骨科的基本操作技术培训课件

3/11/2021
骨科的基本操作技术
9
General technique of applying plaster splints
– Apply stockinette to the extremity (optional). Be careful to avoid wrinkles.
– Measure the required length of splinting material. Then place an additional 3 layers of Webril® onto the layer that was used to measure the length.
3
用法：骨隆突部皮肤保护 衬垫
上肢：10-12层 下肢：12-15层 周径的2/3
3/11/2021
骨科的基本操作技术
4
常用石膏固定类型 石膏托（plaster support) 石膏夹板(splint) 石膏管型(cast) 躯干石膏(trunk plaster)
3/11/2021
– Soak the layers of plaster bandages in room temperature water in bucket.
– Raise the layers vertically over the bucket, firmly holding each end of the roll in your hands. Remove excess water.
骨科的基本操作技术
5
适应症
1 小夹板难于固定的骨折，脊柱骨折 2 开放性骨折清创缝合术后 3 病理性骨折 4 某些骨关节术后：关节融合 5 畸形矫正术后：三关节融合 6 化脓性骨髓炎，关节炎，固定患肢，减轻疼
痛，控制炎症
7 某些软组织损伤：肌腱，肌肉，血管，神经 损伤
3/11/2021
骨科的基本操作技术
– Carefully place splint in the desired location.
– Gently mold the plaster using the palms of your hands (not finger tips).
– Roll an elastic bandage over the splint, from distal to proximal with an overlap of approximately 50%.
3/11/2021
骨科的基本操作技术
10
– Place layers of dry plaster bandages onto the Webril® . In general, upper extremity splints require 8-10 layers of plaster, whereas lower extremity splints will require 10-15 layers.
– Place the wet plaster onto the cast padding (Webril® ), and smooth the surface.
3/11/2021
骨科的基本操作技术
11
– Fold the overhanging edges of cast padding over the plaster and fold any excess padding over the ends of the splint.
石膏固定技术 牵引技术 关节穿刺技术 骨折手法复位技术

3/11/2021
骨科的基本操作技术
1
石膏固定技术
石膏绷带 无水硫酸钙粉沫
3/11/2021
骨科的基本操作技术
2
石膏固定的优缺点
三点固定原理，固定确实，塑形方便， 便于护理
沉重，透气性差，影响摄片，关节僵 硬
3/11/2021
骨科的基本操作技术
3/11/2021
骨科的基本操作技术
8
Procedure
Important considerations before splinting
– Examine the extremity for evidence of an open fracture, which would require cleaning, debridement, and specialist evaluation before splinting.
– Gently mold the splint again to the extremity.
3/11/2021
骨科的基本操作技术
7
Plaster splints
Slightly warm (not over 24°C) water and bucket
Stockinette (optional) Soft cotton bandage/undersplint material
(e.g., Webril® padding), available in 2-, 3-, 4-, and 6-inch width sizes Plaster bandages, available in 2-, 3-, 4-, and 6-inch width sizes Elastic bandages (Ace) Adhesive tape
6
注意事项 1 平整，切勿将石膏绷带扭转后包扎，防止皱
折 2 塑型成型，符合肢体轮廓。下肢注意足弓塑
形 3 手指及足趾露出，观察血液循环，感觉和活
动能力。有剧痛，麻木及血运障碍及时松解， 防止发生缺血性肌挛缩和肢体坏死 4 注意注明时间，及表明伤口位置和开窗 5 防止骨质疏松和肌萎缩，鼓励功能锻炼
– Perform a detailed neurovascular examination before splinting.
– Perform reduction if the fracture has significant displacement or misalignment.
– Obtain appropriate radiographic studies