外科精品教学课件（重庆医科大学）9Deng-Fx-2013.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * PRINCIPLES of FRACTURE TREATMENT Reduction Immobilization Rehabilitation Medication REDUCTION Criterion of Reduction 1. Anatomic Reduction 2. Functional Reduction (1). No Observe Gap and Rotation (2). Shortening ＜1 ~ 2 cm in the Leg (3). Angulation＜ 15 ~ 10 (4). Apposition of the Fragments ＞ １／３( shaft ) , or ３/４ ( epiphyseal ) REDUCTION Methods of Reduction 1. By Closed Manipulation 2. By Mechanical Traction with or without Manipulation 3. By Open Reduction IMMOBILIZATION Reasons of Immobilization 1. Prevention of Displacement or Angulation 2. Prevention of Movement 3. Relief of Pain IMMOBILIZATION Methods of Immobilization 1. By Wooden Splint , Plaster or Splint (other) 2. By Continuous Traction 3. By External Fixer 4. By Internal Fixation REHABILITATION 1. Active Muscular Contraction ( After Injury Within 2 Weeks ) 2. Active Exercises Joints of Adjacent Fracture ( After Injury 2 ~ 8 w ) 3. Active Resistance Exercises ( After 8 w ) 4. Physiotherapy Medication Traditional Medication Forbid Using Nonsteroid Anti- Inflammatory Drugs ( NSAIDs ) TREATMENT of OPEN FRACTURE Prevent Infection !! TREATMENT of OPEN FRACTURE 1. Type of Open Fracture From outside to inner From inner to outside Potential TREATMENT of OPEN FRACTURE 2. Conditions of the Wound Contaminative Extent Degree of Soft Tissue Injury