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锁骨骨折课件_2

锁骨骨折课件_2

ID：20256794

大小：2.31 MB

页数：87页

时间：2018-10-11

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1、InjuriesoftheClavicle,AcromioclavicularJointandSternoclavicularJointAndrewH.Schmidt,MDT.J.McElroyCreatedMarch2004“S”-shapedboneMedial-sternoclavicularjointLateral-acromioclavicularjointandcoracoclavicularligamentsMuscleattachments:Medial:sternocleidomastoidLateral:Trapezius,pecto

2、ralismajorClavicleDiarthrodialjointbetweenmedialfacetofacromionandthelateral(distal)clavicle.Containsintra-articulardiskofvariablesize.Thincapsulestabilizedbyligamentsonallsides:ACligamentscontrolhorizontal(anteroposterior)displacementSuperiorACligamentmostimportantACJointCoracoc

3、lavicularligaments“Suspensoryligamentsoftheupperextremity”Twocomponents:TrapezoidConoidStrongerthanACligamentsProvideverticalstabilitytoACjointDistalClavicleMechanismofInjuryModerateorhigh-energytraumaticimpactstotheshoulderFallfromheightMotorvehicleaccidentSportsinjuryBlowtothep

4、ointoftheshoulderRarelyadirectinjurytotheclaviclePhysicalExaminationInspectionEvaluatedeformityand/ordisplacementBewareofrareinferiororposteriordisplacementofdistalormedialendsofclavicleComparetooppositeside.PhysicalExaminationPalpationEvaluatepainLookforinstabilitywithstressPhys

5、icalExaminationNeurovascularexaminationEvaluateupperextremitymotorandsensationMeasureshoulderrange-of-motionRadiographicEvaluation oftheClavicleAnteroposteriorView30-degreeCephalicTiltViewRadiographicEvaluationoftheClavicleQuesana45-degreeanglesuperiorlyanda45-degreeangleinferior

6、lyProvidebetterassessmentoftheextentofdisplacementRadiographicEvaluationoftheACJointZancaViewAPviewcenteredatACjointwith10degreecephalictiltLessvoltagethanusedforAPshoulderStressViewsoftheDistalClavicle&ACJointRationale:willdemonstrateinstabilityanddifferentiategradeIIIACseparati

7、onsfrompartialGradeI-IIinjuriesPerformedbyhavingpatienthold10#weightwithinjuredarmRarelyusedtoday,sincemostACjointinjuriestreatedthesame,andmanagementofdistalclaviclefracturesdependsoninitialdisplacementandlocationoffracture.RadiographicEvaluationoftheMedialOneThirdX-ray:Cephalic

8、tiltviewof40to45degreesCTscanusuallyindi

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