raf在桡骨远端骨折的应用课件.pptx

1、 年轻族群年轻族群高能量损伤高能量损伤最常见骨折最常见骨折 老年族群老年族群低能量损伤低能量损伤继髋关节周围骨折后第二常见骨折继髋关节周围骨折后第二常见骨折 骨折类型典型3骨折块1.桡骨茎突2.月状骨关节面背侧(die punch 骨折块)3.月状骨关节面掌侧 粉碎形态根据撞击角度承受能量骨品质关节外骨折需避免骨短缩和角度丢失造成的骨不连骨块错位排列导致活动受限腕骨的应力分布改变和失稳桡腕关节炎的风险增加治疗标准治疗标准6565岁以上岁以上(骨质疏松骨质疏松)关节外锁定骨板外固定+克氏针支撑固定关节内大骨块锁定骨板外固定+克氏针支撑固定锁定骨板 6565岁以下岁以下(骨品质相对好骨品质相对好)

2、关节外掌倾20骨板石膏/骨板/外固定关节内骨板内侧块 mini螺钉固定1.亚洲曲率的问题2.男女尺寸不同3.必需依不同分类选择内固定器目前的目前的困境困境扇形叶radial screws for the radial columnmedial screwsulnar screws for the intermediate column经过临床比对确认真实ML差异Anatomical Fan-Shaped Plate Design assists in restoring the original geometry of the patients anatomyStandardSmall茎突骨折

3、茎突骨折茎突骨折53O5053O男板男板女板女板病例二指掌骨折多由什么引起？“The distribution of hand fractures:a british perspective”Edward Laugharne,Dhruvar Bhavsar,Vaikunthan Rajaratnam,Eur J Plast Surg 2013克氏针还是钢板内固定克氏针还是钢板内固定 “Internal fixation with the low profile plate system compared with Kirshner wire fixation:clinical results

4、of treatment for metacarpal and phalangeal fractures”Hidetake Takigami,Hiroaki Sakano,Hand Surgery 2010骨折发生手术干预尽早康复预后佳“Management of acute fractures of the hand”,P Nithin Unnikrishnan,Vijay Bhalaik,Mini-symposium:Hand injuries 2014传统微型骨板强度无法满足术后康复治疗强度不锈钢锁定骨板高切迹影响术后活动度为了避免ORIF对伸肌腱的激惹“Unstable metacar

5、pal and phalangeal fractures:treatment by internal fixation using AO mini-fragment plates and screws”Mumtaz,Farooq,Rasool,Kawoosa,Badoo,Dhar,Turkish Journal of Trauma&Emergency Surgery 2010骨板太薄并发症风险高Takigami H1,Sakano H,Saito T.Internal fixation with the low profile plate system compared with Kirsch

6、ner wire fixation:clinical results of treatment for metacarpal and phalangeal fractures.Hand Surg.2010;15(1):1-6.1.1.螺钉脱出螺钉脱出2.2.复位丢失复位丢失3.3.强度不能满足康复治疗强度不能满足康复治疗于是百家争鸣，越做越薄2.0mm系统切迹1.2mm1.5mm系统切迹0.8mm最薄的锁定骨板1.2 0.8十字螺钉设计十字螺钉设计钛合金雕刻、低切迹设计1.5mm/2.0mm Mini骨板锁定系统提供您小骨折块全面解决方案1.5mm/2.0mm1.5mm/2.0mm病例1病例2病例368Fractures