骨科的基本操作技术培训课件

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– Gently mold the splint again to the extremity.
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Plaster splints
Slightly warm (not over 24°C) water and bucket
Stockinette (optional) Soft cotton bandage/undersplint material
(e.g., Webril® padding), available in 2-, 3-, 4-, and 6-inch width sizes Plaster bandages, available in 2-, 3-, 4-, and 6-inch width sizes Elastic bandages (Ace) Adhesive tape
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– Place layers of dry plaster bandages onto the Webril® . In general, upper extremity splints require 8-10 layers of plaster, whereas lower extremity splints will require 10-15 layers.
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适应症
1 小夹板难于固定的骨折,脊柱骨折 2 开放性骨折清创缝合术后 3 病理性骨折 4 某些骨关节术后:关节融合 5 畸形矫正术后:三关节融合 6 化脓性骨髓炎,关节炎,固定患肢,减轻疼
痛,控制炎症
7 某些软组织损伤:肌腱,肌肉,血管,神经 损伤
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用法:骨隆突部皮肤保护 衬垫
上肢:10-12层 下肢:12-15层 周径的2/3
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来自百度文库
常用石膏固定类型 石膏托(plaster support) 石膏夹板(splint) 石膏管型(cast) 躯干石膏(trunk plaster)
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– Carefully place splint in the desired location.
– Gently mold the plaster using the palms of your hands (not finger tips).
– Roll an elastic bandage over the splint, from distal to proximal with an overlap of approximately 50%.
– Soak the layers of plaster bandages in room temperature water in bucket.
– Raise the layers vertically over the bucket, firmly holding each end of the roll in your hands. Remove excess water.
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注意事项 1 平整,切勿将石膏绷带扭转后包扎,防止皱
折 2 塑型成型,符合肢体轮廓。下肢注意足弓塑
形 3 手指及足趾露出,观察血液循环,感觉和活
动能力。有剧痛,麻木及血运障碍及时松解, 防止发生缺血性肌挛缩和肢体坏死 4 注意注明时间,及表明伤口位置和开窗 5 防止骨质疏松和肌萎缩,鼓励功能锻炼
– Perform a detailed neurovascular examination before splinting.
– Perform reduction if the fracture has significant displacement or misalignment.
– Obtain appropriate radiographic studies
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General technique of applying plaster splints
– Apply stockinette to the extremity (optional). Be careful to avoid wrinkles.
– Measure the required length of splinting material. Then place an additional 3 layers of Webril® onto the layer that was used to measure the length.
石膏固定技术 牵引技术 关节穿刺技术 骨折手法复位技术
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石膏固定技术
石膏绷带 无水硫酸钙粉沫
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石膏固定的优缺点
三点固定原理,固定确实,塑形方便, 便于护理
沉重,透气性差,影响摄片,关节僵 硬
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– Place the wet plaster onto the cast padding (Webril® ), and smooth the surface.
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– Fold the overhanging edges of cast padding over the plaster and fold any excess padding over the ends of the splint.
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Procedure
Important considerations before splinting
– Examine the extremity for evidence of an open fracture, which would require cleaning, debridement, and specialist evaluation before splinting.
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