月骨骨折-zxq的.pptVIP

月骨骨折 大连市第三人民医院 邹向前 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 原因 单次暴力：外伤 疲劳骨折：头状骨与桡骨不断挤压月骨。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 损伤机制 常有腕关节过度背伸外伤史： 滑到后手掌支撑着地，头状骨与月骨撞击，致冠状面横断骨折。 月骨掌背侧极撕脱骨折：腕关节过度屈伸牵拉。 月骨背侧极骨折：桡骨远端关节面背侧缘撞击或者外来的直接暴力。 轻微外力长期作用： 疲劳骨折及月骨内血管网损伤，症状轻微，易被忽视，导致缺血坏死。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 分类 掌侧滋养动脉的掌侧前方骨折 无滋养动脉损伤的临近关节面的骨软骨骨折 背侧前方骨折 月骨体横行骨折 横跨关节的月骨前方骨折 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 临床表现与诊断 急性骨折：腕关节背伸外伤史，关节背侧疼痛，肿胀，运动受限，局部压痛。 疲劳骨折：症状轻微。 常规x片可以显示背侧骨折，但骨影遮掩常显示不清。 CT Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 治疗 掌侧极骨折：管型石膏-----腕关节屈曲位。 背侧极骨折：管型石膏-----固定背伸位。 4-6周后，去石膏活动 无移位骨折:石膏固定 有移位骨折：ORIF X线、CT、MRI Kienbock Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Kienbock病 1910年，Kienbock对以月骨碎裂、进行性塌陷为主要表现而X线无明显表现的腕关节疾病进行系统描述，称为月骨缺血性坏死，即为Kienbock病。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 病因 月骨外动脉损伤 月骨内动脉损伤 月骨静脉栓塞 腕关节解剖变异： 其他：类风关、痛风、酒精中毒 滋养动脉缺如 尺骨负变异 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 事实表明，Kienbock病的发生是创伤、尺骨变异、受损血管等因素共同作用的结果。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Classification scheme Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.