Ènya alesi woaɖɔ metacarpal ƒe gbagbã ɖoa?

Metacarpophalangeal fractures nye asi ƒe gbagbã si bɔ, si nye asi ƒe nuveviwɔame dɔnɔwo katã ƒe akpa 1/4. Le asi ƒe wɔwɔme si le bɔbɔe eye wòsesẽ kple eƒe mɔ̃ ƒe dɔwɔwɔ nyuie ta la, asi ƒe gbagbã dzi kpɔkpɔ le vevie sãsãsã eye wòsesẽ wu mɔ̃ɖaŋununya ƒe ŋeŋe le ʋuƒo didi bubuwo ŋu.

Kakaɖedzi nana be gbagbãƒea ƒe liƒo le teƒe si wogbugbɔ ɖo ɖe teƒe bubu vɔ megbee nye nu vevitɔ si ana metacarpophalangeal fracture dɔdamɔnua nakpɔ dzidzedze. In order to restore the function of the hand, the fracture often requires proper fixation, and in the past, external fixation with plaster or internal fixation with Kirschner pins was commonly used, but often due to inaccurate fixation or long fixation time, which is not conducive to early postoperative joint rehabilitation, and has a greater impact on the functional recovery of the metacarpophalangeal joint, bringing some difficulties to the functional rehabilitation of the hand.

Egbegbe atikewɔwɔmɔnu siwo wozãna le ememe la le ememe fixation si sẽ wu zãm geɖe wu, abe micro plate screw fixation ene.

Atikewɔwɔ ƒe gɔmeɖosewo .

Gɔmeɖose siwo ku ɖe atikewɔwɔ na metacarpal kple phalangeal fractures of asi ŋue nye: ŋutilã ƒe nɔnɔme tɔtrɔ, kekeli kple sesẽ ƒe fixation, ʋuʋu kaba kple dɔwɔwɔ ƒe kamedede. Gɔmeɖose siwo ku ɖe asi ƒe akpa si le ƒunukpeƒea me kple esi le ƒunukpeƒewo ƒe akpa si le lãkusi me ŋu la sɔ kple esiwo wowɔ na ƒunukpeƒewo ƒe akpa bubuwo: ƒunukpeƒewo ƒe akpa si nye ŋutilã ƒe wɔwɔme kple dɔwɔwɔ kaba ƒe wɔwɔme gbugbɔgaɖoanyi. Ele be asi la ƒe metacarpal kple phalangeal fractures dada nadze agbagba be yeaɖo ŋutilã ƒe nɔnɔme ƒe tɔtrɔ gbɔ, axadzi ƒe ʋuʋu, alo dzogoe ƒe ʋuʋu >10° na deti ƒe megbe ƒe akpa. Ne woɖɔli metacarpal ƒe gbagbãƒe ƒe nuwuwu alo woɖee ɖe axadzi le dzogoe aɖe dzi la, atrɔ asi le asibidɛa ƒe ʋuʋu kple eƒe kekeɖenu ƒe zɔzɔ si sɔ ŋu, si ana wòatutu alo adze anyi tso asibidɛ si te ɖe eŋu la me le eƒe ƒoƒo me, si akpɔ ŋusẽ ɖe asibidɛ ƒe dɔwɔwɔ ƒe nyateƒenyenye dzi; Togbɔ be dzogoe ƒe ʋuʋu >10° yi deti ƒe akɔta agblẽ ƒu kple lãkusi ƒe kadodo si le gbadzaa la me, si ana lãkusia ƒe tsitretsitsi kple eƒe didime nadzi ɖe edzi le lãkusia ƒe ʋuʋu kple eƒe kekeme me, eye wòana abi si le lãkusia ŋu nadidi o, si ahe afɔku si le lãkusi ƒe gbagbã me vɛ. Afɔku si le lãkusi ƒe gbagbã me.

