I-Supracondylar Pratures ye-humerus yenye yezona zinto zixhaphakileyo kubantwana kwaye zenzeka kwindibano ye-humeral shaft kunye neI-humeral checle.
Imbonakalo yeKlinikhi
I-Supracondylar iqhekeza le-humerus yayingabantwana kakhulu, kunye nentlungu yasekuhlaleni, ukudumba, ukuchukumisa, kunye nokungasebenzi kakuhle kunokwenzeka emva kokulimala. I-procares engafakwanga imiqondiso ecacileyo, kwaye i-Exbow Exdation inokuba kuphela kophawu lweklinikhi. I-capsule edibeneyo engezantsi komsipha we-elbow yeyona nto iphambili, apho i-capsule eyidibanisayo, ekwabizwa ngokuba yi-softpot, inokuthi ichaphazele ngexesha lokucaphukisa. Inqaku lokuguquguquka lihlala lingaphandle kumgca oxhuma iziko lentloko ye-radial ukuya kwincam ye-olecranon.
Kwimeko yohlobo lwe-supracondylar ye-III III uqhekeka, kukho ukungcungcutheka kwemini emibini equleneyo ye-elbow, inika inkangeleko ebunjiweyo. Kuhlala kukho ukonyuka okungaphezulu phambi kwengalo ephezulu ye-distal, kwaye ukuba i-phrackid isusiwe ngokupheleleyo, isiphelo se-ractare singena kwi-brachial vercy umsipha we-brachial, kwaye ukopha i-subcutaneous krakra kakhulu. Ngenxa yoko, uphawu lwepucker luvela phambi kwe-elbow, idla ngokubonisa i-protrusion ye-bony ye-protrusion kwi-protrusion kwi-protumare ingena kwi-dermis. Ukuba ihamba kunye nokulimala kwethambo le-radial, ukwandiswa kwe-dorsal kwisithupha kunokulinganiselwa; Ukulimala kwe-nerve ye-nerve kunokubangela isithupha kunye nomnwe wesalathiso ukuba ungakwazi ukwenza i-flex; I-Ulnar nerve mouras inokubangela ukwahlula-hlula kweminwe kunye nokudibana.
Isifo
(1) Isiseko sokufumana isifo
Imbali ye-Morauma; Iimpawu kunye nemiqondiso ye-②clinec kunye neempawu: Intlungu yendawo, ukudumba, isisa kunye nokungasebenzi kakuhle; I-③X-ray ibonisa umgca wokuqhekeka of Supracondylar kunye neziqwenga eziphucukileyo ze-humers.
(2) I-diyalograsi eyahlukileyo
Ingqwalaselo kufuneka ihlawulwe ekuchongeniI-elbow dislocation, kodwa ukuchongwa kwesahlulo seSupracondylar esaphukileyo sokufuduswa kwe-elbow kunzima. Kwi-Supracondylar ye-humerus, i-Epicondyle ye-humersis igcina ubudlelwane obuqhelekileyo be-anatomicacacal buby kunye ne-olecranon. Nangona kunjalo, kwi-Eleclonow yokungabinamali, kuba i-Olecram ibekwe emva kwe-Epicondyy ye-humerus, ibalasele ngakumbi. Xa kuthelekiswa neqhekeza lesiseko, ukuvelela kwengxowankulu ekusasazileni i-Ellow kuninzi kakhulu. Ubukho okanye ukungabikho kwe-Bony Frilielies kuya kudlala indima ekuchongeni ububi be-humerus ekusasazeni i-humenting ye-elbow, kwaye ngamanye amaxesha kunzima ukwenza i-bony firives. Ngenxa yokudumba okukhulu kunye nentlungu, ukukhohlisa izinto ezithambileyo ze-bony zihlala zibangela ukuba umntwana akhale. Ngenxa yomngcipheko wokwenzakala kwe-neurovascular. Ke ngoko, i-ringseltions exhaphazi amathambo e-bone kufuneka ithintelwe. Uviwo lwe-X-RAY unokunceda ekuchongeni.
