Ukuqhekeka okugqithisileyo nge-Councinal okanye akukho ntshukumo ye-racking yethambo le-metacarpan (intamo okanye i-diaphysis), setha kwakhona yiTrafiki yeNqaku. Iproximal phalanx iguqulwe kakhulu ukubhenca intloko ye-metacarpal. I-0.5- 1 cm iguqukayo yenziwa kwaye i-tendon yase-Usson ithathelwe ingqalelo ixesha elide kwi-minerline. Phantsi kwesikhokelo seFluoroscopic, sifake i-1.0 mm iwile kwi-wire kwi-axis yexesha elide lesandla. Incam yeSikhokelo yeSikhokelo yayikukuphepha ukungena kwi-cortical kunye nokwenza lula ukutyibilika ngaphakathi kwe-canal. Emva kokuba isikhundla sesikhokelo simiselwe i-fluooroscopic, iplate yethambo le-subchotral yahlaziywa ngokusebenzisa kuphela i-gobll bill. Ubude obufanelekileyo babalwa kwimifanekiso efanelekileyo. Uninzi lwezinto ezenziwe ngendlela ye-metacarpal, ngaphandle kwentsimbi yesihlanu, sisebenzisa i-3.0-mm ye-screwter screw. Sisebenzise i-Autofix Folls engenamsebenzi Oku kunqabile kunokuba ubude bethambo lemephu (malunga ne-6.0 cm), kodwa kudala ngokwaneleyo ukubandakanya imisonto kwi-medulla ukuze ufumane ulungiso olukhuselekileyo lwesikhafu. Ububanzi be-cavity ye-Medillary ye-Medicarpal yesihlanu buhlala bukhulu, kwaye apha sisebenzise isikhafu se-4.0 mm sine-scater ephezulu ukuya kwi-50 mm. Ekupheleni kwenkqubo, siqinisekisa ukuba intambo ye-caudal ingcwatywe ngokupheleleyo ngezantsi komgca we-cartilage. Kwelinye icala, kubalulekile ukuphepha ukubeka i-Prospheris ngokunzulu, ngakumbi kwimeko yamaqhekeza entanyeni.
Umzobo we-14 kwi-a, intamo yesiqhelo yokuqhekeka ayinakuthathelwa kwaye intloko ifuna ubunzulu obuncinci njengoko i-B Cortex iya kunyanzelwa
Indlela yokuhlinzwa yokuqhekeka okuthe tyaba kwiproximal phalanx efanayo (umzobo 15). Senze isithuba esiguqukayo se-0,5 cm entloko kwintloko ye-proximal phalanx ngelixa ikhulu iguqulela i-proximal conterphangel edibeneyo. Iithenda zahlulwa kwaye zarhoxiswa ixesha elide ukuze iveze intloko ye-proximal chalanx. Ngobuninzi bokuqhekeka kweProximal Hilanx, sisebenzisa isikrini esi-2,5 se-2,5 mm, kodwa sezokuchitha samabala amakhulu esisebenzisa isikrini se-3.0 mm. Ubude obuninzi bee-2.5 mm chs ezisetyenzisiweyo zii-30 mm. Sikhathalela ukuba singaziqiqisi izikrelemnqa. Kuba izikrelemnqa kukuziqhelanisa nokuziqhelanisa, zinokungena kwisiseko se-chalanx esinenkcaso esincinci. Indlela efanayo isetyenziselwa ukwaphulwa kwe-phalangeal phalangeal falanges, kunye nendawo eqala entlokweni yeMidphalangel phalanx ukuvumela ukubekwa kwe-screengrade.
I-Fig. Imbonakalo yentsusa ye-Trest phalanx Imeko ye-palanx.aa 1-MM i-1-MM ye-1 Ngenxa yobume obuthile beepalanges, uxinzelelo lunokubangela ukwahlukaniswa kwe-metacarpan Cortex. (Isigulana esifanayo njengakwimifanekiso 8)
I-quactions Ke ngoko, ngaphandle kwento yokuba ukusetyenziswa kwe-CHS kukuthintelwa kwiimeko ezinjalo, sifumene isisombululo kwiimeko ezimbini eziqhelekileyo esijongene nazo.
Umzobo 16 AC Ukuba ukuqhekeka akuxhaswa ngokuthe tye, ukuqinisa isikhafu kuya kukhokelela ekuphumeni kwengqokelela ngaphandle kokuncitshiswa ngokupheleleyo kwe-5 ye-5 mm). Umgca obomvu uhambelana nomgca we-metacarpal.
