骨折治疗原则.pptVIP

PRINCIPLES OF TREATMENT OF FRACTURES GOALS OF FRACTURE TREATMENT Restore the patient to optimal functional state Prevent fracture and soft-tissue complications Get the fracture to heal, and in a position which will produce optimal functional recovery Rehabilitate the patient as early as possible HOW FRACTURES HEAL In nature Regeneration vs repair Three phases of healing by callus Rapid process, rehabilitation slow, low risk With operative intervention (reduction + compression) Primary bone healing Slow process, rehabilitation rapid, high risk With operative intervention (nailing or external fixation) Healing by callus Rapid process, rehabilitation rapid, lesser risk FACTORS AFFECTING FRACTURE HEALING The energy transfer of the injury The tissue response Two bone ends in opposition or compressed Micro-movement or no movement BS (scaphoid, talus, femoral and humeral head) NS No infection The patient The method of treatment DESCRIBING THE FRACTURE Mechanism of injury (traumatic, pathological, stress) Anatomical site (bone and location in bone) Configuration Displacement three planes of angulation translation shortening Articular involvement/epiphyseal injuries fracture involving joint dislocation ligamentous avulsion Soft tissue injury MANAGEMENT OF THE INJURED PATIENT Life saving measures Diagnose and treat life threatening injuries Emergency orthopaedic involvement Life saving Complication saving Emergency orthopaedic management (Day 1) Monitoring of fracture (Days to weeks) Rehabilitation + treatment of complications (weeks to months) LIFE SAVING MEASURES A Airway and cervical spine immobilisation B Breathing C Circulation (treatment and diagnosis of cause) D Disability (head injury) E Exposure (musculo-skeletal injury) EMERGENCY ORTHOPAEDIC MANAGEMENT Life saving measures Reducing a pelvic fracture in haemodynamically unstable patient Applying pressure to reduce haemorrhage from open fracture Complication saving Early and complete diagnosis o