Uhlobo
Ukuhlelwa komgangatho we-Supracondylar ye-sunderal ye-humeral kukwahlulahlulahlulo kunye nokuguquguquka. Uhlobo lwenguqulo lunqabile, kwaye i-X-ray ye-ray ibonisa ukuba ukuphela kokuphela kokuqhekeka okuphambi kwe-humeral shaft. Uhlobo oluthe tye luxhaphakile, kwaye i-garland yahlulahlula kudidi i-III (iTheyibhile 1).
| Uhlobo | Imbonakalo yeKlinikhi |
| Ⅰ Uhlobo | I-Fracture ngaphandle kokususwa, i-version okanye i-valgus |
| Uhlobo | Ukupheliswa kokuthamba, ukuqhekeza kwe-medial Corting, umgca we-humeral humeral ngentloko ye-humeral |
| Ⅱ Uhlobo | I-hyperextexterions, ingqibelelo engaphakathi, intloko ye-humeral emva komda we-humeral humeral humeral, akukho jikelezo |
| Uhlobo | Ukuthambeka kwexesha elide okanye ukujikeleza ngoqhakamshelwano malunga nokuphela kokuphela kwento |
| Ⅲ Uhlobo | Gcwalisa i-PoterTecent ye-Posterity ye-Posteringer ngaphandle konxibelelwano oluqhelekileyo, uninzi lwe-distal kwi-PostTeAlity PollTe |
| Uhlobo | Ukususwa okucacileyo, izicubu ezithambileyo ezifakelweyo kwisiphelo sokuqhekeka, ukugqithisa okukhulu okanye ukufuduswa okujikelezayo kwesiphelo sokuphela |
Itheyibhile 1 i-Gartland ihlelo le-sumerussus
Phatha
Phambi konyango olufanelekileyo, udibaniso lwe-elbow kufuneka luhlelwe okwethutyana kwisikhundla se-20 ° ukuya kwi-30 ° aguquguqukayo, kodwa kunciphisa uxinzelelo kuphela lwesigulana.
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. °) Ukulungiswa kugcina isikhundla emva kokuncitshiswa, kodwa yonyusa umngcipheko wokulimala kwe-neurovascular yelungu elichaphazelekayo kunye nomngcipheko we-Abchrome ye-Abchrome. Ke, i-percutaneousI-Kirschner Wire yokulungisailungileyo emva kokuncitshiswa kwesandla (umzobo 1), kwaye emva koko ulungiso lwangaphandle kunye nodaka olufihliweyo kwisikhundla esikhuselekileyo (i-elbow slexion 60 °).
Umzobo 1 umfanekiso we-percutaneous kirschner ciotion
. Ukuncitshiswa okuvaliweyo kunye nokulungiswa kwe-wirschner kirschner ye-kirschner kufowuni kuhlala kunokwenzeka, kodwa ukuncitshiswa okukhulu kuyafuneka ukuba i-tishu ye-tishu ye-tishu ethambileyo ayinakuncitshiswa okanye ukuba kukho ukulimala kwe-rachial (umzobo 2).
Umzobo we-5-3 ofanelekileyo kunye neefilimu ze-X-ray ze-X-ray ze-Supracondylar humerus
Kukho iindlela zoqhaqho ezine zokuncitshiswa okukhulu kwe-sumeracondylar ye-humerus: (1) indlela ye-Ellural Elbow (kubandakanya indlela ye-anterolateral); (2) indlela yeMedicaw; . kunye (4) nendlela engasemva.
Zombini indlela ye-Ellural Elbow kunye nendlela yeMedial zinezibonelelo zezicubu ezingaphantsi komhlaba kunye nesakhiwo esilula se-Aatomical. I-Action Points ikhuselekile kune-pattions Ingxaki yokuba akukho namnye kubo onokuthi abone ngokuthe ngqo iqhekeza lecala lolwaphulo-mthetho, kwaye unokuncitshiswa kuphela kwaye alungiswe ngemvakalelo yesandla, efuna ubuchule obuphezulu. Inkqubo ye-posterew elbow ibinempikiswano ngenxa yokutshatyalaliswa kwentembeko yemisipha yetrayi kunye nomonakalo omkhulu. Inkqubo edityanisiweyo ye-Medial kunye ne-Lateral inokwenza ukuba i-veloges engakwazi ukubona ngokuthe ngqo ithambo lethambo lolwaphulo-mthetho. Inezibonelelo ze-Medial kunye ne-Latebow elbow, elungele ukuncitshiswa kwenziwe kunye nokulungiswa, kwaye kungancitshisela ubude bezinto ezichaphazelekayo. Kuyingenelo kukukhululeka kunye nokuncitshiswa kwe-tissies eshukumayo; Kodwa ukungaqiniseki kwayo kukuba ukonyusa ukungcungcuthekiswa kwetyala; Iphakame kakhulu kunendlela yedwa.
