Iindaba- "Ukulungiswa kwangaphakathi kokuqhekeka kwe-humeral shaft kusetyenziswa ubuchule be-medial internal plate osteosynthesis (MIPPO)."

Imilinganiselo eyamkelekileyo yokuphulukiswa kwe-humeral shaft fractures yi-anterior-posterior angulation engaphantsi kwe-20 °, i-angulation esecaleni engaphantsi kwe-30 °, ukujikeleza ngaphantsi kwe-15 °, kunye nokunciphisa ngaphantsi kwe-3cm. Kwiminyaka yakutshanje, ngokunyuka kweemfuno zomsebenzi welungu eliphezulu kunye nokuchacha kwangoko kubomi bemihla ngemihla, unyango lotyando lwe-humeral shaft fractures luye lwaxhaphaka. Iindlela eziphambili ziquka i-anterior, anterolateral, okanye i-posterior plating yokulungiswa kwangaphakathi, kunye ne-intramedullary nailing. Uphononongo lubonisa ukuba izinga le-nonnunion lokunciphisa okuvulekileyo ukulungiswa kwangaphakathi kwe-humeral fractures malunga ne-4-13%, kunye nokulimala kwe-iatrogenic radial nerve okwenzeka malunga ne-7% yamatyala.

Ukuze ugweme ukulimala kwe-iatrogenic radial nerve kunye nokunciphisa izinga le-nonnunion lokunciphisa okuvulekileyo, abaphengululi basekhaya base-China baye bamkela indlela ye-medial, besebenzisa ubuchule be-MIPPO ukulungisa i-humeral shaft fractures, kwaye baye bafumana iziphumo ezilungileyo.

Iinkqubo zotyando

Inyathelo lokuqala: Ukuma. Isigulana silala kwindawo ephantsi, kunye nelungu elichaphazelekayo lihluthwe i-90 degrees kwaye libekwe kwitafile yokusebenza esecaleni.

Inyathelo lesibini: Ukusikwa kotyando. Kwi-medial medial single-plate fixation (Kanghui) yezigulane, izithintelo ezimbini ze-longitudinal malunga ne-3cm nganye zenziwe kufuphi ne-proximal kunye ne-distal ends. I-proximal incision isebenza njengomnyango we-deltoid inxalenye kunye ne-pectoralis enkulu, ngelixa i-distal incision ifumaneka ngaphezu kwe-epicondyle ephakathi ye-humerus, phakathi kwe-biceps brachii kunye ne-triceps brachii.

▲ Umzobo weskimu we-proximal incision.

①: Ukusikwa kotyando; ②: Umthambo weCephalic; ③: iPectoralis enkulu; ④: Izihlunu ze-deltoid.

▲ Umzobo wesicwangciso se-distal incision.

①: Imithambo-luvo yeMedi; ②: I-Ulnar nerve; ③: Isihlunu seBrachialis; ④: Ukusikwa kotyando.

Inyathelo lesithathu: Ukufakwa kwepleyiti kunye nokulungiswa. Ipleyiti ifakwe kwi-incision proximal, igxininise ngokubhekiselele kwithambo, idlula ngaphantsi kwe-brachialis muscle. Ipleyiti ikhuselwe kuqala ukuya ekupheleni kwe-humeral shaft fracture. Emva koko, kunye nokujikeleza okujikelezayo kwinqanaba eliphezulu, i-fracture ivaliwe kwaye ihambelana. Emva kokunciphisa okwanelisayo phantsi kwe-fluoroscopy, i-screw esemgangathweni ifakwe kwi-distal incision ukukhusela ipleyiti kumphezulu wethambo. Isikrufu sokutshixa siyaqiniswa, sigqibezela ukulungiswa kwepleyiti.