關節(jié)脫位JointDislocation中山大學外科學.ppt
《關節(jié)脫位JointDislocation中山大學外科學.ppt》由會員分享,可在線閱讀,更多相關《關節(jié)脫位JointDislocation中山大學外科學.ppt(62頁珍藏版)》請在裝配圖網上搜索。
JointDislocationandPeripheralNerveInjury RONGLi minThe3rdaffiliatedhospitalofSunYat senuniversity Jointdislocation Definition Jointdislocation orluxationAdislocationisaseparationoftwoboneswheretheymeetatajointOftencausedbyasuddenimpacttothejointAdislocationmayalsocauseligamentornervedamageSubluxation 半脫位 isapartialdislocation Classification Traumatic Congenital 先天性 PathologicComplete subluxationAnterio posterio lateral central Acute old habitual shoulders Close open bilateraldislocationofthehipbecauseoftrafficaccident Congenitaldislocationofthehip 先天性髖關節(jié)脫位 Shenton sline Rheumatoidarthritis 類風濕性關節(jié)炎 ofthewristandhands Subluxationandulnardeviationatthemetacarpophalangealjoint Occurrence themostcommonsitesShouldersElbowsHipsFingersAnkles mostlikelybeaccompaniedbyafracture KneesWrists SymptomsofaJointDislocation IntensePainSwellingImmobilityoftheaffectedjointDeformity NOMENCLATUREFORDISLOCATIONS NametheJOINTNamethedislocationbythepositionoftheDISTALFRAGMENTinrelationtotheproximalfragmentAddFRACTUREtothenameifthereisaperiarticularfracture AddOPENifawoundcommunicateswiththedislocation Complications FractureNerve vascularinjuryBonenecrosisTraumaticarthritis Galeazziinjury Monteggiainjury Treatment CloseReductionImmobilizeRehabilitationprogramSurgicalreductionLigamentreconstruction Hipjointdislocation Allismaneuver 提拉法 Bigelow smaneuver 問號法 AftercareTraction 4weeks Bed 2weeks Walkstick 2weeks Ambulate 8weekslat Shoulderinjury Anteriordislocationoftheshoulder Kocher s Hippocrate s Stimson s Elbowinjury Manipulativereduction Otherjointdislocation Acromioclavicularseparation Completedislocationofaproximalinterphalangealjoint Lunatedislocation Perilunatedislocation Nursemaid selbow pulledelbow牽拉肘 ApartialdislocationofradialheadcommonintoddlersThemainsymptomisrefusaltousethearmCanbeeasilytreatedinadoctor sofficewithoutthefollowingfirstaidsteps Manualreduction Peripheralnerveinjury Orthopaedicsurgeryisnolongerlimitedtoinjuriesofthebone bloodvessels andskin buthasexpandedtoincludenerveinjuryaswell Axon 軸索 Myelinsheath 髓鞘 Schwanncell 施萬細胞 NodesofRanvier PeripheralNerve PeripheralNerveInjury AcuteinjuryChronicinjury entrapmentneuropathy CLASSIFICATIONOFNERVEINJURIES neuropraxia 神經傳導功能障礙 axonotmesis 神經軸索中斷 nerotmesis 神經斷裂 neuropraxia 神經傳導功能障礙 preservationoftheaxis cylinderminoredemaorbreakdownofmyelinsheathrecoveryiscompleteinafewdaysorweeks axonotmesis 神經軸索中斷 breakdownoftheaxondistalwalleriandegenerationpreservationoftheSchwanncellSpontaneousregenerationwithgoodfunctionalrecovery nerotmesis 神經斷裂 completeanatomicalseveranceofthenervedistalwalleriandegenerationperineuriumandepineuriumalsoaredisruptedspontaneousrecoverycannotbeexpected Walleriandegeneration 華勒氏變性 Symptoms Pain withthedegreeofintensityrangingfromatinglingsensationtoextreme burningpainLossoffeelingorabnormalsensationsLossofmotorfunction suchasahandorlegbeingdifficulttomoveLossofactiverangeofmotion suchasdifficultyliftingfingersorflexingthewrist Diagnosis evaluatemotor sensoryandautonomiclossTinelsign 神經干叩擊試驗 Electromyogram EMGorElectromyography NerveConductionStudyMagneticResonanceImaging MRI Peronealnerve oftendamagedduringdislocationoftheknee withruptureofthelateralcollateralligamentofthekneeorfracturesoftheupperfibulaasthecommonperonealnervewrapsaroundtheneckofthefibula SymptomofperonealnerveInj Completeparalysisofdorsiflexionofthefootandankle footdropandsteppagegait跨閾步態(tài) Sensorylossoverthemedialtwo thirdsofthedorsumofthefootandlateralsideoftheleg Tibialnerve DamageduetoadislocationofthekneeleadstovariableparalysisofplantarflexionofthefootandtoesThenumbnessoftheheelandpartofthesoleandthelateralsideofthefootandposterioraspectoftheleg Tinglingsensationorlackofsensationinthebackofthearm forearmandhandWeaknessinarmmuscles makingitdifficulttostraightentheelbow wristandfingers wristdrop垂腕 RadialNerveInjury Mediannerve SensorylossoflateralsideofpalmThumbabductionparalysis Fromentsign 夾紙試驗 ULNARNERVE Claw fingerdeformity 爪形手 Treatment ObservationNerveisinjuredbutnotcutRehabilitationandcarefulmonitoringareneededSurgeryforNerveRepairReconnect sutures NervegraftNervetransferOthersurgeryTendonstransfering Epineuralrepair 外膜縫合 PrimarynervesuturesremainthetreatmentofchoicefortherepairofdividedperipheralnervesIncluding Groupfascicularrepair 束膜縫合 EpineuralRepair FascicularRepair NerveGraft leadingcauseoffailureofnervegraftInadequateresectionDistractionofrepairsite Nervegraft 神經移植 Nervetransfer 神經移位術 PeripheralNerveInjuries Bythebeginningofthe20thcentury somemeasureofsuccesswasreportedwithautografts Althoughregenerationaxonsgainentrancetothedistalsegment regenerationisslow Keypoint Manifestation diagnosisandmanagementofHip ShoulderandElbowjointdislocationTreatmentprinciplesofperipheralnerveinjuryBrachialplexusinjury 臂叢損傷 References TEXTBOOKofSURGERY Thebiologicalbasisofmodernsurgicalpractice 17edition ThanksandQuestions Email ronglimin- 配套講稿:
如PPT文件的首頁顯示word圖標,表示該PPT已包含配套word講稿。雙擊word圖標可打開word文檔。
- 特殊限制:
部分文檔作品中含有的國旗、國徽等圖片,僅作為作品整體效果示例展示,禁止商用。設計者僅對作品中獨創(chuàng)性部分享有著作權。
- 關 鍵 詞:
- 關節(jié) 脫位 JointDislocation 中山大學 外科學
裝配圖網所有資源均是用戶自行上傳分享,僅供網友學習交流,未經上傳用戶書面授權,請勿作他用。
鏈接地址:http://m.jqnhouse.com/p-6317257.html