Clausa reductionem surgery pro inferioribus extremitatem fracturae.

Closed reduction is the minimally invasive technique that can be used for stable fractures of extremities with no loss of blood flow, no risk of infection, fast functional recovery, significantly reduced medical costs, and can be used for closed reduction hollow nail and intramedullary pin fixation treatment of various unstable fractures, such as femoral neck fractures, femoral stem fractures, tibiofibular fractures, humeral stem Fracturae, etc., eliminating exitium sanguinis influunt per incisionum reductionem.

Fractura de collo de femoris

(I) tractus

Patientes estote in lectulo et Tibialis Taberositas tractu fit cum mitescere membri in neutrum positio mitis interno. Pondus tractu variatur personam, fere 6-9 kg et durationem tractus non excedat XII horas. XC% de aegris potest consequi repositioning a tractu.

(B) clausa manipulative repositioning

Si tractu non ad consequi repositioning requisitis, manual repositioning potest addidit, sub Epidural anesthesia:

1. Mc Elvnny modum

Quod ad figere pelvi, exterius gyrari motum membrum et crescere tractu vi, et tunc intrinsecus Rotate et intrinsecus retractare ad motum membrum ad consequi ad repositioning.

II. Leadbetter modum

The patient lies flat on the ground, bend the affected hip and knee by 90°, traction along the femoral axis of the affected limb for 2 to 3 minutes, then internally rotate the affected limb and lightly flex it, after resetting, gently lower the affected limb, and if the affected foot does not appear to be externally rotated, it mostly indicates successful resetting. Ante faciendo internum solidamentum, in C-brachium apparatus est usus ad cognoscere.

(C) Percutaneeous acus prying technica

If repositioning is not achieved by the above methods, it usually indicates either that the femoral head has been broken or that there has been a rotational separation between the head and neck (Figure 1A), or that there is an insertion somewhere between the head and neck. (Hoc potest fieri in aliquo hortus II, III, aut IV genera). In hoc casu, rotating affectata membri ad Dovetail caput et collum fractura non iam efficax. Ut vitare incisionem et repositioning, perterleous acus prying ars potest ad repositionis fractura.

• A 3.0- ad 3.5-mm-diameter os circularis acus inseritur perpendiculariter per cutem I ad II cm infra in coniunctas in inguinal ligamentum et femoralem in fronte ad femoris capitis, et acus est rotatur ad centrum et in capite in vectigal in C-in medio femoris in capite et in C-Stryter in C-Machina (Figuram in C-Arteria ad C-Machina (Figuram in C-Stryter in C-Machina (Figure 1b).

• Ad confirma prying vis, a secundo os circularis acus potest inserendum 4-5 mm huic acus, cum finis foramen egressus extra cutem.

• Per maiorem trochanturum duorum 3.5 mm diameter os circularis acus agricolae perternatus secundum angulum ceruicis caule et angulus anteriori forisque pertractare finem) relinquens extremum foramen foras extra cutem.

• Operante tenet duos sets of acus caudis cum manibus et accommodat caput et collum fractura sectiones ad align cum se cum cooperatione adiutorem (Figure 1C-E).

• Post alignment satisfacit, os per ACUS inserta ad maiorem trochanteris est daturam in femoralem caput ad tempus fixation, et plures cavas Cochleas sunt ergo inserta in femoris caput (Figuram 1f).

Et clausa reductionem modum descriptus superius potest consequi requiritur reductionem circiter XCVIII% of femoris collum fracturae. Melius est de Gratia diei et alignment fracturam, utrum clausa vel incisa, in melius prognosis. Plerumque, in gradu fracturam peccetur ostensum est in X-radius est minus quam ipsa gradu fractura peccetur. Quia fractura alignment directe afficit sanitatem fractura et facultatem necrosis et femoris caput, necesse est habere rectam judicium X-radius film post fractura alignment. Si S-informibus curva non lenis vel intermitti, indicat quod femoralis collum fractura non pervenit anatomica repositioning (Figura II).

