Emva kokuqhekeka, ithambo kunye nezicubu ezijikelezileyo zonakele, kwaye kukho imigaqo-nkqubo eyahlukileyo yonyango kunye neendlela ngokwenqanaba lokulimala. Ngaphambi kokuba anyange zonke izinto zokuqhekezwa, kubalulekile ukufumanisa ubungakanani bobubi.
Ukulimala okuthambileyo
I.Ukuziqhelanisa
I-quations ezivaliweyo
Ukulimala okuthambileyo kwe-tishule kubulamqwanqwanqwanqwanqwanqwanqileyo, ihlala isebenzisa indlela yeTsisne (Fig. 1)
Ukulimala kweBanga le-20: ukulimala okuncinci okuthambileyo
Ukulimala kweBanga le-31: I-Superficialial Abrasion okanye i-thession ye-tission ethambileyo egubungela indawo yokuqhekeka
Ukulimala kweBanga le-2: I-suscussion enkulu ye-suscus okanye i-studenion yolusu okanye zombini
Ukulimala kweBakala
Umzobo1: Ukuhlelwa kweTscherne
Vula iqhekeza
Kuba iqhekeza linxibelelana nehlabathi elingaphandle, inqanaba lomonakalo wezicubu othambileyo unxulumene nenani lamandla afunyanwa ngumbane ngexesha loxinzelelo, kunye ne-Gustilo Requyation ihlala isetyenziswa (umzobo 2)
Umzobo
Chwetheza i-IT
Chwetheza iii: Uluhlu lwenxeba lubandakanya ulusu, umsipha, i-periosteum, kunye nethambo, kubandakanya iindidi ezibanzi ngakumbi, kubandakanya iindidi ezikhethekileyo zamanxeba kunye nokwenzakala kweentsini
Chwetheza ii-IIIa
Chwetheza IIB: Ngomonakalo ombi wezicubu oqinileyo, i-metastases ye-mssian okanye yasimahla ye-miscle ifunekayo ngexesha lonyango ukuya kufezekisa ukugubungela
Chwetheza i-IIIIIII
II.I-jjjury
Ukuphilisa inxeba kufuna ioksijini, ukuvuselelwa kweendlela zeselula, ukucocwa kwamanxeba kwasimahla kunye nezicubu ezingcolisekileyo nezicocekileyo. Kukho amanqanaba amane aphambili okuphilisa: Ukucofa (imizuzu); iSigaba se-FUNAMMARIOTOTO (iiyure); Inqanaba lezicubu ze-granse (iintsuku zibaliwe); Ixesha lokutyikitywa kwe-tissue (iiveki).
Ukubeka unyango
Isigaba se-Actoute:Ukunkcenkceshela okunkcenkceshela, ukubopha kwempahla, ukwakhiwa kwakhona kwethambo, kunye nokubuyiswa koluhlu lwentshukumo
(1) Vavanya ubungakanani bomonakalo wezicubu othambileyo kunye nokulimala kwe-neurovascular
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(5) Isiphelo sokuqhekeka simahla sikhutshiwe enxebeni; I-CORTEXa esincinci esincinci isuswe ukuze ihlolisise kwaye icoce i-bone marw cavity
Ukwakhiwa kwakhona:Ukujongana neSequelae ye-Trauma (Imanyano ye-UNIT, i-Nouncinan, Isiphene, usulelo)
I-Convalerce:Ingqondo yengqondo, ezentlalo, neyemsebenzi yesigulana
Uhlobo lwenxeba lokuvalwa kunye nokugubungela
Ukuvalwa kwenxeba kwangoko okanye ukugubungela (3 ~ 5) kunokufezekisa iziphumo ezanelisayo zonyango: (1) Ukuvalwa okuphambili
(2) ukulibaziseka ukuvala
(3) Ukuvalwa kwesibini
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(5) iflethi yokuqhutywa ngokuzithandela (iflegi yedijithali)
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(7) I-Flap yasimahla (Fig. 3)
Umzobo3: Iimbono zenxalenye yokutshintsha zasimahla zihlala zinikezelwa
Umonakalo wethambo
I.Fracture Forting
Thulalisa: Iphethini yomthwalo wefreyitha ebiyelweyo ebangelwa kukuxinana
I-abliquetively: Imowudi yeXhayithi yoxinzelelo ngenxa yokuqhekeka kwe-diagonal
I-Spiral: Iphethini yomthwalo wokuqhekeka kwethayile ngenxa yokuqhekeka kweSpiral
II.FIRT
Ukwahlulahlulwa ngokwenziwayo, iintlobo zesandla, njl. Njl. (Fig. 4)
I-quads ekhutshiweyo iqhekeza i-3 okanye ngaphezulu iziqwenga zethambo eziphilayo, zihlala zikhokelela ekulimaleni kwamandla aphezulu.
