儿童桡骨颈骨折治疗 ppt课件

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1、RadialNeckFracturesinChildrenTreatedWithElasticStableIntramedullaryNailingNingboNo.6hospitalCaojinAnatomyCharacteristicbeginsatfouryearsanditfusesattheageof14infemalesand17inmales.OssificationcenterCharacteristicage4～14yearsdiseaserate:5%ofelbowinjuriesor1%

2、ofallinjuriesinchindrenMechanismElbowinextension:morecommontypeElbowinflexed:raretypeClassificationJudetDWilkinsEDiagnosishistorysymptomphysicalsignradiographTreatmentcontroversyacceptabledegrees15°~45°themajorityopinion30°ReductionClosedreductionPercutaneous

3、pinreductionOpenrecuctionClosedreduction30°～60°＞60°PercutaneouspinreductionRisk:radialnerveinjuryOpenreductioncontroversialoutcomesincidenceofcomplicationcausesadditionaldamageopenreductionFixationK-wiresElasticnailingTecniqueofelasticnailingPostoperativeradi

4、ographCase1A6-year-oldboysustainedaJudettypeIVfractureoftheradialneck.Follow-upradiographafterelasticnailingshowsgoodreduction.Thepatienthadanexcellentoutcome.Case1Follow-upradiographshowsfractureunionandanatomicreduction.Thepatientshowedanexcellentclinicalre

5、sultandresumedfullmotion.ComplicationInfectionelbowstiffnessavascularnecrosisprematurephysealclosureAdvantageofESINminimallyinvasivetechniquestablefixationearlymobilizationanatomicalreductionlowercomplicationrategood-to-excellentresultsCase210-year-oldboysust

6、ainedaJudettypeIVfractureoftheradialneck.Postoperativeradiographshowsanatomicreduction.Thepatientshowedaminimalincision.ThankYouThankYouThankYouAnatomyByfouryearsofage,theradialheadandneckhaveassumedtheiradultshapewithaphysiologicalangulationoftheneckintheant

7、eroposterior(AP)planeofanaverageof12.5°laterallyandinthelateralplaneofanaverageof3.5°anteriorly.Theproximalradialepiphysisismainlysuppliedbyperiostealbloodvesselsrunningfromdistaltoproximal.Mechanism’2mainmechanismsofinjuryweredescribedinliterature.Inthemorec

8、ommontype,aradialneckfractureoccursafterafallwiththeelbowinextensionandvalgus,resultinginafracturewithvalgusangulation.Intheraretype,themechanismisafallwiththeelbowflexed,whichcausestempo