Clavicle kari .

Clavicle fractures sɔrɔli ye 30-60 ye mɔgɔ 100.000 kan, cɛ ni muso hakɛ bɛ se 2:1 ma, o bɛ kɛ 5% fo 10% ye kari bɛɛ la ani 44% ka bɔ kamankunw na. O clavicle ye kolo fɔlɔ ye min bɛ kolotugudaw sɔrɔ hadamaden farikolo la, wa a koloci bɛ daminɛ den ka ɲɛnamaya dɔgɔkun duurunan na, wa o ye kolo janyalen kelen ye min bɛ kolosinsin ni kolosinsinnan kɔnɔna na. Ossification centre primitifs bɛ sɔrɔ clavicle cɛmancɛ la, wa a bɛ kɛ sababu ye ka clavicle bonya fo ka se san 5 ma. Epifizi plati min bɛ ka bonya ka taa a fɛ, o bɛ sɔrɔ clavicle kɔnɔna ni kɛnɛma dakun kelen-kelen bɛɛ la, nka a ka c’a la, cɛmancɛ-sɔgɔsɔgɔyɔrɔ dɔrɔn de bɛ se ka ye ni X-ray ye. Epifizini cɛmancɛ la, o bɛ kɛ sababu ye ka 80% bɔ a janya la, wa a ka c’a la, a koloci yɔrɔ tɛ daminɛ ka bɔ fo san 13 ka se san 19 ma, wa a tɛ ɲɔgɔn sɔrɔ ni a si hakɛ ye fo ka se san 22 fo san 25 ma. O la, ni aw bɛ sternoclaviculaire dislocation (sternoclavicular dislocation) sɛgɛsɛgɛli kɛ banabagatɔ fitiniw na, a nafa ka bon ka a danfara bɔ ni claviculaire epiphyseal injury (banakisɛfagalanw) cɛmancɛ ye.

Anatomie functionnel .

Clavicle bɛ tilennen ni a lajɛra ɲɛfɛla la, nka a bɛ kɛ i n’a fɔ a bɛ kɛ ni a lajɛra ka ɲɛ, a bɛ kurukuru kɔfɛ ani a bɛ kɛ cɛmancɛ la ka taa kɔnɔbara fan fɛ. A tigɛtigɛli bɛ Changé (Yɛlɛma) axis (yɔrɔ) jan na, ni a kɔkanna 1/3 bɛ flakɛ walasa ka farikolo ni ligament (ligament) sama; cɛmancɛ 1/3 bɛ kɛ tubulu ye, a cɛmancɛ bɛ dɔgɔya ani a bɛ kɛ ni kolomugu ye min ka bon ka tɛmɛ tɔw kan, walasa ka aksidan tansiyɔn ni tension (janya) sɔrɔ ani ka joli-sira-funu-yɔrɔw lakana a jukɔrɔ Kɔnɔna 1/3 ye rhombic ye wa a bɛ tali kɛ kɔkolo ni a kɔkolo fɔlɔ la ni jiribulu barikama ye (Jaa 1). Anatomical kalanw y’a Jira ko clavicle (daɲɛ) barika ka dɔgɔ yan k’a sababu Kɛ a cogoya caman ɲɔgɔnna ye cɛmancɛ ni kɛnɛma 1/3 la. Ka fara o kan, a bɛ sɔrɔ kɛrɛfɛ ka ɲɛsin subclavian muscle stop ma ani farikolo yɔrɔw lakanani tɛ a la, o b’a to a bɛ kɛ yɔrɔ ye min ka jugu kosɛbɛ kari, i n’a fɔ a jiralen bɛ cogo min na kɛnɛyaso kɔlɔsiliw fɛ.

Joginni fɛɛrɛ .

