UpperLimbIncludeClavicle鎖骨Scapula肩胛骨ShoulderJoint肩關節Humerus肱骨ElbowJoint肘關節RadiusandUlna尺橈骨WristJoint腕關節ScaphoidBone舟狀骨當前1頁，總共63頁。Mechanism損傷機制MostlyIndirectCommonlydescribedas“afallonoutstretchedhand“Typeofinjurydependsonpositionoftheupperlimbatthetimeofimpact:Flexed屈曲,Extended伸直,Adducted內收,Abducted外展,Pronated旋前orSupinated旋后當前2頁，總共63頁。FractureoftheClavicle鎖骨骨折CommonespeciallyinchildrenandelderlyCommonestsiteisthemiddleonethirdMainlyduetoindirectinjuryDirectinjuryleadstocomminutedfracture當前3頁，總共63頁。當前4頁，總共63頁。TreatmentConservativebyanarmsling手臂吊帶oreightbandage八字繃帶Operativefixationisindicatedifthereisanopenfracture,neurovascularinjuryornonunion當前5頁，總共63頁。FigureofeightBandage8字固定帶當前6頁，總共63頁。AcromioClavicularJ

Disloc

肩鎖關節脫位I型：關節囊、韌帶未斷裂II型：關節囊破裂III型：關節囊、韌帶完全斷裂HookPlate鉤鋼板當前7頁，總共63頁。DislocationoftheShoulder肩關節脫位MostlyAnterior>95%ofdislocationsPosteriorDislocationoccurs<5%TrueInferiordislocation(luxatioerecta直舉性肱骨脫位)occurs<1% Habitual

習慣性脫位NontraumaticdislocationmaypresentasMultidirectionaldislocationduetogeneralizedligamentouslaxityandisPainless

Inferior當前8頁，總共63頁。Mechanism機制UsuallyIndirectfallonAbductedandextendedshoulderMaybedirectwhenthereisablowontheshoulderfrombehind當前9頁，總共63頁。AnteriorShoulderdislocationUsuallyalsoinferiorBankart’sLesion前盂唇損傷當前10頁，總共63頁。ClinicalPicturePatientisinpainHoldstheinjuredlimbwithotherhandclosetothetrunkTheshoulderisabductedandtheelbowiskeptflexedThereislossofthenormalcontour輪廓oftheshoulder當前11頁，總共63頁。ClinicalPictureLossofthecontouroftheshouldermayappearasastepAnteriorbulge膨脹ofheadofhumerusmaybevisibleorpalpableAgapcanbepalpatedabovethedislocatedheadofthehumerus當前12頁，總共63頁。XRayofDislocationofShoulder

當前13頁，總共63頁。AssociatedInjuriesofShoulderDislocationInjurytotheneurovascularbundleinaxilla(rare)Injuryof

theAxillary腋神經(Usuallystretchingleadingtotemporaryneuropraxia)Associatedfracture當前14頁，總共63頁。AxillaryNerveInjury腋神經傷AlsocalledcircumflexnerveItisabranchfromposteriorcordofBrachialplexusIthookscloseroundneckofhumerusfromposteriortoanteriorItpiercesthedeepsurfaceofdeltoid三角肌andsupplyitandthepartofskinoverit當前15頁，總共63頁。ManagementofShoulderDislocationIsanEmergencyItshouldbereducedinlessthan24hoursortheremaybeAvascularNecrosisofheadofhumerusFollowingreductiontheshouldershouldbeimmobilisedstrappedtothetrunkfor3-4weeksandrestedinacollarandcuff當前16頁，總共63頁。MethodsofReductionHippocratesMethod(Anesthesia麻醉isrequired)Stimpson’stechnique(Sedation鎮靜andAnalgesia止痛areused,butNoanesthesia)Kocher’stechniqueisthemethodusedinhospitalsundergeneralanesthesiaandmusclerelaxation當前17頁，總共63頁。HippocratesMethod當前18頁，總共63頁。Stimpson’stechnique當前19頁，總共63頁。Kocher’sTechnique當前20頁，總共63頁。ComplicationsofShoulderDislocation:EarlyNeurovascularinjury(rare)AxillarynerveinjuryAssociatedFractureofneckofhumerusorgreaterorlessertuberosities（肱骨結節）當前21頁，總共63頁。ComplicationsofShoulderDislocation:LateAvascularnecrosisoftheheadoftheHumerus(highriskwithdelayedreduction)Heterotopiccalcification(usedtobecalledMyositisOssificans)骨化性肌炎Recurrentdislocation當前22頁，總共63頁。FracturesofTheHumerusProximalHumerus:surgicalandanatomicalneckShaftofHumerusDistalhumerus當前23頁，總共63頁。FracturesofTheHumerus當前24頁，總共63頁。FractureProximalHumerus當前25頁，總共63頁。Intra-medullaryKwirefixation當前26頁，總共63頁。FracturesShaftoftheHumerusCommonlyIndirectIndirectinjuryresultsinSpiralorObliquefracturesDirectinjuriesresultsintransverseorcomminutedfractureMaybeassociatedwithRadialNerveinjury當前27頁，總共63頁。FractureshaftoftheHumerus當前28頁，總共63頁。Treatment:PlatingorNail當前29頁，總共63頁。FractureDistaloftheHumerus當前30頁，總共63頁。RadialNerveInjuryResultsinWristdropAssociatedwithfracture

