锁骨远端骨折伴肩锁关节脱位的治疗(yq)VIP免费

Department of Orthopedics The Affilliated Hospital of Xuzhou Medical University锁骨远端骨折伴肩锁关节脱位的治疗XXXDepartment of Orthopedics The Affilliated Hospital of Xuzhou Medical University锁骨骨折分型Allman 分型：I 类 锁骨中段1/3 的骨折，占72%~80% 。II 类 锁骨外侧1/3 的骨折，占10%~30% 。III 类 锁骨内侧1/3 的骨折，不足5% 。Department of Orthopedics The Affilliated Hospital of Xuzhou Medical University受伤机制直接暴力: 上臂内收肩部上外侧着地致伤间接暴力：FOOS 受伤机制上臂外展；肱骨将暴力传达到肩峰Department of Orthopedics The Affilliated Hospital of Xuzhou Medical University内容锁骨远端解剖特点与诊断骨折分类内固定的挫折与反思治疗方法的合理选择锁骨远端骨折固定的发展Department of Orthopedics The Affilliated Hospital of Xuzhou Medical UniversityDepartment of Orthopedics The Affilliated Hospital of Xuzhou Medical University重建喙锁韧带？讨论（Discussion ）锥状韧带：维持锁骨冠状位的稳定斜方韧带：维持锁骨水平位的稳定肩关节腋位片确定锁骨在水平位是否稳定－－斜方韧带是否完整探查喙锁韧带－－重建韧带减少肩锁韧带负荷Department of Orthopedics The Affilliated Hospital of Xuzhou Medical UniversityDepartment of Orthopedics The Affilliated Hospital of Xuzhou Medical UniversityDepartment of Orthopedics The Affilliated Hospital of Xuzhou Medical UniversityDepartment of Orthopedics The Affilliated Hospital of Xuzhou Medical UniversityNeer II 型骨折的治疗 Neer 指出：尽管锁骨远端1/3 的骨折并不常见，但其几乎占了所有锁骨骨折不愈合的一半。大多数肩关节外科医生建议对移位的锁骨远端II 型骨折行手术治疗 Department of Orthopedics The Affilliated Hospital of Xuzhou Medical University物理检查1. 神经血管进行的检查 臂丛的内侧束损伤：类似“尺神经损伤”的表现 2. 测量并对比双侧的脉搏 3. 创伤后生命体征变化评估系统（Advanced Trauma Life Support, ATLS ）评估生命体征变化并进行相关的治疗，直到其他的损伤被明确排除 Department of Orthopedics The Affilliated Hospit...