中医骨科学外文版 (11).ppt

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1、Plaster fixation(1).PrinciplePlaster of Paris(Ca2SO4H2O)absorbs water and becomes a hard crystal of raw gypsum(Ca2SO42H2O).Advantages of plaster fixationo(1)Plaster with a wide range of sources,convenient collection of materials,simple production,and inexpensive price,is suitable for extensive appli

2、cation in hospitals at all levels.o(2)It is easy to operate and perform and applicable in primary hospitals in remote rural areas,on-site rescue,and battlefield rescue.o(3)Plaster fixation causes no harm to tissues and belongs to non-invasive external fixation.o(4)Plaster exhibits good shaping abili

3、ty.It is soft as mud before crystallization and drying;can be properly shaped according to the convex and concave and flexion forms of limbs;will not deform after drying and hardening,facilitating shaping and fixation.o(5)Plaster dries and hardens rapidly and forms a shape in 5-10 min,which facilita

4、tes fixation and protecting limbs.o(6)It has a good supporting function and can harden within 15 min after being wrapped with gypsum rolls soaked in hot water.The dried plaster is solid and can provide reliable fixation.o(7)It has a certain orthopedic effect and can correct residual angulation defor

5、mity of the fracture by wedge incision.o(8)Tubular plaster by three-point extrusion molding can correct the angulation deformity of fracture and prevent dislocation.o(9)Plaster is semipermeable to X-ray,so the fracture alignment can still be clearly observed by X-ray film of limbs fixed with plaster

6、.Plaster fixationDisadvantages of plaster fixationo(1)It is not convenient to adjust at any time,and the plaster is solid and firm once it is shaped.When the limb continues to be swollen after injury,the blood circulation of the limb will be affected and even the ischemic necrosis will occur.When th

7、e limb swells to a certain extent,it begins to subside,leading to a relatively loose fixed part which will result in the fracture re-displacement.o(2)Replacement of plaster is cumbersome.It is very inconvenient to remove the plaster for replacement when the plaster is fixed unsatisfactorily and need

8、s reduction and fixation again,or when long-term fixation affects the development of the limb.o(3)Long fixation time may cause limb muscular atrophy,joint stiffness,osteoporosis and other complications.o(4)If plaster fixation is used for open fractures or limbs with infected wounds,it is easy to cau

9、se malodor and aggravate the infection of injured parts if the plaster is polluted by purulent blood,and it is also very inconvenient to change the dressing of wounds.o(5)Plaster is heavy,which is inconvenient for the affected limb exercise and walking.It is difficult to keep warm in winter and diss

10、ipate heat in summer.It is easy to cause dermatitis because the skin cant be cleaned and cared for.Plaster fixation typeo(1)Plaster support:it is suitable for patients with stable fracture or incomplete fracture of limbs,soft tissue injuries and severe swollen limbs.Plaster fixation typeoPlaster cla

11、mp:it is suitable for patients with stable fractures or multisegmental fracture of limbs and severe swollen limbs.Plaster fixation typeoU-shaped plaster:slightly different from plaster clamp,the plaster strips on both sides of limbs are connected with each other without disconnection,which are suita

12、ble for fracture of upper arm,forearm,foot and leg,dislocation of ankle joint and soft tissue contusion,etc.Plaster fixation typeoCast plaster:it is suitable for stable fracture of limbs.Classification according to the shape of plasteroHead and chest plaster,neck plaster,trunk plaster,shoulder plast

13、er,upper limb plaster,hip plaster,lower limb plaster and other classifications.Classification according to the shape of plasteroSmall plaster for head,neck and chest:it is used for fixation of 1-2 cervical vertebral fracture without displacement or reduction and postoperative fixation of patients ag

14、ed 5-12 years with myogenic torticollis.Classification according to the shape of plasteroLarge plaster for head,neck and chest:it is mainly used for fixation of 3-4 cervical vertebral fracture without displacement or reduction and postoperative fixation of patients over 12 years with myogenic tortic

15、ollis.Classification according to the shape of plasteroHead and neck plaster-of-Paris jacket:it is mostly used for fixation of neck and chest with multisegmental fracture or tuberculosis and scoliosis.Trunk plasterNeck plasteroPlaster collar:it is also known as plaster neck circumference.It is mainl

16、y used after conservative treatment or surgical treatment for 1-7 cervical vertebral fracture,dislocation,bone tuberculosis,bone tumor,stiff neck and soft tissue injury in the neck.It can also be used for cervical fixation after myogenic torticollis operation and cervical spondylosis.Shoulder plaste

17、roShoulder abduction spica cast:it is suitable for fracture and dislocation of shoulder and humerus fracture.Shoulder plasteroShoulder-lifting spica cast:It is mostly used for external fixation of shoulder fracture or dislocation(including fracture and dislocation of acromioclavicular joint fracture

18、 and scapular fracture,etc.),proximal humerus fracture(including avulsion fracture of greater and lesser tuberosity humerus,anatomical neck fracture of humerus,fracture of surgical neck of humerus,etc.),proximal 1/3 fracture of humeral shaft after reduction or internal fixation,rotator cuff injury,r

19、otator cuff suture or repair.Finger spica castFinger plasterUnilateral hip spica castoIt is suitable for fixation of unilateral femur fracture,hip joint fracture and lesion,femoral osteotomy,hip fusion,etc.Bilateral hip spica castoIt is suitable for external fixation of unilateral femur fracture,con

20、tralateral hip fracture and lesion,bilateral hip dislocation,pelvic fracture,acetabulum fracture,proximal femur fracture,etc.Frog plasteroIt is often used for fixation after manipulative reduction of congenital hip dislocation in children.The plaster should be replaced every 3 months to prevent the

21、growth of children be restricted by plaster because of childrens fast growth.Six months later,the hip joint is gradually changed from abduction to adduction by using abduction-medial rotation long leg plaster.Long leg cast plasteroIt is mostly used for fixation of distal femur fracture,knee joint in

22、jury,proximal tibia fracture reduction,Achilles tendon lengthening,distal femur or proximal tibia osteotomy and correction,and lower limb vascular and nerve anastomosis.(2)Materials.oPlaster bandage,pad,bandage,etc.3.Fixing methodI.Determine single support,double support or cast fixation.Measure the

23、 length of fixed range.Pave the plaster bandage and immerse it in water.Squeeze out excess water and flatten the plaster bandage.After placing the pad,place the plaster bandage on the limb and bind it up with bandage or plaster bandage.(video)(6)Precautions.Limbs should be fixed in functional positions.During operation,the assistant should support the plaster with the palm,thenar and hypothenar.Before the plaster is completely dry,do not press or move the limbs.When winding plaster bandage,do not fold it back.Before the plaster is completely dry,make necessary shaping and finishing.