Download Fracture Clavicle

Fracture Clavicle
Middle 1/3 **
Distal 1/3
Medial 1/3
อนุพงษ์ เลาหพูนรังษี
Middle 1/3 Clavicle fracture
Reduction of Middle 1/3 clavicle fracture
Treatment of middle third clavicle fracture
Figure of eight bandage
Indication for ORIF
- Vascular injury
- Associate certain type
yp of
scapular fracture
- Pathologic fracture
- Impending open fracture
Treatment of displaced distal 1/3 clavicle fracture
Distal 1/3 clavicle
fracture
Conservative treatment
Shoulder harness
Operative treatment
Acromioclavicular joint injury
Acromioclavicular ligament
C
Coracoclavicular
l i l liligamentt
Grade 1 AC ligament sprain
Grade 2 AC ligament
g
rupture
p
CC ligament
g
sprain
p
Grade3
Grade
3 AC ligament
g
rupture
p
CC ligament
g
rupture
p
Stress film both shoulders
Treatment :
Conservative treatment
Operative treatment
Shoulder dislocation
Anterior dislocation ***
Posterior dislocation
Superior dislocation
Inferior dislocation
Anterior shoulder dislocation
D ’ test
Duga’s
t t -ve
D ’ test
Duga’s
t t +ve
+
Treatment
Transcapular view
Treatment
Closed reduction
Modified Stimson
AP. view
Closed reduction
Traction
Traction--counter traction
Zero position : Abduction 160 , Forward flexion 45 degre
Treatment
Immobilization after closed reduction
Cl d reduction
Closed
d i
Aft reduction
After
d ti
- Neurovascular status
- X ray
- Immobilization
I bili ti
Vl
Velpeau
bandage
b d
Fracture Proximal Humerus
Stable fracture : Impact fracture
Unstable fracture : Minimal displaced
Di l d
Displaced
Displacement > 1 cm.
Angulation
g
> 45 degrees
g
Sli & swathe
Sling
th
Fracture dislocation
Fracture humerus
Operative treatment when
- Failure conservative treatment
- Bilateral humerus fracture
-Displaced transverse
transverse midshaft fx
j y
- Vascular injury
- Multiple fractures or injuries
- Pathologic fracture
- Ipsilateral forearm fracture
- Iatrogenic radial nerve palsy
Conservative treatment of Humeral shaft fracture
F t Di
Fracture
Distal
t l humerus
h
Fracture Distal humerus
Medial epicondyle fracture
Supracondylar
p
y fracture
Medial condyle fracture
Lateral condyle
y fracture
Extraarticular fracture
I
Intraarticular
i l ffracture
F t Di
Fracture
Distal
t l Humerus
H
Intraarticular fracture
Supracondylar fracture
Intercondylar fracture
Treatment : ORIF
Intercondylar fracture
Elbow dislocation
Treatment : ORIF
Elbow dislocation
Treatment
Cl d reduction
Closed
d i
Aft Reduction
After
R d ti
- Neurovascular status
- X ray
- Immobilization
I bili ti
T t t
Treatment
Closed reduction
Fracture Olecranon
Nondisplaced fracture
Displaced
p
fracture
1 Displacement < 2 mm.
1.
2 No difference in displacement of the fracture at
2.
0 and 90 degrees
g elbow flexion in lateral film
3. Able to perform active elbow extension against gravity
Non--displaced Olecranon fracture
Non
C
Conservative
ti treatment
t t t
Monteggia ’s Fracture
Displaced Olecranon fracture
Operative treatment
Nightstick Fracture
Fracture proximal 1/3
of ulnar and dislocation
of radial head
Treatment
Closed reduction of radial head
ORIF ulnar
ORIF when
Displacement > 50 %
Angulation > 10 degrees
Galeazzi ’s fracture
F t Radius
Fracture
R di
Fracture distal
1/3 of radius with
dislocation of DRUJ.
Treatment :
Closed reduction of DRUJ.
ORIF radius
Treatment : ORIF
Fracture Radius & Ulnar
Treatment : ORIF
Why ORIF in most forearm fractures