前臂双骨折的手术入路.pptVIP

前臂双骨折的手术入路第一页，共四十七页，2022年，8月28日 AP and lateral views of the both bones fracture of the forearm,demonstrating significant shortening and relatively simpleoblique fracture patterns.第二页，共四十七页，2022年，8月28日 The patient is positioned supine with the arm prepped anddraped to just above the elbow and a tourniquet in place. This figure demonstrates the arm held in supination. Note theposition of the biceps insertion as well as the palpable tendonof the FCR and radial artery.BICEPSTENDONRADIALARTERYFLEXOR CARPIRADIALIS (FCR)第三页，共四十七页，2022年，8月28日 A useful technique to make the skin incision is to take a bovicord and pull it taught from the radial side of the biceps tendonto the FCR at the level of the wrist. This can then be used as a template for the incision line.第四页，共四十七页，2022年，8月28日 第五页，共四十七页，2022年，8月28日 The incision is taken down through the skin, identifying the fascial layer with care taken not to damage any superficial veins that may be intact. The FCR tendon is clearly visible throughout the wound, as is the radial artery in the distal extent of the wound.FCRRADIALARTERY第六页，共四十七页，2022年，8月28日 A closeup of the distal aspect of the wound demonstratingThe radial artery and its venous commtantes.RADIAL ARTERY ANDVENOUS COMMTANTES第七页，共四十七页，2022年，8月28日 FCRRADIALARTERYThe fascia on the radial side of the flexor carpi radialis is released, exposing the deep tissue. The radial artery can be followed now throughout the entire incision. 第八页，共四十七页，2022年，8月28日 The radial artery may be taken in either direction, however, typically it is easier to take the artery to the radial side.FCRRADIALARTERY第九页，共四十七页，2022年，8月28日 The deep dissection is now performed between the flexor-pronator mass on the ulnar side and the artery and the mobile wad on the radial side.第十页，共四十七页，2022年，8月28日 PRONATORFor the proximal dissection, the forearm is brought intosupination and the pronator, FDS and FDP are releasedfrom the volar aspect of the radius第十一页，共四十七页，2022年，8月28日 FDSThe pronator is being relea