I-Clavicle fractures yenye yezona zinto zixhaphakileyo eziphezulu ze-fractures kwikliniki, kunye ne-82% ye-clavicle fractures yi-midshaft fractures.Uninzi lweefractures ze-clavicle ngaphandle kokufuduswa okubalulekileyo zinokunyangwa ngokufanelekileyo kunye neebhanti ezisibhozo, ngelixa ezo zihamba ngokuphawulekayo, izicubu ezithambileyo ezidibeneyo, umngcipheko we-vascular or neurological compromise, okanye iimfuno eziphezulu zokusebenza zingadinga ukulungiswa kwangaphakathi kunye namacwecwe.Izinga le-nonnunion emva kokulungiswa kwangaphakathi kwe-clavicle fractures iphantsi, malunga ne-2.6%.Iimpawu ezingaqhelekanga zifuna utyando oluhlaziyiweyo, eyona ndlela iqhelekileyo kukuxhunyaniswa kwamathambo okurhoxiswayo kudityaniswe nokulungiswa kwangaphakathi.Nangona kunjalo, ukulawula ii-atrophic nonunion eziphindaphindiweyo kwizigulana esele zenziwe uhlaziyo lwe-nonunion ngumngeni omkhulu kwaye kuhlala kuyingxaki kubo bobabini oogqirha kunye nezigulana.
Ukujongana nalo mba, unjingalwazi kwiSibhedlele iXi'an Red Cross uye wasebenzisa ngokutsha i-autologous iliac bone structural grafting edityaniswe ne-autologous cancellous bone grafting ukunyanga i-nonununions yokwaphuka kwe-clavicle emva kotyando lohlaziyo olungaphumelelanga, olufumana iziphumo ezincomekayo.Iziphumo zophando zapapashwa kwiphephancwadi elithi "International Orthopedics".
Inkqubo yotyando
Iinkqubo zotyando ezithile zinokushwankathelwa njengalo mfanekiso ungezantsi:
a: Susa ukulungiswa kwe-clavicular yasekuqaleni, susa ithambo le-sclerotic kunye ne-fiber scar ekupheleni kweqhekeza;
b: Iiplati zeplastiki zokuvuselela i-clavicle zisetyenzisiwe, i-screws yokukhiya ifakwe kwiiphelo zangaphakathi nangaphandle ukuze kugcinwe ukuzinza okupheleleyo kwe-clavicle, kunye nezikrini azizange zilungiswe kwindawo yokuphathwa ekupheleni kwe-clavicle.
c: Emva kokulungiswa kwepleyiti, galela imingxuma ngenaliti yeKirschler ecaleni kwesiphelo esaphukileyo sokwaphuka ukuya ngaphakathi nangaphandle de umngxuma ukhuphe igazi (uphawu lwepepile ebomvu), ebonisa ukuthuthwa kwegazi lamathambo apha;
d: Ngeli xesha, qhubeka uqhube i-5mm ngaphakathi nangaphandle, kwaye uqhube imingxuma emide ngasemva, ehambelana ne-osteotomy elandelayo;
e: Emva kwe-osteotomy ecaleni komngxuma wokuqala wokugrumba, hambisa ikhoreksi yamathambo ezantsi ukushiya umkhombe wamathambo;
f: I-bicortical iliac bone yafakelwa kwi-groove yethambo, kwaye emva koko i-cortex ephezulu, i-iliac crest kunye ne-cortex ephantsi yalungiswa ngezikrufu;I-iliac cancellous bone yafakwa kwindawo yokuphuka
Isiqhelo
iimeko:
▲ Isigulane sasiyindoda eneminyaka eyi-42 ubudala kunye ne-middle-section fracture ye-clavicle ekhohlo ebangelwa yi-trauma (a);Emva kotyando (b);Ukuqhekeka okungaguqukiyo kunye nethambo elingeyomanyano phakathi kweenyanga ezi-8 emva kotyando (c);Emva kohlaziyo lokuqala (d);Ukuqhekeka kweplate yensimbi kwiinyanga ezi-7 emva kokulungiswa kunye nokunganyangi (e);Ukuqhekeka kuphila (h, i) emva kokuxutywa kwethambo lesakhiwo (f, g) ye-ilium cortex.
Kwisifundo sombhali, i-12 epheleleyo yeemeko ze-refractory bone nonunion zifakiwe, zonke eziye zafumana ukuphulukiswa kwamathambo emva kokuhlinzwa, kunye nezigulane ze-2 zineengxaki, i-1 imeko ye-calol intermuscular vein thrombosis kunye ne-1 icala lentlungu yokususwa kwethambo.
I-refractory clavicular nonunion yingxaki enzima kakhulu ekusebenzeni kweklinikhi, ezisa umthwalo onzima wengqondo kwizigulane zombini kunye noogqirha.Le ndlela, idibaniswe ne-structural bone bone grafting ye-cortical bone ye-ilium kunye ne-cancellous bone i-grafting, iphumelele isiphumo esihle sokuphulukiswa kwamathambo, kunye nokusebenza okuchanekileyo, okunokusetyenziswa njengesalathiso kwiiklinikhi.
Ixesha lokuposa: Mar-23-2024
