral joint (6). Fractures of the ilial wing (4) were only identified by ultrasonography not by standing radiography. Of 9 acetabular fractures, 3 were identified on radiographs only, 5 were identified with both modalities. One pubic fracture was identified using ultrasonography and radiography. One acetabular and 1 pubic fracture were only diagnosed on necropsy.
Conclusions— We found reasonable agreement (73%; 24/33) between ultrasonography and standing radiography for diagnosis of pelvic–femoral disorders. Ultrasonography was more useful for ilial wing fractures and radiography for acetabular fractures.
Clinical Relevance— Ultrasonography is a rapid, safe imaging technique for detecting disorders of the pelvic region with a high diagnostic yield and is a preferred initial approach in horses with severe hindlimb lameness. 相似文献
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DANIELA GORGAS PATRICK KIRCHER MARCUS G. DOHERR GOTTLIEB UELTSCHI JOHANN LANG 《Veterinary radiology & ultrasound》2007,48(6):501-506
Radiography is part of evaluating horses with poor performance and pelvic limb lameness; however, the radiographic appearance of the sacroiliac region is poorly described. The goal of the present study was to describe the use of a simple technique to obtain radiographs of the sacroiliac region in the anesthetized horse and to describe the radiographic appearance of this region. Seventy-nine horses underwent radiography of the pelvis under general anesthesia in dorsal recumbency. During a 5s exposure time the horse was actively ventilated to blur the abdominal viscera, which allowed assessment of individual bone structures in 77 horses. A large variation in the shape of the sacral wings, their articulation with the transverse processes of L6, and the relation of the sacrum to the ilium were observed. Females had significantly narrower width of the sacral wings. Broad sacral wings and bony proliferations at the caudal aspect were commonly observed features and their size was highly correlated with gender. In males, caudal osteophytes were significantly larger than in females. Five horses had transitional or hemitransitional vertebrae. Radiography with the ventilation-induced blurring technique is a simple approach that results in diagnostic quality radiographs and delineation of the highly variable bone structures of the sacroiliac region. 相似文献
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RADIOGRAPHIC APPEARANCE OF EQUINE LUMBOSACRAL AND PELVIC ABNORMALITIES BY LINEAR TOMOGRAPHY 总被引：1，自引：0，他引：1
Radiologic findings are described in 20 horses with clinical signs of a caudal lumbar or hindlimb problem; the horses were subjected to linear tomography of the lumbosacral and pelvic regions. The cases could be divided into four groups: sacroiliac arthrosis (6 horses), lumbosacral abnormalities (3 horses), pelvic or lumbar fracture (6 horses), and no radiographic abnormalities (5 horses). Five of the six horses with sacroiliac arthrosis had spur formation, with localized arthrosis at the caudal aspect of the sacral wing and its articulation with the auricular surface of the ilium. In one horse these lesions were confirmed at postmortem examination. The sixth horse, a Standardbred trotter, had more even and widespread arthrosis of the sacroiliac joint. The three lumbosacral abnormalities were present in two horses with fusion of the L5 -L6 articulation and one horse with a wider than normal sacrolumbar articulation. Linear tomography also proved to be of diagnostic and prognostic value in the evaluation of lumbar and pelvic fractures. Finally, tomography could be used to eliminate the presence of sacroiliac or lumbosacral damage in some horses that presented with clinical signs suggestive of disease of the lumbosacral or sacroiliac region. 相似文献
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J. M. Romero M. C. Pressanto M. Pepe A. Di Meo F. Beccati 《Equine Veterinary Education》2021,33(7):e210-e218
Proximal gastrocnemius and superficial digital flexor (SDF) muscle injuries are reported in the horse but are uncommon. In adult horses, the definitive diagnosis is more commonly based on clinical signs with or without the use of radiographic examination and/or nuclear scintigraphy. This case report describes the clinical and ultrasonographic findings of a tear of the gastrocnemius muscle in a 6-year-old reining mare. At standing physical examination, there was a sickled hock appearance, with the point of the hock of the left hindlimb lower (dropped hock) than that of the right hindlimb. At dynamic examination at walk, the mare had instability of the left hock characterised by medial rotation of the hoof and lateral rotation of the point of the hock (twisting motion); at trot, the horse showed mild/moderate left hindlimb lameness characterised by more downward movement of the pelvis during weightbearing of the lame limb compared with that of the sound limb. Ultrasonographic examination of the left thigh and crus showed a large irregular hypoechogenic area and irregularly shaped, retracted muscle stumps on the lateral aspect of the gastrocnemius muscles; the proximal insertion of the SDF muscle on the supracondylar fossa of the femur was irregular in its outline, hypoechogenic and thickened compared with that of the right side. Characteristic muscle fibre pattern was not identified in the left gastrocnemius muscle. On the radiography, a mild irregularity of the bone margin of the lateral supracondylar tuberosity was detected on the caudo 45° medial-craniolateral oblique view of the distal femur. Clinical and diagnostic imaging findings were consistent with partial failure of the caudal part of the reciprocal apparatus and injury of the gastrocnemius and SDF muscles/origin. The horse was managed conservatively by corrective shoeing, muscle relaxing drugs, controlled exercise and manual stretching. 相似文献
