Ukuqhekeka kwe-Clavicle yenye yezona zifo zixhaphakileyo kwimiqolo ephezulu kunyango, apho ama-82% okuqhekeka kwe-clavicle kukwaphuka kwe-midshaft. Uninzi lokuqhekeka kwe-clavicle ngaphandle kokushukuma okukhulu kunokuphathwa ngendlela egcinayo ngeebhandishi ezisibhozo, ngelixa ezo zinokushukuma okukhulu, izicubu ezithambileyo ezidityanisiweyo, umngcipheko wokuphazamiseka kwemithambo yegazi okanye yemithambo-luvo, okanye iimfuno eziphezulu zokusebenza zinokufuna ukulungiswa kwangaphakathi ngeeplate. Izinga lokungaxhumi emva kokulungiswa kwangaphakathi kokuqhekeka kwe-clavicle liphantsi kakhulu, malunga ne-2.6%. Ukungaxhumi kwiimpawu kudla ngokufuna utyando lokuhlaziywa, apho indlela eqhelekileyo ikukuxhunyelelwa kwamathambo okurhoxiswa kunye nokulungiswa kwangaphakathi. Nangona kunjalo, ukulawula ukungaxhumi kwakhona kwe-atrophic kwizigulana esele zihlengahlengiswe ukungaxhumi kunzima kakhulu kwaye kuhlala kuyingxaki koogqirha nakwizigulane.
Ukujongana nale ngxaki, unjingalwazi kwiSibhedlele iXi'an Red Cross usebenzise i-autologous iliac bone structural grafting kunye ne-autologous cancellous bone grafting ukunyanga ukungahambelani kwe-clavicle fractures emva kotyando lokuhlaziya olungaphumelelanga, nto leyo eyabangela iziphumo ezilungileyo. Iziphumo zophando zapapashwa kwijenali ethi "International Orthopaedics".
Inkqubo yotyando
Iinkqubo ezithile zotyando zingashwankathelwa ngolu hlobo lungezantsi:
a: Susa i-clavicular fixation yokuqala, susa i-sclerotic bone kunye ne-fiber scar kwisiphelo esiphukileyo se-fracture;
b: Kusetyenziswe iipleyiti zokwakhiwa kwakhona kwe-clavicle zeplastiki, kwafakwa izikrufu zokutshixa kwiziphelo zangaphakathi nezangaphandle ukugcina uzinzo lulonke lwe-clavicle, kwaye izikrufu azizange zilungiswe kwindawo eza kunyangwa kwisiphelo esiphukileyo se-clavicle.
c: Emva kokufakela ipleyiti, bhoboza imingxunya ngenaliti kaKirschler ecaleni kwesiphelo esiqhekekileyo sendawo eqhekekileyo ukuya ngaphakathi nangaphandle ude umngxuma ukhuphe igazi (uphawu lwepepile ebomvu), nto leyo ebonisa ukuhamba kakuhle kwegazi emathanjeni apha;
d: Ngeli xesha, qhubeka ugqobhoza i-5mm ngaphakathi nangaphandle, kwaye ugqobhoze imingxunya emide ngasemva, nto leyo elungele i-osteotomy elandelayo;
e: Emva kokuhlinzwa kwe-osteotomy kumngxuma wokuqala wokugrumba, susa i-cortex yamathambo asezantsi ezantsi ukuze ushiye umkhombe wamathambo;
f: Ithambo le-bicortical iliac lafakwa kwi-bone groove, emva koko i-upper cortex, i-iliac crest kunye ne-lower cortex zaqiniswa ngezikrufu; Ithambo le-iliac cancellous lafakwa kwindawo yokuqhekeka.
Okuqhelekileyo
amatyala:
▲ Isigulana sasiyindoda eneminyaka engama-42 ubudala eyaphuka phakathi kwe-clavicle yasekhohlo ngenxa yokwenzakala (a); Emva kotyando (b); Yaphuka yaza yaphela ithambo laza layeka ukuhlangana phakathi kweenyanga ezi-8 emva kotyando (c); Emva kokulungiswa kokuqala (d); Yaphuka ipleyiti yentsimbi emva kweenyanga ezi-7 emva kokulungiswa nokungapholi (e); Yaphuka yaphiliswa (h, i) emva kokufakelwa kwethambo (f, g) kwi-ilium cortex.
Kwisifundo sombhali, kuqukwe amatyala ali-12 e-refractory bone nonion, onke aphumelele ekuphilisweni kwamathambo emva kotyando, kwaye izigulana ezi-2 zazineengxaki, ityala eli-1 le-calf intermuscular vein thrombosis kunye netyala eli-1 leentlungu zokususwa kwamathambo e-iliac.
Ukungasebenzi kakuhle kwe-clavicular nonion yingxaki enzima kakhulu kwizonyango, nto leyo ezisa umthwalo onzima wengqondo kwizigulane nakoogqirha. Le ndlela, idibene nokufakelwa kwamathambo kwi-cortical bone ye-ilium kunye nokufakelwa kwamathambo e-cancellous, ifumene iziphumo ezilungileyo zokuphiliswa kwamathambo, kwaye ukusebenza kwayo kuchanekile, okunokusetyenziswa njengesalathiso koogqirha.
Ixesha leposi: Matshi-23-2024