Figura I femoris collum fractura repositum per percutaneous acus prying

Figura II Formor collum fracturam X radios cum continua externa curvae in anatomica et noctis et intermisit externum curvam in non-anatomica alignment

Formor Fractura

Et clausa reductionem ars potest adiuvaret in alignment de femoris derivantur fractura sine damnosa aliqua mollis textuum aut sanguinem copia ad fractura finis, et potest adhiberi internum solidamentum cum intracedullary clavus.

• Under epidural anesthesia, the patient is lying flat on the bed (the skin of the affected limb has not been sterilized at this time), one assistant holds the calf of the affected limb, and the other assistant pulls the patient's thigh root with a cloth belt to counteract the traction, with the affected limb in a neutral position and the patella of the knee facing upward (the femoral stem fracture is usually not rotated and displaced Per musculus trahens, et potest corrigi automatice a tractu, ita operator non indiget corrigere anterior posterior et lateralis obsessio fracti finem de caulis).

• Operator utraque armis circumdari motum et tenet manus simul (Figura III et Figura IV) et corrigit anterius posterior et latera mota de utroque ante per obliquus et brachia.

• Exempli gratia, si propinimalis femur Fractura est motum exterius et anterius, una brachio est ad exprimendum ad proximalem segmentum fractura interna et deorsum. Alterum brachium exprimitur distal fractura segmentis externa et sursum mutuari vim (resetting medicus propriam iudicium fractura obsessio directionem displacement ante reseting) ut fractura possint reset ante tempus. Per repositioning processus, adiutor debet augere tractu vi et custodire femur ex rotating.

• Cum fracturam finem basically lambped mitis os frictio sonitus audiri hoc tempore adiutor ad adhuc tractu sed redigere tractu vi.

• When the fracture is basically aligned by the C-arm machine (if there is still a little misalignment, make some adjustments to make sure the fracture ends match each other), maintain the traction, disinfect the affected limb and spread the towel, and then perform intramedullary nail fixation.

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Fig. III anterior posterior et lateralis obsessio fractura corrigitur simul per involventes utraque arma circa motum membrum et ferit manus simul, utendo clamping vim et brachia.

Figura IV femoris derivantur fractura repositioning mechanicis schematic

• Nam aegris cum magna fractura obslacement, male clausa manipulation vel comminutas fracturae, a chirurgicam tractus lectum potest adhiberi ad claudi reductionem cum aliqua instrumentalis, quae potest efficaciter completum claudi reductionem ad femoris derivantur fracturam.

• Posito affectata membri in tractu frame ad tractu et C, brachium examen ostendit quod imbricatis fractura obsessio est correptum, in longius finem et in alignment et alignment in orthostatic ad imaginem et alignment caule.

• Quia tensio femur musculi sub tractu potest ludere a mollis TEXTUS Splinting munus in femoris derivantur fractura, maxime de femoris caule fracturae potest obtinere magis satisfactorium in orthogonal X-radius imago.

• However, at this time, due to the lack of effective support at the distal end of the fracture segment under the effect of gravity, the distal fracture segment of the femoral stem is mostly displaced posteriorly, and at this time, the sterile towel-covered brace can be placed on the posterior side of the distal fracture end after sterilization and skin preparation and laying of sterile sheets, and the posterior displacement of the Differt fractura finis potest corrigi adcommodare altitudinem ue.

• Si posterius displacement distalus fractura segmentum tamen corrigitur, proximalis clavus constare potest perterneously ad apicem maiorum trochant et pyrifosis in medulla et in capite proximal repositioning virga et manubrium deinci Ad deprimere ad proximal fractura de femoris retrorsum per usura vecte repositioning virga, ita restituit alignment cum posterius motus distal fractura,

• Post fracturam aligned, diu dux pin inseritur in distal fractura cavum perficere clausa reset. IntramMedullary repositioning virga est maxime efficax corrigendo flexura, raptum et externum gyrationis deformitates commune in proximal fracturae proximalis femoris (figura V).

