机器翻译字幕，仅供参考：
in this presentation the fixation of a distal humerus fracture ao
在本演示文稿中，将使用垂直钢板配置的 va lcp 肱骨远端骨板 2.7 3.5 展示肱骨远端骨折 ao
classification 1 3 c3 will be shown using va lcp distal humerus plates 2.7
分类 1 3 c3 的固定
3.5 in a perpendicular plating configuration
these plates are available in both titanium and stainless steel
这些钢板有钛和不锈钢两种 钢板上
the va lcp locking holes in the plate accept va locking screws which are
的 val lcp 锁定孔接受 va 锁定螺钉是
coloured purple locking screws and cortex screws
紫色锁定螺钉和皮质螺钉，
following this exercise you should be able to perform the surgical approach
在此练习之后，您应该能够执行手术方法
and exposure of the fracture zone to describe the steps to attain
和骨折区域的暴露，以描述实现
anatomical reduction and apply the distal humerus plate system to a 1 3 c 3
解剖复位并将肱骨远端钢板系统应用于 1 3 c 的步骤 3
fracture
to obtain sufficient exposure of the fracture the patient is placed either in
骨折 获得足够的骨折暴露 患者被
a lateral decubitus position or a prone position the prone position is the
置于侧卧位或俯卧位 俯卧位是
preferred option a short arm support is used so that the
首选选择使用短臂支撑以便
surgeon may sit care must be taken to ensure that the
外科医生可以坐下必须小心以确保
elbow can be flexed at least to an angle of between 110 and 120 degrees
肘部至少可以弯曲到110 到 120 度之间
the skin incision is marked because of the foam start higher to make
的角度 标记皮肤切口是因为 泡沫从较高处开始做
a straight incision then curve around the olecranon
一个笔直的切口，然后围绕鹰嘴弯曲
and then back down the crest of the ulna
，然后回到尺骨的顶部
the incision is made down to the fascia of the triceps and down to the ulna
切口一直到三头肌的筋膜，再到
the self-holding spreaders are inserted to hold back the soft tissues
尺骨 插入自持式扩张器以阻止 软
the fracture of the distal humerus is visible
组织 肱骨远端骨折
with a proximal diaphyseal metaphyseal fragment
可见 近端骨干 干骺端
an ulnar fragment a radial fragment and an intermediate
碎片 尺骨碎片 桡骨碎片和中间
fragment the next step will be to perform an
碎片 下一步将进行
osteotomy of the proximal ulna in order to visualize the intra-articular
尺骨近端截骨术，以观察关节内
component spreaders are applied distally to allow
组件扩张器 向远端应用，以便
visualization of the proximal ulna the ulnar nerve is identified
观察尺骨近端识别尺神经
it may be elevated with a sling at the ulnar epicondyle if necessary
如有必要，可以在尺骨上髁处用吊带抬高
a v-shaped or chevron osteotomy will be made
进行 V 形或 V 形
the osteotomy is marked with its center at the base of the coronoid process
截骨术 截骨术标记其中心位于尺骨的底部
where there is ample cartilage
有充足软骨
the oscillating saw is used and the bone is cut almost completely across
的冠状突，使用摆动锯，几乎完全切割骨头
the separation is completed with an osteotome to avoid a loss of substance
，分离是 c 配有骨刀以避免
at the articular level the proximal ulna is reflected to give
关节水平的物质损失 近端尺骨被反射以提供
an excellent view of the fracture and the intermediate fragment
骨折和中间碎片
the next step is the articular reduction the instruments needed are
的绝佳视野 下一步是关节复位所需的仪器
the 2.5 millimeter drill bit the universal drill guide 3.5
是 2.5 毫米钻头 通用钻头 指南 3.5 带点
the asymmetric reduction forceps with points
的不对称复位钳
and the large reduction forceps with points
和带点的大复位钳，
to allow an easier application of the asymmetric reduction forceps a 2.5
以便更轻松地应用不对称复位钳
millimeter hole is made in the radial cortex
在桡骨皮质上打一个 2.5 毫米的孔
the radial column fragment is reduced and held temporarily with the reduction
将桡骨柱碎片复位并用复位钳暂时固定
forceps
the next step is temporary fixation of the reduced fragment using k wires
下一个 步骤是使用 k 线临时固定减少的碎片
when positioning the k wires it is imperative that the definitive position