Metacarpal kple phalangeal ƒe gbagbãwo sɔ le woƒe ŋutete be woado dzi le tɔtrɔ ƒe nɔnɔme madeamedzi me, esime metacarpal la ɖea mɔ ɖe shortening displacement kple dorsal angular displacement ŋu wu phalangeal. Carpometacarpal kple metacarpophalangeal joints ate ŋu axe fe ɖe metacarpal ƒe dzogoe ƒe nɔnɔme madeamedzi ta, eye asibidɛ sue si le abe dzogoe ene la trɔna nyuie wu ɖe metacarpal ƒe dzogoe ƒe nɔnɔme madeamedzi wu titina asibidɛ si woɖo ɖi la nu. Asiléƒe ƒe ŋusẽ si dzi ɖe kpɔtɔ le asi ƒe lãmeka ƒe kpuiƒe si le eme ta la dzena ne metacarpal la le dzogoe si wu 30° dzi va ɖo akɔta ƒe akpa dzi ko.

Amekoko ƒe mɔnu .

Amekoko ƒe mɔnu si wozãna na metacarpal fractures la le bɔbɔe vie eye zi geɖe la, ezãa akɔta ƒe mɔnu, abe alesi woɖee fia le Nɔnɔmetata 4-14 me ene. Woɖea metacarpal evelia ɖe ŋgɔ le ŋgɔgbe esime woɖea metacarpal atɔ̃lia ɖe ulnarly, eye zi geɖe la, woɖea metacarpal etɔ̃lia kple enelia ɖe titina. Ne wowɔ dɔ le metacarpals eve siwo te ɖe wo nɔewo ŋu dzi le ɣeyiɣi ɖeka me la, wozãa incision si ƒe nɔnɔme le abe S ene tsɔ bua amekoko teƒe eveawo siaa ŋu.

Mɔnu tiatia si woɖo ɖi .

Ememe nu geɖe li na metacarpophalangeal gbagbãwo, abe Kirschner pins, screws, plates kple external fixation frames, siwo dometɔ aɖewoe nye Kirschner pins kple microplate wu. Le metacarpal fractures, ememe fixation kple microplate la le viɖe siwo dze ƒã wu fixation kple Kirschner pins eye woate ŋu anyo wu; Le proximal phalangeal fractures gome la, wolɔ̃a microplate zi geɖe, gake ne esesẽ be woatsɔ gaviwo ade akpa si le didiƒe le proximal phalangeal kple ta ƒe gbagbã me la, wolɔ̃a ememe fixation kple crossed kirschner pins, si nyo wu na asibidɛ si ŋu wòku ɖo ƒe dɔwɔwɔ ƒe hayahaya; Le titina phalangeal ƒe gbagbãwo dada gome la, ele be woadi be woalɔ̃ kirschner pins.

1、Kirschner ƒe aŋenu: 

Wozã Kirschner ƒe aŋe ememe fixation le atikewɔƒea ƒe 70 kple edzivɔe nye sia eye wònye ememe fixation material si wozãna wu na metacarpophalangeal fractures, si le bɔbɔe be woawɔ dɔ, ganyawo kple dɔwɔwɔ, eye wònye ememe fixation mɔnu si wonya nyuie wu, abe alesi woɖee fia le Nɔnɔmetata 4-15 me ene. Abe ememe fixation si wozãna wu tsɔ daa asi ƒe gbagbã ene la, wogazãnɛ kokoko. 

Viɖe siwo le ememe fixation kple Kirschner pins:

1 Ele bɔbɔe be woawɔ dɔ le eŋu eye woate ŋu atrɔ asi le eŋu ŋutɔ le ezazã me; 

2 Lãmetsi falɛfalɛwo ƒe ʋuʋu si mesɔ gbɔ o, ŋusẽ si womekpɔna ɖe ʋu ƒe sisi dzi boo le ƒunukpeƒea ƒe nuwuwu o, amekoko ƒe nuveviwɔame si mesɔ gbɔ o, eye wònyo na gbagbã ƒe dɔyɔyɔ; 

3 PIN ƒe evelia xɔxɔ bɔbɔe; 

. 

Nusiwo gblẽ le ememe fixation ŋu: 

(1) Ne wotsɔe sɔ kple plate fixation la, liƒoa menyo o, eye womate ŋu atsɔ pin ɖeka aɖu shortening kple rotational displacement dzi o, zi geɖe la, pin siwo wu 2 hiã na cross fixation; 

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

(3) ƒunukpeƒea ƒe akpa si wotsɔ ƒo ƒu ɖe wo nɔewo ŋu la gblẽna le esi wotsɔa cross-joint fixation gblẽa nu le eŋu; 

(4) ƒunukpeƒea ƒe ƒoƒo kple lãkusia ƒe mɔxexe xea mɔ na asi ƒe ƒuƒoƒoa be wòagade kame kaba o eye wòakpɔ ŋusẽ ɖe dɔwɔwɔ ƒe hayahaya dzi.

