骨折概论(英文版本)---陈芒芒
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translate to the bone-than fracture. Violence indirect to the fracture part.(such as colle’s fracture) 。 myotility ：muscles attached the bone(patella fracture) 。 transverse process fracture.
3fatigue fracture ：
Long-term, repeated and minor external force. the stress accumulated. such as: the second and third metatarsal fractures because of long-distance march ;distal 1/3 part fibula
四、fragment displacement
Relatement: force is big/small;,the direction /character of the
force 。
The weight of the distal body。
Pull force of the muscles。 Transfer/treatment is not proper.
• traumatic arthritis
• arthroclisis
• ischemic contraction • ischemic necrosis • ischemic muscle
contracture
stardard of Clinical healing
• Local tenderness and longitudinal taps pain; • Abnormal activity • X-ray show:fracture line is obscure; callus • continuous observation for two weeks without deformation; • Without fixion,hold the upper limbs at least for 1min,1kg;walk for 3min,at least 30 steps for lower limbs.
according to … time
• 1、fresh fracture：less than 3 weeks. • 2、old fracture：More than 3 weeks 。 * Involving the articular surface:Intra-
articular fractures----Anatomical reduction
angulation deformity 。（like Willow branches ）
• 2、complete fracture：The integrity
and/or continuity of the bone be interruptted completely • According to fracture line and shape： 1）Transverse Fracture： fracture and vertical axis =vertical。
Section 2:clinical manifestation and x ray examimation
General menifestation
• shock
– Could be ： serious open fracture,pelvis fracture – cause ： Extensive soft tissue contusion 、 Severe pain 、 bleeding、Visceral injury
fracture
above three types,all occur in healthy bone,called Traumatic fractures
4pathological fracture ：
occur in Bone disease , Slight force 。(tumor、infection)
（blood vessel、surrounding nerve、spinal nerve cord injury） • bonefascial compartment syndrome （Common in the calves and forearm ）
（二）later complication
(right pic.）
三、 according to severity and shape
2）oblique fracture ：
fracture line and vertical
axis to form a certain Angle （as right figure）
（ according to severity and shape ）
section3 complication
（一）early complication
• syndrome • Visceral injury(Lung,
liver, spleen, bladder, urethra, rectum )
Important surrounding tissue damage
fracture of metaphysis 。
Insert cancellous bone cortical
bone
inserted
into
cancellous
bone(right pic.)
三
6compression fracture ：compressed and deformed。 Occurs in spongy bone 。如spinal fracture ， calcaneal fracture 。 (right
Xray examination
• Have an important value of diagnosis and treatment ,so Routinely to take the x-ray.
• AP-Xray,LP-Xray(contain adjacent joints )
• Compared with the contralateral limb if necessary
pic.)
三
7）depressed fracture： Skull bone。 8）Epiphyseal separation：
fracture line goes through the epiphyseal。
according to …stable or not
• 1 、 stable fracture ： the ends of the fracture is not easy to move/stabe after reduction.such as:Crack fracture, greenstick fracture, transverse fracture, compression fractures, impacted fractures etc. • 2、un stable fracture：move again easily.。 Such as:Oblique fracture, spiral fracture, comminuted fracture etc.
四、 fragment displace
• The most common types
Øangular
Ølateral Øshorten Øseparation Ø rotating
displacement
displacement displacement displacement displacement
（二） according to severity and shape
• 1 、 incomplete fracture ： The integrity and/or continuity of the bone be interruptted • 1 ） linear fracture ： gap,not displaced. （ The skull bone,scapula bone） 2 ） greendstick fracture ： Bone and periosteum partly broken ， with or without
3）spiral fracture:
(right pic.）
4 comminuted fracture ：
more than 2 fragments。
（as right pic.）
三、 according to severity and
shape
5）impacted fracture： the fragments compacted into the other one ， mainly occurs in
• Hypostatic pneumonia
• bedsore
• Deep vein thrombosis of lower limbs
• infection（pyogenic osteomyelitis ）
（二） later complication
• Traumatic ossification
• soft tissue injury • Soft tissue insert • infection
三、The influence of treatment
• • • repeatedly gimmick reset (outer membrane injury of soft tissue and bone) Cut open reduction (soft tissue, stripping bone outer membrane) improper debridement of open fracture(bone defect caused by removing the broken bone)
Section 5 Factors affectting the healing of fracture
一、Systemic factors
• age
• Health status
二、local factors
• types and quantities • Blood supply
• Objective
The integrity and/or continuity of the bone be interruptted
二、cause
1direct violence： meas:violence direct to the bone---
-than fracture.
2indirect violence：
• fever
– Hematoma,body temperature less than 38℃
local menifestation
• usual manifestations： – pain、swelling 、obstacle 。 • Special signs ：
• deformity;
• abnormal movement; • bony crepitus One of above 3=fracture A question?
