肩关节的功能直接关系到我们的生活质量,出现问题最容易直接影响我们的日常起居,轻则酸软隐痛、渐僵受限,穿戴受累;重则反复脱位、弹响交锁,不敢运动;甚至夜不能寐,力弱剧痛,精神焦虑。随着人口的老龄化,肩痛的人群越来越多。反肩关节置换随着假体设计的不断改进和肩关节手术技术的不断提高,成为肩关节医师的“压轴”法宝。今天早读为大家详解肩关节损伤的分型、风险评估和治疗选择。值得大家学习参考! 一 病例一则
风险判断
治疗选择
打钢板病例
讨论
二 损伤分型 回顾三大血供影响风险
骨折类型与血供损伤 预测肱骨头缺血的最佳指标:
如果三者均存在,坏死率几乎100%。 分型
猜猜这是什么分型? 回到最初的病例
三 手术风险评估 内皮质整体血管供应
Calcar结构的概念
如何分型?
肱骨头血供的预测
四 治疗选择
总结
ps:本文为付中国教授【肩关节损伤治疗认识与技术课程】视频课程中的一课时整理而成,开通好医术会员,可观看更详细的完整版视频课程! 付中国 北京大学人民医院 创伤骨科主任医师、教授 Dr. Fu Zhongguo, associate director of Department of Trauma and Orthopaedics, Peking University People’s Hospital, was graduated from Medical Department of Jilin University. He is now the standing member of the First Chinese Shoulder and Elbow Surgery Association, the Sixth committee of Chinese Medical Association Hand Surgery Branch, and the member of Chinese Medical Association Orthopaedics Branch Traumatology Group, Expert Committee of Peking University Traffic Medicine Center. He is also the communication editor of Chinese Journal of Trauma, and the editor of Chinese Journal of Orthopaedic Trauma. The field of his research and expertise include the lime, back bone and pelvic fracture, spinal and peripheral nerve diseases, articulation of shoulder pain and rotator cuff injury, children cerebral palsy, hallux valgus, hand surgery and microsurgery. |
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