(外科学课件）上肢骨折 翻译_30.pptVIP

(外科学课件）上肢骨折 翻译;Anatomy;Classification ;Extension type;Extension type; ;Flexion type;Flexion type; Clinical features;Physical Examination Careful neurovascular examination of the arm is essential. Brachial artery（肱动脉） may be lacerated by the proximal fracture fragment , either at the time of injury or during reduction, Osteofascial compartment syndrome（骨筋膜室综合征） may be developed. Radial and median nerves（桡神经和正中神经） are the most commonly affected in extension type Ular nerve（尺神经） is commonly affected in flexion type ;Radiographic evaluation;Treatment;Operative treatment;Open reduction and internal fixation ;Section II-Part I;Two bones There is a interosseous membrane（骨间膜） between the bones Five joints: Radiohumeral（桡肱关节）, ulnohumeral（尺肱关节）, proximal radioulnar（近端桡尺关节）, radiocarpal （桡腕关节）and distal radioulnar joints（远端桡尺关节）. These joints make it possible for the radius to rotate by rolling over the ulnar;Mechanism;Pain,crepitus,swelling secondary to fracture hematoma and soft-tissue injury. Apparent deformity（明显的畸形）:results from the high energy and the multitude of deforming muscle force. Skin:should be throughly inspected for any breaks that may communicate with fracture.;More severe swelling Tense forearm compartments（前臂隔间紧张） Pain out of proportion（成比例的） to the injury Pain with passive extension of fingers Any signs of compartment syndrome warrants immediate fasciotomy（筋膜切开术）;Radiographic evaluation;Two special fractures of forearm Monteggia fracture（孟氏骨折） Galeazzi fracture（盖氏骨折）;Monteggia;Galeazzi; Treatment;Compression plate and screws;Segmental fractures of diaphysis of forearm;Fracture of distal end of radius;Fracture of distal end of radius;Anatomy; Classification based on the mechanism of injury Extension type fracture（伸直型骨折） (Colles) Flexion type fracture （屈曲型骨折） (Simith) Fracture-dislocation （Barton）;Mechanism of injury The fracture occurs from a fall on extended arm and on the p