Ukwaphuka kwe-clavicle kunye ne-ipsilateral acromioclavicular dislocation yimeko engaqhelekanga kakhulu kwizonyango. Emva kokwenzakala, iqhekeza elikude le-clavicle lihambahamba, kwaye i-acromioclavicular dislocation enxulumene nayo isenokungabonakalisi ukushukuma okucacileyo, nto leyo eyenza ukuba ifumane unyango olungafanelekanga.
Kolu hlobo lokulimala, kukho iindlela ezahlukeneyo zotyando, kuquka ipleyiti ende yehoki, indibaniselwano yepleyiti ye-clavicle kunye nepleyiti yehoki, kunye nepleyiti ye-clavicle edityaniswe nokufakwa kwesikrufu kwinkqubo ye-coracoid. Nangona kunjalo, iipleyiti zehoki zihlala zimfutshane ngobude bazo zonke, nto leyo enokubangela ukungafakwa ngokwaneleyo kwisiphelo esikufutshane. Indibaniselwano yepleyiti ye-clavicle kunye nepleyiti yehoki inokubangela uxinzelelo kwindawo yokudibana, nto leyo enyusa umngcipheko wokuqhekeka.
Ukwaphuka kwe-clavicle yasekhohlo kudityaniswe nokuqhekeka kwe-ipsilateral acromioclavicular, kuzinziswe kusetyenziswa indibaniselwano ye-hook plate kunye ne-clavicle plate.
Ukuphendula oku, abanye abaphengululi baye bacebisa indlela yokusebenzisa indibaniselwano yepleyiti ye-clavicle kunye nezikrufu ze-anchor ukuze kufakwe. Umzekelo uboniswe kumfanekiso olandelayo, obonisa isigulana esine-midshaft clavicle fracture edibene ne-ipsilateral type IV acromioclavicular joint dislocation:
Okokuqala, ipleyiti ye-clavicular anatomical isetyenziselwa ukulungisa ukwaphuka kwe-clavicle. Emva kokunciphisa i-acromioclavicular joint ekhutshiweyo, kufakwa izikrufu ezimbini zentsimbi ze-anchor kwinkqubo ye-coracoid. Izikrufu eziqhotyoshelwe kwizikrufu ze-anchor emva koko zifakwa ngemingxunya yezikrufu zepleyiti ye-clavicle, kwaye amaqhina abotshelelwe ukuze aziqinise ngaphambili nangasemva kwe-clavicle. Okokugqibela, izikrufu ze-acromioclavicular kunye ne-coracoclavicular zithungwa ngokuthe ngqo kusetyenziswa izikrufu.
Ukuqhekeka kwe-clavicle ehlukanisiweyo okanye ukuqhekeka kwe-acromioclavicular ehlukanisiweyo zizinto ezixhaphakileyo kakhulu kwizonyango. Ukuqhekeka kwe-Clavicle kubangela i-2.6%-4% yazo zonke iiqhekeko, ngelixa ukuqhekeka kwe-acromioclavicular kwenza i-12%-35% yeengozi ze-scapular. Nangona kunjalo, indibaniselwano yezi zingozi zombini ayiqhelekanga. Uninzi lweencwadi ezikhoyo luquka iingxelo zetyala. Ukusetyenziswa kwenkqubo yeTightRope kunye nokulungiswa kweplate ye-clavicle kunokuba yindlela entsha, kodwa ukubekwa kweplate ye-clavicle kunokuphazamisana nokubekwa kwe-graft yeTightRope, nto leyo ebangela umngeni ekufuneka ujongwane nawo.
Ngaphezu koko, kwiimeko apho ukwenzakala okudibeneyo kungenakukwazi ukuvavanywa ngaphambi kotyando, kuyacetyiswa ukuba kuvavanywe rhoqo ukuzinza kwejoyinti ye-acromioclavicular ngexesha lokuvavanya ukwaphuka kwe-clavicle. Le ndlela inceda ekuthinteleni ukungayihoyi imiphumo yokwenzakala ngexesha elinye.
Ixesha lokuthumela: Agasti-17-2023
