Iindaba - Iindlela zokulungisa zangaphakathi zokuqhekeka kwesiphelo se-medial ye-clavicle

Ukuqhekeka kwe-Clavicle yenye yezona zinto zixhaphakileyo, zibalelwa kwi-2.6% -4% yazo zonke iifractures.Ngenxa yeempawu ze-anatomical ze-midshaft ye-clavicle, i-midshaft fractures ixhaphake kakhulu, i-akhawunti ye-69% ye-clavicle fractures, ngelixa i-fractures ye-lateral kunye ne-medial ekupheleni kwe-akhawunti ye-clavicle ye-28% kunye ne-3% ngokulandelanayo.

Njengolunye uhlobo olungaqhelekanga lokuphuka, ngokungafaniyo ne-midshaft clavicle fractures ezibangelwa ukuxhatshazwa kwegxalaba ngokuthe ngqo okanye ukunyanzeliswa kokudluliselwa kokulimala kwemilenze ephezulu, iifractures of the medial end of the clavicle ngokuqhelekileyo zidibene nokulimala okuninzi.Kwixesha elidlulileyo, indlela yonyango yokwaphuka kwesiphelo se-medial se-clavicle ngokuqhelekileyo igcinwe.Nangona kunjalo, uphando lubonise ukuba i-14% yezigulane ezinezahlulo ezifudukayo zesiphelo se-medial zinokufumana i-nonunion ye-symptomatic.Ke ngoko, kwiminyaka yakutshanje, ngakumbi nangakumbi abaphengululi baye bangqiyama kunyango lotyando lwezahlulo ezigxothiweyo zesiphelo se-medial esibandakanya i-sternoclavicular joint.Nangona kunjalo, iziqwenga ze-clavicular medial zihlala zincinci, kwaye kukho imida yokulungiswa usebenzisa iiplate kunye nezikrufu.Ukugxininiswa koxinzelelo lwengingqi kuhlala kungumngeni onzima koogqirha bamathambo ngokubhekiselele ekuzinziseni ngokufanelekileyo ukuphuka kunye nokuphepha ukungaphumeleli kokulungiswa.

I.Distal Clavicle LCP Inversion
Isiphelo se-distal se-clavicle sabelana ngezakhiwo ezifanayo ze-anatomical kunye ne-proximal end, zombini zinesiseko esibanzi.Ukuphela kwe-distal ye-clavicle locking compression plate (LCP) ixhotyiswe ngeemingxuma ezininzi zokutshixa izikhonkwane, ezivumela ukulungiswa okusebenzayo kweqhekeza le-distal.

Ukuthathela ingqalelo ukufana kwesakhiwo phakathi kwezi zibini, abanye abaphengululi baye babeka ipleyiti yentsimbi ngokuthe tye kwi-angle ye-180 ° ekupheleni kwe-distal ye-clavicle.Baye banciphisa inxalenye yokuqala eyayisetyenziselwa ukuzinzisa ukuphela kwe-distal ye-clavicle kwaye bafumanisa ukuba ukufakelwa kwangaphakathi kuhambelana ngokufanelekileyo ngaphandle kwemfuneko yokubunjwa.

Ukubeka i-distal end ye-clavicle kwindawo eguquliweyo kunye nokuyilungisa ngeplate yethambo kwicala le-medial ifunyenwe ukubonelela ngokufanelekileyo okwanelisayo.
Iindlela zokulungisa zangaphakathi 5

Kwimeko yesigulane esineminyaka engama-40 yesigulane esine-fracture ekupheleni kwesigxina se-clavicle echanekileyo, i-distal clavicle steel plate isetyenzisiweyo.Uvavanyo olulandelelweyo emva kweenyanga ezili-12 emva kotyando lubonise umphumo omuhle wokuphilisa.

I-distal clavicle yokutshixa i-plate yokutshixa i-inverted (LCP) yindlela yokulungiswa kwangaphakathi esetyenziswa ngokuqhelekileyo kwindlela yokusebenza kwekliniki.Inzuzo yale ndlela kukuba i-fragment yamathambo ephakathi ibanjwe ngama-screws amaninzi, inika ukulungiswa okukhuselekileyo.Nangona kunjalo, obu buchule bokulungisa bufuna iqhekeza elikhulu ngokwaneleyo lethambo eliphakathi ukuze ufumane iziphumo ezilungileyo.Ukuba iqhekeza lethambo lincinci okanye kukho i-intra-articular comminution, ukusebenza kokulungiswa kunokuthi kuphazamiseke.

II.ITeknikhi yokuLungisa iPleti ezimbini nkqo
Ubuchwephesha bepleyiti ephindwe kabini yindlela esetyenziswa ngokuqhelekileyo kwiifractures ezintsonkothileyo, ezinje ngokuqhekeka kwe-distal humerus, i-fractures edibeneyo yeradius kunye ne-ulna, njalo njalo.Xa ukulungiswa okusebenzayo kungenakufezekiswa kwinqwelo-moya enye, iipleyiti zetsimbi ezimbini zokutshixa zisetyenziselwa ukulungiswa ngokuthe nkqo, ukudala isakhiwo esizinzile seenqwelo-moya ezimbini.I-Biomechanically, ukulungiswa kweepleyiti ezimbini kunika izibonelelo zoomatshini ngaphezu kokulungiswa kwepleyiti enye.