桡骨小头骨折切开内固定术-课件

桡骨小头骨折切开内固定术-课件1Preoperative AP radiograph of a Type 2 radial head fracture.Preoperative AP radiograph of 2Preoperative lateral radiograph of a Type 2 radial head fracture.Preoperative lateral radiograp3Preoperative lateral radiograph of the Type 2 radial head fracture.Preoperative lateral radiograp4The elbow is flexed and positioned on a radiolucent table.The incision begins just above the lateral epicondyle and extends down towards the ulna,passing directly over the radial head,as depicted.The elbow is flexed and positi5The skin incision is brought down through the subcutaneoustissue and the common extensor origin is identified.The skin incision is brought d6The common extensor origin is incised between the anconeus and the extensor carpi ulnaris over the capitellum radial head.ANCONEUSECUThe common extensor origin is 7The upper edge of the capitellum and the radial head are exposed.The upper edge of the capitel8RADIAL HEADRADIAL HEAD9With sharp retraction and rotation of the radial head,the fracture is identified.Care must be taken not to extend this incision too far distally,as this may damage to the posterior interosseous nerve,as it lay over the radial neck.ANNULARLIGAMENTRADIAL HEAD FRACTUREWith sharp retraction and rota10A Freer elevator or small osteotome is introduced tomobilize the radial head fracture.A Freer elevator or small oste11桡骨小头骨折切开内固定术-课件12Close up viewCAPITELLUMRADIAL HEADClose up viewCAPITELLUMRADIAL 13After anatomic reduction is achieved,K-wires are used to maintain the reduction.K-WIREREDUCTIONAfter anatomic reduction is ac14After anatomic reduction is achieved,K-wires are used to maintain the reduction.K-WIREREDUCTIONAfter anatomic reduction is ac15Using the external jig,a screw is placed such that it is countersunk below the articular surface of the radial head.In this example,a solid Herbert screw is utilized.Using the external jig,a scre16The reduced and fixed radial head.The Herbert screw seated under the articular surface.Occasionally,the second K-wire is exchanged for a Herbert screw.FRACTUREHERBERTSCREWThe reduced and fixed radial h17The range of motion of the forearm as well as pronation andsupination are confirmed,and the reduction is visualizedthroughout in arc of motion of the elbow.If adequately fixedand stable,closure is performed.FRACTUREHERBERTSCREWThe range of motion of the for18The common extensor mechanism is brought together,enclosed over the radio-capitellar joint.The common extensor mechanism 19After closure.After closure.20