Open reduction of scaphoid fracture with bone grafting and internal fixation with Kirschner wire

Applicable to those who do not heal the scaphoid fracture. Treatment of diseases: scaphoid fractures of the scaphoid bone fracture Indication Applicable to those who do not heal the scaphoid fracture. Contraindications 1. The infection after the local injury has not been eliminated. 2. Injury refers to the passive flexion and extension of each joint. Preoperative preparation 1. The fracture is caused by severe trauma. The patient has severe pain and blood loss. Analgesic and blood matching should be given before surgery. For patients with poor general condition or existing shock, anti-shock treatment such as infusion and blood transfusion should be given, and the operation should be performed after the condition is stable. 2. The preoperative preoperative fracture site should be taken with a positive lateral radiograph to determine the location, shape and displacement of the fracture, which is convenient for determining the surgical procedure and internal fixation. For those who need to take X-rays during surgery, they should inform the radiology department and the operating room in advance to prepare. 3. The surgeon should propose special equipment to be used and check whether the equipment preparation is complete, so as to avoid temporary preparation and prolong the operation time. Surgical procedure 1. On the lateral side of the distal radius of the humerus, a diagonal incision is made along the direction of the thumb abductor tendon, and the distal wrist transverse line is turned into an L-shaped incision toward the volar side. 2. Expose and protect the sacral nerve branch to the dorsal side of the thumb. 3, free and protect the spurs, veins. 4, longitudinally cut open the long abductor tendon, the short extensor tendon sheath, retract the tendon, reveal the joint capsule. 5. Longitudinal incision of the temporal joint capsule and periosteum, revealing and resecting the styloid process of the humerus, so that the section is located near the fracture line. When removing the styloid process, pay attention to the attachment of the scaphoid ligament on the styloid process. 6. Expose the scaphoid bone and fracture to protect the soft tissue of the dorsal side of the scaphoid. 7. Insert the cancellous bone from the humerus into the scaphoid cavity and fill it. 8, fracture reduction, from the distal side to the proximal side of the Kirschner wire to fix. The contraction of the joint capsule and periosteum is tightened. 9, loose stop bleeding, stop bleeding. Make sure the wound is closed without bleeding. complication Suppurative infection, infected wounds have pain, redness, tenderness, purulent secretions, etc., body temperature can be increased and neutrophils can be increased.

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