Le egbegbe ememe fixation mɔnuwo kple dɔwɔnuwo ƒe ŋgɔyiyi kabakaba me la, ememe fixation kple Kirschner pins va le asi trɔm ɖe edzi geɖe wu, eye woate ŋu aɖɔ wo dometɔ akpa gãtɔ ɖo evɔ womatso ƒunukpeƒea o, eye wogblẽa nu boo aɖeke le lãkusi falɛfalɛwo kple lãkusi siwo ƒo xlã ƒunukpeƒea ŋu o, eye womekpɔa ŋusẽ ɖe dɔwɔwɔ vɔ megbe ƒunukpeƒe ƒe dɔwɔwɔ ƒe hehexɔxɔ gbãtɔ dzi o. To C-Arm X-ray mɔ̃ ƒe kpekpeɖeŋu me la, nɔnɔme aɖewo hã ate ŋu akpɔ emetsonu siwo ana dzidzeme ame to ememe fixation dzi ɖeɖe kpɔtɔ si wotu kple clinique pins me, si gaɖe nusiwo gblẽ le nutoa me ƒe lãkusi falɛfalɛwo ŋu dzi kpɔtɔ eye wòagblẽ nu le ʋu ƒe tsɔtsɔ yi gbagbãƒea ƒe nuwuwu ŋu, si ana woahe gbagbãƒea ƒe dɔyɔyɔ ɖe ŋgɔ. 

Kpɔ nyuie le ememe fixation kple Kristen Pins: 

. 

2 Esi taɖodzinue nye be woagbugbɔ ŋusẽ ƒe fli la aɖo anyi ta la, ele be woatrɔ asi le ƒunukpeƒewo ƒe gbagbãƒewo ŋu le ŋutilã ƒe wɔwɔme nu eye woaɖo wo ɖe ɖoɖo nu sesĩe; 

. 

1 Kristen pinwo metoa asibidɛa ƒe lãkusi alo lãkusi ƒe lãkusi ƒe lãkusi me be woawɔ kamedede ƒe kamedede kaba alesi woate ŋui o; 

3 Ele be ɖoɖo sesẽ aɖe nanɔ anyi do ŋgɔ na dɔwɔwɔ eye womagagbugbɔ awɔ dɔ na ame le dɔwɔwɔ me o, ne menye nenema o la, woate ŋu agbã gbagbãƒea alo womate ŋu aɖɔe ɖo gɔ̃ hã o; 

1 Zi geɖe la, ele be woatsɔ Kirschner pin la ade ŋutigbalẽa me be wòaɖe dɔlékui ƒe mɔnukpɔkpɔ dzi akpɔtɔ eye masesẽ be woaɖee ɖa o.

2、metacarpal micro plate: 

Asi ƒe gbagbã ƒe ememe fixation sesẽ nye gɔmeɖoanyi na dɔwɔwɔ kaba ƒe kamedede eye wòhiã be woagbugbɔ asi ƒe dɔwɔwɔ nyui aɖo anyi.AO ememe fixation technique bia ŋutilã ƒe ŋutilã ƒe tɔtrɔ pɛpɛpɛ le gbagbãƒe ƒe nuwuwu ƒe nuwuwu kple gbagbã ƒe nuwuwu ƒe nuwuwu le dɔwɔwɔ ƒe nɔnɔme me, si woyɔna zi geɖe be dɔwɔwɔ ƒe ʋuʋu sesẽ, si te gbe ɖe ʋuʋu kaba hã dzi.AO. AO tea gbe ɖe amekoko ƒe mɔnu siwo me wowɔa nu boo aɖeke le o siwo ku ɖe ʋu ƒe sisi ta kpɔkpɔ ŋu hã dzi. Microplate ememe fixation le asi ƒe gbagbã naa dzidzeme me tsonu le ŋusẽ, liƒo ƒe gbagbã nuwuwu kple nyaƒoɖeamenu le nuwuwuawo dome. Le dɔwɔwɔ vɔ megbe dɔwɔwɔ ƒe hayahaya, fracture dɔyɔyɔ ɣeyiɣi kple dɔlékui ƒe agbɔsɔsɔ ne wotsɔe sɔ kple la, wobua micro titanium plates ƒe dɔwɔwɔ be enyo ŋutɔ wu kerf pins tɔ, eye elabena fracture gbedada ɣeyiɣi le micro titanium plate fixation megbe la le kpuie ŋutɔ wu fixation modalities bubuwo tɔ, si wɔnɛ be wòtrɔna kaba ɖe dɔnɔa ƒe agbe si sɔ ŋu.

