股骨干骨折逆行股骨髓内钉内固定术课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,RETROGRADE,INTRAMEDULLARY,NAILING,AP radiograph of the femoral shaft fracture,A high quality a p radiograph of the hip is required before nailing,ensues in order to rule out femoral neck fracture. In most situations,the ct scan done for evaluation of the abdomen and pelvis should be,reviewed for occult femoral neck fractures,图,The leg is free-draped from the calf to the asis,Proximal,Distal,A small incision, usually no more than 15mm,ade over the medial,spect of the patellar tendon. This incision is brought paratendinous,through the deep tissue so as not to go through the patellar tendon,PATELLA,TENDON,PATELLA,Proximal,Distal,The portal may be made using many methods including,guidewire followed by a reamer, a straight awl, or a step,drill as seen here,The knee should be in approximately 40 degrees of flexion to,portal and reng the inferior patella or proximal tibia as the,avoid damage,aming is performed,For the starter reamer, guidewire, or awl the direction of insertion must,be in the center and parallel with the formal shaft in both the ap and,lateral views. The perfect starting portal is just at the intersection of,Blumensaats line with the line representing thethe trochlear groove,on the perfect lateral radiograph,On the ap it should be in the center of the notch directed toward the,center of the shaft rather than perpendicular to the condyles, which,would direct the nail toward the medial cortex,A beaded-tipped guidewire is advanced to the fracture,