I-Pratlical Fracture Fracture Fracture ye-Fracture yenzeka kwindawo yethambo lesi sifo sangaphambili, kubandakanya: i-tumoor yethambo, i-bone metastases, i-osteoporolic, njl
Amaqhekeza angaphelelanga awaphuli kwiziqwenga ezahlukeneyo zethambo
I-quenesi quatures ezine-distal, embindini, kunye neziqwengana ze-proximal. Icandelo eliphakathi lichaphazelekile kukubonelela ngegazi, ngesiqhelo ngenxa yokulimala okuphezulu, kunye nokuthathwa kwezicubu ezithambileyo ukusuka kwithambo, kubangela iingxaki ngokuphiliswa kwethambo.
I-quartsure eneziphene zethambo, vula iqhekeza elinamaqhinga amathambo, okanye uxinzelelo olungasebenziyo oludinga ukucocwa, okanye ukuqhekeka okubi kakhulu okukhokelela kwisiphene sethambo.
I-quartsures ezineziqwenga zebhabhathane ziyafana nezenzo zecandelo lokuba azibandakanyi kuwo wonke umnqamlezo wethambo kwaye zihlala ziziphumo zokugoba ubundlobongela.
Uxinzelelo lweqhekeza lubangelwa yimithwalo ephindaphindiweyo kwaye ihlala yenzeka kwi-calcaneus neTibia.
I-Aviulsion Fracts ibangela ukuqhekezwa kwendawo yokufakelwa kwethambo xa i-tendon okanye i-ligament yoluliwe.
I-factions yokucinezela iqhekeza apho iziqwenga zethambo zinyibilika khona, zihlala yimithwalo ye-axial.
Umzobo 4: Ukwahlulahlulahlulahlula
I-III.Acluacking ephembelela ukuphiliswa
Izinto zebhayoloji, isifo sethambo le-metabolic, inqanaba elisebenzayo, inqanaba lesondlo, inqanaba le-vascular, iqondo lokutshaya, isidanga sethambo, isidanga sethambo, inqanaba lokuncamathela kwezicubu ezithambileyo ukuya Ithambo, uzinzo, isakhiwo se-Anatomical, inqanaba lamandla oxinzelelo, inqanaba lesiphene sethambo.
Iv. Uhlengahlengiso lonyango
Unyango olungahlikiyo lubonakalisiwe kwizigulana ezinokonzakala kwamandla ephantsi okanye ezingenakwenziwa ngenxa yenkqubo yenkqubo okanye yendawo.
Ukunciphisa: Ukulandelwa ecaleni kwe-axis ende yelungu, ukwahlulahlulahlulahlulahlulahlulahlula.
Ukulungiswa kwe-brace kwiziphelo zomibini ukuqhekeka kwakhona: Ukulungiswa kwethambo elincitshisiweyo ngolungiso lwangaphandle, kubandakanya nendlela yokulungisa yamanqaku amathathu.
I-Tubimar Bone I-Bone ye-Puibar yokuCwangciswa kweNgxoxo
Unyango lonyango
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Umzobo 5: Inkqubo yangaphandle yokulungisa
(2) Ukulungiswa kwangaphakathi kusebenza kwezinye iintlobo zefraures kwaye kulandele uMgaqo-nkqubo we-AO (iTheyibhile 1)
Itheyibhile 1: Indaleko ye-AO kwi-fecture upatrapy
Iziqwenga ezingalunganga zifuna ukulungiswa koxinzelelo, kubandakanya uxinzelelo oluqingqiweyo (isikali sokucinezelwa), isikhafu se-disnamic (isikhonkwane esingatshiyo), ithambo eliphakathi, kunye nokulungiswa kwethambo (izixhobo ezingaphakathi)
(4) Ukuncitshiswa ngokungathanga ngqo:
Itekhnoloji yomthetho iphunyezwa kwindawo ephucukileyo yokunciphisa isiqwenga sezinto ezithambileyo, kwaye amagunya athambileyo athathwe kwisixhobo sembonakalo yento, i-chaator yangaphandle, i-AO Getner Open Count okanye i-AO Getner Open Count okanye i-AO Getner Open Count okanye i-AO Getner Open Count okanye i-AO Joint Page.
