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Endotracheal intubation in the emergency rescue of critically ill patients and nursing


Back on the inward before exposure, a little screwdriver periosteum separated traction test a low one finger squeeze reset. And guide the direction of 1 to 2 screws fixed by the previous oblique maintain traction. The greater tuberosity vertices and Trochanteric bone, temporary fixation with Kirschner wires to maintain the form of crushed tuberosity. Better, the hollow screw fixation, C-arm fluoroscopy is lateral, into the proximal two fixed screw, after location entrance point well along the Kirschner wire screwed into the hollow nails, nails fixed into the femoral side, closed Cut El, install external fixation device, placed drainage. After 30 knees hip flexor. Semi-supine, isometric muscle exercise, swelling subsided after 1 week. Hip and knee functional training, 6 to 12 weeks walk with partial weight-bearing. 2 results of intraoperative and postoperative blood transfusion, lost 0 to 2 units of red blood cell suspension, all patients were followed up for 5 months to 6 years, an average of 24.4 months, no death during hospitalization, postoperative deep vein thrombosis 2 cases. Window of the articular surface of bolt 1 case, fracture is not healing for intertrochanteric fractures and femoral neck fracture, screw loosening in 1 case, for the sequelae of cerebral thrombosis patients, physical activity limitation, osteoporosis, but did not nail, fracture healing , femoral nail to the infection in 2 cases, removal of fracture healing by dressing fixed needle cure. Follow-up results, according to Kyle evaluation standard, excellent in 26 cases, good in 9 cases, fair in 1 case, poor in 1. Excellent, good, fair cases were 10 to 14 months in fracture healing. 3 Discussion 3.1 intertrochanteric fracture of hip fractures account for about 50%, occurs in the elderly, non-surgical treatment of bed for a long time, and prone to complications, such as bed sores, pulmonary infection, urinary tract infection , deep vein thrombosis, the mortality rate higher than that of surgical treatment, it is the current preference for surgery. Surgical treatment of intertrochanteric fractures are many ways for EvartsI, Ⅱ, Ⅲ A fracture or hollow with the DHS's reconstruction nail fixation may be better off. 3.2 for Evans Ⅲ B, IV fractures can be DHS + P (trochanter supporting plate) fixed. Loss for large, fixed difficulty. If only DHS fixed, because DHS has dynamic compression on the role of fracture, dynamic hip screw steel strong,[link widoczny dla zalogowanych], with shear force, but for intertrochanteric comminuted fracture patients, particularly when there is coronal fracture, due to loss of femoral lateral support bone, can cause shortening of the femoral neck,[link widoczny dla zalogowanych], femoral hip screw rotation could easily lead to thick, very vulnerable to steel, screw breakage, fracture, hip screw through the articular surface. Cause joint pain. 3-3 reconstruction nail a short pull, slide,[link widoczny dla zalogowanych], anti-rotation triple features, the same support as the lateral femur bone loss, resulting in shortening of femoral neck and lateral support for lack of strength, not firmly fixed, proximal fixation is not solid, pressure on the femoral shaft, could easily lead to fractures. 3.4 The limited internal fixation and external fixation comminuted fracture of femur,[link widoczny dla zalogowanych], the proximal edge point in the neck, head, point the remote force acting on the femoral shaft, through the external fixator for the bridge. Efficient Synthesis of a whole bone anchor for the lateral femur bone integrity requirements low, limited internal fixation to the fracture to better adhesion, is conducive to fracture healing. Effective solution to support the poor femoral bone problems, with less damage, shorter operative time, especially for frail elderly patients with other diseases or in combination. 3.5 limited internal fixation and external fixation, although structure is more solid, basic to the effective load-bearing, but should still be in bed early active or passive functional exercise based, particularly in patients with unstable fractures or osteoporosis,[link widoczny dla zalogowanych], should not be overemphasized early ambulation. Should be 4 to 6 weeks after walking crutch ambulation. Against internal and external lower extremity rotation. f