前臂双骨折的手术.ppt

* ppt课件 * ppt课件 This image demonstrates the reduced fracture, viewed from the volarly. * ppt课件 This image shows that the fracture is also compressed on the opposite side due to proper contouring of the plate. Once the radius is fixed, the ulna is approached using a standard subcutaneous longitudinal incision with the arm flexed, as seen in the next image. * ppt课件 * ppt课件 These images demonstrate the superficial dissection down to the fascia directly over the ulna, which is the common fascia between the flexor carpi ulnaris and the extensor carpi ulnaris. This is divided in line with the muscles directly over the subcutaneous border of the ulna. * ppt课件 * ppt课件 ECU EXTENSOR CARPI ULNARIS FCU FLEXOR CARPI ULNARIS * ppt课件 A periosteal elevator is used to clean the external surface of the ulna. * ppt课件 五附院骨二科 尺桡骨双骨折 * ppt课件 AP and lateral views of the both bones fracture of the forearm, demonstrating significant shortening and relatively simple oblique fracture patterns. * ppt课件 The patient is positioned supine with the arm prepped and draped to just above the elbow and a tourniquet in place. This figure demonstrates the arm held in supination. Note the position of the biceps insertion as well as the palpable tendon of the FCR and radial artery. BICEPS TENDON RADIAL ARTERY FLEXOR CARPI RADIALIS (FCR) * ppt课件 A useful technique to make the skin incision is to take a bovi cord and pull it taught from the radial side of the biceps tendon to the FCR at the level of the wrist. This can then be used as a template for the incision line. * ppt课件 * ppt课件 The incision is taken down through the skin, identifying the fascial layer with care taken not to damage any superficial veins that may be intact. The FCR tendon is clearly visible throughout the wound, as is the radial artery in the distal extent of the wound. FCR RADIAL ARTERY * ppt课件 A closeup of the distal aspect of the wound demonstrating The radial artery and its venous commtantes. RADIAL ARTERY AND VENOUS C