上肢骨折和手外伤共51张课件

上肢骨折和手外伤上肢骨折和手外伤上肢骨折和手外伤ClavicleFractures

锁骨骨折AnatomyCausesofClavicleFractureAccidentssuchasfallsSometimes,ablowfromabluntobjectoracollisionofsomesort上肢骨折和手外伤上肢骨折和手外伤上肢骨折和手外伤Clavic1上肢骨折和手外伤共51张课件2上肢骨折和手外伤共51张课件3上肢骨折和手外伤共51张课件4上肢骨折和手外伤共51张课件5SymptomsofClavicleFracturePainSwellingTendernessDeformityInternalbleedingIfaskedtolifttheirarm,patientswithabrokenclaviclecannotdosowithoutextremepain.SymptomsofClavicleFractureP6TreatmentofClavicleFracture

Thegoaloftreatingbrokenbonesistosetthem,makingthemwholeagainfigure-8splintorstrapimmobilizedfor6-8weeksOpenreductionandinternalfixationTreatmentofClavicleFracture7HumerusShaftFractures

肱骨干骨折HumerusShaftFractures

肱骨干骨折8CausesofHumeralShaftFractureDirectstress,suchasablowtothearm.Indirectforces,suchasafall,twistingortorsionalforces.

CausesofHumeralShaftFractu9mechanismbendingforceproducestransversefrxoftheshaft;torsionforcewillresultinaspiralfracture;combinationofbendingandtorsionproduceobliquefrxw/orw/oabutterflyfragment;compressionforceswillfrxeitherproximalordistalendsofhumerus;

mechanismbendingforceproduce10typesofhumeralshaftfractureTransversehumeralfracturesShortobliquefracturesLongspiralfracturestypesofhumeralshaftfractur11SymptomsofhumeralshaftfracturePainLossofstrengthinthegripSwellDeformityTenderness

Ifthebloodsupplyisimpaired,theremaybenumbnessandcoldnessinthearmandhand.Symptomsofhumeralshaftfrac12NonOperativeTreatmentofHumeralShaftfractureLongarmsplintneedstobeappliedfromshouldertowristtofullyimmobilizetheextremity;NonOperativeTreatmentofHum13OperativeTreatment:internalfixationshouldbereservedforfractureswithinadequatereductionorpatientswithmultipletrauma;OperativeTreatment:internalf14IMNailingofHumeralShaftFracturesIMNailingofHumeralShaftFr15PlateFixationPlateFixation16AnatomySupracondylarFracture

oftheHumerus

肱骨髁上骨折AnatomySupracondylarFracture17CausesByafall

Thechildmaystretchouthisorherhandandtheforcefromtheimpactmaybeenoughtocauseabreakinthebone.

Butanytraumatothearea,suchasaninjuryfromacaraccident,mayalsobeacause.

CausesByafall

18-typeI:non-displacedfrx-typeII:displacedwithintactposteriorcortex-typeIII:displacedwithnocorticalcontact-typeI:non-displacedfrx19SymptomspainintheelbowswellingintheelbowinabilitytomovethearmduetopainSymptomspainintheelbow20ComplicationscompartmentsyndromeVolkmann‘scontracturemedianorulnarnerveinjurystiffnessangulationmyositisossificansComplicationscompartmentsyndr21TreatmentCase1TreatmentCase122Case2Case223Bothboneforearmfractures

前臂双骨折Bothboneforearmfractures

前臂24ClassificationBothBoneForearmFracturesLocationProximal,middle,distalthird,epiphysealSkinIntegrityOpen,ClosedFracturePatternSamelevel,differentlevel,associatedjointdisruption

MonteggiaFractures

GaleazziFracturesDisplacementRotation,translation,shortening,interosseousspaceSkeletalMaturityMaturevsimmatureClassificationBothBoneForear25Case1:42yearoldmaninjuredinacaraccident.HisleftarmCase1:42yearoldmaninju26Case2Case227CollesfractureSmithfractureDistalradiusFracture

