整形外科學(xué)

內(nèi)容概要

　　《整形外科學(xué)》覆蓋面已擴(kuò)大到涵蓋大部分醫(yī)學(xué)臨床專業(yè)，包括：急診醫(yī)學(xué)、家庭醫(yī)學(xué)、神經(jīng)病學(xué)、心臟病學(xué)、影像學(xué)、兒科學(xué)、婦產(chǎn)科學(xué)、精神病學(xué)、麻醉學(xué)、骨科學(xué)及外科學(xué)等專業(yè)。該套叢書是科學(xué)性的集中體現(xiàn)，無(wú)論在篇章設(shè)置、概念引用、文字表達(dá)，還是圖表運(yùn)用上都秉承嚴(yán)肅認(rèn)真的科學(xué)態(tài)度，進(jìn)行了合理的安排與控制。已成為美國(guó)廣大醫(yī)學(xué)生和住院醫(yī)師獲取專業(yè)知識(shí)的最佳讀物，深受廣大讀者的喜愛(ài)，已被打造成為高質(zhì)量、值得信賴的品牌叢書?！　”咎讌矔捎弥杏⑽膶?duì)照的形式，在獲得豐富醫(yī)學(xué)知識(shí)的同時(shí)還可以提高專業(yè)英語(yǔ)水平，該叢書可供醫(yī)學(xué)生、住院醫(yī)師、全科醫(yī)師學(xué)習(xí)閱讀，也可作為?？漆t(yī)生參考用書。

作者簡(jiǎn)介

趙世光，中共黨員，主任醫(yī)師，教授，博士生導(dǎo)師，博士后指導(dǎo)教師。現(xiàn)任哈爾濱醫(yī)科大學(xué)附屬第一醫(yī)院神經(jīng)外科主任，哈爾濱醫(yī)科大學(xué)附屬第一醫(yī)院副院長(zhǎng)。
中華醫(yī)學(xué)會(huì)神經(jīng)外科分會(huì)常委，中國(guó)醫(yī)師協(xié)會(huì)神經(jīng)外科分會(huì)常委，中國(guó)康復(fù)醫(yī)學(xué)會(huì)創(chuàng)傷康復(fù)專業(yè)委員會(huì)副主任委員，中國(guó)抗癌協(xié)會(huì)中國(guó)神經(jīng)腫瘤學(xué)會(huì)副主任委員，黑龍江省醫(yī)學(xué)會(huì)神經(jīng)外科專業(yè)委員會(huì)主任委員，黑龍江省醫(yī)師協(xié)會(huì)神經(jīng)外科專業(yè)委員會(huì)主任委員，黑龍江省神經(jīng)外科學(xué)學(xué)會(huì)神經(jīng)外科分會(huì)主任委員，黑龍江省博士學(xué)術(shù)研究會(huì)醫(yī)學(xué)專業(yè)委員會(huì)副主任委員，國(guó)家自然科學(xué)基金評(píng)審專家，美國(guó)神經(jīng)外科醫(yī)師協(xié)會(huì)(AANS)會(huì)員，亞太地區(qū)神經(jīng)外科學(xué)會(huì)會(huì)員，日本國(guó)際腦腫瘤病理學(xué)會(huì)會(huì)員。
 ((Brain Tumor
Pathology))國(guó)際編委，《中國(guó)神經(jīng)腫瘤雜志》副主編，《中華神經(jīng)外科疾病研究雜志》、《中華神經(jīng)醫(yī)學(xué)雜志》、《中國(guó)臨床神經(jīng)外科雜志》、《中國(guó)微侵襲神經(jīng)外科雜志》、《中國(guó)急救醫(yī)學(xué)雜志》、《中華腦血管病雜志》編委，《European
Journal of Cancer》、《中華醫(yī)學(xué)雜志英文版》、《中華神經(jīng)外科雜志》特約審稿專家。
曾獲教育部提名國(guó)家科技進(jìn)步二等獎(jiǎng)、黑龍江谷醫(yī)藥衛(wèi)生科技進(jìn)步一等獎(jiǎng)、黑龍江省高?？茖W(xué)技術(shù)二等獎(jiǎng)、黑龍江省人民政府科學(xué)技術(shù)進(jìn)步二等獎(jiǎng)等國(guó)家、省部級(jí)獎(jiǎng)勵(lì)共18項(xiàng)。
曾承擔(dān)國(guó)家973計(jì)劃前期研究專項(xiàng)、國(guó)家自然科學(xué)基金等國(guó)家、省部級(jí)各類課題20余項(xiàng)。獲國(guó)家發(fā)明專利4項(xiàng)。在國(guó)際、國(guó)內(nèi)等核心期刊發(fā)表論文100余篇(其中SCI收錄18篇)。

