腕部舟状骨骨折.ppt

文档介绍：腕部舟状骨骨折Scaphoid fracture
2017/11/12
1
Department of Traumatic Orthopedic
近极部
腰部
结节部
最大的一块近排腕骨
4个关节面
近侧面桡舟关节
远内侧面头舟关节
尺侧面舟月关节
远侧面舟骨大小多角骨关节 STT joint
(scaphotrapezotrapezoidal joint)
2017/11/12
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Department of Traumatic Orthopedic
关节软骨覆盖80%
舟骨结节-重要韧带的附着点
舟骨腰部-无关节软骨覆盖,腰部最细又正对桡骨茎突
2017/11/12
3
Department of Traumatic Orthopedic
Blood supply to the scaphoid
Radial artery
70~80% - radial artery through the dorsal ridge
20~30%- volar radial artery branches
2017/11/12
4
Department of Traumatic Orthopedic
愈合时间
6~8周
10~12周
12~20周
}
愈合时间为4~5个月
2017/11/12
5
Department of Traumatic Orthopedic
占全身骨折的 2%
占腕部骨折的60~70%
发病率仅次于桡骨远端骨折
几乎全部发生于青壮年
连接近排与远排腕骨的杠杆
治疗过程长,效果相对较差
2017/11/12
6
Department of Traumatic Orthopedic
损伤机制
最常见过伸-跌倒手掌触地,手腕强度背屈,轻微桡偏,桡骨背侧缘切断舟骨
较少见冲压工舟骨-腕关节处于中立或轻度屈曲,
2017/11/12
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Department of Traumatic Orthopedic
查体
鼻烟壶局部肿胀、压痛,腕部活动受限
2017/11/12
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Department of Traumatic Orthopedic
腕舟骨移动试验(Waston’s test) 检查方法:将患者患侧腕关节被动尺偏,检查者一只手握住患者腕部,用拇指压迫舟骨结节,另一只手握住患者手掌使腕关节逐渐转向桡侧,感觉腕部疼痛剧烈则为阳性
2017/11/12
9
Department of Traumatic Orthopedic
舟骨冲击试验:拇指向背侧按压舟骨结节
舟骨剪力试验:拇指、示指捏住舟骨远、近极,向掌侧、背侧或尺、桡侧推移舟骨
2017/11/12
10
Department of Traumatic Orthopedic