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The clinical and ultrasonographic features of seven horses with coxofemoral subluxation are presented. Affected horses included five adult geldings (11–20 years), one large pony (6 years) and a 3-month-old filly. All were lame at the walk except for the pony with grade 3/5 lameness. Lameness was acute in all horses, but three horses progressed after initial improvement. Crepitus, muscle atrophy, and pelvic asymmetry were inconsistent findings. Ultrasonographic diagnosis of subluxation required dynamic visualization of femoral head displacement from the acetabulum while placing weight on the affected limb and subsequent replacement into its normal position upon limb resting. Acetabular rim fractures and joint effusion were visible regardless of weight bearing status in six horses each. No fractures were identified in the pony; the only patient with a good outcome. Six horses had a poor outcome with severe chronic lameness, four of which were euthanized. Postmortem ventrodorsal radiographs obtained in two horses confirmed subluxation only on extended limb projections, but not on hip-flexed projections. Acetabular rim fractures were not visible radiographically in either horse but were confirmed at necropsy. Subluxation was due to an elongated but intact ligament of the head of the femur in both horses. Osteoarthrosis was evident ultrasonographically, radiographically, and at necropsy. Dynamic ultrasonography was readily performed in the standing horse and produced diagnostic images with a low frequency curvilinear transducer. The apparent poor prognosis for horses with subluxation and acetabular fracture illustrate the importance of this imaging technique to identify affected horses. 相似文献
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REASON FOR PERFORMING STUDY: Coxofemoral joint pain is probably underestimated due to difficulties in identifying hip pain. The deep location of the joint and proximity of the sciatic nerve make arthrocentesis based on external landmarks a difficult and potentially risky procedure in mature horses. OBJECTIVES: To describe an ultrasound-guided injection technique of the coxofemoral joint in standing horses and to evaluate its accuracy and potential difficulties/complications. METHODS: Nine mature horses had both pelvic areas prepared for sterile ultrasound examination (3.5 MHz curvilinear probe). Coxofemoral joints were located and penetrated at their craniodorsolateral aspect under ultrasonographic guidance and injected with sterile contrast medium. A standing ventrodorsal radiographic view of each hemipelvis centred on the hip was obtained for each horse to assess the injection site. Horses were evaluated for 10 days following injection for possible complications. RESULTS: Intra-articular injection was successful in all 18 joints. The procedure was well tolerated by horses under minimal restraint. Mean +/- s.d. needle repositionings required before accurate placement was 1.5 +/- 1.3 per joint. Once the needle was in the joint, synovial fluid was obtained in 7/18 joints. Minimal periarticular contrast medium was detected in 2/18 joints. Mean +/- s.d. ultrasonographic examination time required for coxofemoral localisation, accurate needle positioning and injection was 4.3 +/- 2.1 min. No complications were observed in the 10 days following injection. CONCLUSION: The ultrasound-guided coxofemoral arthrocentesis is an accurate, reliable and safe technique that offers a real time evaluation of needle introduction into the deep and narrow coxofemoral joint space. POTENTIAL RELEVANCE: Although this technique remains to be tested on clinical cases, it is a promising tool to facilitate diagnosis of coxofemoral pain, septic arthritis or administration of intra-articular medication. 相似文献
