桡骨小头骨折切开内固定

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1、PreoperativeAPradiographofaType2radialheadfracture.PreoperativelateralradiographofaType2radialheadfracture.PreoperativelateralradiographoftheType2radialheadfracture.Theelbowisflexedandpositionedonaradiolucenttable.Theincisionbeginsjustabovethelateralepicondyleandextendsdownto

2、wardstheulna,passingdirectlyovertheradialhead,asdepicted.Theskinincisionisbroughtdownthroughthesubcutaneoustissueandthecommonextensororiginisidentified.Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellumradialhead.ANCONEUSECUTheuppere

3、dgeofthecapitellumandtheradialheadareexposed.RADIALHEADWithsharpretractionandrotationoftheradialhead,thefractureisidentified.Caremustbetakennottoextendthisincisiontoofardistally,asthismaydamagetotheposteriorinterosseousnerve,asitlayovertheradialneck.ANNULARLIGAMENTRADIALHEADF

4、RACTUREAFreerelevatororsmallosteotomeisintroducedtomobilizetheradialheadfracture.CloseupviewCAPITELLUMRADIALHEADAfteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIREREDUCTIONAfteranatomicreductionisachieved,K-wiresareusedtomaintainthereduction.K-WIRERED

5、UCTIONUsingtheexternaljig,ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead.Inthisexample,asolidHerbertscrewisutilized.Thereducedandfixedradialhead.TheHerbertscrewseatedunderthearticularsurface.Occasionally,thesecondK-wireisexchangedforaHerbertscrew

6、.FRACTUREHERBERTSCREWTherangeofmotionoftheforearmaswellaspronationandsupinationareconfirmed,andthereductionisvisualizedthroughoutinarcofmotionoftheelbow.Ifadequatelyfixedandstable,closureisperformed.FRACTUREHERBERTSCREWThecommonextensormechanismisbroughttogether,enclosedovert

7、heradio-capitellarjoint.Afterclosure.Lateralview,demonstratingthereduction