Kɔgɔjida karilenw na balikuw la, joginni kɛcogo min ka ca ni tɔw bɛɛ ye, o tun bɛ miiri fɔlɔ ko o ye bin ni bolo ye min bɛ yɔrɔ janyalenba la, nka Stanley et al. A y’a sɔrɔ ko nin joginni fɛɛrɛ in bɛ kɛ 6,3% dɔrɔn ye cɛmancɛ-clavicle fractures ani 5,9% la distal clavicle fractures la, ani banabagatɔ bɛɛ la, joginni fɛɛrɛ min ka ca ni tɔw bɛɛ ye, o bɔra fanga tilennenw na minnu bɛ baara kɛ ka ɲɛsin kamankun joli ma banabagatɔ bɛɛ la, o ye fanga tilennen ye kamankun joli kan, a ka c’a la, a tɛ se ka wuli kosɛbɛ walima ni a ma wuli dɔɔnin dɔrɔn.

Ni bin ni bolokɔni bɛ yɔrɔ la min janya ka bon kosɛbɛ, a ka c’a la, o karilen bɛ sɔrɔ kɛnɛma fanga dɔ nɔfɛta fɛ min bɛ kɛ filanan ye bin na. Kari suguya wɛrɛ min bɛ sɔrɔ fariya siratigɛ la, o ye ni kɛnɛma fanga dɔ bɛ baara kɛ a kamankun kan, o bɛ kɛ sababu ye ka a kɛ sababu ye ka fɛn dɔ sɔgɔ ni kɔkili fɔlɔ ye, o bɛ kɛ sababu ye ka jiribolo karilen dɔ sigi sen kan 1/3 cɛmancɛ la. Ka fara o kan, ni sirabakan-kasaara kɛli ka caya nin san laban ninnu na, k’a sababu kɛ nɔba ye mobili kasaara la, o la, a ka lafiya cɛsirilan bɛ fanga dafalen dɔ kɛ a kamankun na, o bɛ kɛ sababu ye tuma caman na ka fɛn dɔ fara ɲɔgɔn kan min bɛ tɛmɛ walima ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye, mɔgɔw bɛ min wele ko cɛsirilan kari. Laala, bawo a ka c’a la, o bɔnɛ in ka fariyakow ka bon, nin kari suguya in ka teli ka kɛ fɛn ye min tɛ se ka kɛ fɛn ye min tɛ fɛn ye.

Furakɛli

Cɛmancɛla ka kari ka bɔ ɲɔgɔn na:

Splint fixation:Splint fixation de clavicle fractures ye 'Gold Standard' ye hali bi. Platew ye 3,5mm LC-DCP, 3.5mm reconstruction plates, LCP da tugulanw, ani plati suguya kɛrɛnkɛrɛnnen dɔw. Nafa minnu bɛ sɔrɔ sɔgɔsɔgɔninjɛw la, olu ye: karili transversale compression; oblique walima butterfly fractures fixation ni tension vises faralen ɲɔgɔn kan ni neutralizing splints ye; Yɛlɛma kɔlɔsili ɲuman; Banabagatɔ ka don o don baaraw ka kari ka se ka a siri; ani a ka ca a la, sɔgɔsɔgɔninjɛw man kan ka bɔ (ni u ka kan ka bɔ fo kalo 12 fo kalo 18 opereli kɔfɛ).

Distal clavicle fracture:

Clavicle hook splint ye fixation indirect fɛɛrɛ ye, nafa minnu bɛ sɔrɔ a la, olu ye kɔnɔna-filɛli nɔgɔyali ye, repositioning (yɔrɔ-yɔrɔ-ko) ladonni ka ɲɛ, acromioclavicular joint (acromioclavicular joint) tiɲɛni tɛ, ani kɔnɔna fiɲɛ sabatili danfaralen k’a sɔrɔ a ma sɛgɛn ka don a lamini na i n’a fɔ a bɛ kɛ cogo min na ni laadala pin ye.

Kɔgɔjida karili proximal fɛ:

Sɛbɛnw y’a jira ko furakɛli min tɛ opereli ye, o ka fisa ni nin kari suguya in ye, ni sɔgɔsɔgɔninjɛ-sɔgɔli frein ye. Kɔnɔnafili tigɛlen bɛ se ka jateminɛ ni joli-sira-funu joginni bɛ yen, walima ni kari bɛ wuli kɔfɛ ka banabagatɔ ninakili gɛlɛya walima ka a kunu, walima ni o taamasiɲɛ suguw tɛ yen nka ni ja bɛ a jira ko kari min bɛ bɔ a nɔ na, ​​o bɛ nɔ bila kɔfɛlafɛn nafama dɔ la ani ko o yɔrɔ jiginni ye nafa tɛ o la. Ni fixation tɛ se ka kɛ, a bɛ se ka kɛ ko proximal clavicle bɛ se ka bɔ ni a mago bɛ o la.