Uxinzelelo
Imikhwa ye-sunderaclar ye-sunderallar ibandakanya: (1) Ukulimala kwe-neurovascular; (2) i-syprome ye-septure; (3) Ubutyebi obukhuselekileyo; (4) ii-mysitis ze-mysitis; (5) i-avascular necrosis; (6) Ukuhluka kwe-curitus (7) Ukuhlanjwa kweCuncius.
Shwankathela
I-Supracondylar iqhekeza le-humerus iphakathi kwelona qhekeza iqhelekileyo ebantwaneni. Kwiminyaka yakutshanje, ukuncitshiswa kakubi kwe-supracondylar ye-sumerus ye-humers kuvuse ingqalelo yabantu. Kwixa elidlulileyo, i-gouris ye-curitus okanye i-curitus ihlathiwe ibangelwa kukubanjwa kokukhula kwePipharal Epiphal Epiphyseal PleittySeal PlateEy Pleithyseal PlateEy Pleittyseal PlateEy Platedyseal PlateEy Platedyseal Pitety Uninzi lobungqina obuqinileyo luxhasa ukuba ukuncitshiswa kobuhlwempu yinto ebaluleke kakhulu kwii-cussim ze-curis. Ke ngoko, ukuncitshiswa kwe-humerus ye-humerus ye-humers, ukulungiswa kwe-Ulnar ekugxothweni, ukujikeleza okuthe tye kunye nokubuyiselwa kwe-humer humerus ephezulu zizitshixo.
Zininzi iindlela zonyango kwi-Sturacondylar Pratus, ezinjengokuncitshiswa kwencwadi + Ukulungiswa kwangaphandleNgotsola, ifomati ye-Olecranon, ulungiso lwangaphandle nge-splint, ukuncitshiswa okuvulekileyo kunye nokulungiswa kwangaphakathi, kunye nokuncitshiswa kwangaphakathi. Kwixesha elidlulileyo, ukunciphisa okuqinisekileyo kunye neplastanition Ukulungiswa ngaphandle kwelona nyango luphambili, apho i-cuitus ye-kutus yaxelwa i-50% eTshayina. Okwangoku, ngohlobo lwe-II kunye nohlobo lwe-III ye-III Supracondylar Prictures, ukulungiswa kwenaliti kwi-Inaliti emva kokuncitshiswa kwesaphulelo kuyeyona ndlela yamkelekileyo. Inezibonelelo zokungabonakalisi ukuba igazi kunye nokuphiliswa ngokukhawuleza kwethambo.
Kukho nezimvo ezahlukeneyo kwindlela nenani elifanelekileyo locingo lwentambo yeKirschner emva kokuncitshiswa kwawo. Amava omhleli kukuba iingcingo zeKirschner kufuneka zibhangiswe omnye komnye ngexesha lokulungiswa. Kumgama wayo inqwelomoya yefratshi kukuba, uzinzile ngakumbi. Iingcingo zeKirschner akufuneki ziwele kwinqwelomoya eqhekezayo, kungenjalo ukujikeleza akuyi kulawulwa kwaye ulungiso alunakuhlala. Inkathalo kufuneka ithathwe ukunqanda ukonakala kwi-ilnar nerve xa usebenzisa i-Medial Kiresner Wire. Sukuyithambisa inaliti kwindawo eguqukayo ye-elbow, kancinci lungisa i-elbow ivumela i-ilnar nerve ibuyele umva, ichukumise i-rum icime i-k-wire. Ukusetyenziswa kwe-wirchner wire ye-kirschner wire yangaphakathi kunezibonelelo ezinokubakho kwiPhambili eSebenzayo, inqanaba lokuphilisa ireyitha, kunye nenqanaba elihle lokuphiliswa kwendawo yokuhlala.
IXESHA LOKUQALA: UNv-02-2022
