Ènya alesi woaɖɔ afɔkpodzi ƒe gbagbã ɖoa?

Metacarpophalangeal fractures nye asi ƒe gbagbã si bɔ le asi ƒe abixɔxɔ me, eye wònye asibide dɔnɔwo katã ƒe 1/4 lɔƒo. le asi ƒe wɔwɔme si le bɔbɔe eye wòsesẽ kple eƒe dɔwɔwɔ nyuie ta la, asi ƒe gbagbãwo dzi kpɔkpɔ le vevie sã eye le mɔ̃ɖaŋununya gome la, esesẽ wu ʋuka didi bubuwo dada.

Kakaɖedzi nana be ƒu gbagbãƒea li ke le egbugbɔgaɖo teƒe bubue nye nu vevitɔ si ana metacarpophalangeal gbagbãdɔdada nakpɔ dzidzedze. Be asia nagawɔ dɔ ake la, zi geɖe la, ebiana be woatsɔ aŋe ablae nyuie, eye tsã la, wozãa gotagome tsɔtsɔ blae kple aŋɔ alo ememe tsɔtsɔ blae kple Kirschner-kpluwo zi geɖe, gake zi geɖe la, etsoa asiléle si mesɔ o alo ɣeyiɣi didi si woatsɔ ablae ta, si meɖea vi na ƒunukpeƒe ƒe ɖɔɖɔɖo kaba le dɔwɔwɔ vɔ megbe o, eye wòkpɔa ŋusẽ gã aɖe ɖe metacarpophalangeal ƒe dɔwɔwɔ ƒe hayahaya dzi ƒunukpeƒe, si hea kuxi aɖewo vɛ na asi ƒe dɔwɔwɔ gbugbɔgaɖɔɖo.

Egbegbe atikewɔwɔmɔnuawo zãa ememe nuléle sesẽwo geɖe wu, abe micro plate screw fixation ene.

Atikewɔwɔ Ŋuti Gɔmeɖosewo

Gɔmeɖose siwo wozãna le asi ƒe metacarpal kple phalangeal fractures dada me enye: ŋutilã ƒe wɔwɔme gbugbɔgaɖoanyi, eƒe asiɖoɖoanyi bɔbɔe kple sesĩe, ʋuʋu kaba kple kamedede si wɔa dɔ. Gɔmeɖose siwo wotsɔ daa asi ƒe ƒunukpeƒe kple ƒunukpeƒe ƒe gbagbãƒewo sɔ kple esiwo wozãna na asi ƒe gbagbã bubuwo: ƒunukpeƒea ƒe ŋutilã ƒe wɔwɔme gbugbɔgaɖoanyi kple dɔwɔwɔ ƒe dɔwɔwɔ kaba. Ele be asi ƒe metacarpal kple phalangeal fractures dada nadze agbagba be woaɖo ŋutilã ƒe wɔwɔme ƒe teƒe bubu evɔ womatrɔ, axadzi dzogoe, alo dzogoe ƒe ʋuʋu >10° ayi asibidɛ ƒe megbekpa dzi o. Ne wotrɔ asibidɛa ƒe akpa si gbã la ƒe nuwuwu alo woɖee ɖe axadzi le dzogoe aɖe dzi la, atrɔ asibidɛa ƒe ƒoƒo kple kekeɖenudɔwɔwɔ ƒe mɔzɔzɔ si sɔ, si ana wòatu alo adze anyi tso asibidɛ si te ɖe eŋu dzi le ebɔbɔ me, si akpɔ ŋusẽ ɖe asibidɛa ƒe dɔwɔwɔ ƒe nyateƒetoto dzi; esime dzogoe ƒe ʋuʋu >10° yi asibidɛ ƒe megbe agblẽ ƒu kple lãkusi ƒe kadodo gbadzaa me, si ana lãkusia ƒe tsitretsitsi kple eƒe ʋuʋu ƒe didime nadzi ɖe edzi le eƒe ƒoƒo kple kekeme me, eye wòana lãkusia naxɔ abi atraɖii, si ana lãkusia nagbã ƒe afɔku. afɔku si le lãkusia ƒe gbagbã me.

Metacarpal kple phalangeal fractures sɔ le woƒe ŋutete be woado dzi le rotational deformity me, gake metacarpal ya doa dzi kpuie ƒe ʋuʋu kple dorsal angular displacement nyuie wu phalangeal. Carpometacarpal kple metacarpophalangeal ƒe ƒunukpeƒewo ate ŋu axe fe ɖe metacarpal ƒe dzogoe ƒe nɔnɔme madeamedzi ta, eye asibidɛ sue si le abe asigɛ ene la trɔna ɖe metacarpal ƒe dzogoe ƒe nɔnɔme gbegblẽ ŋu nyuie wu titina asibidɛ si wotsɔ fiaa nu. Ne asi ƒe lãmeka ƒe kpuiƒe si le eme ta la ƒe asiléle ƒe ŋusẽ si dzi ɖe kpɔtɔ la dzena ne metacarpal la le dzogoe si wu 30° ɖe megbe ƒe akpa dzi ko.

