桡骨小头骨折切开内固定术PPT课件

.,1,.,2,PreoperativeAPradiographofaType2radialheadfracture.,.,3,PreoperativelateralradiographofaType2radialheadfracture.,.,4,PreoperativelateralradiographoftheType2radialheadfracture.,.,5,Theelbowisflexedandpositionedonaradiolucenttable.Theincisionbeginsjustabovethelateralepicondyleandextendsdowntowardstheulna,passingdirectlyovertheradialhead,asdepicted.,.,6,Theskinincisionisbroughtdownthroughthesubcutaneoustissueandthecommonextensororiginisidentified.,.,7,Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellumradialhead.,ANCONEUS,ECU,.,8,Theupperedgeofthecapitellumandtheradialheadareexposed.,.,9,RADIALHEAD,.,10,Withsharpretractionandrotationoftheradialhead,thefractureisidentified.Caremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asitlayovertheradialneck.,ANNULARLIGAMENT,RADIALHEADFRACTURE,.,11,AFreerelevatororsmallosteotomeisintroducedtomobilizetheradialheadfracture.,.,12,.,13,Closeupview,CAPITELLUM,RADIALHEAD,.,14,Afteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.,K-WIRE,REDUCTION,.,15,Afteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.,K-WIRE,REDUCTION,.,16,Usingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Inthisexample,asolidHerbertscrewisutilized.,.,17,Thereducedandfixedradialhead.TheHerbertscrewseatedunderthearticularsurface.Occasionally,thesecondK-wireisexchangedforaHerbertscrew.,FRACTURE,HERBERTSCREW,.,18,Therangeofmotionoftheforearmaswellaspronationandsupinationareconfirmed,andthereductionisvisualizedthroughoutinarcofmotionoftheelbow.Ifadequatelyfixedandstable,closureisperformed.,FRACTURE,HERBERTSCREW,.,19,Thecommonextensormechanismisbroughttogether,enclosed