Viɖe siwo le microplate ememe fixation treatment me: 

(1) Ne wotsɔe sɔ kple kerf pins la, microplate screws ƒe histocompatibility kple tissue response nyo wu; 

(2) plate nail fixation system ƒe liƒo kple nyaƒoɖeamenu si le fracture end la na be gbagbãƒea te ɖe anatomical repositioning ŋu, fixation si le dedie wu, si sɔ na gbagbãƒe ƒe dɔyɔyɔ; 

(3) Zi geɖe la, woɖea mɔ ɖe kamedede ƒe kamedede kaba ŋu le microplate fixation megbe, si sɔ na asi ƒe dɔwɔwɔ ƒe gbugbɔgaxɔ. 

3. Microscrews.

Microscrews na spiral alo long oblique fracture fixation ƒe liƒo sɔ kple gakpo gbadzɛwo tɔ, gake lãkusi falɛfalɛwo kple periosteal stripping area le sue wu gakpo plate fixation tɔ, si sɔ na ʋu ƒe sisi takpɔkpɔ eye wòle sɔsɔm kple nukpɔsusu si nye be woawɔ dɔ sue aɖe ko. Togbɔ be T- kple L-ƒomevi ƒe aŋewo li na ƒunukpeƒetetedɔ siwo te ɖe wo nɔewo ŋu hã la, tɔtrɔgbɔ va le dɔwɔwɔ vɔ megbe menyo wu esi wowɔ na diaphyseal ƒe gbagbã, eye viɖe aɖewo le microscrews ŋu na intra- kple periarticular fracture fixation. Screw siwo wotsɔ ƒo ƒu ƒe lãkusi me ate ŋu anɔ te ɖe nuteɖeamedzi ƒe agba gã aɖe nu, eyata fixation la li ke eye ate ŋu ahe nyaƒoɖeamenu ɖe ​​fracture ends dome be wòahe fracture surfaces la ɖe go kplikplikpli, si naa dɔyɔyɔ ƒe ɣeyiɣi kpui aɖe eye wònaa fracture healing nɔa bɔbɔe, abe alesi woɖee fia le Figure 4-18 me ene. Wozãa microscrews koŋ na diaphysis ƒe gbagbã alo spiral fractures kple intra-articular avulsion fractures siwo nye ƒu ƒe lolome gãwo. Ele vevie be míade dzesii be ele be ka si ƒe gbagbã ƒe didime nanye diaphysis ƒe didime ƒe teƒe eve ya teti ne wole asi ƒe ke ƒe gbagbã alo spiral gbagbãwo ɖɔm ɖo to microscrews ɖeɖeko zazã me, eye ne mede ɖeke o la, ka ƒe didime ƒe kekeme ƒe teƒe etɔ̃ ne wole intra-articular a afulsion blocks ɖɔm ɖo.