桡骨远端骨折CollesfractureSmithfractureD28ClassificationofdistalradiusfracturesIDorsaldisplacedCollesfracturesIIPalmardisplacedSmithfracturesIIIComminutedfracturesClassificationofdistalradiu29(1.)DistractionwithexternalfixationsupplementedwithpercutaneousKirschnerwires.(2.)Distractionusingatemporaryplateandscrews,tunnelledbetweentwosmallaccessincisions.(3.)Openreductionwithabuttressplate.(4.)OpenreductionwiththeMedofffixationsystem.Fixationofdistalradiusfractures(1.)Distractionwithexternal30ComplicationReflexsympatheticdystrophy;fingerstiffness;ulnarstyloidnonunion;Carpaltunnelsyndrome;posttraumaticarthritis;tendonrupturecarpalinstabilityComplicationReflexsympathetic31Case1This60yearoldwoman.Shewastreatedwithclosedreductionandpinning.TreatmentCase1Treatment32Case2PreopPostopCase2PreopPostop33TheInjuredHand手外伤TheInjuredHand34ArteriesofhandArteriesofhand35NervesofhandNervesofhand36ExaminationoftheInjuredHandAtrest,fingertipsnormallyfallintoacascadepostureofincreasingflexionfromtheindextothesmallfinger.ExaminationoftheInjuredHan37Flapsforfingertipreconstruction(1.)PalmarV-Yneurovascularislandadvancementflap.(2.)Dorsalcrossfingerflap.(3.)Thenarflap.

Flapsforfingertipreconstruc38TendonInjury肌腱损伤TendonInjury39flexortendonsflexortendons40flexortendonzones1:digitalsheathcontainingonetendon;2:digitalsheathcontainingtwotendons("noman'sland")3:palm;4:carpaltunnel;5:theforearm."noman'sland"flexortendonzones1:digital41TendonSutureTendonSuture42Scaphoidfractures

舟骨骨折Scaphoidfractures

舟骨骨折43XraybeforetwomonthspostoptwomonthspostopXraybeforeXraybeforetwomonthspostop44IntraarticularMetacarpalbasefractures

关节内掌骨基底骨折Bennett'sandreversedBennett'sfractures.IntraarticularMetacarpalbase45MetacarpalNeckFractures

掌骨颈部骨折Boxer'sfracture

MetacarpalNeckFractures

掌骨颈部46Phalangealfractures

指骨骨折Phalangealfractures

指骨骨折47middlephalanxbasefractureDorsalfracturedislocation

palmarfracturedislocation

middlephalanxbasefractureD48Unicondylarphalanxheadfractures

指骨头部骨折Unicondylarphalanxheadfract49上肢骨折和手外伤共51张课件5031、只有永远躺在泥坑里的人，才不会再掉进坑里。——黑格尔

32、希望的灯一旦熄灭，生活刹那间变成了一片黑暗。——普列姆昌德

33、希望是人生的乳母。——科策布

34、形成天才的决定因素应该是勤奋。——郭沫若

35、学到很多东西的诀窍，就是一下子不要学很多。——洛克31、只有永远躺在泥坑里的人，才不会再掉进坑里51上肢骨折和手外伤上肢骨折和手外伤上肢骨折和手外伤ClavicleFractures

锁骨骨折AnatomyCausesofClavicleFractureAccidentssuchasfallsSometimes,ablowfromabluntobjectoracollisionofsomesort上肢骨折和手外伤上肢骨折和手外伤上肢骨折和手外伤Clavic52上肢骨折和手外伤共51张课件53上肢骨折和手外伤共51张课件54上肢骨折和手外伤共51张课件55上肢骨折和手外伤共51张课件56SymptomsofClavicleFracturePainSwellingTendernessDeformityInternalbleedingIfaskedtolifttheirarm,patientswithabrokenclaviclecannotdosowithoutextremepain.SymptomsofClavicleFractureP57TreatmentofClavicleFracture

Thegoaloftreatingbrokenbonesistosetthem,makingthemwholeagainfigure-8splintorstrapimmobilizedfor6-8weeksOpenreductionandinternalfixationTreatmentofClavicleFracture58HumerusShaftFractures

肱骨干骨折HumerusShaftFractures

肱骨干骨折59CausesofHumeralShaftFractureDirectstress,suchasablowtothearm.Indirectforces,suchasafall,twistingortorsionalforces.

