وخرد جان خداوند وخرد بنام جان خداوند بنام

Principles of CR,ST,IFPrinciples of CR,ST,IF

Dr.H.SaremiDr.H.Saremi

Orthopaedic surgeon, Hand and Shoulder fellowshipOrthopaedic surgeon, Hand and Shoulder fellowship

Hamedan university of medical sciencesHamedan university of medical sciences

Besat HospitalBesat Hospital

introductionintroduction

Skeletal system is very active metabolicallySkeletal system is very active metabolically

Turnover rate of 3% per year of cortical Turnover rate of 3% per year of cortical and 25% per year of cancellous boneand 25% per year of cancellous bone

ReductionReduction

• CRCR• OROR

fixationfixation

• CR+castingCR+casting• CRIFCRIF• ORIFORIF

FixationFixation

• SplintSplint• CastingCasting• TractionTraction• External fixatorExternal fixator• Internal fixatorInternal fixator

Closed reductionClosed reduction

• What fx? Age soft tissue boneWhat fx? Age soft tissue bone• What is an acceptable reductionWhat is an acceptable reduction• AlignmentAlignment• ShorteningShortening• rotationrotation

CRCR

• TechniqueTechnique

CRCR

CRCR

CRCR

CRCR

TractionTraction

• Skin tractionSkin traction• Skeletal tractionSkeletal traction

Skeletal tractionSkeletal traction

• Skin should be preppedSkin should be prepped• AnesthesiaAnesthesia• complicationscomplications

Internal fixationInternal fixation

• IncisionIncision• TimingTiming• InfectionInfection

InternalfixationInternalfixation

• ReductionReduction

DirectDirect

Indirect Indirect

Internal fixationInternal fixation

• Compression fixationCompression fixation

1.1.Lag effectLag effect

2.2.buttressbuttress

Internal fixationInternal fixation

3)Tension band3)Tension band

PlatePlate

Wire and screwWire and screw

StapleStaple

4)Compression nailing4)Compression nailing

Internal fixationInternal fixation

• Non compression techniquesNon compression techniques

Biologic fixationBiologic fixation

CerclageCerclage