Amekoko ƒe Mɔnu

Amekoko ƒe mɔnu si wozãna na metacarpal fractures le bɔbɔe ŋutɔ eye zi geɖe la, wozãa akɔta ƒe mɔnu, abe alesi woɖee fia le Nɔnɔmetata 4-14 me ene. Wolãa abɔta evelia le titina esime wotsoa abɔta atɔ̃lia le ulnarly, eye zi geɖe la, wotsoa abɔta etɔ̃lia kple enelia le titina. Ne wowɔ dɔ na metacarpal eve siwo te ɖe wo nɔewo ŋu le ɣeyiɣi ɖeka me la, wozãa titina si ƒe nɔnɔme le abe S ene tsɔ bua amekokoƒe eveawo siaa ŋu.

Woɖɔ mɔnu tiatia ɖo

Nu geɖewo li siwo wotsɔ léa ememe na metacarpophalangeal fractures, abe Kirschner pins, screws, plates kple gotagome fixation frames ene, siwo dometɔ aɖewoe wozãna Kirschner pins kple microplates wu. Le metacarpal fractures gome la, viɖe siwo dze ƒã le ememe léle ɖe te kple microplate wu fixation kple Kirschner pins eye woate ŋu alɔ̃e wu; le proximal phalangeal fractures gome la, microplate ye wozãna zi geɖe, gake ne esesẽna be woatsɔ gaviwo ade proximal phalangeal kple ta ƒe gbagbã ƒe akpa si le didiƒe la, wodina be woatsɔ Kirschner pins siwo wotso ɖe wo nɔewo ŋu aɖo ememe, si nyo wu na asibidɛ si ŋu dɔlélea le ƒe dɔwɔwɔ ƒe hayahaya; le titina phalangeal gbagbãwo dada me la, ele be woazã Kirschner pins.

1、Kirschner ƒe aŋe: 

Wozãa Kirschner ƒe aŋe ƒe ememe nuléle le atikewɔƒea ƒe 70 kple edzivɔe nye sia eye eyae nye nusi wozãna wu tsɔ léa ememe na metacarpophalangeal fractures, si zazã le bɔbɔe, mexɔa ga geɖe o eye wòwɔa dɔ, eye wònye ememe ƒoƒo ƒe mɔnu si wonya nyuie wu, abe alesi woɖee fia le Nɔnɔmetata 4-15 me ene. abe ememenu si wozãna wu tsɔ daa asi ƒe gbagbã ene ta la, wogazãnɛ kokoko le afisiafi. 

Viɖe siwo le ememe fixation kple Kirschner pins ŋu:

1 eŋudɔwɔwɔ le bɔbɔe eye wòtrɔna ɖe nɔnɔmewo ŋu ŋutɔ le eŋudɔwɔwɔ me; 

2 lãmeka falɛfalɛwo ɖeɖeɖa mesɔ gbɔ o, ŋusẽ si mekpɔa ŋusẽ ɖe ʋu ƒe sisi dzi le gbagbãƒea ƒe nuwuwu o, amekoko ƒe nuveviwɔame dzi ɖeɖe kpɔtɔ, eye wònyo na gbagbãƒea ƒe dɔyɔyɔ; 

3 bɔbɔe evelia pin xɔxlɔ̃; 

4 ga si mexɔ asi o eye wozãnɛ le teƒe geɖe, si sɔ na asi ƒe gbagbã akpa gãtɔ (abe asi ƒe gbagbã le ƒunukpeƒe, gbagbã sesẽ siwo wogbã kple asi ƒe gbagbã ƒe nuwuwu ene). 

Nusiwo gblẽ le ememe nuléle ŋu: 

(1) ne wotsɔe sɔ kple plate fixation la, eƒe liƒo menyo o, eye womate ŋu atsɔ pin ɖeka akpɔ kpuie kple tɔtrɔ ƒe ʋuʋu dzi o, zi geɖe la, pin 2 kple edzivɔ hiã na atitsoga fixation; 

(2) nutete ƒe ŋusẽkpɔɖeamedzi aɖeke mele gbagbãƒea ƒe nuwuwu o; 

(3) ƒunukpeƒea ƒe anyime gblẽna ne wotsɔ ƒunukpeƒea ƒe atitsoga blae; 

(4) ƒunukpeƒea ƒe tete kple lãkusia ƒe xexe xea mɔ na asi ƒe ƒunukpeƒea be wòagade kame kaba o eye wòkpɔa ŋusẽ ɖe dɔwɔwɔ ƒe hayahaya dzi.

