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桡骨小头骨折切开内固定术
PreoperativeAPradiographofaType2radialheadfracture.
PreoperativelateralradiographofaType2radialheadfracture.
PreoperativelateralradiographoftheType2radialheadfracture.
Theelbowisflexedandpositionedonaradiolucenttable.Theincisionbeginsjustabovethelateralepicondyleandextendsdowntowardstheulna,passingdirectlyovertheradialhead,asdepicted.
Theskinincisionisbroughtdownthroughthesubcutaneoustissueandthecommonextensororiginisidentified.
Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellumradialhead.ANCONEUSECU
Theupperedgeofthecapitellumandtheradialheadareexposed.
RADIALHEAD
Withsharpretractionandrotationoftheradialhead,thefractureisidentified.Caremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asitlayovertheradialneck.ANNULARLIGAMENTRADIALHEADFRACTURE
AFreerelevatororsmallosteotomeisintroducedtomobilizetheradialheadfracture.
CloseupviewCAPITELLUMRADIALHEAD
Afteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTION
Afteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTION
Usingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Inthisexample,asolidHerbertscrewisutilized.
Thereducedandfixedradialhead.TheHerbertscrewseatedunderthearticularsurface.Occasionally,thesecondK-wireisexchangedforaHerbertscrew.FRACTUREHERBERTSCREW
Therangeofmotionoftheforearmaswellaspronationandsupinationareconfirmed,andthereductionisvisualizedthroughoutinarcofmotionoftheelbow.Ifadequatelyfixedandstable,closureisperformed.FRACTUREHERBERTSCREW
Thecommonextensormechanismisbroughttogether,enclosedovertheradio-capitellarjoint.
After
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