The first ever shoulder replacement
The first shoulder replacement was allegedly performed by
the french surgeon Jules Emile Pean in 1893 . The
patient was a 37-year old man who suffered
from bony tuberculosis. The prosthesis was made in two
parts; the shaft was made of platinum and the head was
made of hardened rubber. The initial results were
encouraging but unfortunately Dr. Pean had to remove the
prosthesis two years later owing to infection.
#医学生Medic[超话]##medicaltalks#
The first shoulder replacement was allegedly performed by
the french surgeon Jules Emile Pean in 1893 . The
patient was a 37-year old man who suffered
from bony tuberculosis. The prosthesis was made in two
parts; the shaft was made of platinum and the head was
made of hardened rubber. The initial results were
encouraging but unfortunately Dr. Pean had to remove the
prosthesis two years later owing to infection.
#医学生Medic[超话]##medicaltalks#
Ikka ajan taga oma unistusi ja mõtteid kauguses.Igatsen su järele, aga nii kaua.Ma ei arvanud, et need olid mõlemad pooled.Kui sa mind valgustad, pean ka teadma, kuidas vabaneda.Ma kasutasin minna sama teed iga päevMa ei tea, kuidas neid asjaolusid hinnata.Ma olen täna õhtul üksi.Aga ma kahetsen, et raiskasin aega koos.
跟腱断裂,局麻下修补:
1. 患者局麻,术区准备同开放手术,术中避免损伤腓侧神经。触摸跟腱断裂处,在两侧距断裂处上方 2.5 cm 处各行一切口。用 Pean 钳将皮下腱鞘推移开并固定,将直针(带单丝慢吸收或不可吸收的 0-0 或 1-0 的螺纹线)从切口处自外向内穿过跟腱。
2. 将两根直针分别由切口处穿入、按照术前所绘方向交叉穿过跟腱。并从跟腱远端穿出。
3. 穿出点用手术刀扩大,外侧螺纹线换上弯针,弯针由上述穿出点进入,并从远端跟腱的一半位置处穿出。
4. 穿出点用手术刀扩大,此时可松开腱鞘,换上直针,将直针由上述穿出点由外向内再次穿过跟腱。
5. 穿出点用手术刀扩大,换上弯针,弯针由上述穿出点进入,并从近端跟腱断裂处穿出,随后拉紧螺纹线,并与先前的螺纹线打结。
按情况缝合切口,患肢局部绷带包扎。
术后即刻患足跖屈 20 度固定 2 周,随后踝关节固定在 90 度持续 2 周。去除固定物后水中被动锻炼踝关节,可进行偏心性锻炼和肌肉等长锻炼,还可对患肢实施电刺激。
上述锻炼持续 3~5 周,即在术后 7~9 周后患者可正常行走和进行合适的力量锻炼,术后 4~6 个月患者可回归原先运动。术后 1 年检查患足功能情况。
1. 患者局麻,术区准备同开放手术,术中避免损伤腓侧神经。触摸跟腱断裂处,在两侧距断裂处上方 2.5 cm 处各行一切口。用 Pean 钳将皮下腱鞘推移开并固定,将直针(带单丝慢吸收或不可吸收的 0-0 或 1-0 的螺纹线)从切口处自外向内穿过跟腱。
2. 将两根直针分别由切口处穿入、按照术前所绘方向交叉穿过跟腱。并从跟腱远端穿出。
3. 穿出点用手术刀扩大,外侧螺纹线换上弯针,弯针由上述穿出点进入,并从远端跟腱的一半位置处穿出。
4. 穿出点用手术刀扩大,此时可松开腱鞘,换上直针,将直针由上述穿出点由外向内再次穿过跟腱。
5. 穿出点用手术刀扩大,换上弯针,弯针由上述穿出点进入,并从近端跟腱断裂处穿出,随后拉紧螺纹线,并与先前的螺纹线打结。
按情况缝合切口,患肢局部绷带包扎。
术后即刻患足跖屈 20 度固定 2 周,随后踝关节固定在 90 度持续 2 周。去除固定物后水中被动锻炼踝关节,可进行偏心性锻炼和肌肉等长锻炼,还可对患肢实施电刺激。
上述锻炼持续 3~5 周,即在术后 7~9 周后患者可正常行走和进行合适的力量锻炼,术后 4~6 个月患者可回归原先运动。术后 1 年检查患足功能情况。
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