波多野结衣 女同 老外怎样作念髌骨骨折？50秒视频展示髌骨骨折内固定手术

全球好，我是九楼老王。近期我发现了一系各外洋的优质骨科视频波多野结衣 女同，一共40个傍边，详备展示了一些基础性的骨科手术的作念法，每个约莫1分钟，相配适当学习。本文是其中一个，我作念了动态截图，用AI适配了陶冶，供全球参考。

The Kirschner wire tension band technique is a widely used method for the surgical fixation of patellar fractures， particularly transverse fractures. This procedure aims to restore the extensor mechanism of the knee， achieve anatomical reduction， and provide stable fixation to allow early mobilization. Below are the detailed surgical steps:克氏针张力带时候是平凡用于髌骨骨折手术固定的一种步调，荒谬是横行骨折。该手术旨在收复膝枢纽的伸肌机制，竣事剖解复位，并提供明白的固定以允许早期行径。以下是详备的手术步调：

1. Preoperative Preparation1. 术前准备

Patient Positioning: Place the     patient in a supine position on a radiolucent operating table.      患者体位：将患者置于透射线手术台上横卧位。

Anesthesia: General or regional     anesthesia is administered.     麻醉：经受全身或区域麻醉。

Sterilization and Draping: Prepare     the surgical site with antiseptic solution and drape the area to maintain     a sterile field.     消毒铺巾：用消毒液准备手术部位，并用无菌巾隐蔽以保握无菌环境。

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2. Surgical Exposure2. 手术泄露

Incision: Make a midline     longitudinal incision over the patella.     切口：在髌骨上方作念一正中纵行切口。

Soft Tissue Handling: Carefully     dissect through the subcutaneous tissue to expose the patella while     preserving the surrounding soft tissues， including the retinaculum.     软组织不休：小心区别皮下组织以泄露髌骨，同期保护周围的软组织，包括髌韧带。

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3. Fracture Reduction3. 骨折复位

Debridement: Remove any hematoma，     debris， or interposed soft tissue from the fracture site.     清创术：断根骨折部位的任何血肿、碎片或镶嵌的软组织。

Reduction: Manually reduce the     fracture fragments to achieve anatomical alignment. Temporary fixation     with reduction clamps or small K-wires may be used to hold the fragments     in place.     复位：手动将骨折碎片复位以达到剖解对位。可使用复位钳或小克氏针进行临时固定，以保握碎片位置 。

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4. Placement of Kirschner Wires4. 克氏针遗弃

Insertion: Insert two parallel     K-wires (1.6–2.0 mm in diameter) longitudinally across the fracture site.     The wires should be placed approximately 5 mm from the anterior cortical     surface of the patella and parallel in both the coronal and sagittal     planes.     插入：将两根平行克氏针（直径 1.6–2.0 mm）纵向穿过骨折部位。针应遗弃在髌骨前皮质名义约 5 mm 处，并在冠状面和矢状面平行。

Positioning: Ensure the wires     penetrate the distal and proximal poles of the patella without exiting the     soft tissue excessively to avoid irritation or complications.     定位：确保导线穿透髌骨的远端和近端极，但不外度穿出软组织，以幸免刺激或并发症。

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5. Application of Tension Band5. 张力带的支配

Wire Looping: Pass a stainless     steel cerclage wire (usually 18-gauge) in a figure-of-eight configuration     around the K-wires. The wire should loop anteriorly over the patella and     posteriorly through the quadriceps and patellar tendons.     钢丝环扎：以 8 字形确立将一根不锈钢环扎钢丝（常常为 18 号）绕过 K 型钢针。钢丝应在前线绕过髌骨，并在后方穿过股四头肌和髌腱。

Tensioning: Tighten the cerclage     wire evenly using a tensioning device or twisting technique to compress     the fracture fragments. This converts tensile forces from the extensor     mechanism into compressive forces at the fracture site.     张力施加：使用张力装配或扭转时候均匀地拉紧环扎钢丝，以压缩骨折碎片。这将从伸肌机制产生的拉力滚动为骨折部位的压缩力。

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6. Verification of Fixation6. 固定考证

Stability Check: Confirm the     stability of the fixation by flexing and extending the knee     intraoperatively. Ensure the fracture remains reduced and the fixation is     stable.     明白性搜检：术中通过屈伸膝枢纽证实固定明白性。确保骨折复位保握精熟且固定明白。

Imaging: Use intraoperative     fluoroscopy to verify proper alignment of the fracture， correct placement     of the K-wires， and adequate tension in the cerclage wire.     影像学搜检：术中透视以考证骨折的正确对位、K 线钉的准确遗弃以及环扎钢丝的符合张力。

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7. Final Steps7. 临了步调

Trimming Wires: Cut and bend the     ends of the K-wires to prevent migration. Ensure the ends are buried     beneath the soft tissue to minimize irritation.     修剪钢丝：剪短并袭击 K 型钢丝的结尾以防御移位。确保结尾埋入软组织下以减少刺激。

Closure: Close the retinaculum and     soft tissues in layers. Use absorbable sutures for deeper layers and     non-absorbable sutures for the skin.     关闭：逐层关闭复古带和软组织。深层使用可给与缝线，皮肤使用不成给与缝线。

Dressing: Apply a sterile dressing     and immobilize the knee in extension using a brace or splint.     敷料：支配无菌敷料并用支具或夹板将膝枢纽固定于伸直位。

8. Postoperative Care8. 术后照应

Rehabilitation: Early     range-of-motion exercises are typically initiated within 1–2 weeks     postoperatively， depending on the stability of the fixation and the     surgeon's preference.     康复：常常在术后 1-2 周内启动进行早期枢纽行径度锻练，具体取决于固定明白性及外科大夫的偏好。

Follow-Up: Regular radiographic     evaluations are performed to monitor fracture healing and implant     position.     随访：依期进行辐射学评估，以监测骨折愈合及植入物位置。

Key Considerations关键商酌身分

The modified K-wire tension band technique is effective but may     have complications such as wire migration， skin irritation， or the need     for hardware removal in up to 30–52% of cases.     矫正 克氏针张力带时候虽灵验，但可能出现如钢丝移位、皮肤刺激或高达 30–52%病例需行内固定物取出等并发症。

Alternative techniques， such as using suture materials or     anti-rotation strategies， may be considered for specific fracture patterns     or to reduce complications.     可商酌经受替代时候，如使用缝合材料或抗旋转战术，以针对特定骨折类型或减少并发症。

This method remains a gold standard for patellar fracture fixation due to its simplicity， cost-effectiveness， and reliable outcomes.该步调因其便捷性、本钱效益和可靠的后果，仍然是髌骨骨折固定的金轨范。

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