I-MeticactPal fathangeal fictures iqhekeza eliqhelekileyo kwi-Trauma, i-Accounting malunga ne-1/4 yezigulana ezikhathazekileyo zezandla. Ngenxa yolwakhiwo olucekeceke kunye nobunzima besandla, ukubaluleka kunye nobugcisa bonyango lokuqhekeka kwesandla kubaluleke kakhulu kunonyango lwethambo lethambo elide. Ukuqinisekisa ukuzinza kwengquko emva kokuncitshiswa kwesitshixo sonyango oluyimpumelelo lwe-Metalangeal phalangeal factures. Ukulungisa umsebenzi wesandla, ukwaphuka kudla ngokufuna ukulungiswa okufanelekileyo. Kwixa elidlulileyo, i-plaster ilungiso engaphandle okanye i-kirschner wire isetyenziswa rhoqo, kodwa ihlala ilungelwa kuqeqesho lokuhlaziywa kwesiqhelo okanye ixesha elide, elizisa ubunzima bokubuyiselwa komnwe womnwe wesandla. Iindlela zonyango zanamhlanje ziya ziba senza ulungiso lwangaphakathi olunamandla, olunjengokulungiswa kweplastikhi encinci.
I.Yeyiphi imigaqo yonyango?
Imigaqo yoNyango ye-Stacacarpual ye-Staphacarpan kunye ne-phalangel: Ukuncitshiswa kwe-Anatomical, ukulungiswa okukhoyo, imisebenzi yangaphambili kunye noqeqesho olusebenzayo. Imigaqo-nkqubo yoNyango ye-Intra-Articular ye-Articular yesandla iyafana nezona zinto zixhaphakileyo ze-intra, ezikwanokubuyisela i-anatomy yomgangatho odibeneyo kunye nemisebenzi yangaphambi kwexesha. Xa unyanga i-chalacarpul kunye ne-phalangel quatures, kufuneka zenziwe ukufezekisa ukuncitshiswa kwe-Aatomical, kunye nokujikeleza, ukuthambeka kukamva, okanye i-Anglar ye-Anglar ye-Angm ye-10 ° kwi-dorsal ye-dosal ayifanele yenzeke. Ukuba ukuphela kokuphela kwentsimbi ye-metacarpal phalange ijikeleza okanye ihambisa ngokungagungqiyo, iyakutshintsha indlela yokutshintsha kwesiqhelo kunye nokuhamba komnwe, kubangela ukuba itshise umnwe, echaphazela ukuchaneka komsebenzi; Kwaye xa i-Angular ye-Angular ye-Antsal ye-PARM>
II.Zeziphi izixhobo ezinokukhethwa ukuba ziqhekezwe?
Zininzi izixhobo zokulungisa zangaphakathi zecacacarpal, ezinjenge-kirschner ingcingo, isikali, iipleyiti kunye neengcingo zangaphandle, phakathi kweyona nto isetyenziswayo ye-kirschner kunye nee-micropt zezona zisetyenziswa kakhulu. Kwizityholo ze-metacarpal, ukulungiswa ngaphakathi kwe-Microplace kune-inzuzo ebonakalayo ngaphezulu kokulungiswa kwentambo ye-kirschner kwaye kunokusetyenziswa kuqala; Kwi-proximal phalanx farity, i-microplatis iphezulu kakhulu, kodwa xa kunzima ukufaka isikrelemnqa se-proximal phalanx subment, eyokuphumelela i-wirchner fiotion, elunge ngakumbi ekuvuseleleni umnwe womnwe; Iingcingo zeKirschner kufuneka zisetyenziswe kuqala kunyango lwe-hip eliphakathi lexhwili.