V.stal yonyango
Ngokwenkqubo ye-biochemical yokuphilisa ukuphiliswa, yahlulahlulwe yangamanqanaba amane (iTheyibhile 2). Kwangelo xesha, kudityaniswe nenkqubo ye-biochemical, impatho yokuqhekezwa yahlulwe yangamanqanaba amathathu, ekhuthaza ukugqitywa kwenkqubo ye-biochemical kunye nokuphiliswa kwefratshi (Fig 6).
Itheyibhile 2: Ikhondo lobomi lokuqhekeka
Umzobo 6: Umzobo we-Schematic wokuphilisa ukuphiliswa kweempuku
Inqanaba lokukhuthaza
Hemorrhage from the fracture site and surrounding soft tissues forms a hematoma, fibrovascular tissue forms at the fractured end, and osteoblasts and fibroblasts begin to proliferate.
Ixesha lokuphumla
Impendulo ye-Consus yoqobo yenzeka kwiiveki ezi-2, ngokusekwa kwe-Cartilage ilandelwa ngokusekwa kwe-callus ngokusebenzisa i-goochondral ye-endochandration, kwaye zonke iintlobo zokuphiliswa kwefreyimu zihambelana nonyango lonyango.
Ukwakhiwa
Ngexesha lenkqubo yokulungisa, ithambo elakhiweyo lithatyathwe ithambo leLamellar, kwaye i-cavity ye-medullary ivunjululwa ukumakisha ukugqitywa kwendlela yokuqhekeka.
Uxinzelelo
I-United Union ibonakaliswa ikakhulu kukuqhekeka ngokunganyangekiyo ngaphakathi kwexesha elilindelekileyo, kodwa lisenemisebenzi yebhayiloji, kwaye izizathu zokuhlangulwa komanyano ziyahluka, ezinxulumene nezopolitiko.
I-Nonion ibonakaliswa njengokuqhekeka ngaphandle kobungqina bonyango lweklinikhi okanye lonyango lwemitha, kwaye eyona nto iphambili yile:
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. I-Bone isulele i-osteomselitis sisifo sethambo kunye nosulelo lwethambo, olunokuba lusuleleke ngokuthe ngqo amanxeba okanye ukusuleleka kwe-pathogenic ngokwendlela yegazi kunye ne-pathogens ngaphambi konyango.
I-Syndrome entsokothi ye-haints iphawulwa yintlungu, i-hyperessia, i-limb allegies, ukuhamba kwegazi elingaqhelekanga, ukuthuka, kunye ne-Edema, kubandakanya ukungabi nangqondo kwenkqubo yokuziqhelanisa ne-automic. Ihlala yenzeka emva koxinzelelo kunye notyando, kwaye ifunyenwe kwaye inyangwa kwangoko, kunye nebhloko yerve yovelwano ukuba kukho imfuneko.
• Isincoko se-heterotopic (i-HO) iqhelekile emva koxinzelelo okanye utyando, kwaye ixhaphake kakhulu e-Elbow, i-Hip, kunye nethanga le-bill, kunye ne-biatosphosphonates ethintelayo.
Ingcinezelo kwicandelo lempikiswano enyukayo kwinqanaba elithile, ukubethelela ubungozi ngaphakathi.
• Ukulimala kwe-neurovascular kuneenongeko ezahlukileyo zokulimala kwe-neurovascular ngenxa yeendawo ezahlukeneyo ze-anatomical.
• I-Avascular Necrosis yenzeka kwiindawo zokubonelela ngegazi, ngokukodwa, jonga ukwenzakala kunye nendawo ye-Anatomical, njl njl.
Ixesha leposi: NgoDE-31 ukuya ku-2424
