骨科笔记（Department of orthopedics notes）.docVIP

骨科笔记（Department of orthopedics notes） 1. fractures Definition: the integrity and continuity of the bone are interrupted. Causes: direct violence, indirect violence, accumulated strain. The displacement of fracture segment: angulation displacement, lateral displacement, shortening shift, separation shift and rotation displacement. Clinical manifestation of fracture: Physical manifestation: shock, fever; Local manifestations: general manifestations: local pain, swelling and dysfunction. Special signs: deformity, abnormal activity, bone fricative or bone rubbing. Complications of fracture: Early complications: Shock; Fat embolism syndrome; Important internal organs injuries: rupture of liver and spleen, lung injury, bladder and urethra injury, rectum injury. Important peripheral tissue injuries: Compartment syndrome: Late complications include hypostatic pneumonia, bedsore, deep vein thrombosis, infection, heterotopic ossification, traumatic arthritis, joint stiffness, acute bone atrophy, ischemic necrosis, and ischemic muscle spasm. The healing process of fracture 3 stages: the stage of hematoma evolution, the formation stage of primary bone callus, and the remodeling period of callus. Clinical healing criteria: Local tenderness and longitudinal percussion pain; Local non abnormal activity; X-ray showed continuous callus at the fracture, and the fracture line was blurred; The removal of external fixation, such as the upper limb can move forward Ping 1kg weight lasted 1 minutes; as for the lower limb can help turn on the ground for a 3 minute walk, not less than 30 steps; continuous observation of 2 weeks at the fracture deformation. The treatment principle of fracture is reduction, fixation and functional exercise. Fracture reduction criteria: Anatomic reduction: to restore normal anatomic relation, complete alignment and alignment; Function reset: Standard Rotational displacement, separation and displacement must be completely corrected; Shortening the shift in adult