创伤后关节关节脱 - - 管理的当前方面
Helen M A Ingoe1, Khalid Mohammed1, Alex A Malone1
1Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, 2 Riccarton Avenue, PO Box 4345, Christchurch, 8140, New Zealand; Christchurch Hospital, Riccarton Avenue, Christchurch, 8140, New Zealand.
Injury
|August 27, 2023
概括
后侧关节关节位移是一种罕见但危险的损伤. 迅速的多学科管理,包括成像和血管控制,对于成功的结果和预防危及生命的出血至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 创伤管理 创伤管理
- 血管外科 血管外科
背景情况:
- 后侧关节关节位移是罕见的,可能危及生命的损伤.
- 大规模出血是创伤和减少期间的重大风险.
- 在管理这些伤害方面,集体经验至关重要.
研究的目的:
- 提供多学科的经验,在管理后侧关节关节脱位.
- 确定最佳患者护理的关键学习点.
- 为突出管理相关出血的策略.
主要方法:
- 多学科的团队方法,涉及骨科和心胸外科医生.
- 评估使用计算机断层扫描血管图 (CTA) 来评估血管接近和出血.
- 采用了封闭和开放的减少技术,重点是血管控制措施.
- 在高风险病例中考虑预防性静脉导管治疗.
- 在手术前的讨论和练习,以进行手术内出血管理.
主要成果:
- 管理了五个案例,其中一个是封闭的减少和四个是开放的减少.
- 在48小时内进行封闭式减肥,成功率很高.
- 对于延迟呈现的骨骨折,需要进行开放的减少.
- 有内部支架的手掌移植是首选的重建方法.
- 一些患者在重建后经历了持续的球体感觉或声音变化.
结论:
- 后侧关节关节位移需要一个协调的,多学科的方法.
- 在术前规划中,CTA是必不可少的.
- 血管控制,理想情况下由心胸外科医生进行,在减少过程中至关重要.
- 虽然手术结果可能是有利的,但可能会出现持续的症状,如球体感觉.
相关概念视频
Flail Chest-II
202
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
202
Muscles of the Shoulder
3.9K
The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, and...
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, and...
3.9K
Aortic Regurgitation III: Medical Management
25
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
25
The Thoracic Cage: Sternum
2.5K
The thoracic or rib cage forms the body's thorax (chest) portion. Its primary function in the body is to protect vital organs in the thoracic cavity, such as the heart and the lungs. It consists of 12 pairs of ribs with their costal cartilages and the sternum. The ribs are anchored posteriorly to the 12 thoracic vertebrae (T1-T12).
The sternum is the elongated bony structure on the anterior side of the thoracic cage. It consists of three parts: the manubrium, the body, and the xiphoid...
The sternum is the elongated bony structure on the anterior side of the thoracic cage. It consists of three parts: the manubrium, the body, and the xiphoid...
2.5K
Pericarditis IV: Nursing Management
20
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
20
Pericarditis III: Medical Management
13
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
13


