席智杰桡骨远端骨折ppt课件_1.pptVIP

固定——石膏固定 石膏固定 石膏固定 石膏固定 超肘关节石膏固定 If there is concern about stability of the DRUJ or ulnar fracture 药物治疗（一） “肢体损于外，则气血伤于内，营卫有所不贯，脏腑由之不和” ——薛己《正体类要》 “若因伤折，内动经络，血行之道，不得宣畅，瘀积不散，则为痛为肿” “损伤之症，专从血论”——唐容川《血证论》、钱秀昌《伤科补要》 “气伤痛，形伤肿”——《素问·阴阳应象大论》 药物治疗（二） 早期——活血化瘀，消肿止痛。代表方剂：桃红四物汤。陈士铎在《百病辨证录》中说：“血不活者瘀不去，瘀不去则骨不能接也。” 中期——活血化瘀，和营生新，接骨续筋。代表方剂：七厘散 后期——坚骨壮筋，补养气血、脾胃、肝肾。补中益气丸、左归丸、右归丸 Colles 与smith骨折的受伤机制 诊断 外伤史 局部肿胀、疼痛、腕关节功能障碍 压痛、纵轴叩击痛及骨擦音 畸形 辅助检查 结合中医理论 两种畸形的比较 colles骨折 smith骨折 辅助检查 X-ray CT MRI 关节镜检查 X-ray 测量 正位： 尺偏角 正位： 桡骨高度 尺骨方差 侧位： 掌倾角 0.9mm 10°-15° 泪滴角 Teardrop?angle45° Colles fracture is an extraarticular low energy fracture primarily sustained in the elderly, a fracture almost unique to caucasian women. a classic Colles fracture Abraham?Colles? Colles 骨折 (1814) Smith’s 骨折 1847 Robert William Smith?considered this an injury of exceedingly rare occurrence, but its description heralded the age of vehicular trauma in 1847: The patient, in endeavouring to save himself from being run over by a car, fell with great violence upon the back of his hand . . . Robert William Smith?(1807-1873) The classic Bartons fracture describes the dorsal rim fracture subluxation, a shear-type injury. John Rhea Bartons addresses the difference between a true dislocation and this fracture: a dislocation typically has no crepitus, and once reduced tends to remain that way John Rhea Barton(1794-1871) Barton’s 骨折(1838) Die punch 骨折 die punch fracture, or lunate load impact fracture of the posteromedial corner of the radius, was more recently described by?Scheck The absence of ligamentous attachments to the depressed fragment precludes reduction. In high energy the axial load through the lunate creates an impact fracture on the lunate facet A case a1 a2 Chauffeur‘s 骨折 The backfire, or Chauffeurs fracture, was extremely common in these days of voluminous traffic according to?Harold C. Edwards, who described 42 fractures sustained from the impact of the downward