humerusinupto12%offractures2/3(8%)ofRadialinjuryareNeuropraxia(神經失用)當前31頁，總共63頁。ManagementofRadialNerveInjuryWhenpresentinopenfractures;immediateexplorationand±repairInclosedinjuriestreatedconservatively;initialmanagementisdoingNerveConductionStudies(NCS)andElectromyography(EMG)andawaitingforspontaneousrecovery當前32頁，總共63頁。ManagementofRadialNerveinjuryRecoveryusuallystartsafterfewdaysbutmaytakeupto9monthsforfullrecoveryIfNospontaneousrecoveryoccursin12weeksconfirmedbyNCSandEMG;thenexplorationofthenerveshouldbecarriedout當前33頁，總共63頁。ManagementofHumerusShaftFractureMostofthetimeisConservativeClosedReductioninuprightpositionfollowedbyapplicationofUshapedSlaborCylindercastFewweekslaterorinitiallyinstablefracturesFunctionalBracemaybeused當前34頁，總共63頁。UShapedSlabofPOP當前35頁，總共63頁。FunctionalBrace功能支具當前36頁，總共63頁。IndicationsforORIF切開復位內固定Failuretoreducefractureconservatively保守失敗Bilateralhumeralfractures雙側骨折OpenfracturewithradialnerveInjury開放骨折并神經傷Unconsciouspatient昏迷病人Delayed-Union延遲愈合Non-Union不愈合Mal-Union畸形愈合當前37頁，總共63頁。ORIF：openreduction

internalfixation當前38頁，總共63頁。Supra-condylarFractureofHumerus肱骨髁上骨折當前39頁，總共63頁。PediatricSupra-CondylarHumeralFracture當前40頁，總共63頁。PediatricSupra-condylarfracture當前41頁，總共63頁。Reductionofsupra-condylarFractureAbsoluteEmergencyShouldbedonebyexperienceddoctorassoonaspossibleInthepastthearmwasheldinflexedelbowpositioninback-slabPOPafterreductionAtpresenttimePercutaneousKwirefixationisALWAYS

carriedoutafterreduction當前42頁，總共63頁。ComplicationsSupra-CondylarFracturesEarly=Compartmentsyndrome（Volkmann‘sIschemia）

Late=Stiffness

Volkmann'sIschemicHeterotopicCalcification

Mal-Union(Valgusorvarus)當前43頁，總共63頁。Supracondylarfracture當前44頁，總共63頁。EblowDislocation肘關節脫位FootballWeightlifting當前45頁，總共63頁。ElbowReduction肘關節復位.當前46頁，總共63頁。FractureDislocation骨折脫位當前47頁，總共63頁。SubluxationofRadialHead橈骨小頭半脫位當前48頁，總共63頁。SubluxationofRadialHead橈骨小頭半脫位1.拇指按壓橈骨小頭處；2.將前臂作旋后或旋活動當前49頁，總共63頁。MonteggiaFracture-Dislocation

當前50頁，總共63頁。MonteggiaFractu