当定位 k 线时，必须
of the plate is taken into account to avoid any conflict between the plate
考虑板的最终位置以避免板
position and the k-wire position
位置和 k 线
the forceps are now removed
位置之间的任何冲突 现在移除镊子
the intermediate fragment is reduced next
中间片段被还原，然后
it is positioned into the articulation reduced anatomically to the stabilized
它被定位到关节中在解剖学上减少到稳定的
radial column fragment and preliminarily fixed in position with
桡骨柱片段并用 ak 线初步固定到位
a k wire
the final fragment is reduced to the already reconstructed distal humerus
最后的片段被减少到已经重建的肱骨远端
the large pointed reduction forceps are applied across the fragments
大的尖头复位钳被应用在片段上
a 2.5 millimeter hole is made in the ulna column for the asymmetric reduction
在尺骨柱上制作一个 2.5 毫米的孔用于不对称 复位
forceps the forceps are applied
钳 使用钳子
two k wires are inserted to hold this fragment in position
插入两根 k 线以将这个片段
the transarticular fixation k wire is inserted further
固定到位 进一步插入经关节固定 k 线
both forceps are now removed
两个钳子现在都被
the va lcp elbow plating system offers three main double plating configurations
移除 valcp 肘板系统在本演示文稿中为肱骨远端提供三种主要的双板配置
for the distal humerus in this presentation perpendicular
垂直
plating with lateral support will be shown
将显示
the dorso lateral plate with lateral support is used with the medial plate
带有侧向支撑的钢板 带有侧向支撑的背侧侧板与内侧板一起使用
the screws of the lateral support target the articular block
侧向支撑目标的螺钉
instruments to insert 3.5 millimeter cortex screws are
用于插入 3.5 毫米皮质螺钉
the 2.5 millimeter drill bit the universal drill guide 3.5
的关节块器械 2.5 毫米钻头 通用导钻器
the depth gauge for screws 2.7 to 4.0 millimeters
3.5 深度 螺丝量规 2.7 到 4.0毫米
and the small hexagonal screwdriver with sleeve
和带有套筒工具的小六角螺丝刀
instruments to insert 2.7 millimeter variable angle locking screws are
插入 2.7 毫米可变角度锁定螺钉
the 2.0 millimeter drill bit the va lcp drill sleeve 2.7
是 2.0 毫米钻头 va lcp 钻套 2.7
the depth gauge for screws 2.7 to 4.0 millimeters
用于螺钉的深度计 2.7 到 4.0
the star drive screwdriver shaft sd8 the 1.2 newton-meter torque limiter and
毫米星形驱动螺丝刀轴sd8 1.2 牛顿- 米扭矩限制器
the handle for torque limiters
和扭矩限制器手柄
application of the dorsolateral plate with lateral support
背外侧板的应用与侧向支撑
position the dorso-lateral plate on the distal humerus
位置 肱骨远端背外侧板
use the 2.5 millimeter drill bit with the 3.5 universal drill guide to
使用 2.5 毫米钻头和 3.5 通用钻头导向器
pre-drill the bone through the dcu portion of the elongated plate hole
通过 dcu 部分预钻骨头
through both cortices to set the screws in a neutral position
穿过两个皮质的细长板孔将螺钉设置在中间位置
press the drill guide down
向下按压导钻器
determine the required length of the cortex screw using the depth gauge
使用深度计确定皮质螺钉的所需长度
after tapping if needed insert the appropriate 3.5 millimeter cortex screw
攻丝后如果需要 使用六角螺丝刀插入适当的 3.5 毫米皮质螺钉
using the hexagonal screwdriver do not fully tighten the screw
不要完全 拧紧螺钉，
insert the va lcp drill sleeve 2.7 into the central variable angle locking hole
将 va lcp 钻套 2.7插入中心变量 角度锁定孔
ensuring that the drilled sleeve tip keys into the cloverleaf portion of the
确保钻孔套筒尖端键入板孔的三叶草部分
platehole use the 2.0 millimeter drill bit to
使用 2.0 毫米
drill to the desired depth the fixed angle end of the drill sleeve
钻头钻到所需深度钻套筒的固定角度端
ensures that the drill bit follows the normal trajectory of the locking hole
确保钻头遵循锁定孔的正常轨迹
remove the drill sleeve and use the depth gauge to measure the screw length
卸下钻套并使用深度计测量螺钉长度
use the star drive screwdriver shaft to insert the 2.7 millimeter variable angle
使用星形驱动螺丝刀轴插入 2.7 毫米可变角度
locking screw the 1.2 newton meter torque limiter