Gɛlɛyaw .

• Furakɛli si ma kɛ, sɛbɛn tɛmɛnen dɔ y’a jira ko kɛnɛya ma se 0,9% ma ka se 4% ma clavicle fractures la, wa kɔsa in na, sɛgɛsɛgɛli dɔ kɛra min kɛra ka caya, o y’a jira ko kɛnɛyabaliya hakɛ yɛrɛ ka ca kosɛbɛ ka tɛmɛ mɔgɔ bɛ se ka miiri min na.

• Deformity Healing: Laadalata hakilina ye ko deformity healing of the clavicle ye aesthetic gɛlɛya dɔrɔn ye ani ko ni kɛnɛya tɛ opereli kɔfɛ, a nɔfɛta ka fisa ni ka a to deformity ka kɛ. Nka, kɔlɔsili minnu kɛra kɔsa in na, olu y’a jira ko ni a ka ca ni santimɛtɛrɛ 15 ye, o bɛ kɛ sababu ye ka dimi ni lamaga dan sigi a laban na. Ka fara o kan, dɔnnikɛla dɔw ye 'clavicle shaping' nɔgɔmanw jira deformité kɛnɛyali furakɛli la, nka nin fɛɛrɛ in tɛ ladilikan ye. Scab bɔlen dɔrɔn bɔli bɛ se ka kɛ sababu ye ka clavicle kɛ fɛn finman ye ani ka dɔ fara kosɛbɛ kari farati kan, wa ikomi clavicle ka tiɲɛni bɛ ye dimension saba la, 'smoothing' clavicle in the horizontal plan dɔrɔn tɛna deformité latilen pewu. O la, fɛɛrɛ min bɛ se ka da a kan kosɛbɛ, o bɛ tali kɛ fɛnɲɛnamafagalanw tali la: koloci tɛmɛnen bɔli ka se a dan na, a tigɛlen kɔfɛ, a kɔnɔna jɔli sabatili ani a kolo sɔgɔli kɛcogo kelen. Tiɲɛ don, banabagatɔ ka kan ka ladɔnniya ko a tɛ se ka kɛ a la sani opereli ka kɛ.

• Joli-sira-funu joginni:Jiginni joli-sira-funu-kɔnɔ-joginni bɛ se ka dɔgɔya a daminɛ na, wa a ka c’a la, joginni filanan tɛ kɛ ka a sababu kɛ joli-sira-funu-yɔrɔ jiginni ye ka da a kan joli-sira-funu-yɔrɔ-yɔrɔ-yɔrɔ ka bon kari kɔfɛ, ka sɔrɔ a laban na, kolotugudaw falenni bɛ se ka kɛ sababu ye ka joli-sira-funu taamasiɲɛw bila mɔgɔ la. Ni o kɛra, a ka ca a la, opereli decompression decompression (opereli decompression) de ka kan ka kɛ.

• Joli-sira-funu-banakisɛ-banakisɛ-banakisɛ-banakisɛ-banakisɛ-banakisɛ-banakisɛ karili kɔfɛ, o bɛ teli ka kɛ acromioclaviculaire joint (acromioclaviculaire joint) la, clavicle (banakisɛfagalan) kɛnɛma 1/3 karilen kɔfɛ, kɛrɛnkɛrɛnnenya la, nin joli in tiɲɛni fɛ ni fariya waati ye, ani a dɔw la, a bɛ sɔrɔ kari min bɛ sɔrɔ joli-sira-funu-yɔrɔ la. Ni da tuguni tɛ se ka kɛ, a ka kan ka kɛ ko a ka kan ka kɛ ko a ka kan ka kɛ ko a ka kan ka kɛ ko a ka kan ka kɛ ka clavicules (clavicle) distal (cm 1 distal) tigɛ, ani ka opereli kɛ opereli kɔnɔ walasa ka rostral-claviculaire ligament (sɔgɔsɔgɔninjɛ) lakana.

  
  

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