外科骨科检查与操作文档ppt神经系统检查neurologiccheckneurologiccheck特殊检查specialexamination"4"字试验（Patricksign）深反射①Hoffmann征deepreflex（5）病人有严重的复合损伤，需密切观察而肢Observedistallimbs’bloodcirculation,senseandmotionthesplint为缩小固定范围可用以代替石膏固定当伤肢出现严重的肿胀或水疱时，可待肿胀减轻后Afterinjuryextremity’sswellingorblistermakesease深反射①Hoffmann征limbsTractionbeltdonotpressthefibularheadwhenlowerlimbtraction二、骨科的基本操作技术Basicskillsoforthopaedics持续皮牵引的适应证IndicationofSkintraction腓骨头部以免压迫非总神经骨折手法复位技术ManipulativereductionPreoperativeadjunctivetherapy二、骨科的基本操作技术Basicskillsoforthopaedics石膏固定技术石膏固定适应证Indication（3）四肢闭合性管状骨折Closed,tubiformal深反射①Hoffmann征石膏绷带是将无水硫酸钙（熟石灰）的细粉末撒在特制的细孔绷带上，吸水结晶后硬结成型deepreflexEncouragepatientstodofunctionalexercisepositivelybeeven持续皮肤牵引注意事项SkintractionSkeletaltractionskeletaltractionthroughsupracondyleoffemur持续骨牵引的适应证Indication:PreoperativeadjunctivetherapyTheolderandweakling’sfactureoffemur,toassistWeight≤5KgIfyouhaveanyquestionStrong-muscleoreasy-dislocatedTheolderandweakling’sfactureoffemur,toassistIfyouhaveanyquestion密切观察肢体远端的血液循环、感觉及运动Observedistallimbs’bloodcirculation,senseandmotion鼓励病人积极进行功能锻炼Encouragepatientstodofunctionalexercisepositively小夹板固定技术牵引技术Traction持续皮牵引的适应证IndicationofSkintraction持续皮肤牵引注意事项Skintraction持续骨牵引的适应证Indication:（1）成人长骨不稳定性骨折Unstablefractureofadults’longbones（2）肌力强大或容易移位的骨折Strong-muscleoreasy-dislocatedfracture持续骨牵引的适应证Indication:（3）骨折部皮肤损伤或部分软组织缺损时Wherethereisskindestructionorsomesofttissuedefect（4）开放性骨折感染或战伤骨折Infectionofopenfractureorwar-injuryfracture（5）病人有严重的复合损伤，需密切观察而肢体不宜作其它固定者Severecomplextrauma常用的骨牵引frequentlyusedskeletaltraction特殊牵引骨折手法复位技术Manipulativereduction手法复位的时机手法复位方法Methodofmanipulativereduction手法复位方法ThankYou!IfyouhaveanyquestionDon’thesitatetocontactme!感谢观看