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The objective of this study was to establish a technique for radiographic examination of the coxofemoral joint and adjacent bony structures in standing cattle. Left (or right) 30° dorsal-right (or left) ventral radiographic views of the coxofemoral joint region of standing cattle (n = 10) with hind limb lameness were evaluated retrospectively. In addition, an experimental study of oblique laterolateral views of the coxofemoral joint region of a bovine skeleton at angles of 15-45° was carried out to determine the optimal position for visualization of the hip region. In the 10 clinical patients, the bodies of the ilium and ischium, the acetabulum and proximal third of the femur could be assessed. Six of these cattle had fractures of the body of the ilium and body of the ischium, five with and one without involvement of the acetabulum, two had craniodorsal and one caudoventral luxation of the femur and one had a femoral neck fracture. The described laterodorsal-lateroventral radiographs of the hip region in standing cattle were suitable for assessing the coxofemoral joint, the proximal aspect of the femur and parts of the ischium, ilium and pubis. After testing the optimal angle on the skeleton, it was seen that distortion and superimposition were minimized by positioning the X-ray beam at an angle of 25° to the horizontal plane. It can be concluded that the described technique improves the evaluation of injuries of the coxofemoral region in cattle. With the appropriate angle, the technique can also be applied in recumbent cattle. 相似文献
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R S Shoemaker G S Martin D J Hillmann P F Haynes J R McClure H L Schneiter 《Journal of the American Veterinary Medical Association》1991,198(1):120-122
Two horses became acutely lame following a fall during strenuous exercise and were diagnosed as having disruption of the caudal component of the reciprocal apparatus. Clinical signs consisted of lameness of the right pelvic limb, characterized by flexion of the hock and simultaneous extension of the stifle. Radiography revealed an avulsion fracture from the supracondylar tuberosity and fossa of the distal portion of the femur in one horse. Clinical and radiographic findings indicated avulsion of the lateral origin of the gastrocnemius and superficial digital flexor muscles. Treatment consisted of stall rest, limb immobilization, and phenylbutazone administration. One horse recovered to soundness and the other deteriorated and was euthanatized. 相似文献
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OBJECTIVE: To describe and evaluate subtotal ostectomy of dorsal spinous processes (DSP) performed in standing horses. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Nine adult horses. METHODS: The diseased portions of the DSP were removed with the horses standing and sedated after infiltrating a local anesthetic agent around the affected DSP. Medical records of affected horses were reviewed to determine history, findings of physical and radiographic examination, surgical technique, postoperative complications, and outcome. RESULTS: Five horses had subtotal ostectomy of DSP because of osteomyelitis, and 4 because of impingement and/or fracture of DSP. Affected portions of DSP were removed safely and effectively, with no apparent discomfort to the horses; hemorrhage was minimal. CONCLUSIONS: Subtotal ostectomy of DSP can be performed safely in standing, conscious horses and the risks associated with general anesthesia are eliminated. Hemorrhage is minimal compared to that which occurs when the procedure is performed with horses anesthetized and in lateral recumbency. CLINICAL RELEVANCE: Access and visibility are better when subtotal ostectomy of the DSP is performed with the horse standing rather than anesthetized and in lateral recumbency. Performing subtotal ostectomy of diseased DSP with the horse standing avoids the expense and risks of general anesthesia. 相似文献
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Brian J. Trumpatori BS Kyle G. Mathews DVM MS Simon R. Roe BVSc MS PHD Ian D. Robertson BVSc 《Veterinary radiology & ultrasound》2003,44(5):526-532
A radiographic study of the anatomy of the canine acetabulum was performed. The relationship between the area of dorsal acetabular rim that is subject to early damage in dogs with coxofemoral joint laxity, and the "DAR point" identified on dorsal acetabular rim (DAR) radiographic views was examined. Radiographs and digital photographs were made of the pelvis harvested from each of six skeletally mature dogs. Through analysis of these images, it was determined that in the standing animal, the DAR point is located 4–6 mm (or approximately 37°) caudal to the dorsal acetabular rim area that is prone to early damage in dogs with coxofemoral joint laxity. This study suggests that the DAR radiographic view may under-represent changes to the dorsal acetabular rim in dogs with coxofemoral laxity. 相似文献
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LEWIS C. R. SMITH BVetMed TIMOTHY R. C. GREET BVMS MVM CertEO DESTS Diplomate ECVS FRCVS ANDREW P. BATHE MA VetMB DEO Diplomate ECVS 《Veterinary surgery : VS》2009,38(6):681-688
Objective— To describe a lateral approach for screw fixation in lag fashion of simple spiral medial condylar fractures of the third metacarpus/metatarsus (MC3/MT3).
Study Design— Case series.
Animals— Thoroughbred racehorses (n=9).
Methods— Nondisplaced medial MC3/MT3 condylar fractures (3 thoracic, 6 pelvic limbs), with mean length 126 mm (range, 91–151 mm) were repaired by internal fixation, under general anesthesia, using multiple 4.5 mm cortical screws inserted in lag fashion from the lateral aspect of the limb, using radiographic or fluoroscopic guidance. Horses were recovered from anesthesia in half-limb casts; 7 unassisted and 2 using a rope-recovery system. Horses had 2 months box rest, 1 month in-hand walking, and follow-up radiographic examination at 3 months.
