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ID:18659107
大小:5.94 MB
页数:32页
时间:2018-09-20
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1、RadialNeckFracturesinChildrenTreatedWithElasticStableIntramedullaryNailingNingboNo.6hospitalCaojinAnatomyCharacteristicbeginsatfouryearsanditfusesattheageof14infemalesand17inmales.OssificationcenterCharacteristicage4~14yearsdiseaserate:5%ofelbowinjuriesor1%o
2、fallinjuriesinchindrenMechanismElbowinextension:morecommontypeElbowinflexed:raretypeClassificationJudetDWilkinsEDiagnosishistorysymptomphysicalsignradiographTreatmentcontroversyacceptabledegrees15°~45°themajorityopinion30°ReductionClosedreductionPercutaneouspi
3、nreductionOpenrecuctionClosedreduction30°~60°>60°PercutaneouspinreductionRisk:radialnerveinjuryOpenreductioncontroversialoutcomesincidenceofcomplicationcausesadditionaldamageopenreductionFixationK-wiresElasticnailingTecniqueofelasticnailingPostoperativeradiogr
4、aphCase1A6-year-oldboysustainedaJudettypeIVfractureoftheradialneck.Follow-upradiographafterelasticnailingshowsgoodreduction.Thepatienthadanexcellentoutcome.Case1Follow-upradiographshowsfractureunionandanatomicreduction.Thepatientshowedanexcellentclinicalresult
5、andresumedfullmotion.ComplicationInfectionelbowstiffnessavascularnecrosisprematurephysealclosureAdvantageofESINminimallyinvasivetechniquestablefixationearlymobilizationanatomicalreductionlowercomplicationrategood-to-excellentresultsCase210-year-oldboysustained
6、aJudettypeIVfractureoftheradialneck.Postoperativeradiographshowsanatomicreduction.Thepatientshowedaminimalincision.ThankYouThankYouThankYouAnatomyByfouryearsofage,theradialheadandneckhaveassumedtheiradultshapewithaphysiologicalangulationoftheneckintheanteropos
7、terior(AP)planeofanaverageof12.5°laterallyandinthelateralplaneofanaverageof3.5°anteriorly.Theproximalradialepiphysisismainlysuppliedbyperiostealbloodvesselsrunningfromdistaltoproximal.Mechanism’2mainmechanismsofinjuryweredescribedinliterature.Inthemorecommonty
8、pe,aradialneckfractureoccursafterafallwiththeelbowinextensionandvalgus,resultinginafracturewithvalgusangulation.Intheraretype,themechanismisafallwiththeelbowflexed,whichcausestempo
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