Indlela yokuzinzisa i-midshaft clavicle fracture edityaniswe ne-ipsilateral acromioclavicular dislocation?

Ukuqhekeka kwe-clavicle edibeneyo kunye ne-ipsilateral acromioclavicular dislocation yinto enqabileyo enqabileyo yokulimala kwikliniki.Emva kokulimala, i-distal fragment ye-clavicle ihamba ngokukhawuleza, kwaye i-acromioclavicular dislocation ehambelana nayo isenokungabonakali ukufuduka okucacileyo, okwenza kube lula ukuxilonga.

Ngolu hlobo lokulimala, ngokuqhelekileyo kukho iindlela ezininzi zokuhlinzwa, ezibandakanya i-hook plate ende, idibaniso yeplate ye-clavicle kunye ne-hook plate, kunye ne-clavicle plate edibeneyo kunye ne-screw fixation kwinkqubo ye-coracoid.Nangona kunjalo, iipleyiti ze-hook zivame ukuba zifutshane ngobude obude, obunokukhokelela ekulungisweni okungonelanga ekupheleni kweproximal.Ukudibaniswa kweplate ye-clavicle kunye ne-hook plate kunokubangela uxinzelelo loxinzelelo kwi-junction, ukwandisa umngcipheko wokuqhawula.

Ukuqhekeka kwe-clavicle ekhohlo edibeneyo kunye ne-ipsilateral acromioclavicular dislocation, izinzile ngokusebenzisa ukudibanisa i-hook plate kunye ne-clavicle plate.

Ukuphendula oku, abanye abaphengululi baye bacebisa indlela yokusebenzisa indibaniselwano yepleyiti ye-clavicle kunye nezikrufu ze-anchor zokulungiswa.Umzekelo uboniswe kulo mfanekiso ulandelayo, ubonisa isigulane esine-midshaft clavicle fracture edityaniswe ne-ipsilateral type IV acromioclavicular joint dislocation:

Okokuqala, i-clavicular anatomical plate isetyenziselwa ukulungisa i-clavicle fracture.Emva kokunciphisa i-acromioclavicular joint dislocated, i-screws ezimbini ze-anchor zetsimbi zifakwe kwinkqubo ye-coracoid.I-sutures encanyathiselwe kwizikrufu ze-anchor emva koko ifakwe kwimingxuma ye-screw ye-clavicle plate, kwaye amaqhina abotshwe ukuwakhusela ngaphambili nangasemva kwe-clavicle.Ekugqibeleni, i-acromioclavicular kunye ne-coracoclavicular ligaments i-sutured ngqo usebenzisa i-sutures.

I-Isolated clavicle fractures okanye i-acromioclavicular dislocations yodwa ixhaphake kakhulu ukulimala kwikliniki.I-Clavicle fractures i-akhawunti ye-2.6% -4% yazo zonke iifractures, ngelixa i-acromioclavicular dislocations yenza i-12% -35% yokulimala kwe-scapular.Nangona kunjalo, indibaniselwano yokwenzakala kokubini inqabile.Uninzi loncwadi olukhoyo lubandakanya iingxelo zamatyala.Ukusetyenziswa kwenkqubo ye-TightRope ngokubambisana ne-clavicle plate fixation ingaba yindlela entsha, kodwa ukubekwa kweplate ye-clavicle kunokuphazamisa ukubekwa kwe-graft ye-TightRope, ibeka umngeni omele uqwalaselwe.

Ngaphezu koko, kwiimeko apho ukulimala okudibeneyo kungenakuvavanywa kwangaphambili, kucetyiswa ukuba kuhlolwe rhoqo ukuzinza kwe-acromioclavicular joint ngexesha lovavanyo lwe-clavicle fractures.Le ndlela inceda ukunqanda ukuhoywa kokwenzakala ngexesha elinye.