The various types of fixation of fractures and their advantages and disadvantages.

Fractures are fixed by external and internal fixation.

One. External fixation: 1

Small splint fixation. Indications: Closed tubular fracture of the extremities, but femoral fracture requires continuous bone traction due to strong thigh traction; Those with open fractures of limbs with small wounds that have healed after treatment; Old fractures of the limbs are still suitable for manual reduction.

Advantages: It has the advantages of reliable fixation, fast fracture healing, good functional recovery, low cost and few complications. Cons:

If the tie is too loose or the fixation pad is not used properly, it is easy to re-displace the fracture, and too tight can produce compressive ulcers, ischemic muscle spasms, and even gangrene of the limbs.

2.Immobilized with a plaster bandage. Indications:

After debridement and suturing of open fractures, small splints should not be used before the wound heals; Fractures in some parts and small splints that are difficult to fix; After open reduction and internal fixation of certain fractures, such as intramedullary nail or plate screw fixation for femoral fracture, it is used as an adjunct external fixation; maintenance of the orthopedic position after deformity correction and postoperative fixation of the bone and joint, such as after wrist arthrodesis; Fixation of limbs affected by septic arthritis and osteomyelitis. Advantages: It can be shaped according to the shape of the limb, and the fixation action is reliable and can be maintained for a long time.

Disadvantages: no elasticity, can not adjust the degree of tightness, the fixed range is large, generally need to exceed the upper and lower joints of the fracture part, can not carry out joint activity and function exercise, easy to cause joint stiffness.

3.Abduction rack fixed. Indications:

Humeral fracture with radial nerve injury or humeral shaft fracture after manual reduction and small splint fixation; Swelling, severe upper limb closure fractures and severe upper arm or forearm open injuries; brachial plexus traction; scapula fracture; Septic arthritis of the shoulder and elbow joints or joint tuberculosis.

4.Sustained traction. Indications:

Cervical fracture dislocation using occipitomandibular bracket traction or cranial traction; Femoral fractures use thigh** traction or tibial tuberosity traction; Open tibial fractures use calcaneal traction; open fractures with infection; Supracondylar humeral fractures that are difficult to reduce are drawn using the olecranon ulna. The continuous traction method and traction weight are selected according to the patient's age, gender, muscular development, soft tissue injury and fracture location, and the traction weight is too small to achieve the purpose of fixation and reduction. Too heavy can cause the fracture to separate and displace.

5.External fixator. Applies to:

open fractures; closed fractures with extensive soft-tissue injury; fracture with infection and nonunion of fracture; After osteotomy or arthrodesis. The advantages are reliable fixation, easy wound management, no restriction of joint movement, and early functional exercises.

Two. Internal fixation. It is mainly used for the use of metal internal fixations, such as bone plates, screws, intramedullary nails, intramedullary nails with locking and compression plates, etc., to fix the fracture segment at the position of anatomical reduction after open reduction.

Some fractures, such as femoral neck fractures, can be fixed by a three-edged nail or steel needle from under the greater trochanter's trochanter, under X-ray surveillance, after manual reduction.

Answer]: If there is wound and bleeding, the bleeding should be stopped and bandaged first, and then the fracture should be fixed, and if there is shock, anti-shock treatment should be given first; When dealing with open fractures, do not return the punctured bone end to the wound to avoid infection; The length and width of the splint should be appropriate to the fractured limb, and its length must exceed the upper and lower joints of the fracture; The splint should not be in direct contact with **, and cotton or other items should be padded during it; The fixation should be moderately tightened so as not to affect blood circulation; Avoid unnecessary movement during immobilization, and do not force the wounded to carry out various activities.

With regard to fracture fixation, the incorrect principle of annihilation is ().

a.The prolapsed fracture end is immediately returned to the wound.

b.Do not flush the fracture if you have a seizure.

c.Be sure to hyper-arthrostatic.

Correct answer to the change calendar: a

(1) All wounded who are suspected of having fractures should be treated as fractures. (2) In addition to the danger of life, such as facing **, **, toxic gas, drowning, etc., should be rescued on the spot. (3) When there is heavy bleeding, the bleeding should be stopped first, bandaged, and then the fracture site should be fixed.

4) When the casualty is found to be in shock or unconscious, the life should be saved first, and then the fracture should be treated. (5) When the fracture is fixed, do not reduce it blindly, so as not to aggravate the degree of injury. (6) It is strictly forbidden to return the broken end of the fracture exposed to the wound to the wound.

7) The bandaging should be appropriate so as not to affect the normal blood circulation and play a fixed role. When a limb fracture is fixed, the fingers or toes should be exposed so that the blood circulation of the injured limb can be observed. (8) The splint used to fix the fracture should not be in direct contact with **, and soft items such as gauze and cotton should be used to pad between the splint and **, and soft pads should also be added at both ends of the splint and bone protrusions.

9) The length and width of the splint required to fix the fracture should be suitable for the fractured limb. Its length is generally more than two joints.

It seems to be: (1) if there is a wound, the bleeding should be stopped and bandaged before fixation, and the shock should be corrected when shock occurs; (2) For open fractures, the punctured bone end should not be sent back to the wound for fixation to prevent infection; (3) When the splint is fixed, the splint should be selected with appropriate length and width, and the cotton should be padded between the splint and **, especially in the protruding and concave parts; The fixation is moderately tight, and the fingers and toes are exposed to observe the blood circulation. That's it.

There are two types of fixation methods for fractures: external fixation and internal fixation. Some people think that after a fracture, find someone who knows how to pinch it, and then paste it or find some medicine to rub it. With the continuous development of medicine, some of the practices that used to be pinched, kneaded, and then pasted have been denied, and some are still continuing.

But no matter how it develops, as one of the three principles of fracture ** (reduction, fixation, and functional exercise), the principle of fixation is always the same. Only if the fixation is really effective, the fracture can heal well. At present, there are two types of fracture fixation, namely external fixation and internal fixation.

The external fixation includes plaster, small splints, polymer materials, external fixation brackets, etc. There are various types of steel plates, screws, intramedullary nails, memory alloy materials, bioresorbable materials, etc. When you are suddenly injured in daily life and there are no professionals around, the materials that can be obtained nearby such as umbrellas, wooden sticks, books, etc. can be temporarily fixed, and when the external fixation materials cannot be obtained in the field, the lower limb can be fixed with the opposite limb after injury, and the upper limb can be fixed with the chest wall, and sent to the hospital as soon as possible to ask for professionals.

It is very dangerous not to try to walk or move a limb to determine if there is a fracture after the injury, as it may make the injury worse. (Sun Jianfeng).

Basic principles: stop bleeding first, then bandage, then fix, and then transport.