骨折专业知识讲座.pptx

Fractures

骨折;Historyandclinicexamination

病史和臨床檢查;Routineforclinicexaminationincludesinspection,palpation,movementandstressing.Examingpainfulareaslastandleavingthemostpainfulmanoeuvreuntillast.

常規臨床檢查包含望、触、動、壓。最终檢查疼痛區域，將可引起最明顯疼痛手法操作留在最终施行。;Fracturesdescription

骨折描述;Lookforevidenceofcomplications:compoundiepresenceofpuncturewound,circulationcheckpulsesandcolorofskin,skinviability,anddistalnervetesting.

檢查是否有并發症：合并如開放傷口、檢查脈搏、皮膚顏色、皮膚活性及末梢神經。;Fracture/Dislocationearlycomplications

骨折和脫位早期并發症;compartmentsyndrome:requiresfasciotomyurgently

骨筋膜室綜合征：需要马上行筋膜室切開術。

tendonrupture:requiressurgicalrepair.

肌腱斷裂：需外科修复;DistalFemurFracture;Fractures:Initialcare

骨折：早期治療;Fractures:Initialcare;Splinttheextremityinpositionedfoundifdistalpulsesarepresent.Ifdistalpulsesabsentthenanattemptatrealignmentshouldbetriedafteradministrationofanalgesiaeg5mgIVmorphine.

假如肢体远端脉搏存在时，可用夹板固定。假如远端脉搏消失，应该考虑在给予镇痛剂后重新安排夹板，如5mg吗啡静注。

Donotforcerealignmentofdeformedextremity.Ifnoteasilyrealignssplintinpositionfound.

假如在现有姿势上有困难话，不要对畸形肢体用力复位。;OPENfracture开放骨折;SEVEREDEFORMITY

严重畸形;Checkpulse(distal)forvesselinj.

检验末端血管搏动

Checkfunction(distal)fornerveinj.

检验末端神经功效;骨折专业知识讲座;骨折专业知识讲座;骨折专业知识讲座;Fractureofthescaphoid

舟状骨骨折;Fractureofthescaphoid

DiagnosisandTreatment:

舟状骨骨折诊疗和治疗;Treatment:suspectedScaphoidfracturesshouldbeimmobilizedinascaphoidplasterandifnecessaryrepeatX-rayoutofplasterat10days.

治疗：怀疑舟状骨骨折病人应使用舟状骨石膏固定，假如必要话，10天后去除石膏再复查X线。;骨折专业知识讲座;骨折专业知识讲座;Colles’fractureColles’骨折;ComplicationsofColles’fracture

Colles’骨折并发症;SpecificcomplicationsofCollesfractureinclude:

Colles骨折??殊并发症

Mediannerveinjury

正中神经损伤

Ruptureofextensorpollicislongus

拇长伸肌断裂

Latecomplicationssuchas:Mal-unionandSudeck’satrophy

远期并发症，如Mal-unionandSudeck’s萎缩。;骨折专业知识讲座;骨折专业知识讲座;Smith’fracture

Smith’骨折;Smith’fracture-Smith’骨折;;Fractureoftheclav