骨折概论祥解.ppt

骨 科 学矫形外科学 Orthopaedics 研 究 内 容 运动系统的创伤和疾病 矫形外科发展史 骨折治疗的历史 History of Osteosynthesis 1770 Lapejode Sicre internal fixation 1820 John Kearny Rogers silver wire suture 1843 Malgaigne griffe(claw) (first external fixatior) Albin Lambotte (1866-1955) 现代内、外固定之父 Rober Danis 1932-1949 soudure autogene(welding) direct bone healing Maurice E. Müller AO Arbeitsgemeinschaft fur Osteosynthese fragen 第一节 概 述(General Outline) There is no class of injuries which a practitioner approaches with more doubt and misgiving than fractures, or one which demands a greater amount of ready knowledge , self reliance, and consummate skill. Samuel D.Gross, 1882. Definition Fracture is interrupted in the communication of bone. Etiology and classification 1. Causal Factors and Mechanism of Injury. A direct force tapping crushing A indirect force twisting angulation axial compression Avulsion force Stress 2. Classification Stable stable fracture unstable fracture Soft tissuγe closed fracture open fracture Pathology pathological fracture Fracture Lines transverse oblique spiral compression avulsion green-stick comminuted dislocation shaped-star shaped-T、Y、V butterfly crushing Amount of Fruacture multiple double Epiphysis Time fresh old 第二节 骨折的临床表现和诊断( Clinical manifestation and Diagnosis of Fracture ) 1. Injury history shock or haemorrhage associated damage to brain , spinal cord or viscera a predisposing cause 2. Syptoms and signs pain, tenderness, conductible pain swelling, ecchymosis function disablity deformity a