Esi egbegbe mɔnu kple dɔwɔnu siwo wotsɔ blaa ƒunukpeƒewoe va le ŋgɔ yim kabakaba ta la, wova le ɖɔɖɔɖo le ememe kple Kirschner-kpluwo ŋu, eye woate ŋu aɖɔ wo dometɔ akpa gãtɔ ɖo evɔ womatso ƒunukpeƒea o, womagblẽ nu boo aɖeke le lãkusi falɛfalɛwo kple lãkusi siwo ƒo xlã ƒunukpeƒea ŋu o, eye womakpɔ ŋusẽ ɖe ƒunukpeƒetetedɔ ƒe hehexɔxɔ le dɔwɔwɔ vɔ megbe ƒe hehexɔxɔ gbãtɔ dzi o. To C-arm X-ray mɔ̃ ƒe kpekpeɖeŋu me la, dɔléle aɖewo hã ate ŋu akpɔ emetsonu siwo naa dzidzeme ame to Clinique pins ƒe ememe nuléle dzi ɖeɖe kpɔtɔ nutsitsi me, si aɖe nusiwo gblẽ le teƒea ƒe lãmeka falɛfalɛwo ŋu kple ŋusẽ si wòkpɔna ɖe ʋu ƒe sisi yi gbagbãƒea ƒe nuwuwu dzi akpɔtɔ, si ana wòado gbagbãƒea ƒe dɔyɔyɔ ɖe ŋgɔ. 

Mɔxexe ɖe ememe nuléle kple Kristen pins ŋu: 

1 Dzra ƒu gã siwo lolo wu ɖo kple Kristen-kplu siwo ƒe didime nye milimeta 1.0~1.2, eye nànya afisi woage ɖo kple afisi woage ɖo le alesi fli si wogbã la le nu; 

2 Le taɖodzinu be woagbugbɔ ŋusẽ ƒe fli la aɖo anyi la, ele be woagbugbɔ akɔta ƒe gbagbãƒewo aɖo teƒe bubu le ŋutilã ƒe wɔwɔme nu eye woaɖɔ wo ɖo sesĩe; 

3 Menye ɖe wòhiã be woatsɔ Kristen-kpluwo aɖɔ ƒu ƒe ʋuƒoawo katã ɖo o, eye le susu si nye be woana ƒu gbagbã ƒe nuwuwu nali ke ta la, ele be woazã Kristen-kplu ʋɛ aɖewo alesi woate ŋui; 

4 Wometsɔa Kristen-kpluwo to asibidɛa ƒe lãkusi alo akɔta ƒe lãkusi me be woawɔ kamedede si wɔa dɔ kaba alesi wòanya wɔe o; 

5 ele be ɖoɖo sesẽ aɖe nanɔ anyi do ŋgɔ na dɔwɔwɔ nɛ eye womagawɔ dɔa ake le dɔwɔwɔ na amea me o, ne menye nenema o la, ate ŋu agbã mɔ si xe mɔ na ʋua ƒe gbagbã la wu alo womate ŋu aɖɔe ɖo gɔ̃ hã o; 

6 zi geɖe la, ele be woatsɔ Kirschner pin la ade ŋutigbalẽa me be wòaɖe dɔlékui ƒe mɔnukpɔkpɔ dzi akpɔtɔ eye eɖeɖe ɖa mesesẽna o.

2、Metacarpal micro agbalẽvi: 