锁定螺钉
connected to the handle for torque limiters must be used for the last few
连接到扭矩限制器手柄的 1.2 牛顿米扭矩限制器必须用于最后
turns of the screw to avoid damaging the threads of either the screw or the plate
几圈 为避免损坏螺钉或板孔的螺纹，将
hole
two more variable angle locking screws are inserted in the distal plate holes
另外两个可变角度锁定螺钉插入远端板孔中，
and a cortex screw inserted in the most proximal plate hole
并将皮质螺钉插入最近端板孔中，
position the plate on the medial ridge slightly dorsal to the intermuscular
将板定位在内侧脊稍微背侧至 肌
septum choose a plate position that allows the
间隔选择允许
longest possible distal screws insert a 3.5 millimeter cortex screw
最长的远端螺钉插入 3.5 毫米的板位置 皮质螺钉
through the dcu portion of the elongated plate hole in the neutral position
在中立位置穿过细长板孔的 dcu 部分
take care to avoid the lateral plate and screws
注意避开侧板和螺钉
place the funnel shaped end of the va lcp drill sleeve in the second most
将 valcp 钻套的漏斗形端放置在第二个最
distal plate hole and drill a hole at the desired angle to cross the fracture
远端的板孔中，并以所需的角度钻孔 穿过骨折
fragments
碎片
insert the appropriate 2.7 millimeter variable angle locking screw using the
使用标准技术插入适当的 2.7 毫米可变角度锁定螺钉
standard technique the screw must be long enough to reach
螺钉必须足够长以
the far fragment
到达远处的碎片
make sure the last turns are made by hand with the 1.2 newton meter torque
确保最后一圈是用手使用 1.2 牛顿米扭矩
limiter
a variable angle locking screw is inserted through the most distal plate
限制器 可变角度锁定螺钉通过最远端的板
hole
孔
a variable angle locking screw is inserted through a plate hole in the
插入可变角度锁定螺钉通过板轴中的板孔插入
shaft of the plate
all the k wires are now removed
所有 k 线现在已移除
use the funnel shaped end of the va lcp drill sleeve to insert variable angle
使用 valcp 钻套的漏斗形末端插入可变角度
locking screws through the plate holes in the lateral support
锁定螺钉侧向支架上的板孔
the screws of the lateral support target the articular block
侧向支架的螺钉瞄准关节
the electron is reduced and secured with two 1.6 millimeter k wires inserted
块 电子减少并固定 d 将两根 1.6 毫米的 k 线
parallel to each other through the olecranon and into the ulna
相互平行地插入穿过鹰嘴并进入尺骨
position the plate on the dorsal aspect of the proximal ulna
位置，将钢板置于尺骨近端的背侧，
the triceps tendon may need to be split in order to apply the plate
可能需要分开肱三头肌肌腱，以便应用钢板
insert a 3.5 millimeter cortex screw through the dcu portion of the elongated
插入 3.5 毫米皮质螺钉
plate hole in the neutral position using standard technique
使用标准技术在中立位置穿过细长板孔的 dcu
place the funnel shaped end of the va lcp drill sleeve in one of the proximal
部分 将 valcp 钻套的漏斗形端置于近端板孔之一中，
plate holes and drill a hole at the desired angle through the olecranon and
并以所需角度钻一个孔，穿过鹰嘴并
into the ulna
进入尺骨
insert the appropriate 2.7 millimeter variable angle locking screw
插入物 合适的 2.7 毫米可变角度锁定螺钉
make sure the last turns are made by hand with the 1.2 newton-meter torque
确保最后一圈是手工完成的 使用 1.2 牛顿米扭矩
limiter
限制器
insert a second variable angle locking screw in the proximal section of the
在板的近端插入第二个可变角度锁定螺钉，并在最远端的
plate and insert a cortex screw in the most distal plate hole
板孔中插入皮质螺钉
remove the k wires
移除 k 根
the model shows that optimum reduction of the fracture and plate placement have
钢丝 模型显示已实现最佳骨折复位和钢板放置
been achieved
you should now be able to perform the surgical approach and exposure of the
您现在应该能够进行 改变手术方法和
fracture zone to describe the steps to attain
骨折区域的暴露，以描述实现
anatomical reduction and apply the distal humerus plate
解剖复位并将肱骨远端钢板
system to a 1 3 c 3 fracture
系统应用于 1 3 c 3 骨折的步骤
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