Fx about the upper limb上肢骨折 中山大学

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1、FracturesoftheUpperLimbQing-TangZhu,MDPhDDepartmentofMicrosurgery&OrthopedicTraumaTheFirstAffiliatedHospital,SunYat-SenUniversityPretest•Specificsignsofthefracturesaboutthelimb•Principlesforfracturemanagement•Fracture-relatedcomplicationsAims•Knowhowtoevaluateandtreatthecommonfracturesa

2、bouttheupperlimb–Fracturesoftheclavicle–Fracturesoftheproximalhumerus–Fracturesoftheshaftofthehumerus–Supracondylarfracturesofthedistalhumerus–Fracturesoftheshaftsoftheradiusandulna–Fracturesofthedistalradius•KnowthecomplicationsresultedfromfracturesormedicalinterventionsSkeletalStructu

3、reoftheUpperLimb•Connecttothetrunkviaclavicle•LargeROMoftheshoulder•Forearmrotation•Non-weightbearingBasicPrinciplesinFractureEvaluation•Mechanismofinjury(MOI)•Classification•PhysicalExamination–Non-specificandspecificsigns–Associatedinjuriesandcomplications•Radiography–X-ray–CT•Diagnos

4、is(includingcomplicationsandassociatedinjuries)BasicPrinciplesinFractureManagementNon-operationVSOperation•Reduction•Immobilization•RehabilitationCommonFracturesabouttheUpperLimb•Fracturesoftheclavicle•Fracturesoftheproximalhumerus•Fracturesoftheshaftofthehumerus•Supracondylarfractureso

5、fthedistalhumerus•Fracturesoftheshaftsoftheradiusandulna•FracturesofthedistalradiusMechanismofInjury•Directforce(94%)–Blowonthetop–Fallontheside•Indirectforce(6%)–Fallonanoutstretchedhand–ForcetransmitteduptotheshoulderClinicalManifestation•Posture–Splintingofaffectedextremity–Armadduct

6、edacrossthechest–Supportingtheinjuredlimbwiththeotherhand•Signs–Swelling,tenderness–Deformity–Abnormalmovement–CrepitusswRadiographyAPviewoftheclavicleClassificationouterendshaftinnerend•Allman•AO/OTACBANonoperativeTreatment•Greenstickfracture•Non-displacedfracture–Immobilizedwitharmsli

7、ngfor4-6weeksNonoperativeTreatment•Markeddisplacementofthefracture–Closereduction,correcttheanteriordriftofthescapula–Immobilizedwithfigure-of-eightbandageNonoperativeTreatment-Aftercare•Carefulsupervision•Inspectionandpossibletighteningthebraceevery2-4daysinitially•Theslingmay