書籍目錄

第1章　基本技術(shù)
第2章　傷口愈合
第3章　移植和皮瓣
第4章　皮膚和軟組織
第5章　熱損傷和化學(xué)灼傷
第6章　顱面手術(shù)
第7章　胸部和軀干整形
第8章　手和上肢
第9章　下肢和生殖器
第10章　美容外科
附錄A 整形外科的時(shí)機(jī)
附錄B　習(xí)題與參考答案
附錄C 常用藥
名詞對(duì)照表

章節(jié)摘錄

　　Most nasal bone fractures can be managed by closed reduction　techniques and splinting. Late deformities such as a dorsal hump，saddle-nose　deformity， and deviation can be managed with　formal thinoplasty （see Chapter 10）.　　Naso-Orbito-Ethmoidal Fractures　　Fractures of the naso-orbito-ethmoidal complex of the central　midface have　a high potential for significant facial deformity　because of displacement of the nose and eyes. Injury leads to lat-　eralization of the frontal processes of the maxilla， which in tum　leads to widening of the intercanthal distance， or telecanthus.Other common stigmata include a wide and shortened nose， epi-staxis， orbital hematomas， and crepitance over the involved area.The frontal processes of the maxilla are mobile on palpation.　　Examination of the lacrimal apparatus， including the naso-lacrimal duct， reveals concomitant injury　　Naso-orbito-ethmoidal complex fractures demand open　　reduction and internal fixation to relieve telecanthus and nasal　deformities. If injured， the lacrimal dua may be repaired with fine　suture and stented with silastic tubing.　　Zygomatic Fraaures　　Because of the prominence of the cheek， the zygoma （cheek　bone） is commonly fractured. The zygoma articulates with the　maxilla medially and irtferiorly， the frontal bone superiorly， the　sphenoid bone laterally， and the temporal bone via its arch. With　the exception of isolated zygomatic arch fractures， all fractures of　the zygoma affect the orbit， and thus diagnosis and treatment　incorporates the orbit. Isolated zygomatic arch fractures are man-　aged nonoperatively or through small incisions （the Gilles　approach）. Displaced fractures of the body of the zygoma with　　resultant orbital and cheek deformity are treated with open　reduction and intemal fixation.　　　Moxillary Fraaures　　Fractures of the maxilla essentially involve the entire midface　region， and are dassified by the Le Fort classification system. Le　Fort fractures can occur unilateraUy， bilaterally， in combination （a　left Le Fort II and right Le Fort rrd， and at multiple levels （a left　Le　Fort I　and rrd . A Le　Fort I fracture is a transverse fracture se-p-　arating the lower， tooth-bearing segment of the maxilla from the　rest of the midface. A Le Fort II fracture is pyramidal in shape，　and separates the tooth-bearing， lower maxillary bone from the　orbits and upper craniofaaal skeleton. A Le Fort III fracture， or　craniofacial dysjunction， separates the upper maxilla from the　skull base. The hallmark of a Le Fort fracture is mobility of the　maxilla on physical examination. Other signs and symptomsinclude orbital hematomas， epistaxis， pain in the midface， facial　elongation， midface retrusion， and tooth occlusal abnormalities　　Nondisplaced Le Fort fractures may be managed nonopera-　tively. Displaced Le Fort fractures often require open reduction　and internal fixation， as well as maxillomandibular fixation.Important concerns include stabilization of tooth occlusion andreduction of facial buttresses.　　Mandible Fractures　　The prominent position of the mandible makes it the second most　commonly fractured faaal bone. Because of its shape， it is commonly　broken in two places. Areas that are weakest， like the subcondylar　area， are the most frequendy fractured. A mandible fracture is sus-pected any time acute malocdusion exists in the trauma setting.　Other signs and symptoms of a mandible fracture include pain，sweUing， trismus （pain on moving the jaw）， inabdity to open or　close the jaw， fractured teeth， discrepancies in the height of den-tition， and intraoral lacerations. Radiographic examination with a　CT scan or Panorex aids in diagnosis. （A Panorex is a specialized　　plain radiograph in which the x-rays rotate around the mandible，essentially transforming it from a curved structure to a flat　　imageJ　Treatment of mandible fractures always begins with restora-tion of ocdusion. It is essential that all stable teeth are reduced to　their premorbid location so that the patient can continue to chew　food.Restoration of proper occlusion usually requires binding the　maxillary and mandibular teeth together with a series of wires，　screws， or arch bars， so-called maxillomandibular fixation（MMF）. Sometimes MMF is aU that is required to adequately　treat a mandibular fracture.　　Many mandibular fractures require open reduction and inter-nal fixation. This can be performed through intraoral lower gin-givobuccal sukus incisions， extraoral incisions， or percutaneous　methods. Titanium plates and screws hold the reduced bony seg-ments in place. Complications of mandibular fracture treatment　indude chin numbness from injury to the inferior alveolar nerve，　malocclusion， nonunion of bony segments， and infection.　　……

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