骨干骨折诊断和治疗幻灯片.ppt

* * * * * * * * * * * * * * * * Management of Diaphyseal Fractures 骨干骨折诊断和治疗 Management of Diaphyseal Fractures Repair of fractures is a race between achieving bone union and failure of the implants. 骨折治疗是争取骨愈合和防止骨板等失效的技术 骨 干 骨 折 诊 治 Management of Diaphyseal Fractures Mechanical approach 机械性固定法 Reconstruction of bone column 骨干之重建 Absolute stability 确保稳定 Superior mechanical strength 一定的机械强度 骨 干 骨 折 诊 治 Management of Diaphyseal Fractures Mechanical approach 骨折机械性固定方法 Load-sharing 分散负重 Early return of function 早期功能恢复 Greater soft tissue trauma 软组织创伤较大 Prolonged exposure of fracture site 骨折处暴露时间拖长 骨干骨折诊断和治疗 Management of Diaphyseal Fractures Biological approach 生物医学角度 Preservation of soft tissues and blood supply 保存软组织及血液供应 Rotational and shearing forces not adequately treated 防止骨断端的旋转和划伤 骨干骨折诊断和治疗 Management of Diaphyseal Fractures Biological approach 生物医学角度 Rapid establishment of blood supply 尽快建立血液供应 Low risk of infection 降低感染风险 Greater risk of malunion and delayed union 愈合不良及延迟愈合风险较大 Slower return of function 功能恢复较慢 骨干骨折诊断和治疗 Management of Diaphyseal Fractures Balanced approach 比较周全的方法 Preservation of soft tissues and blood supply 保存软组织及血液供应 Restore axial alignment/bone length, eliminate torsional deformity 修复轴排列/骨长/去除扭转性变形 Provide favourable mechanical environment 提供合适的机械固定 Encourage early return of function 鼓励尽早恢复功能 骨干骨折诊断和治疗 Management of Diaphyseal Fractures 骨干骨折诊断和治疗 Management of Diaphyseal Fractures 骨干骨折诊断和治疗 Management of Diaphyseal Fractures Principle of open-but-do-not-touch 开放但不接触原则 骨干骨折诊断和治疗 Management of Diaphyseal Fractures 骨干骨折诊断和治疗 Management of Diaphyseal Fractures 骨干骨折诊断和治疗 Management of Diaphyseal Fractures 骨干骨折诊断和治疗 Fracture Assessment Score 骨折评估表 Scale for scoring 分数 Unfavourable 不良 Moderately favourable 中等 Very favourable 良好 1 2 3 4 5 6