(外科学课件）03.Deng Fractue introduction2016f.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Methods of Immobilization: 1. Wooden Splint , Plaster Cast 2. Continuous Traction 3. External Fixator 4. Internal Fixation IMMOBILIZATION REHABILITATION 1. Active Muscular Contraction (Within 2 Weeks postfracture) 2. Active Motion on Joints Adjacent to Fracture (2 ~ 8 w postfracture) 3. Active Resistance Exercises ( Over 8 ws postfracture ) 4. Physiotherapy MEDICATION Traditional medicine Avoid to use Nonsteroid Anti-Inflammatory Drugs ( NSAIDs ) TREATMENT Of OPEN FRACTURE Prevent Infection !! 1. Types of Open Fracture From outside to inside From inside to outside Potential open fracture TREATMENT Of OPEN FRACTURE 2. Conditions of the Wound Contamination degree Soft Tissue Injury TREATMENT Of OPEN FRACTURE 3. Debridement Same Principles as Surgical Debridement Golden Time : 6 ~ 8 h (after injury) Larger Bony Piece Should be Preserved Properly fix the fracture Repair Nerve、Tendon、Vessel Properly Close the wound TREATMENT Of OPEN FRACTURE Same Principles as Surgical Debridement 1). Restore the smooth surface of joint 2). Not to Leave Foreign Bodies in Joint 3). Forbid to Open Draining ( Can Use Irrigation ) 4). Repair of Capsule and Ligaments TREATMENT Of OPEN FRACTURE 5). Inject Antibiotics into the Joint After operation 6). Aspiration is Especially Important in hemarthrosis 7). The Joint should be Immobilized with traction , Splint or Plaster TREATMENT Of OPEN FRACTURE DELAYED UNION