Ukusetyenziswa kwe-submeticalpal, sisebenzisa ubuchwephesha obuguqulweyo ngokusekwe kwimbono yoyilo yokubiyela (okt, izinto zesakhiwo ezisetyenziselwa ukuxhasa ukunyanzelwa okanye ukuxhasa). Ngokwenza i-Y Siyibize le ngxobo ye-y-fit. Njengakwindlela yangaphambili, i-1.0 mm ye-10 mm ye-wire ye-wire ngencam ye-blunt ifakiwe. Ngelixa ugcina ubude obuchanekileyo be-metacarpal, esinye i-wire iwile ifakwe, kodwa kwi-engile kwi-wire yesikhokelo sokuqala, ngaloo ndlela besenza isakhiwo soxantathu. Zombini izikhokelo zandiswa kusetyenziswa umqulu wokukhokelwa ukwandisa iMedulla. Kwisitimela se-axial kunye ne-oblique, sihlala sisebenzisa i-3.0 mm kunye ne-2,5 mm seamereter, ngokulandelelana. I-Axial Screw ifakwe kuqala de intambo ye-caudal yinqanaba nge-cartilage. Isikhafu se-offirset ubude sifakiwe. Kuba akukho gumbi laneleyo kwi-carling kwisikhafu sesibini, ubude bezikrelemnqa ze-oblique kufuneka ziqhotyoshelwe ngenyameko kwintloko ye-axial ukuqinisekisa uzinzo olwaneleyo ngaphandle kwe-screw protrusion. I-screw yokuqala iqhubekile ngaphambili de ingcwatywe ngokupheleleyo. Oku kuphepha ukunqunyulwa kwe-axial ye-metacarpal kunye nokuwa kwentloko, enokuthi kuthintelwe zizikrelemnqa ze-oblique. Senza iimviwo ezixhaphakileyo zeFluoroscopic ukuqinisekisa ukuba ukuwa kwe-wills kungenzeki kwaye izikrelem zifakiwe ngaphakathi kwe-cansal ye-cam. 17).
Umzobo 17 I-Ac Y-Bracket itekhnoloji
Xa uSomaphicotho-mali uchaze i-dorsal cortex kwisiseko seProximal Hilanx, saqulunqa indlela eguqulweyo; Siyibiza ngokuba yi-Axial Bicrang kuba i-screw isebenza njenge-chalanx. Emva kokuseta kwakhona i-proximal phalanx, uWire we-Axial Fire waziswa kwi-carmlal canal njenge-dorsilly njengoko kunokwenzeka. I-chs imfutshane kakhulu ubude be-chalanx (i-2.5 okanye i-3.0 mm) ifakwe kude kube sekupheleni kwangaphandle ihlangana neplate ye-chalanx. Okwangoku, imisonto ye-caudal yesikali itshixiwe kwi-canal yedumbarensi, ngaloo ndlela isebenza njengenkxaso yangaphakathi kunye nokubonisa isiseko se-chalanx. Iimviwo ezininzi zeFluoroscopic ziyafuneka ukuthintela ukungena ngokudibeneyo (umzobo 18). Kuxhomekeka kwipateni yokuqhekeka, ezinye izikrikhi okanye indibaniselwano yezixhobo zangaphakathi zinokufuneka (umzobo 19).
Umzobo we-19: Iindlela ezahlukeneyo zokulungiswa kwizigulana zokutsala umdla. I-subthatictacarpurpal ye-subthacarpal ye-subthacarpal yomnwe womnwe kwi-racket yesiseko somnwe ophakathi (i-tyrey etyhefu isetyenziselwe umnwe ophakathi, i-SMM yenqanaba lesiphelo), kunye ne-4.0 mm ye Iminwe ye-pinky.f i-free flaps isetyenziselwe ukugubungela okuthambileyo. Ithambo le-metacarpal yomnwe omncinci liphilisiwe. Abanye be-bone benziwe kwenye indawo, bebonisa ukuphiliswa kwenqanaba lesibini.d unyaka omnye emva kwengozi, ifleki isusiwe; Nangona i-Ayymptomatic, isikhafu sasuswa kwi-metacarpal yomnwe womsesane ngenxa yokungena kwi-intra-orticular erhanelwa. Iziphumo ezilungileyo (≥240 ° TAM) zifunyenwe kumnwe ngamnye kutyelelo lokugqibela.Changes kwi-metacarpophalalpophalal ye-metacarphalal
I-Fig (Iintolo ziphawula amanqaku okungena kwezikrelem zesiseko)
Umzobo 21 PoterTestatic kunye no-Puttatal Radiography of Shest of Shest of Guqula ububi (kwiintolo) baphathwa ngee-2,5-mm ze-screen. Akukho lutshintsho lubalulekileyo kwi-tryphalangeal corphalangel laviwa emva kweminyaka emi-2
I-Post Time: Sep-18 ukuya kwi-2024