4. Miniature gotagome fixation brace.

Wogbugbɔa metacarpophalangeal fractures comminuted comminuted resisted restued na anatogically ne wowɔ dɔ na wo gɔ̃ hã alo womate ŋu aɖo wo ɖe ememe sesĩe le ememe o elabena ƒu scaffold la tsrɔ̃. External fixation brace la ɖea mɔ na comminud fracture la be wòahaya eye wòalé eƒe didime ɖe te le traction ƒe ŋusẽkpɔɖeamedzi te, si wɔa akpa aɖe si woɖo ɖi vie, abe alesi woɖee fia le Nɔnɔmetata 4-19 me ene. Wotsɔ gotagome fixation brace la ƒe ɖoɖo to vovo na metacarpals vovovowo: wotsɔa metacarpals 1st kple 2nd dana ɖe megbe radial ƒe akpa dzi, wotsɔa metacarpals 4 lia kple 5 lia dana ɖe megbeƒu ƒe akpa si le megbe, eye wotsɔa metacarpal la dana ɖe megbe, eye wotsɔa metacarpal la dana ɖe megbe, eye wotsɔa metacarpal la dana ɖe megbe, eye wotsɔa megbea ƒe akpa si le megbe la dana ɖe megbe. Woate ŋu axe gbagbãƒe siwo wotu la eye woagbugbɔ wo aɖo ɖe X-ray te, eye woate ŋu awɔ nu suesuesuewo be woakpe ɖe wo ŋu le woƒe nɔƒewo ɖoɖo me nenye be teƒe si wogbugbɔ ɖo la mesɔ nyuie o.

Viɖe siwo le gotagome fixation brace ŋu.

(1) dɔwɔwɔ le bɔbɔe eye ate ŋu atrɔ asi le ʋuʋudedi ƒe nuwuwu ƒe ʋuʋu vovovowo ŋu;

(2) Ate ŋu agbugbɔ aɖo metacarpal phalanges ƒe akpa si le ƒunukpeƒea me nyuie eye wòaɖɔe ɖo evɔ magblẽ nu le ƒunukpeƒea ƒe anyime ŋu o, eye wòte ŋu hea alɔnu ƒe akpa si le ƒunukpeƒea ƒe akpa si nye joint capsule kple lateral collateral ligaments; 

(3) woate ŋu atsɔe aƒo ƒu kple ememe fixation si seɖoƒe li na na commimed fractures siwo womate ŋu agbugbɔ awɔ le ŋutilã ƒe wɔwɔme nu o, eye gotagome fixation brace ate ŋu agbugbɔ aɖo ŋusẽ ƒe fli la ƒe akpa aɖe ahalé be nɛ; 

(4) Enaa asibidɛ si ŋu dɔlélea le ƒe dɔwɔwɔ kaba le ƒunukpeƒe si womeɖo o la 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 si wowɔ le dɔwɔwɔ nɛ vɔ megbe dzi o.

Ale Si Nàƒle Ƒumeŋutinunya Kple Ƒumeŋuɖuiwo ƒe Dɔwɔnuwo)

na . czmediTech , míekpɔa atike ƒomevi aɖe si de blibo ŋutɔ le ƒumeŋutinunya ƒe dɔwɔwɔ na ame ƒe ŋutilã kple dɔwɔnu siwo sɔ kplii me, atikeawo dometɔ aɖewoe nye . Akɔta ƒe nusiwo wotsɔ dea akɔtae ., Intramedullary ƒe ɖawo ., nuveviwɔame ƒe agbalẽvi ., Locking Plate ., Tagbɔ-maxillofacial ., Ametia ƒe akpa aɖe ., Ŋusẽ Dɔwɔnuwo ., External fixators ., Arthroscopy ., Lãwo ƒe dɔlélewo gbɔ kpɔkpɔ kple woƒe dɔwɔnu siwo kpena ɖe wo ŋu.

Tsɔ kpe ɖe eŋu la, míeɖoe kplikpaa be míayi edzi anɔ atike yeyewo tum ɖo eye míakeke atikewo ɖe enu, ale be míakpɔ ɖɔkta kple dɔnɔ geɖe ƒe amekoko ƒe nuhiahiãwo gbɔ, eye míana míaƒe dɔwɔƒea hã nakpɔ hoʋiʋli geɖe wu le xexeame katã ƒe ƒumeŋutinunya kple dɔwɔnuwo ƒe dɔwɔƒe bliboa me.

Míeɖoa wo ɖe xexeame katã, ale be nàte ŋu awɔ . Ka ɖe mía dzi le email adrɛs song@orthopedic-china.com hena nyayɔyɔ femaxee, alo ɖo gbedasi ɖe WhatsApp hena ŋuɖoɖo kaba +86- 18112515727 .

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