Intshayelelo yendlela yokufumana "i-radial nerve" kwindlela engasemva ye-humerus

Unyango lotyando lokuqhekeka kwe-humerus ephakathi (njengaleyo ibangelwa "kukulwa kwesandla") okanye i-humeral osteomyelitis idla ngokufuna ukusetyenziswa kwendlela engasemva ngqo kwi-humerus. Umngcipheko ophambili onxulumene nale ndlela kukwenzakala kwe-radial nerve. Uphando lubonise ukuba amathuba okwenzakala kwe-radial nerve ngenxa ye-iatrogenic abangelwa yindlela engasemva eya kwi-humerus aqala kwi-0% ukuya kwi-10%, kwaye amathuba okwenzakala kwe-radial nerve ahlala ehleli aqala kwi-0% ukuya kwi-3%.

Nangona ingcamango yokhuseleko lwemithambo-luvo yeradial, uninzi lwezifundo luxhomekeke kwiimpawu zomzimba ezinamathambo ezifana nommandla we-supracondylar we-humerus okanye i-scapula ukuze kubekwe indawo ngexesha lotyando. Nangona kunjalo, ukufumana imithambo-luvo yeradial ngexesha lenkqubo kusaqhubeka kungumngeni kwaye kunxulunyaniswa nokungaqiniseki okukhulu.

Umfanekiso wendawo yokhuseleko lwe-radial nerve. Umgama oqhelekileyo ukusuka kwi-radial nerve plane ukuya kwi-lateral condyle ye-humerus umalunga ne-12cm, kunye nendawo yokhuseleko edlula kwi-10cm ngaphezulu kwe-lateral condyle.

Ngokuphathelele oku, abanye abaphandi badibanise iimeko zokwenyani ngexesha lotyando baza balinganisa umgama phakathi kwencam ye-triceps tendon fascia kunye ne-radial nerve. Bafumanise ukuba lo mgama awuguquguquki kwaye unexabiso eliphezulu lokuma ngaphakathi kotyando. Intloko ende ye-triceps brachii muscle tendon ibaleka ngokuthe nkqo, ngelixa intloko esecaleni yenza i-arc eqikelelweyo. Indawo yokuhlangana kwezi tendon yenza incam ye-triceps tendon fascia. Ngokufumana i-2.5cm ngaphezulu kwale ncam, i-radial nerve inokuchongwa.

 Indlela Yokubeka Indawo

Ngokusebenzisa incopho ye-triceps tendon fascia njengesalathiso, i-radial nerve ingafumaneka ngokuhamba malunga ne-2.5cm ukuya phezulu.

Ngophando olubandakanya umyinge wezigulane ezingama-60, xa kuthelekiswa nendlela yendabuko yokuhlola ethathe imizuzu eli-16, le ndlela yokubeka iliso yanciphisa ixesha lokusikwa kolusu ukuya kwi-radial nerve exposure ukuya kwimizuzu emi-6. Ngaphezu koko, ikwazile ukuphepha ukwenzakala kwi-radial nerve.

Ukulungiswa kwe-macroscopic kwi-Intraoperative yomfanekiso we-mid-distal 1/3 humeral fracture. Ngokubeka ii-sutures ezimbini ezinokufunxwa ezidibana malunga ne-2.5cm ngaphezulu kwendawo ye-triceps tendon fascia apex, ukuhlola kule ndawo yokudibana kuvumela ukuvezwa kwe-radial nerve kunye ne-vascular bundle.
Umgama okhankanyiweyo ngokwenene unxulumene nobude besigulane kunye nobude bengalo. Xa usebenza, ungalungiswa kancinci ngokusekelwe kumzimba wesigulane kunye nobungakanani bomzimba wakhe.