Asi ƒe gbagbãwo ƒe ememe léle sesẽe nye nusi dzi wotu kamedede si wɔa dɔ kabakaba ɖo eye wòhiã be woagbugbɔ asi ƒe dɔwɔwɔ nyuie aɖo anyi.AO ememetɔ ƒe mɔnu bia be woagbugbɔ asi gbagbã ƒe nuwuwu aɖo ɖe ŋutilã ƒe nɔnɔme me pɛpɛpɛ eye woana gbagbãƒea ƒe nuwuwu nali ke le dɔwɔwɔ ƒe nɔnɔme me, si woyɔna zi geɖe be asi ƒe gbagbã sesẽ, be woaɖe mɔ na ʋuʋu kabakaba.AO hã tea gbe ɖe amekoko ƒe dɔwɔwɔ siwo me womewɔa nuvevi ame boo o dzi, siwo léa fɔ ɖe ʋu ƒe sisi takpɔkpɔ ŋu. AO tea gbe ɖe amekoko siwo me womewɔa nu boo aɖeke le o siwo me wotsia dzi ɖe ʋu ƒe sisi takpɔkpɔ ŋu hã dzi. Microplate ememe fixation na asi gbagbã naa nusiwo naa dzidzeme le ŋusẽ, gbagbã ƒe nuwuwu ƒe liƒo kple nyaƒoɖeamenu le eƒe nuwuwu dome gome. Le dɔwɔwɔ vɔ megbe ƒe dɔwɔwɔ ƒe hayahaya, ɣeyiɣi si woatsɔ ada gbe le lãmekawo me kple dɔlékuiwo ƒe agbɔsɔsɔ gome la, wobu micro titanium-gbadzɛwo ƒe dɔwɔwɔ be enyo ŋutɔ wu kerf-kpluwo tɔ, eye le esi gbagbãƒea ƒe dɔyɔɣi le micro titanium-gbadzɛwo tutu vɔ megbe le kpuie ŋutɔ wu esi wotsɔ ɖɔa nu bubuwoe, si wɔnɛ be dɔnɔa trɔna yia agbe si sɔ gbɔ kaba.

Viɖe siwo le microplate ƒe ememe fixation dɔdamɔnu ŋu: 

(1) ne wotsɔe sɔ kple kerf pins la, microplate screws ƒe histocompatibility kple lãmenugbagbeviwo ƒe dɔwɔwɔ nyuie wu; 

(2) alesi plate nail fixation system la li ke kple nyaƒoɖeamenu si le gbagbãƒea ƒe nuwuwu nana be gbagbãƒea tena ɖe ŋutilã ƒe akpa si wogbugbɔ ɖoa ​​teƒe bubu ŋu, si le dedie wu, si nyo na gbagbãƒea ƒe dɔyɔyɔ; 

(3) zi geɖe la, woɖea mɔ ɖe kamedede si wɔa dɔ kaba ŋu le microplate fixation megbe, si nyo na asi ƒe dɔwɔwɔ ƒe gbugbɔgadzɔ. 

3. Nusuewo ƒe ʋuƒo.

Microscrews siwo wotsɔ léa ʋuka si le spiral alo long oblique fracture fixation la li ke abe gakpo gbadzɛwo ene, gake teƒe si woɖea lãkusi falɛfalɛwo kple periosteal stripping le la le sue wu steel plate fixation tɔ, si nyo na ʋu ƒe sisi ta eye wòwɔ ɖeka kple nukpɔsusu si nye be woawɔ dɔ si me womedea ame dzi boo o. Togbɔ be T- kple L-ƒomevi ƒe aŋenuwo li na ƒunukpeƒetetedɔ ƒe gbagbã hã la, tɔtrɔyi le dɔwɔwɔ vɔ megbe menyo wu esi na ƒunukpeƒe ƒe gbagbãwo o, eye viɖe aɖewo le microscrews ŋu le ƒunukpeƒe ƒe gbagbã le ƒunukpeƒe kple ƒunukpeƒe ƒe gbagbã ŋu. Gavi siwo wotsɔ ga ƒo ƒu ɖe ƒu ƒe lãkusi me ate ŋu anɔ te ɖe nuteɖeamedzi ƒe agba si lolo wu nu, eyata nusi wotsɔ blae la sesẽ eye ate ŋu ade nyaƒoɖeamenu si le ƒu gbagbãƒea ƒe nugbɔwo dome be wòana ƒu ƒe akpa siwo wogbã la nate ɖe wo nɔewo ŋu kplikplikpli, si wɔnɛ be ɣeyiɣi si woatsɔ ada dɔe la nɔa kpuie eye wònana ƒua ƒe gbagbã ƒe dɔyɔyɔ nɔa bɔbɔe, abe alesi woɖee fia le Nɔnɔmetata 4-18 me ene. wozãa microscrews koŋ na diaphysis ƒe gbagbã siwo le oblique alo spiral kple intra-articular avulsion fractures siwo ƒe ƒu lolo wu. Ele vevie be míade dzesii be ele be ka si wotsɔ gbã la ƒe didime nanye diaphysis ƒe didime ƒe teƒe eve ya teti ne wole asi ƒe ke ƒe gbagbã siwo le tsia dzi alo esiwo le tsatsam la ɖɔm to microscrews ɖeɖeko zazã me, eye ne mede ɖeke o la, ka ƒe kekeme nanye ka ƒe didime ƒe teƒe etɔ̃ ya teti ne wole intra-articular avulsion fracture blocks ɖɔm ɖo.

