亞洲髖演示-骨科手術(shù)器械課件

HipFracturePortfolio

April2009HipFracturePortfolioApril2HipfractureMarket中國(guó)每年約1.5million髖部骨折50%粗隆周圍骨折50%不穩(wěn)定骨折50歲以上1年內(nèi)死亡率25%40%需要特殊護(hù)理50%愈合后需要輔助行走HipfractureMarketHipfractureLegend1950’1980’1990’2000’HipfractureLegend1950’1980’1HipfractureTotalSolutionHipfractureTotalSolutionIntegratedInterlockingScrews

FemoralHeadAndShaftStabilityWORMGEAR/RACK&PINIONIntegratedInterlockingScrewsLinearCompressionLinearCompressionORS 2004ORS 2004Peri-Loc4.5mmProximalFemurLockingPlatePeri-Loc4.5mmProximalFemurDesignFeaturesandBenefitsDesignFeaturesandBenefitsDesignFeaturesandBenefits–ContinuedDesignFeaturesandBenefits–DesignFeaturesandBenefits–ContinuedDesignFeaturesandBenefits–LateralWallSupportPalmetal.,“IntegrityoftheLateralFemoralWallinIntertrochantericHipFractures:AnImportantPredictorofaReoperation”,JBJS2007;89:470–475Gotfried,“TheLateralTrochantericWall:AKeyElementintheReconstructionofUnstablePertrochantericHipFractures”,CLINICALORTHOPAEDICSANDRELATEDRESEARCH,Number425,pp.82–86LateralWallSupportPalmetalInterTANCHSInterTANCHS亞洲髖演示--骨科手術(shù)器械課件DesignFeaturesandBenefitsRotationalStabilityTheuniquefigure-8designoftheintegratedINTERTANlagandcompressionscrewsoptimizesfemoralneckandheadstabilitytosignificantlyincreaseresistancetorotationalinstabilityandpost-operativefailureduetocut-out.PERI-LOCTechnologyPERI-LOCscrewholesintheplateshaftcombinetheadvantageoffixed-anglestabilitywiththeflexibilityandbenefitsoftraditionalplateandscrewtechnology.Screwholesaccept4.5mmCortexand/or4.5mmLockingScrews.EnhancedLateralStabilityTheproximalflangeoftheINTERTANCHSside-platebuttressesthegreatertrochanterandlateralcortexoftheproximalfemurforincreasedresistancetomedialfragmentlateralization.DesignFeaturesandBenefitsRoHottopicHottopic治療要點(diǎn)（一）

UsetheTip-to-ApexDistance----永遠(yuǎn)關(guān)注TAD

治療要點(diǎn)（一）UsetheTip-to-ApexDi治療要點(diǎn)（二）

NoLateralWall,nohipscrew-----外側(cè)皮質(zhì)不完整，不可用加壓滑動(dòng)螺釘

治療要點(diǎn)（二）NoLateralWall,nohip治療要點(diǎn)（三）KnowtheUnstableIntertrochantericFracturePatterns,andNailThem-----了解不穩(wěn)定粗隆間骨折的類型，并用髓內(nèi)釘固定

Unloadsthelateralcortex治療要點(diǎn)（三）KnowtheUnstableInter治療要點(diǎn)（四）BewareoftheAnteriorBowoftheFemoralShaft----注意股骨前弓

治療要點(diǎn)（四）BewareoftheAnterior治療要點(diǎn)（五）WhenUsingaTrochantericEntryNail,StartSlightlyMedialtotheExactTipoftheGreaterTrochanter----大粗隆釘?shù)倪M(jìn)針點(diǎn)在頂點(diǎn)的偏內(nèi)側(cè)

治療要點(diǎn)（五）WhenUsingaTrochanter治療要點(diǎn)（六）DoNotReamanUnreducedFracture----骨折未復(fù)位前不要擴(kuò)髓

治療要點(diǎn)（六）DoNotReamanUnreduce治療要點(diǎn)（七）

BeCautiousAbouttheNailInsertionTrajectory,andDoNotUseaHammertoSeattheNail----主釘插入時(shí)注意通道，不要用滑錘打入

選擇正確進(jìn)針點(diǎn)開(kāi)口器足夠深擴(kuò)髓大于1mm治療要點(diǎn)（七）BeCautiousAboutthe治療要點(diǎn)（八）AvoidVarusAngulationoftheProximalFragment—UsetheRelationshipBetweentheTipoftheTrochanterandtheCenteroftheFemoralHead-----用大粗隆頂點(diǎn)和股骨頭中心之間位置關(guān)系來(lái)避免股骨近端骨塊內(nèi)翻成角

治療要點(diǎn)（八）AvoidVarusAngulation治療要點(diǎn)（九）WhenNailing,LocktheNailDistallyiftheFractureIsAxiallyorRotationallyUnstable----骨折有軸向或