Fractue introduction2016f 骨 科 学 教学课件.ppt

1. Age 2. Systemic Condition Factors Influenced Fracture Healing Systemic Factors 1. Pattern of Fracture 2. Blood Supply ( Fragments ) A. Blood supply of both fragments are rich. B. One is rich while the other is poor. C. Blood supply of both fragments are poor. D. Absence of blood supply. Local Factors Local Factors 3. Infection 4. Injuries of Soft Tissue 5. Soft tissue into the fracture gap 6. Basic Disease ( local) Factors Influenced Fracture Healing Methods of Treatment: 1. Repeated Reduction by Manipulation 2. Over Traction to Fragments 3. Incorrect Fixation 4. Incorrect Debridement 5. Influence of Open Reduction 6. Incorrect Functional Exercises Factors Influenced Fracture Healing Biological Factors 20 % Medical Factors 80 % !! Factors Responsible for Fracture Poor Healing What we should do is to facilitate fracture healing PRINCIPLES of FRACTURE TREATMENT Reduction Immobilization Rehabilitation Medication REDUCTION Criteria of Reduction 1. Anatomic Reduction 2. Functional Reduction (1). No Observe Gap and Rotation (2). Shortening ＜1 ~ 2 cm in the Leg (3). Angulation＜ 15 ~ 10 (4). Apposition of the Fragments ＞ １/3 ( shaft ) , or ３/４ ( epiphyseal ) On the basis of displacements Undisplaced fracture On the basis of pattern On the basis of relationship with external environment On the basis of aetiology No significant displacement fractures Displaced fracture angulation shift overlap gap rotation 3. CLASSIFICATION OF RACTURES Factors which are responsible for displacements The fracturing force The muscle pull on the fracture fragments The gravity to the fragm