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.I-plate ifakwe kwi-incision proximal, i-snug ngokubhekiselele kwithambo, idlula ngaphantsi kwe-brachialis muscle.Ipleyiti ikhuselwe okokuqala kwisiphelo esisondeleyo se-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.
▲ Umzobo oqingqiweyo wetonela yepleyiti ephezulu.
①: Umsipha weBrachialis;②: Imisipha ye-Biceps brachii;③: Iinqanawa eziphakathi kunye nemithambo-luvo;④: Pectoralis enkulu.
▲ Umzobo wesicwangciso setonela ye-distal plate.
①: Umsipha weBrachialis;②: I-nerve median;③: Umthambo we-Ulnar.
Ixesha lokuposa: Nov-10-2023
