上肢骨折与关节损伤吕海2.pptVIP

Radial Nerve Injury Results in Wrist drop Associated with fracture humerus in up to 12% of fractures 2/3 ( 8%) of Radial injury are Neuropraxia(神经失用) 当前31页，共60页，星期日。 Management of Radial Nerve Injury When present in open fractures ; immediate exploration and ± repair In closed injuries treated conservatively ; initial management is doing Nerve Conduction Studies ( NCS ) and Electromyography ( EMG ) and awaiting for spontaneous recovery 当前32页，共60页，星期日。 Management of Radial Nerve injury Recovery usually starts after few days but may take up to 9 months for full recovery If No spontaneous recovery occurs in 12 weeks confirmed by NCS and EMG ;then exploration of the nerve should be carried out 当前33页，共60页，星期日。 Management of Humerus Shaft Fracture Most of the time is Conservative Closed Reduction in upright position followed by application of U shaped Slab or Cylinder cast Few weeks later or initially in stable fractures Functional Brace may be used 当前34页，共60页，星期日。 U Shaped Slab of POP 当前35页，共60页，星期日。 Functional Brace 功能支具 当前36页，共60页，星期日。 Indications for ORIF 切开复位内固定 Failure to reduce fracture conservatively 保守失败 Bilateral humeral fractures 双侧骨折 Open fracture with radial nerve Injury 开放骨折并神经伤 Unconscious patient 昏迷病人 Delayed-Union 延迟愈合 Non-Union 不愈合 Mal-Union 畸形愈合 当前37页，共60页，星期日。 ORIF：open reduction internal fixation 当前38页，共60页，星期日。 Supra-condylar Fracture of Humerus 肱骨髁上骨折 当前39页，共60页，星期日。 Pediatric Supra-Condylar Humeral Fracture 当前40页，共60页，星期日。 Pediatric Supra-condylar fracture 当前41页，共60页，星期日。 Reduction of supra-condylar Fracture Absolute Emergency Should be done by experienced doctor as soon as possible In the past the arm was held in flexed elbow position in back-slab POP after reduction At present time Percutaneous K wire fixation is ALWAYS carried out after reduction 当前42页，共60页，星期日。 Upper Limb Include Clavicle 锁骨 Scapula 肩胛骨 Shoulder Joint 肩关节 Humerus 肱骨 Elbow Joint 肘关节 Radius and Ulna尺桡骨 Wrist Joint 腕关节 Scaphoid Bone 舟状骨 当前1页，共60页，星期日。 Mechanis