Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,Preoperative AP radiograph of a Type 2 radial head fracture.,Preoperative AP radiograph of,1,Preoperative lateral radiograph of a Type 2 radial head fracture.,Preoperative lateral radiograp,2,Preoperative lateral radiograph of the Type 2 radial head fracture.,Preoperative lateral radiograp,3,The elbow is flexed and positioned on a radiolucent table.The incision begins just above the lateral epicondyle and extends down towards the ulna,passing directly over the radial head,as depicted.,The elbow is flexed and positi,4,The skin incision is brought down through the subcutaneous,tissue and the common extensor origin is identified.,The skin incision is brought d,5,The common extensor origin is incised between the anconeus and the extensor carpi ulnaris over the capitellum radial head.,ANCONEUS,ECU,The common extensor origin is,6,The upper edge of the capitellum and the radial head are exposed.,The upper edge of the capitel,7,RADIAL HEAD,RADIAL HEAD,8,With sharp retraction and rotation of the radial head,the fracture,is identified.Care must be taken not to extend this incision too far distally,as this may damage to the posterior interosseous nerve,as it lay over the radial neck.,ANNULAR,LIGAMENT,RADIAL HEAD FRACTURE,With sharp retraction and rota,9,A Freer elevator or small osteotome is introduced to,mobilize the radial head fracture.,A Freer elevator or small oste,10,Close up view,CAPITELLUM,RADIAL HEAD,Close up viewCAPITELLUMRADIAL,11,After anatomic reduction is achieved,K-wires,are used to maintain the reduction.,K-WIRE,REDUCTION,After anatomic reduction is ac,12,After anatomic reduction is achieved,K-wires,are used to maintain the reduction.,K-WIRE,REDUCTION,After anatomic reduction is ac,13,Using the external jig,a screw is placed such that it is countersunk below the articular surface of the radial head.In this example,a solid Herbert screw is utilized.,Using the external jig,a scre,14,The reduced and fixed radial head.The Herbert screw seated under the articular surface.Occasionally,the second K-wire is exchanged for a Herbert screw.,FRACTURE,HERBERT,SCREW,The reduced and fixed radial h,15,The range of motion of the forearm as well as pronation and,supination are confirmed,and the reduction is visualized,throughout in arc of motion of the elbow.If adequately fixed,and stable,closure is performed.,FRACTURE,HERBERT,SCREW,The range of motion of the for,16,The common extensor mechanism is brought together,enclosed over the radio-capitellar joint.,The common extensor mechanism,17,After closure.,After closure.,18,Lateral view,demonstrating the reduction,Lateral view,demonstrating th,19,docin/sanshengshiyuan,doc88/sanshenglu,更多精品资源请访问,docin/sanshengshiyuan 更多精品,20,