- I-wirchner wire:I-Kirschner uWire ukulungiswa kwangaphakathi sele kusetyenziswa ukwenziwa kweklinikhi kangangesithuba seminyaka engama-70 kwaye yayisoloko isetyenziswa eyona nto isetyenziswayo yangaphakathi yokulungiswa kwe-metacarpal kunye ne-chalangeal gwenxa. Kulula ukusebenza, uqoqosho kwaye lusebenza, kwaye yeyona ndlela yangaphakathi yokulungisa. Njengoko eyona isetyenziswayo isetyenziswa kakhulu kunyango lwangaphakathi lokunyanga ukwaphuka kwesandla, kusetyenziswa ngokubanzi. IINGXAKI ZOKUXHASA I-KIRCHERNER WIOP INDLELA YOKUZIPHATHA NGOKUGQIBELA: Ngaba kulula ukusebenza kwaye iguqulwe kakhulu ukuyisebenzisa; ② I-TIDE ye-tityul ethambileyo, ifuthe elincinci ekunikezelweni kwegazi lokuphela kokuphela, kwaye inciphise uloyiko oluphezulu, kwaye ilungele ukuphilisa ukuphiliswa; Kulula ukuyisusa inaliti okwesibini; ④ Uluhlu olusezantsi kunye noluhlu olubanzi lwesicelo, lifanelekile ukuba uninzi lwesandla (njengokuqhekeka kwe-intra
2.Metacarpophalangeal: Ukulungiswa okuqinileyo kwe-procares yesandla sisiseko soqeqesho lokuqala kunye nemeko efanelekileyo yokubuyisela umsebenzi ofanelekileyo. Itekhnoloji ye-AO yangaphakathi ifuna ukuba i-facraure iphela ngokuchanekileyo ngokwendlela ye-Aatomical kwaye i-quatomication iphela ibe zizinzile phantsi kweemeko ezisebenzayo, eziqhele ukwaziwa ngokulungiswa okuqinileyo, ukuze kuvumeleke ukuhamba okuphakathi. I-AO ikwagxininisa kwimisebenzi yoqhaqho encinane, kugxilwe ekukhuseleni ukubonelelwa kwegazi. Ukulungiswa kwe-Microplate Ukulungiswa ngaphakathi kunyango lwefrackis zesandla kunokufezekisa iziphumo ezanelisayo ngokwamandla, uzinzo lwezinto zokuqhekeka, kunye noxinzelelo phakathi kwe-phractore uphela. Ngokwendawo yokubuyisela kwimeko yesiqhelo, ixesha lokuphilisa ixesha lokuphilisa, kunye nenqanaba losuleleko, kukholelwa ukuba ukusebenza ngempumelelo kweepleyiti ze-microtitanium kubaluleke kakhulu kunelo yeengcingo zeKirschner. Ngapha koko, ukusukela kwixesha lokuphilisa ixesha emva kokuba i-microtitanium plates ifutshane kakhulu kunezo ezinye iindlela zokulungisa, kuyingenelo kwizigulana zokuphinda ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde zibuyele ebomini kwangoko.
(1) Zeziphi izibonelelo zolungiso lwangaphakathi?
① xa kuthelekiswa neengcingo zeKirschner, izixhobo ze-microplate izixhobo zine-tishu enye yokuhambelana ne-tissue ② Ukuzinza kwenkqubo yokulungiswa kweplate kunye noxinzelelo kwisiphelo sokuqhekeka kwenza ukuba iqhekeza lisondele kwi-Anatomical Ukuncitshiswa komhlaba, ukulungiswa okukhuselekileyo, kunye nokuphelisa ukuphiliswa; ③ Ukuzilolonga kwangoko kuvunyelwe ngokubanzi emva kokulungiswa kwe-hicroplate, elungele ukubuyiselwa komsebenzi wesandla.
(2) Yeyiphi indlela yotyando kwiikreyiti?
Utyando luhlala luyenziwa phantsi kwe-bloxial Plexual Plexia, kwaye i-Pneumatic Traumatic ifunelwa. I-dorsal ityhefu ye-contactal phalanges ithathiwe, i-aponelis yesifo se-dornelis inqunyulwe okanye ithambo lemisipha kunye nethambo le-phalangel lifakwe i-subsersure okanye i-phalangel yamathambo, kwaye i-pullaal incitshisiwe phantsi kombono ocacileyo. Iipleyiti ezithe tye zilungele ukwaphulwa kwecandelo eliphakathi kunye neflegi ye-oblique ye-oblique, ilungele ukulungiswa kwe-phalacarpal kunye ne-chillang, kunye ne-150 ° I-150 ° I-150 ° I-150 ° I-PARTART. Iplate ifakwe kwindawo esecaleni yethambo ukuthintela i-tendoon yokutsala kunye nexesha elide, elilungele uqeqesho lwangoko. Ubuncinci isikhafu sesibini kufuneka sisetyenziselwe ukulungisa izilwanyana ezibini zokuqhekeka, kungenjalo uzinzo kuhlwempuzekile, kwaye iingcingo zeKirschner okanye isikrelemnqa ngaphandle kokufezekisa injongo yokufezekisa injongo yokufezekisa injongo yokulungiswa kwezinto.