Results— Horses recovered uneventfully from anesthesia. Five horses raced; 1 returned to training, was persistently lame, and was retired to stud; 2 were retired directly to stud; and 1 horse was lost to follow-up.
Conclusions— MC3/MT3 medial condylar fractures were successfully repaired by screws inserted n lag fashion form the lateral aspect.
Clinical Relevance— Use of a lateral approach to medial condylar MC3/MT3 fractures allows screw insertion perpendicular to the fracture plane without interference with palmar/plantar soft tissue structures or from the splint bones. Although repair was performed under general anesthesia, the technique should be adaptable to application in standing horses. 相似文献
Study Design— Case series.
Animals— Thoroughbred racehorses (n=9).
Methods— Nondisplaced medial MC3/MT3 condylar fractures (3 thoracic, 6 pelvic limbs), with mean length 126 mm (range, 91–151 mm) were repaired by internal fixation, under general anesthesia, using multiple 4.5 mm cortical screws inserted in lag fashion from the lateral aspect of the limb, using radiographic or fluoroscopic guidance. Horses were recovered from anesthesia in half-limb casts; 7 unassisted and 2 using a rope-recovery system. Horses had 2 months box rest, 1 month in-hand walking, and follow-up radiographic examination at 3 months.
Results— Horses recovered uneventfully from anesthesia. Five horses raced; 1 returned to training, was persistently lame, and was retired to stud; 2 were retired directly to stud; and 1 horse was lost to follow-up.
Conclusions— MC3/MT3 medial condylar fractures were successfully repaired by screws inserted n lag fashion form the lateral aspect.
Clinical Relevance— Use of a lateral approach to medial condylar MC3/MT3 fractures allows screw insertion perpendicular to the fracture plane without interference with palmar/plantar soft tissue structures or from the splint bones. Although repair was performed under general anesthesia, the technique should be adaptable to application in standing horses. 相似文献
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BETH M. KRAUS MICHAEL W. ROSS ROBERT P. BOSWELL 《Veterinary radiology & ultrasound》2005,46(6):524-528
Two 2-year-old pacers, a 3-year-old pacer and a 2-year-old-trotter with acute forelimb lameness were admitted for nuclear scintigraphic examination. Horses were grade 3-4/5 lame. There was increased radiopharmaceutical uptake (IRU) in the distal cranial medial aspect of the humerus in one horse and along the caudal humeral cortex in the other three horses. Two of the four horses were affected bilaterally. Radiographic abnormalities consisted of thickening of the caudal cortex of the mid-diaphysis of the humerus but radiographic changes were not present in all horses. All horses were managed with stall rest initially then stall rest with hand-walking followed by limited turn out for a total of four months. None of the horses had raced before injury. One horse has returned to race training and the other three horses have returned to racing. Average time to return to racing was 329 days. Humeral stress fractures in Standardbred horses are rare. Diffuse patterns of IRU have not been reported in the humerus and are likely indicative of severe stress remodeling. Standardbred racehorses with stress fractures or stress remodeling of the humerus appear to have a good prognosis for return to racing. 相似文献
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Osteochondral dysplasia of the coxofemoral joints in a Friesian foal: Clinical findings and methods of diagnosis 
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下载免费PDF全文 H. Hermans S. Veraa M. Ploeg S. Boerma H. A. W. Hazewinkel W. Back 《Equine Veterinary Education》2016,28(9):486-491
Diseases of the coxofemoral (hip) joint are infrequently diagnosed in horses. Most cases are presented as an unilateral condition and usually are of traumatic origin. This case report describes a Friesian foal with a clinically obvious thoracolumbar kyphosis, combined with a weight‐shifting stance and a shortened stride of both hindlimbs. General clinical and lameness examinations, computed tomographic examination of the pelvis, and macroscopic and histopathological examinations of the coxofemoral joints were performed. This revealed a final, phenotypical diagnosis of a primary osteochondral dysplasia of both coxofemoral joints with secondary osteoarthritis. Similar to the occurrence of this condition in other species and considering the small genetic basis of the Friesian horse breed, a genetic predisposing factor is suspected to play a key role in the developing mechanism of dysplastic coxofemoral joint disease in horses as illustrated with this case. Computed tomography scanning appears to be a useful imaging technique in the detection of coxofemoral joint disease in small horses and foals. 相似文献
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Barbara Kaser-Hotz Dr med vet Gottlieb Ueltschi Dr med vet Nikolaus Hess Dr med vet 《Veterinary radiology & ultrasound》1991,32(6):283-285
The case history, radiographic and scintigraphic findings of two horses with pelvic limb navicular bone fractures are presented. In both cases the fractures were of traumatic origin. One horse had a bilateral fracture of the navicular bone, distal border, the other horse had a fracture of the proximal articular border in one pelvic limb navicular bone. 相似文献
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BRUCE C. WATT DVM JOSEPH J. FOERNER DVM Diplomate ACVS GREG R. HAINES DVM 《Veterinary surgery : VS》1998,27(4):337-341
Objective —To describe incomplete oblique sagittal dorsal cortical fractures of the equine third metacarpal bone, their surgical repair, and subsequent performance of the horses.
