(外科学课件）05.1 (翻译)Hand injury for students知识介绍.pptxVIP

Hand injuryXiangjun ChengDepartment of Orthopedics The Second Affiliated Hospital of CQMUIntroduction of HandThe most complex and versatile（多功能的） structure in the human body 27 bones more than 30 muscles a vast web of ligaments and tendonsComplicated（结构复杂的） vascular and nervous systemHand PositionsResting position（休息位） of handThe position in which the forearm?前臂 is midway between pronation旋前and supination旋后, the wrist is at 10° to 15° dorsiflexion, and the phalanges指骨 are slightly flexed屈曲的. The thumb is in partial opposition and forward. Functional position（功能位） of handConsists of dorsiflexing向背弯曲both the wrist between 20° and 35° and the proximal interphalangeal joints第一指间关节 between 45° and 60°. The thumb is abducted外展 and in opposition and alignment排成直线with the pads of the fingers.Hand PositionsResting position of handThis position would be changed if some structures (e.g. tendons or nerves) damagedFunctional position of handFacilitate促进 locomotion 运动of hand (e.g. grasp, making a fist) for manipulative操作性的 tasksCauses of hand injurystabPenetrating trauma刺穿伤Blunt钝的trauma: injury by club, injury by falling…Crushing injuryFirearm wound: bullet wound, explosion injury…Principles in treatments to hand injurySection 1 Injury to skin of hand Open hand injuryCareful history taking and physical examination1 location and character2 estimate skin defect3 judgement of skin vitalitySection 1 Injury to skin of hand How to predict the skin vitalitySection 1 Injury to skin of hand Section 1 Injury to skin of hand Treatment of skin injury of handSection 1 Injury to skin of hand Common-used skin grafts or flapsSection 1 Injury to skin of hand Common-used skin grafts or flapsSection 1 Injury to skin of hand Common-used skin grafts or flapsSection 1 Injury to skin of hand Common-used skin grafts or flapsSection 2 Injury to tendon of the hand Movement of the muscles of the hand and arm are transmitted into finger and wrist motion by the tendons筋，腱Strong, compact结实的 units tha