I-3.minisi screwsI-mini mini ineendlela ezifanayo kwiipleyiti zentsimbi kulungiso lwe-spiral okanye i-tishu eyomeleleyo, kodwa i-periostica incinci kwaye inomxholo wokuhambisa intsholongwane kwaye ihambelane nomsebenzi wokungabikho kwentsimbi. Nangona kukho uhlobo lwe-T Izikrelem ezincinci zikwanazo izibonelelo ezithile ekucwangcisweni kwe-intra-articular kunye ne-peri-foarikos. Izikrikhi zikrokrela kwithambo le-cortical linokumelana nomthwalo omkhulu, ke ukulungiswa kuqinile, kwaye ukuqhekeza ukuqhekeza kunokuqhutywa ukwenza indawo yokuqhekezwa, njengoko kubonisiwe kumzobo we-4-18. I-Mini Screw Ukulungiswa kwangaphakathi kwesandla sesandla sisetyenziselwa ikakhulu i-oblique okanye i-spinerals ye-diaphysese ye-diaphysese kunye ne-Avarury Avarul Avarsion yeebhloko ezinkulu zethambo. Kuya kufuneka kuqatshelwe ukuba xa usebenzisa i-screws ye-minidwa ukulungisa i-oblique okanye i-spinerals yethambo le-diaphyseal kwi-diamere ye-diaphyseal kwi-diamere, kwaye xa ububanzi bethambo kufuneka bube ngamaxesha ama-3 ububanzi bomsonto.
4.Microsoft ulungelelwano lwangaphandle:I-commerical fictarpal phalangeal phalalal factures ngamanye amaxesha kunzima ukunciphisa okanye akunakulungiswa ngaphakathi nangaphakathi na emva kokutshatyalaliswa kwethambo. Umnxeba wangaphandle unokubuyisela kwaye ugcine ubude bokuqhekeka okhethiweyo phantsi kwengqungquthela, ukudlala indima yokulungiswa kwesihlobo. Iilungiso zangaphandle ze-MetacalPal phalangeal chalangeal chalagal zibekwe kwizikhundla ezahlukeneyo: I-1 ye-1st kunye ne-2nd ye-metacarpal ifakwe kwicala le-dorsal, kwaye i-4th kunye ne-3 ye-mesdarpal phalang ifakwe ecaleni kwemeko. Nika ingqalelo kwi-Inaliti ye-Inaliti yokuthintela umonakalo we-tendoon. I-qualups ezivaliweyo zinokuncitshiswa phantsi kwe-X-rays. Xa ukuncitshiswa akulunganga, i-vem encinci inokwenziwa ukunceda ukuncitshiswa.
Zithini izibonelelo zolungiso lwangaphandle?
① Ukusebenza ngokulula, unokuhlengahlengisa iziphelo ezahlukeneyo zokuphela kwengqokelela; ② inokunciphisa ngokufanelekileyo kwaye ilungisa ubugcisa be-intra-antra ye-Intracarpophalaulpophalal ngaphandle kokwenzakalisa umphezulu ohlanganisiweyo, kwaye inokuphazamisa umphezulu odibeneyo, kwaye inokuphazamisa umphezulu odibeneyo ukuthintela i-supsule kunye ne-ligament ye-lixiel; ③ Xa i-quinsures ayinakubakho i-anatomic incitshisiwe, zinokudityaniswa kunye nokulungiswa kwangaphakathi, kwaye i-fall yangaphandle inciphisa ngokuyinxenye kwaye igcinwe umgca; ④ Vumela imisebenzi yangaphambili yomnwe ochaphazelekayo kwiNtlawulo engafakwanga ukunqanda ukuqina okukhuni kunye ne-osteoporosis; ⑤ inokulungisa ngokufanelekileyo iqhekeza lezandla ngaphandle kokuchaphazela unyango lwe-Postoperation yenxeba kwisandla esichaphazelekayo.
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