桡骨小头骨折切开内固定术课件

桡骨小头骨折切开内固定术桡骨小头骨折切开内固定术1PreoperativeAPradiographofaType2radialheadfracture.PreoperativeAPradiographof2PreoperativelateralradiographofaType2radialheadfracture.Preoperativelateralradiograp3PreoperativelateralradiographoftheType2radialheadfracture.Preoperativelateralradiograp4Theelbowisflexedandpositionedonaradiolucenttable.Theincisionbeginsjustabovethelateralepicondyleandextendsdowntowardstheulna,passingdirectlyovertheradialhead,asdepicted.Theelbowisflexedandpositi5Theskinincisionisbroughtdownthroughthesubcutaneoustissueandthecommonextensororiginisidentified.Theskinincisionisbroughtd6Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellumradialhead.ANCONEUSECUThecommonextensororiginis7Theupperedgeofthecapitellumandtheradialheadareexposed.Theupperedgeofthecapitel8RADIALHEADRADIALHEAD9Withsharpretractionandrotationoftheradialhead,thefractureisidentified.Caremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asitlayovertheradialneck.ANNULARLIGAMENTRADIALHEADFRACTUREWithsharpretractionandrota10AFreerelevatororsmallosteotomeisintroducedtomobilizetheradialheadfracture.AFreerelevatororsmalloste11PreoperativeAPradiographofaType2radialheadfracture.CloseupviewTheelbowisflexedandpositionedonaradiolucenttable.Theskinincisionisbroughtdownthroughthesubcutaneousisidentified.TheHerbertscrewseatedunderthearticularsurface.andstable,closureisperformed.Inthisexample,asolidHerbertscrewisutilized.Inthisexample,asolidHerbertscrewisutilized.TheskinincisionisbroughtdownthroughthesubcutaneousTheelbowisflexedandpositionedonaradiolucenttable.IfadequatelyfixedTheHerbertscrewseatedunderthearticularsurface.throughoutinarcofmotionoftheelbow.mobilizetheradialheadfracture.Theelbowisflexedandpositionedonaradiolucenttable.Afteranatomicreductionisachieved,K-wiresThereducedandfixedradialhead.Therangeofmotionoftheforearmaswellaspronationandmobilizetheradialheadfracture.PreoperativeAPradiographof12CloseupviewCAPITELLUMRADIALHEADCloseupviewCAPITELLUMRADIAL13Afteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTIONAfteranatomicreductionisac14Afteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTIONAfteranatomicreductionisac15Usingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Inthisexample,asolidHerbertscrewisutilized.Usingtheexternaljig,ascre16Thereducedandfixedradialhead.TheHerbertscrewseatedunderthearticularsurface.Occasionally,thesecondK-wireisexchangedforaHerbertscrew.FRACTUREHERBERTSCREWThereducedandfixedradialh17Therangeofmotionoftheforearmaswellaspronationandsupinationareconfirmed,andthereductionisvisualizedthroughoutinarcofmotionoftheelbow.Ifadequatelyfixedandstable,closureisperformed.FRACTUREHERBERTSCREWTherangeofmotionofthefor18Thecommonextensormechanismisbroughttogether,enclosedovertheradio-capitellarjoint.Thecommonextensormechanism19Caremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asitlayovertheradialneck.Inthisexample,asolidHerbertscrewisutilized.PreoperativelateralradiographofaType2radialheadfracture.CloseupviewUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.RADIALHEADFRACTURETheHerbertscrewseatedunderthearticularsurface.isidentified.TheHerbertscrewseatedunderthearticularsurface.supinationareconfirmed,andthereductionisvisualizedmobilizetheradialheadfracture.Afteranatomicreductionisachieved,K-wiresmobilizetheradialheadfracture.Theupperedgeofthecapitellumandtheradialheadareexposed.桡骨小头骨折切开内固定术TherangeofmotionoftheforearmaswellaspronationandAfteranatomicreductionisachieved,K-wiresthroughoutinarcofmotionoftheelbow.Withsharpretractionandrotationoftheradialhead,thefractureTheHerbertscrewseatedunderthearticularsurface.CloseupviewPreoperativelateralradiographofaType2radialheadfracture.Afteranatomicreductionisachieved,K-wiresisidentified.TheskinincisionisbroughtdownthroughthesubcutaneousAfteranatomicreductionisachieved,K-wiresTherangeofmotionoftheforearmaswellaspronationandRADIALHEADFRACTUREmobilizetheradialheadfracture.Afteranatomicreductionisachieved,K-wiresUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Afteranatomicreductionisachieved,K-wiresOccasionally,thesecondK-wireisexchangedforaHerbertscrew.isidentified.Thecommonextensormechanismisbroughttogether,Afteranatomicreductionisachieved,K-wiresandstable,closureisperformed.Afteranatomicreductionisachieved,K-wiresisidentified.Inthisexample,asolidHerbertscrewisutilized.Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellumradialhead.Afteranatomicreductionisachieved,K-wiresAfteranatomicreductionisachieved,K-wiresUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.andstable,closureisperformed.PreoperativeAPradiographofaType2radialheadfracture.CloseupviewCloseupview桡骨小头骨折切开内固定术Afteranatomicreductionisachieved,K-wiresPreoperativelateralradiographofaType2radialheadfracture.TheHerbertscrewseatedunderthearticularsurface.PreoperativelateralradiographoftheType2radialheadfracture.Inthisexample,asolidHerbertscrewisutilized.桡骨小头骨折切开内固定术TheskinincisionisbroughtdownthroughthesubcutaneousTherangeofmotionoftheforearmaswellaspronationandRADIALHEADFRACTURETheskinincisionisbroughtdownthroughthesubcutaneousTheelbowisflexedandpositionedonaradiolucenttable.PreoperativelateralradiographofaType2radialheadfracture.Theupperedgeofthecapitellumandtheradialheadareexposed.supinationareconfirmed,andthereductionisvisualizedThereducedandfixedradialhead.Withsharpretractionandrotationoftheradialhead,thefracture桡骨小头骨折切开内固定术Thereducedandfixedradialhead.RADIALHEADUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.mobilizetheradialheadfracture.Theskinincisionisbroughtdownthroughthesubcutaneousmobilizetheradialheadfracture.CloseupviewRADIALHEADRADIALHEADWithsharpretractionandrotationoftheradialhead,thefractureAfteranatomicreductionisachieved,K-wiresThereducedandfixedradialhead.Thecommonextensormechanismisbroughttogether,Inthisexample,asolidHerbertscrewisutilized.Afteranatomicreductionisachieved,K-wiresOccasionally,thesecondK-wireisexchangedforaHerbertscrew.Afteranatomicreductionisachieved,K-wiresPreoperativelateralradiographofaType2radialheadfracture.PreoperativelateralradiographoftheType2radialheadfracture.isidentified.Withsharpretractionandrotationoftheradialhead,thefractureareusedtomaintainthereduction.areusedtomaintainthereduction.Afteranatomicreductionisachieved,K-wiresIfadequatelyfixedsupinationareconfirmed,andthereductionisvisualizedAfteranatomicreductionisachieved,K-wiressupinationareconfirmed,andthereductionisvisualizedInthisexample,asolidHerbertscrewisutilized.Usingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Withsharpretractionandrotationoftheradialhead,thefractureInthisexample,asolidHerbertscrewisutilized.mobilizetheradialheadfracture.isidentified.RADIALHEADTherangeofmotionoftheforearmaswellaspronationandareusedtomaintainthereduction.RADIALHEADTherangeofmotionoftheforearmaswellaspronationandCloseupviewInthisexample,asolidHerbertscrewisutilized.Therangeofmotionoftheforearmaswellaspronationand桡骨小头骨折切开内固定术CloseupviewAfteranatomicreductionisachieved,K-wiresmobilizetheradialheadfracture.Inthisexample,asolidHerbertscrewisutilized.Afteranatomicreductionisachieved,K-wiresCaremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asitlayovertheradialneck.Thecommonextensormechanismisbroughttogether,Withsharpretractionandrotationoftheradialhead,thefractureAfteranatomicreductionisachieved,K-wiressupinationareconfirmed,andthereductionisvisualizedOccasionally,thesecondK-wireisexchangedforaHerbertscrew.isidentified.PreoperativelateralradiographoftheType2radialheadfracture.RADIALHEADAfterclosure.Caremustbetakennottoexte20桡骨小头骨折切开内固定术桡骨小头骨折切开内固定术21PreoperativeAPradiographofaType2radialheadfracture.PreoperativeAPradiographof22PreoperativelateralradiographofaType2radialheadfracture.Preoperativelateralradiograp23PreoperativelateralradiographoftheType2radialheadfracture.Preoperativelateralradiograp24Theelbowisflexedandpositionedonaradiolucenttable.Theincisionbeginsjustabovethelateralepicondyleandextendsdowntowardstheulna,passingdirectlyovertheradialhead,asdepicted.Theelbowisflexedandpositi25Theskinincisionisbroughtdownthroughthesubcutaneoustissueandthecommonextensororiginisidentified.Theskinincisionisbroughtd26Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellumradialhead.ANCONEUSECUThecommonextensororiginis27Theupperedgeofthecapitellumandtheradialheadareexposed.Theupperedgeofthecapitel28RADIALHEADRADIALHEAD29Withsharpretractionandrotationoftheradialhead,thefractureisidentified.Caremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asitlayovertheradialneck.ANNULARLIGAMENTRADIALHEADFRACTUREWithsharpretractionandrota30AFreerelevatororsmallosteotomeisintroducedtomobilizetheradialheadfracture.AFreerelevatororsmalloste31PreoperativeAPradiographofaType2radialheadfracture.CloseupviewTheelbowisflexedandpositionedonaradiolucenttable.Theskinincisionisbroughtdownthroughthesubcutaneousisidentified.TheHerbertscrewseatedunderthearticularsurface.andstable,closureisperformed.Inthisexample,asolidHerbertscrewisutilized.Inthisexample,asolidHerbertscrewisutilized.TheskinincisionisbroughtdownthroughthesubcutaneousTheelbowisflexedandpositionedonaradiolucenttable.IfadequatelyfixedTheHerbertscrewseatedunderthearticularsurface.throughoutinarcofmotionoftheelbow.mobilizetheradialheadfracture.Theelbowisflexedandpositionedonaradiolucenttable.Afteranatomicreductionisachieved,K-wiresThereducedandfixedradialhead.Therangeofmotionoftheforearmaswellaspronationandmobilizetheradialheadfracture.PreoperativeAPradiographof32CloseupviewCAPITELLUMRADIALHEADCloseupviewCAPITELLUMRADIAL33Afteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTIONAfteranatomicreductionisac34Afteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTIONAfteranatomicreductionisac35Usingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Inthisexample,asolidHerbertscrewisutilized.Usingtheexternaljig,ascre36Thereducedandfixedradialhead.TheHerbertscrewseatedunderthearticularsurface.Occasionally,thesecondK-wireisexchangedforaHerbertscrew.FRACTUREHERBERTSCREWThereducedandfixedradialh37Therangeofmotionoftheforearmaswellaspronationandsupinationareconfirmed,andthereductionisvisualizedthroughoutinarcofmotionoftheelbow.Ifadequatelyfixedandstable,closureisperformed.FRACTUREHERBERTSCREWTherangeofmotionofthefor38Thecommonextensormechanismisbroughttogether,enclosedovertheradio-capitellarjoint.Thecommonextensormechanism39Caremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asitlayovertheradialneck.Inthisexample,asolidHerbertscrewisutilized.PreoperativelateralradiographofaType2radialheadfracture.CloseupviewUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.RADIALHEADFRACTURETheHerbertscrewseatedunderthearticularsurface.isidentified.TheHerbertscrewseatedunderthearticularsurface.supinationareconfirmed,andthereductionisvisualizedmobilizetheradialheadfracture.Afteranatomicreductionisachieved,K-wiresmobilizetheradialheadfracture.Theupperedgeofthecapitellumandtheradialheadareexposed.桡骨小头骨折切开内固定术TherangeofmotionoftheforearmaswellaspronationandAfteranatomicreductionisachieved,K-wiresthroughoutinarcofmotionoftheelbow.Withsharpretractionandrotationoftheradialhead,thefractureTheHerbertscrewseatedunderthearticularsurface.CloseupviewPreoperativelateralradiographofaType2radialheadfracture.Afteranatomicreductionisachieved,K-wiresisidentified.TheskinincisionisbroughtdownthroughthesubcutaneousAfteranatomicreductionisachieved,K-wiresTherangeofmotionoftheforearmaswellaspronationandRADIALHEADFRACTUREmobilizetheradialheadfracture.Afteranatomicreductionisachieved,K-wiresUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Afteranatomicreductionisachieved,K-wiresOccasionally,thesecondK-wireisexchangedforaHerbertscrew.isidentified.Thecommonextensormechanismisbroughttogether,Afteranatomicreductionisachieved,K-wiresandstable,closureisperformed.Afteranatomicreductionisachieved,K-wiresisidentified.Inthisexample,asolidHerbertscrewisutilized.Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellumradialhead.Afteranatomicreductionisachieved,K-wiresAfteranatomicreductionisachieved,K-wiresUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.andstable,closureisperformed.PreoperativeAPradiographofaType2radialheadfracture.CloseupviewCloseupview桡骨小头骨折切开内固定术Afteranatomicreductionisachieved,K-wiresPreoperativelateralradiographofaType2radialheadfracture.TheHerbertscrewseatedunderthearticularsurface.PreoperativelateralradiographoftheType2radialheadfracture.Inthisexample,asolidHerbertscrewisutilized.桡骨小头骨折切开内固定术TheskinincisionisbroughtdownthroughthesubcutaneousTherangeofmotionoftheforearmaswellaspronationandRADIALHEADFRACTURETheskinincisionisbroughtdownthroughthesubcutaneousTheelbowisflexedandpositionedonaradiolucenttable.PreoperativelateralradiographofaType2radialheadfracture.Theupperedgeofthecapitellumandtheradialheadareexposed.supinationareconfirmed,andthereductionisvisualizedThereducedandfixedradialhead.Withsharpretractionandrotationoftheradialhead,thefracture桡骨小头骨折切开内固定术Thereducedandfixedradialhead.RADIALHEADUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.mobilizetheradialheadfracture.Theskinincisionisbroughtdownthroughthesubcutaneousmobilizetheradialheadfracture.CloseupviewRADIALHEADRADIALHEADWithsharpretractionandrotationoftheradialhead,thefractureAfteranatomicreductionisachieved,K-wiresThereducedandfixedradialhead.Thecommonextensormechanismisbroughttogether,Inthisexample,asolidHerbertscrewisutilized.Afteranatomicreductionisachieved,K-wiresOccasionally,thesecondK-wireisexchangedforaHerbertscrew.Afteranatomicreductionisachieved,K-wiresPreoperativelateralradiographofaType2radial