• Nam RELICTUM lateralis obsessio, ad ostium curvam finem Intramedullary virga potest esse accommodetur ad ducem Dux Duce Pin in Distal fractura cavum perficere clausa reductionem.

• Alius modum claudi reductionem est ad stupra a schanz clavus in os cortex ex parte motus fractura finis et adjust fractura finis per schanz clavus ad clausa reductionem (Figura VI). Post fractura satis varius, intramedullary clavus inseritur in proximalis et distal medullary cavum fractura ad perficere internum solidamentum (fights VII).

  
  

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Figura V Manipulation De proximal fractura segmentum pro clausis repositioning per IntramMedullary repositioning virga

Figura VI clausa reductionem per schanz clavus positus in unilateralis os cortex ad fractura finis

Figura VII clausa reduction intrasmedullary clavus solidamentum de multisegamental comminutae Fractura de femoris caule per schanz clavus

Tarso Fractura

(A) Praeparative Praeparatio

• Radiographic Diagnose: The Latin Ankle Imaging Aestimatio debet includere III gradus: anteroposterior (figure VIII), tarso punctum (XV ° internum rotationis) (figura IX) et lateralis (figuram X).

• Cum tarso iuncturam graviter deterioratus est internum et externum tarso et talus et movetur ad XI diversis gradus (figura XI). Static radiographs non accurate reflectunt stabilitatem tarso iuncturam. Suspendisse radiographs et MRI potest amplio taxationem de stabilitate tarso iuncturam et ligamentum damnum (figuram XII).

• In hoc casu, quod genus tarso injuriam debet esse verius determinari per mechanism injuriam et radiological notitia de motum membrum ut bene dirige repositioning et solidamentum.

• Interdum est simplex medialis tarso fractura potest esse pars magis universa 'maisonneuve fractura ', quae etiam includit proximalis fractura et combined ligamentum iniuriam, ita tota Tibiofibula sit radiographically examinato.

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Figura VIII fronte et tergo positus

Figura IX tarso puncta (XV ° internum Rotation)

Figura X lateralis positio

Figura XI fractura obsessio videtur coniuncta cum peccetur

Figura XII accentus radiograph (triangularis ligamentum rupture)

(II) Anesthesia

Femoralis et esca nervus anesthesia solet.

(C) reset ars

Posterior, externum gyrationis genus clausis repositioning fit in ordine externi tarso-internum tarso-posterior tarso-inferior Tibiofibular unio. Et posterior gyrationis, internus gyrationis genus fit in ordinem internum tarso externum tarso.

• In casu de posterior-externa gyrationis type IV, in patientes estote est positus supina et genu flexus ad XC ° ad relaxat vitulum triceps.

• Duo assistentes Popliteal pars femur et pedem respectively et tractu applicatur directionem fractura deformitatem (vim ne nimium vitare aggravans iniuriam).

• Suffragium trahens pedem conuertitur pedem interiorem corrigere externum gyrationis deformitas (figura XIII). Dum propellentibus dimisit finem tibial latus et trahens distal Tibia ad fibularum parte adiutor interius vertit et dorso tarso iuncturam corrigere obsessio externa tarso talai (Figura XIV).

• Ponere internum gyrationis internum gyrationis dorsalis extensio positio. Tum posterior tarso fracturam obstructionum tenetur tam pollices quatuor digitos circumdans distal Tibia et thrinas dis et exprimi, cum trahens down distal Tibia ad reset in tarso (Figura XV).

• Denique operator tendat medialis tarso retrorsum et deorsum cum pollices ad reset eam (Figura XVI). Duo assistentes ponere pedem et tarso in internum rotentur-internus gyrationis dorsalis extensio in praeparatione ad solidamentum.

Figura XIII tractus correptionem externum gyrationis deformitas

Figura XIV correctione latus obsessio externi tarso et talus

Figura XV correctione posterioris tarso subcinctus

Figura XVI correctione internum tarso displacement

Et post-gyrationis, internum repositioning processus est oppositum post-gyrationis, externa repositioning processus et fit in ordo internum tarso-externa tarso.

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