踝部骨折-2067480.ppt

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,临床解决方案,CLINICAL SOLUTIONS,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,临床解决方案,CLINICAL SOLUTIONS,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Basic Trauma Training 2013,*,临床解决方案,CLINICAL SOLUTIONS,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,踝部,骨折,目标,重要,的解剖结构,X,光,骨折,分类,内植物,踝关节解剖,由胫骨、腓骨与距骨组成的铰链关节,外踝是腓骨的一部分,内踝是胫骨的一部分,胫骨,腓骨,距骨,外踝,内踝,穹窿,穹窿是胫骨的关节面,韧带,侧副韧带将距骨固定在位置上,三角韧带,(,内侧,),外侧副韧带,(,外侧,),下胫腓联合,将胫骨和腓骨相互连接的韧带,骨间膜,和韧带,下胫腓联合韧带,(,前与后,),踝关节,X,光片,正常的踝关节,X,光片,:,正位、侧位与,Mortise,位,胫腓重叠,内侧空间,胫骨倾斜,骨折分类,Weber,分类,根据腓骨骨折与下胫腓韧带联合的关系，以及向近端延伸的情况分类,A,型,B,型,C,型,Weber A,型,腓骨骨折发生在下胫腓联合,以下,Weber A,型,一般用克氏针，张力带或拉力钉（小骨折块或空心钉或,HCS,）固定,Weber A,型,Basic Trauma Training 2013,Weber B,型,腓骨骨折发生在下胫腓联合,水平,下胫腓联合经常撕裂,Weber B,型,Basic Trauma Training 2013,Weber C,型,腓骨骨折发生在下胫腓联合以,上,影响关节面的各个平面,骨间膜撕裂,经常伴随后方骨折,Weber C,型,Basic Trauma Training 2013,穹窿骨折,累及胫骨承重的关节面,经常出现在胫骨的表面撞击距骨顶时,高能量。车祸或高处坠落,严重软组织损伤，肿胀和开放伤口,穹窿,骨折,Plafond,(,法语,：天花板,),Ankle Mortise,(Mortar&Pestle),穹窿,骨折,Basic Trauma Training 2013,LCP,腓骨远端板,2.7/3.5mm,LCP,腓骨远端板,LCP,腓骨远端后外侧板,Indications,适应症,腓骨远端干骺端与骨干的骨折、截骨术与骨不连固定，特别是在骨量减少的骨骼。,特点和益处,解剖型,减少术中弯板，优化腓骨远端贴配,骨干的加长孔和结合孔,可调整接骨板位置,可使用,3.5mm,锁定螺钉，,3.5mm,皮质骨螺钉和,4.0mm,松质骨螺钉,特点和益处,共轴螺钉孔(远端),减少螺钉突出，更低切迹,可通过板打拉力螺钉，抓持小骨折块,可使用,2.4,或,2.7,（头为,2.4,）锁定钉或皮钉,特点和益处,多种接骨板,覆盖多种骨折类型,分左右设计，,9,种骨干长度,接骨板切迹优化,螺钉头部突出,克氏针孔（后,-,外）,可进行临时固定,