Femoral neck fracture is a common and potentially devastating injury for orthopaedic surgeons, due to the fragile blood supply, the incidence of fracture non-union and osteonecrosis is higher, the optimal treatment for femoral neck fracture is still controversial, most scholars believe that patients over 65 years of age can be considered for arthroplasty, and patients under the age of 65 years of age can be selected for internal Fixation surgery, et maxime gravis impulsum in sanguine fluxus causatur per subcapsular genus fractura de femoris collum. Subcapital fractura de femoris collum habet maxime gravi haemodynamic impulsum, et clausa reductionem et internum solidamentum est usque in exercitatione curatio ratio ad subcapital fractura femoris collum. Bonum reductionem est conducere ad stabilientem fractura, promovens fractura sanationis et ne femoris caput necrosis.
Et haec est typical casus femoralis collum subcapital fractura disserere quam ad praestare clausa, obsessio internum fixation cum cannulated cochlea.
Ⅰ basic notitia ex causa
Patientes estote Information: Male XLV annorum
Querimonia: reliquit coxae dolor et actio limitationem pro VI horas.
History: The patient fell down while taking a bath, causing pain in the left hip and limitation of activity, which could not be relieved by resting, and was admitted to our hospital with a fracture of the neck of the left femur on radiographs, and was admitted to the hospital in a clear state of mind and poor spirit, complaining of pain in the left hip and limitation of activity, and had not eaten and had not relieved himself of his second bowel movement after the injuriam.
Ⅱ Corporalis examen (totum corpus Check & specialist reprehendo)
T 36.8 ° C P87 Beat / Min R20 Beats / Min BP135 / 85MMHG
Normalis progressionem, bonum nutritionem, passiva positio, patet mentis, cooperatores operativa in examinatione. Cutis color est normalis, elastica, non OEDEMA aut temerarium, non dilatationem superficialis lymphaticorum nodorum totius corporis loci elit. Caput mole, normalis morphologia, nec pressura dolor, missa, capillus crus. Et alumni aequales in magnitudine et per sensitivo lumen reflexum. The neck was soft, the trachea was centred, the thyroid gland was not enlarged, the chest was symmetrical, respiration was slightly shortened, there was no abnormality on cardiopulmonary auscultation, the heart boundaries were normal on percussion, the heart rate was 87 beats/min, the heart rhythm was Qi, the abdomen was flat and soft, there was no pressure pain or rebound pain. Et iecur et lienis non deprehenditur, et non fuit teneritudine in renibus. Anterior et posterius diaphragmata non examinantur et non deformitates spinae superioris artus et recti membra, cum normalis motus. Physiologica reflexes sunt in praesentem in neurological examen et pathologicum reflexes non elicitur.
Nesciebatur obvious tumor sinistrum coxae, obvious pressura dolor in medium sinistrum inguine, externa externa gyratio deformitas sinistra inferius membrum, sinistra inferius ad sinistram pede et operatio quinque digitos axis et sentias et dorsalis arteriarum pede et actione et dorsalis arteriarum pede erant ok et dorsalis arteriarum pulsus est ok et dorsalis arteriarum pulsus est ok et dorsalis arteriarum pulsus est ok et dorsalis arteriarum pulsus est ok, et dorsalis arteriarum pulsus est ok et dorsalis arteriae pulsus est ok et dorsalis arteriae pulsus est ok et dorsalis arteriarum et pede erat normalis.
Ⅲ Auxiliares examinations
X-Ray amet ostendit: sinistra femoris collum subcapital fractura, peccetur de contriveribus fine.
Reliqua autem examination, pectus X-radius, os densitometria, et color ultrasound de altum venis in inferioribus membra non ostendere ullo manifestum deprauationem.
Ⅳ diagnosis et differentiales diagnosi
Secundum ad patientes estote scriptor historia trauma, reliquit coxae dolor, actio limitationem, corporalis examen sinistra inferius membrum externa externa gyratione deformitas, inguina scilicet distemperat, combined in X-Ray film potest esse evidenter diagnosed. Et fractura ex trochanteris potest etiam habere coxae dolor et actio limitationem, sed plerumque loci tumor manifestum est, pressura punctum sita est in trochanturum, et externum angulum est maior, ita potest esse differentia.
Ⅴ curatio
Clausa reductionem et cavae clavus internum solidamentum fiebat post completum examen.
Et preoperative film est ut sequitur
Maneuver cum internus gyrationis et tractus a mm-cum levi raptum a mm-cum restitutio et fluoroscopy ostendit bonum restitutio
A paxillum pin in superficie corporis in directionem femoris collum fluoroscopy et parva cutis incisum factum secundum locum finem pin.
A Pin ACUS inseritur in colla parallelae ad corpus superficiem in directionem kirschner pin dum maintaining an anteriori benificium circa XV gradus et fluoroscopy fit
Secundum dux pin inseritur per femoralem calcar per dux parallel ad underside de directionem primae dux ACUS.
A tertia acus inseritur parallela ad tergum primi acus per dux.
Using roris fluoroscopic lateralibus, omnes tres kirschner paxillos visa sunt intra femoris collum
EXERCTUS foramina directionem dux ACUS mensura altitudinem et eligere conveniens longitudinem cavae clavus didiculos per dux paxilli commendatur ad cochleal in damnum de cavas.
Cochlea in aliis duo cannulated cochlea una post alterum et videre per
Cutis incisio conditione
Postoperative Review Film
Combined with the patient's age, fracture type, and bone quality, closed reduction hollow nail internal fixation was preferred, which has the advantages of small trauma, sure fixation effect, simple operation and easy to master, can be powered compression, hollow structure is conducive to intracranial decompression, and the fracture healing rate is high.
Summary
I collocatione de kirirschner acus in corpore superficiem cum fluoroscopy conducit determinandum punctum et directionem acum insertion et range de cutis incisum;
II De tria kirschner est paxillos esse ut parallel, inversus Zigzag, et prope in ore gladii quam fieri potest, quae est ad fractura stabilization et postea illapsum compressio;
III imo kirschner pin ingressum punctum debet electus ad maxime prominent lateralibus femoris crest ut pin in medio femoris collum, cum tips in summo duo paxilli lacus et retrorsum per prominentibus cristam adhaesit
IV non eiciam kirschner pin nimis altum simul ad vitare penetrabilibus articularis superficiem, quod terebro frenum potest esse per fracturam lineam, una est ne eas per femoralem compressam;
5 The hollow screws screwed into the almost and then through a little, judge the length of the hollow screw is accurate, if the length is not too far, try to avoid frequent replacement of screws, if osteoporosis, replacement of screws basically become invalid fixation of screws, for the patient's prognosis of effective fixation of screws, but length of the length of the screws is just a little bit worse than the length of ineffective fixation of the Cochleas multo melius!
Post tempus: Ian-15-2024