三、classification(plenty of)
（一） according to skin 、 Mucosa of the frature . • 1、close fracture：ends of the fracture and air are interlinked. • 2、open fracture：aren’t interlinked
ORTHOPEDICS INTRODUCTION
Wenzhou Central Hospital
Traumatology Department
Chen Mang-mang
•Section one definition cause classification displacement
一、Definition：
3fatigue fracture ：
Long-term, repeated and minor external force. the stress accumulated. such as: the second and third metatarsal fractures because of long-distance march ;distal 1/3 part fibula
四、fragment displacement
Relatement: force is big/small;,the direction /character of the
force 。
The weight of the distal body。
Pull force of the muscles。 Transfer/treatment is not proper.
• traumatic arthritis
• arthroclisis
• ischemic contraction • ischemic necrosis • ischemic muscle
contracture
stardard of Clinical healing
• Local tenderness and longitudinal taps pain; • Abnormal activity • X-ray show:fracture line is obscure; callus • continuous observation for two weeks without deformation; • Without fixion,hold the upper limbs at least for 1min,1kg;walk for 3min,at least 30 steps for lower limbs.
according to … time
• 1、fresh fracture：less than 3 weeks. • 2、old fracture：More than 3 weeks 。 * Involving the articular surface:Intra-
articular fractures----Anatomical reduction
angulation deformity 。（like Willow branches ）
• 2、complete fracture：The integrity
and/or continuity of the bone be interruptted completely • According to fracture line and shape： 1）Transverse Fracture： fracture and vertical axis =vertical。
Section 2:clinical manifestation and x ray examimation
General menifestation
• shock
– Could be ： serious open fracture,pelvis fracture – cause ： Extensive soft tissue contusion 、 Severe pain 、 bleeding、Visceral injury
fracture
above three types,all occur in healthy bone,called Traumatic fractures
4pathological fracture ：
occur in Bone disease , Slight force 。(tumor、infection)
（blood vessel、surrounding nerve、spinal nerve cord injury） • bonefascial compartment syndrome （Common in the calves and forearm ）
（二）later complication
(right pic.）
三、 according to severity and shape
2）oblique fracture ：
fracture line and vertical
axis to form a certain Angle （as right figure）
（ according to severity and shape ）
section3 complication
（一）early complication
• syndrome • Visceral injury(Lung,
liver, spleen, bladder, urethra, rectum )
Important surrounding tissue damage
fracture of metaphysis 。
Insert cancellous bone cortical
bone
inserted
into
cancellous
bone(right pic.)
三
6compression fracture ：compressed and deformed。 Occurs in spongy bone 。如spinal fracture ， calcaneal fracture 。 (right
Xray examination
• Have an important value of diagnosis and treatment ,so Routinely to take the x-ray.
• AP-Xray,LP-Xray(contain adjacent joints )
• Compared with the contralateral limb if necessary
pic.)
三
7）depressed fracture： Skull bone。 8）Epiphyseal separation：
fracture line goes through the epiphyseal。
according to …stable or not
• 1 、 stable fracture ： the ends of the fracture is not easy to move/stabe after reduction.such as:Crack fracture, greenstick fracture, transverse fracture, compression fractures, impacted fractures etc. • 2、un stable fracture：move again easily.。 Such as:Oblique fracture, spiral fracture, comminuted fracture etc.
四、 fragment displace
• The most common types
Øangular
Ølateral Øshorten Øseparation Ø rotating
displacement
displacement displacement displacement displacement
（二） according to severity and shape
• 1 、 incomplete fracture ： The integrity and/or continuity of the bone be interruptted • 1 ） linear fracture ： gap,not displaced. （ The skull bone,scapula bone） 2 ） greendstick fracture ： Bone and periosteum partly broken ， with or without
3）spiral fracture:
(right pic.）
4 comminuted fracture ：
more than 2 fragments。
（as right pic.）
三、 according to severity and
shape
5）impacted fracture： the fragments compacted into the other one ， mainly occurs in
• Hypostatic pneumonia
• bedsore
• Deep vein thrombosis of lower limbs
• infection（pyogenic osteomyelitis ）
（二） later complication
• Traumatic ossification
• soft tissue injury • Soft tissue insert • infection
三、The influence of treatment
• • • repeatedly gimmick reset (outer membrane injury of soft tissue and bone) Cut open reduction (soft tissue, stripping bone outer membrane) improper debridement of open fracture(bone defect caused by removing the broken bone)
Section 5 Factors affectting the healing of fracture
一、Systemic factors
• age
• Health status
二、local factors
• types and quantities • Blood supply
• Objective
The integrity and/or continuity of the bone be interruptted
二、cause
1direct violence： meas:violence direct to the bone---
-than fracture.
2indirect violence：
• fever
– Hematoma,body temperature less than 38℃
local menifestation
• usual manifestations： – pain、swelling 、obstacle 。 • Special signs ：
• deformity;
• abnormal movement; • bony crepitus One of above 3=fracture A question?
三、classification(plenty of)
（一） according to skin 、 Mucosa of the frature . • 1、close fracture：ends of the fracture and air are interlinked. • 2、open fracture：aren’t interlinked
ORTHOPEDICS INTRODUCTION
Wenzhou Central Hospital
Traumatology Department
Chen Mang-mang
•Section one definition cause classification displacement
一、Definition：