4. Miniature gotagome fixation akɔtaɖonu.

Esesẽna ɣeaɖewoɣi be woagbugbɔ aɖo metacarpophalangeal fractures siwo gblẽ la le ŋutilã ƒe wɔwɔme nu ne wotsoe gɔ̃ hã alo womate ŋu aɖɔ wo ɖo sesĩe le ememe o elabena ƒu ƒe ʋuƒoa gblẽ. Gotagome nusi wotsɔna léa nu ɖe ​​te la ɖea mɔ na gbagbãƒe si wogbã la be wòagahaya eye wòléa eƒe didime me ɖe asi le hehe ƒe ŋusẽkpɔɖeamedzi te, eye wòwɔa akpa si me mekɔ tututu o, abe alesi woɖee fia le Nɔnɔmetata 4-19 me ene. Woda gotagome fixation brace ƒe ɖoɖo to vovo na metacarpals vovovowo: wotsɔa 1st kple 2nd metacarpals dana ɖe dorsal radial side, 4th kple 5th metacarpals wotsɔa dorsal ulnar side, eye wotsɔa 3rd metacarpal dana dorsal radial alo dorsal ulnar side le nɔnɔmea nu, eye woléa ŋku ɖe gege ɖe eme ŋu be woaxe mɔ ɖe injury to lãkusia. Woate ŋu atu gbagbãƒe siwo wotu eye woagbugbɔ aɖo wo ɖe teƒe bubu le X-ray te, eye woate ŋu atso nu suesuesuewo be wòakpe ɖe wo ŋu woagbugbɔ aɖo wo nɔƒe nenye be wogbugbɔ ɖo teƒe bubu mesɔ o.

Viɖe siwo le gotagome fixation brace ŋu.

(1) eŋudɔwɔwɔ le bɔbɔe eye ate ŋu atrɔ asi le ʋuʋudedi vovovowo ƒe nuwuƒe si wogbã ŋu;

(2) ate ŋu agbugbɔ aɖo ƒunukpeƒea ƒe ƒunukpeƒetetedɔ ƒe gbagbãwo nyuie ahaɖɔ wo ɖo evɔ magblẽ nu le ƒunukpeƒea ƒe akpa ŋu o, eye ate ŋu ahe ƒunukpeƒea ƒe susu ɖa be wòaxe mɔ ɖe ƒunukpeƒea ƒe lãkusi kple axadzi ƒe lãkusiwo ƒe ƒoƒo nu; 

. 

(4) enaa asibidɛ si ŋu dɔlélea le ƒe dɔwɔwɔ ƒe kamedede kaba le ƒunukpeƒe si womeɖo o me be woaƒo asa na ƒunukpeƒea 

(5) Ate ŋu aɖɔ asi ƒe gbagbã ɖo nyuie evɔ makpɔ ŋusẽ ɖe asi si ŋu dɔlélea le ƒe abi ƒe atikewɔwɔ le dɔwɔwɔ vɔ megbe dzi o.

Ale Si Nàƒle Ƒumeŋuɖuiwo Kple Ƒumeŋuɖui Dɔwɔnuwo?

Elabena CZMEDITECH , míekpɔa adzɔnuwo ƒe hatsotso si de blibo ŋutɔ si nye ƒumeŋuɖui ƒe amekoko ƒe nusiwo wotsɔ dea ame me kple dɔwɔnu siwo sɔ kplii, nusiwo dometɔ aɖewoe nye akɔta ƒe akpa siwo wotsɔ dea ame me, ɖa siwo le lãkusi me, trauma plate, ʋuƒo si wotsɔ xea mɔ na nu, cranial-maxillofacial ƒe tagbɔ, ametia ƒe ŋutilã ƒe akpa aɖe, elektrikdɔwɔnuwo, gotagome fixators, ƒunukpeƒetetedɔ (arthroscopy)., lãwo ƒe dɔlélewo gbɔ kpɔkpɔ kple woƒe kpeɖeŋutɔ dɔwɔnuwo.

Tsɔ kpe ɖe eŋu la, míeɖoe kplikpaa be míayi edzi anɔ atike yeyewo wɔm eye míakeke adzɔnuwo ƒe hatsotsowo ɖe enu, ale be míakpɔ ɖɔkta kple dɔnɔ geɖe ƒe amekoko ƒe nuhiahiãwo gbɔ, eye míana míaƒe dɔwɔƒea hã nate ŋu aʋli ho geɖe wu le xexeame katã ƒe ƒumeŋuɖui kple dɔwɔnuwo ƒe dɔwɔƒe bliboa me.

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