CausesofHumeralShaftFractu60mechanismbendingforceproducestransversefrxoftheshaft;torsionforcewillresultinaspiralfracture;combinationofbendingandtorsionproduceobliquefrxw/orw/oabutterflyfragment;compressionforceswillfrxeitherproximalordistalendsofhumerus;

mechanismbendingforceproduce61typesofhumeralshaftfractureTransversehumeralfracturesShortobliquefracturesLongspiralfracturestypesofhumeralshaftfractur62SymptomsofhumeralshaftfracturePainLossofstrengthinthegripSwellDeformityTenderness

Ifthebloodsupplyisimpaired,theremaybenumbnessandcoldnessinthearmandhand.Symptomsofhumeralshaftfrac63NonOperativeTreatmentofHumeralShaftfractureLongarmsplintneedstobeappliedfromshouldertowristtofullyimmobilizetheextremity;NonOperativeTreatmentofHum64OperativeTreatment:internalfixationshouldbereservedforfractureswithinadequatereductionorpatientswithmultipletrauma;OperativeTreatment:internalf65IMNailingofHumeralShaftFracturesIMNailingofHumeralShaftFr66PlateFixationPlateFixation67AnatomySupracondylarFracture

oftheHumerus

肱骨髁上骨折AnatomySupracondylarFracture68CausesByafall

Thechildmaystretchouthisorherhandandtheforcefromtheimpactmaybeenoughtocauseabreakinthebone.

Butanytraumatothearea,suchasaninjuryfromacaraccident,mayalsobeacause.

CausesByafall

69-typeI:non-displacedfrx-typeII:displacedwithintactposteriorcortex-typeIII:displacedwithnocorticalcontact-typeI:non-displacedfrx70SymptomspainintheelbowswellingintheelbowinabilitytomovethearmduetopainSymptomspainintheelbow71ComplicationscompartmentsyndromeVolkmann‘scontracturemedianorulnarnerveinjurystiffnessangulationmyositisossificansComplicationscompartmentsyndr72TreatmentCase1TreatmentCase173Case2Case274Bothboneforearmfractures

前臂双骨折Bothboneforearmfractures

前臂75ClassificationBothBoneForearmFracturesLocationProximal,middle,distalthird,epiphysealSkinIntegrityOpen,ClosedFracturePatternSamelevel,differentlevel,associatedjointdisruption

MonteggiaFractures

GaleazziFracturesDisplacementRotation,translation,shortening,interosseousspaceSkeletalMaturityMaturevsimmatureClassificationBothBoneForear76Case1:42yearoldmaninjuredinacaraccident.HisleftarmCase1:42yearoldmaninju77Case2Case278CollesfractureSmithfractureDistalradiusFracture

桡骨远端骨折CollesfractureSmithfractureD79ClassificationofdistalradiusfracturesIDorsaldisplacedCollesfracturesIIPalmardisplacedSmithfracturesIIIComminutedfracturesClassificationofdistalradiu80(1.)DistractionwithexternalfixationsupplementedwithpercutaneousKirschnerwires.(2.)Distractionusingatemporaryplateandscrews,tunnelledbetweentwosmallaccessincisions.(3.)Openreductionwithabuttressplate.(4.)OpenreductionwiththeMedofffixationsystem.Fixationofdistalradiusfractures(1.)Distractionwithexternal81ComplicationReflexsympatheticdystrophy;fingerstiffness;ulnarstyloidnonunion;Carpaltunnelsyndrome;posttraumaticarthritis;tendonrupturecarpalinstabilityComplicationReflexsympathetic82Case1This60yearoldwoman.Shewastreatedwithclosedreductionandpinning.TreatmentCase1Treatment83Case2PreopPostopCase2PreopPostop84TheInjuredHand手外伤TheInjuredHand85ArteriesofhandArteriesofhand86NervesofhandNervesofhand87ExaminationoftheInjuredHandAtrest,fingertipsnormallyfallintoacascadepostureofincreasingflexionfromtheindextothesmallfinger.ExaminationoftheInjuredHan88Flapsforfingertipreconstruction(1.)PalmarV-Yneurovascularislandadvancementflap.(2.)Dorsalcrossfingerflap.(3.)Thenarflap.

Flapsforfinge