Ukuqhekeka kweClavicle yenye yezona zifo zixhaphakileyo, ebanga i-2.6%-4% yazo zonke izifo eziqhawukileyo. Ngenxa yeempawu zomzimba ze-midshaft ye-clavicle, izifo eziqhawukileyo ze-midshaft zixhaphake kakhulu, zibanga i-69% yezimfa ze-clavicle, ngelixa izifo eziqhawukileyo zecala kunye neziphelo ze-clavicle zibalelwa kwi-28% kunye ne-3% ngokulandelelana.
Njengohlobo olungaqhelekanga lokuqhekeka, ngokungafaniyo nokuqhekeka kwe-clavicle ye-midshaft okubangelwa kukwenzakala kwegxalaba ngqo okanye ukudluliselwa kwamandla okuvela kwingozi yokuthwala ubunzima kwimilenze ephezulu, ukuqhekeka kwesiphelo se-medial se-clavicle kudla ngokunxulunyaniswa nokwenzakala okuninzi. Kwixesha elidlulileyo, indlela yonyango yokuqhekeka kwesiphelo se-medial se-clavicle ibisoloko igcina. Nangona kunjalo, izifundo zibonise ukuba i-14% yezigulana ezinee-fractures ezisusiweyo zesiphelo se-medial zinokufumana iimpawu zokungahambelani. Ke ngoko, kwiminyaka yakutshanje, iingcali ezininzi ziye zathambekela kunyango lotyando lwe-fractures ezisusiweyo zesiphelo se-medial ezibandakanya i-sternoclavicular joint. Nangona kunjalo, iziqwenga ze-medial clavicular zihlala zincinci, kwaye kukho imida yokulungiswa kusetyenziswa iipleyiti kunye nezikrufu. Uxinzelelo lwengingqi luhlala luyingxaki enzima koogqirha bamathambo malunga nokuzinzisa ngempumelelo ukwaphuka kunye nokuphepha ukungaphumeleli kokulungiswa.
I.Distal Clavicle LCP Inversion
Isiphelo esikude se-clavicle sabelana ngezakhiwo ezifanayo ze-anatomical kunye nesiphelo esikufutshane, zombini zinesiseko esibanzi. Isiphelo esikude se-clavicle locking compression plate (LCP) sixhotyiswe ngemingxuma emininzi yezikrufu zokutshixa, okuvumela ukulungiswa ngempumelelo kwe-distal fragment.
Xa kujongwa ukufana kwesakhiwo phakathi kwezi zimbini, ezinye iingcali zibeke ipleyiti yentsimbi ngokuthe tye kwi-engile ye-180° kwisiphelo esikude se-clavicle. Zifinyeze nenxalenye eyayisetyenziswa ekuqaleni ukuzinzisa isiphelo esikude se-clavicle kwaye zafumanisa ukuba i-implant yangaphakathi ingena kakuhle ngaphandle kwesidingo sokuyila.
Ukubeka isiphelo se-clavicle kwindawo egobileyo nokusilungisa ngepleyiti yethambo kwicala eliphakathi kuye kwafunyaniswa ukuba kulungelelana ngokwaneleyo.
Kwimeko yesigulana esiyindoda esineminyaka engama-40 ubudala esineqhenqa eliphukileyo kwicala eliphakathi le-clavicle yasekunene, kusetyenziswe ipleyiti yentsimbi ye-clavicle ejikelezileyo. Uvavanyo olulandelayo emva kweenyanga ezili-12 emva kotyando lubonise isiphumo esihle sokuphiliswa.
Ipleyiti yokucinezela i-inverted distal clavicle locking compression (LCP) yindlela esetyenziswa kakhulu yokubopha ngaphakathi kwiklinikhi. Inzuzo yale ndlela kukuba i-medial bone fragment ibanjwe zizikrufu ezininzi, nto leyo enika ukuqina okukhuselekileyo. Nangona kunjalo, le ndlela yokubopha ifuna i-medial bone fragment enkulu ngokwaneleyo ukuze kufumaneke iziphumo ezilungileyo. Ukuba i-bone fragment incinci okanye kukho i-intra-articular comminution, ukusebenza kakuhle kokubopha kunokuphazamiseka.
II. Indlela Yokulungisa Ipleyiti Embini Eme nkqo
Indlela ye-dual plate yindlela esetyenziswa rhoqo kwii-complex complex commonized fractures, ezifana ne-distal humerus, comminted fractures ye-radius kunye ne-ulna, njl. Xa i-fixation esebenzayo ingenakufezekiswa kwi-single plane, ii-dual locking steel plates zisetyenziselwa i-vertical fixation, okwenza isakhiwo esizinzileyo se-dual-plane. Ngokwe-biomechanically, i-dual plate fixation inika iingenelo ze-mechanical ngaphezu kwe-single plate fixation.
Ipleyiti yokulungisa ephezulu
Ipleyiti yokulungisa esezantsi kunye neendibaniselwano ezine zeendlela ezimbini zokumisela iipleyiti
Ixesha lokuthumela: Juni-12-2023
