Intshayelelo yendlela yokufumana "i-radial nerve" kwindlela yangasemva kwi-humerus

Ukunyangwa konyango kwi-middle-distal humerus fractures (ezifana nezo zibangelwa "i-wrist-wrestling") okanye i-osteomyelitis ye-humeral ngokuqhelekileyo idinga ukusetyenziswa kwendlela echanekileyo yangasemva kwi-humerus.Umngcipheko ophambili ohambelana nale ndlela yokulimala kwe-radial nerve.Uphando luye lwabonisa ukuba amathuba okulimala kwe-iatrogenic radial nerve ngenxa yendlela yangasemva kwi-humerus ukusuka kwi-0% ukuya kwi-10%, kunye nokulimala okungapheliyo kwe-nerve ye-nerve evela kwi-0% ukuya kwi-3%.

Ngaphandle kombono wokhuseleko lwe-nerve ye-radial, uninzi lwezifundo luxhomekeke kwiimpawu zomhlaba ze-anatomical ezifana nengingqi ye-supracondylar ye-humerus okanye i-scapula yokubeka i-intraoperative.Nangona kunjalo, ukufumana i-nerve ye-radial ngexesha lenkqubo kuhlala kungumngeni kwaye kuhambelana nokungaqiniseki okubalulekileyo.

Umzobo wendawo yokhuseleko lwe-nerve ye-radial.Umgama ophakathi ukusuka kwi-radial nerve plane ukuya kwi-condyle esecaleni ye-humerus imalunga ne-12cm, kunye nommandla wokhuseleko ohamba nge-10cm ngaphezu kwe-condyle esecaleni.

Kule nkalo, abanye abaphandi baye badibanisa iimeko zangempela ze-intraoperative kwaye balinganisa umgama phakathi kwencam ye-triceps tendon fascia kunye ne-nerve ye-radial.Baye bafumanisa ukuba lo mgama awutshintshi kwaye unexabiso eliphezulu lokumiswa kwe-intraoperative.Intloko ende ye-triceps brachii muscle tendon ihamba ngokuthe nkqo, ngelixa intloko esecaleni yenza i-arc esondeleyo.I-intersection yale tendon yenza incam ye-triceps tendon fascia.Ngokufumana i-2.5cm ngaphezu kweli nqaku, i-nerve ye-radial inokuchongwa.

 Indlela yokuma

Ngokusebenzisa i-apex ye-triceps tendon fascia njengesalathisi, i-nerve ye-radial inokufumaneka ngokuhamba malunga ne-2.5cm ukuya phezulu.

Ngophononongo olubandakanya umyinge wezigulane ze-60, xa kuthelekiswa nendlela yokuhlola yendabuko ethathe imizuzu ye-16, le ndlela yokumisa yanciphisa ukusika kwesikhumba ukuya kwixesha lokuvezwa kwe-nerve ye-radial kwimizuzu ye-6.Ngapha koko, ithintele ngempumelelo ukulimala kwemithambo ye-radial.

Ukulungiswa kwe-intraoperative umfanekiso wemacroscopic we-mid-distal 1/3 yokwaphuka kwe-humeral.Ngokubeka i-sutures e-absorbeble edibanisa malunga ne-2.5cm ngaphezu kwendiza ye-triceps tendon fascia apex, ukuhlola ngeli nqanaba le-intersection kuvumela ukuvezwa kwe-nerve ye-radial kunye ne-vascular bundle.
Umgama okhankanywe ngokwenene unxulumene nobude besigulane kunye nobude bengalo.Kwisicelo esisebenzayo, inokulungelelaniswa kancinane ngokusekelwe kumzimba wesigulane kunye nobukhulu bomzimba.