Study Design —Retrospective examination of medical records and racing performance.
Animal Population —Six Thoroughbred race horses, 2 to 4 years of age.
Methods —Radiographic confirmation of all fractures preceded general anesthesia and surgical correction. Three fractures were treated by intracortical compression using screws placed in lag fashion, and five fractures were treated by osteostixis. Race records were reviewed for each horse to determine performance after surgery.
Results —Fractures were best observed on palmarodorsal radiographic projections. Three horses treated by intracortical compression returned to racing, but fracture recurred in one horse and was treated by osteostixis. This horse and the other three horses treated by osteostixis raced after surgery.
Conclusions —Horses with incomplete oblique sagittal fractures of the dorsal cortex of the third metacarpal bone can race after surgical management of the fracture by screws placed in lag fashion or osteostixis. The authors' preferred surgical procedure for managing this fracture is osteostixis.
Clinical Relevance —Palmarodorsal radiographic projections of the third metacarpal bone are recommended in young Thoroughbred race horses suspected of having dorsal metacarpal stress fractures. 相似文献
Study Design —Retrospective examination of medical records and racing performance.
Animal Population —Six Thoroughbred race horses, 2 to 4 years of age.
Methods —Radiographic confirmation of all fractures preceded general anesthesia and surgical correction. Three fractures were treated by intracortical compression using screws placed in lag fashion, and five fractures were treated by osteostixis. Race records were reviewed for each horse to determine performance after surgery.
Results —Fractures were best observed on palmarodorsal radiographic projections. Three horses treated by intracortical compression returned to racing, but fracture recurred in one horse and was treated by osteostixis. This horse and the other three horses treated by osteostixis raced after surgery.
Conclusions —Horses with incomplete oblique sagittal fractures of the dorsal cortex of the third metacarpal bone can race after surgical management of the fracture by screws placed in lag fashion or osteostixis. The authors' preferred surgical procedure for managing this fracture is osteostixis.
Clinical Relevance —Palmarodorsal radiographic projections of the third metacarpal bone are recommended in young Thoroughbred race horses suspected of having dorsal metacarpal stress fractures. 相似文献
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Starke A Herzog K Sohrt J Haist V Höhling A Baumgärtner W Rehage J 《Veterinary surgery : VS》2007,36(2):99-106
OBJECTIVE: To report use of ultrasonographic examination of the coxofemoral joint, a surgical technique for repair of craniodorsal coxofemoral dislocation, and outcome. STUDY DESIGN: Clinical case reports. ANIMALS: Calves (n=4) with coxofemoral luxation. METHODS: Craniodorsal coxofemoral luxation was diagnosed by physical examination, radiographic, and ultrasonographic findings. Open surgical reduction of the femoral head was performed using a modified caudal approach. RESULTS: Craniodorsal luxation of the femoral head and the presence of an intact femoral neck were confirmed by ultrasonography. All luxations were successfully reduced and reluxation did not occur. At follow-up, 1 heifer had calved and 1 was 5 months pregnant. One calf died of bronchopneumonia 6 days after surgery. One calf had severe coxofemoral degenerative joint disease diagnosed (ultrasonography, radiography, and arthrocentesis) 3 months after surgery and confirmed by necropsy. CONCLUSION: Ultrasonography proved to be a simple and effective non-invasive technique for diagnosis of coxofemoral luxation. Immediate surgical intervention in hip dislocation in calves is necessary to avoid unnecessary trauma to subchondral structures. In calves, open instead of closed surgical reduction appears preferable because it allows access to the acetabular cavity for removal of debris. CLINICAL RELEVANCE: Ultrasonography should be considered a supplementary but not an alternative to radiographic examination for diagnosis of coxofemoral luxation and for follow-up examinations after reduction. 相似文献