桡骨小头骨折切开内固定术

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1、PreoperativeAPradiographofaType2radialheadfracture.PreoperativelateralradiographofaType2radialheadfracture.PreoperativelateralradiographoftheType2radialheadfracture.Theelbowisflexedandpositionedonaradiolucenttable.Theincisionbeginsjustabovethelateralepicondyle

2、andextendsdowntowardstheulna,passingdirectlyovertheradialhead,asdepicted.Theskinincisionisbroughtdownthroughthesubcutaneoustissueandthecommonextensororiginisidentified.Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellu

3、mradialhead.ANCONEUSECUTheupperedgeofthecapitellumandtheradialheadareexposed.RADIALHEADWithsharpretractionandrotationoftheradialhead,thefractureisidentified.Caremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asi

4、tlayovertheradialneck.ANNULARLIGAMENTRADIALHEADFRACTUREAFreerelevatororsmallosteotomeisintroducedtomobilizetheradialheadfracture.CloseupviewCAPITELLUMRADIALHEADAfteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTIONAfteranatomicre

5、ductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTIONUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Inthisexample,asolidHerbertscrewisutilized.Thereducedandfixedradialhead.TheHerbertscrewseated

6、underthearticularsurface.Occasionally,thesecondK-wireisexchangedforaHerbertscrew.FRACTUREHERBERTSCREWTherangeofmotionoftheforearmaswellaspronationandsupinationareconfirmed,andthereductionisvisualizedthroughoutinarcofmotionoftheelbow.Ifadequatelyfixedandstable,

7、closureisperformed.FRACTUREHERBERTSCREWThecommonextensormechanismisbroughttogether,enclosedovertheradio-capitellarjoint.Afterclosure.Lateralview,demonstratingthereduction