Ènya alesi wowɔa humerus ƒe gbagbã siwo te ɖe eŋu la?

Proximal humerus fractures nye ƒu ƒe gbagbã siwo bɔ wu le nuveviwɔame ƒe ƒunukpeƒetetedɔ me la dometɔ ɖeka, eye humerus ƒe gbagbã akpa gãtɔ nye ƒu ƒe gbagbã siwo me ŋusẽ mele o le ame tsitsiwo me.

Togbɔ be woate ŋu ada proximal humerus fractures ƒe akpa gãtɔ le mɔ si me susu mele o nu hã la, 10-15% ƒe gbagbã gakpɔtɔ hiã amekoko ƒe atikewɔwɔ, si ƒe ɖee nye incisional reduction plate fixation, closed reduction intramedullary nail internal fixation, kple ƒunukpeƒewo ɖɔliɖɔli.

Ele be woatu atikewɔwɔ ƒe nyametsotsoa ɖe dɔnɔa ƒe ŋutilãmenɔnɔme, eya ŋutɔ ƒe nukpɔsusu, susuŋutinunya ƒe mɔkpɔkpɔwo, kple eƒe gbagbã ƒomevi dzi.

1. Gbɔdzɔgbɔdzɔ ƒe gbagbãwo gbugbɔgaɖoɖo kple wo léle ɖe te .

【Aɖaŋuɖoɖo】Na proximal humeral greater tuberosity (anɔ ƒomevi 2 partial fracture) fractures siwo wotsɔ ƒo ƒu kple abɔta ƒe ʋuʋu, do ŋgɔ na dɔwɔwɔ CT dodokpɔ, negbe le amekoko ƒe kɔ ƒe nuto me, repositioning kple braking kple traumatic abɔta brace le kpata me (

2. Vevesesenutsitike si wowɔna do ŋgɔ na dɔwɔwɔ na ame hafi wowɔa dɔ na ame .

【Aɖaŋuɖoɖo】Dɔnɔ siwo ƒe akɔta ƒe gbagbã le ŋgɔgbe la lɔ̃a vevesesenutsitike si wodona do ŋgɔ na dɔwɔwɔ kple acetaminophen si woano alo NSAIDs, eye woate ŋu atsɔ opioid siwo woano akpe ɖe eŋu ne ŋusẽkpɔɖeamedzia menyo o (expert kafukafu ƒe agbɔsɔsɔ: 100%;

3. Dutanyanyuigbɔgblɔdɔ si wowɔ do ŋgɔ na dɔwɔwɔ na ame .

[Aɖaŋuɖoɖo] Ele be woawɔ hehexɔxɔ do ŋgɔ na dɔwɔwɔ le mɔ si to vovo eye woawɔe le mɔ vovovowo nu nu. (Expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 100%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 83.8%)

4. Do ŋgɔ na dɔwɔwɔ na ame ƒe nunyiame ŋuti numekuku kple atikewɔwɔ si kpena ɖe ame ŋu .

【Aɖaŋuɖoɖo】be woawu nunyiame dodokpɔ nu na dɔnɔwo le 24 h tso esime woxɔ wo eye woana nunyiame ƒe nudede dɔnɔ siwo ŋu nunyiame ƒe afɔku le. (Expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 98.5%; Kafukafu ƒe agbɔsɔsɔ sesẽ: 55.9%)

5. suklidɔléla ƒe suklidɔléla ƒe dodokpɔ kple ɖoɖowɔwɔ le dɔwɔwɔ nɛ me .

【Aɖaŋuɖoɖo】Nu si wokafu be woatsɔ akpɔ suklidɔléla akpa gãtɔ siwo wowɔ dɔ na lae nye 7.8 va ɖo 10.0 mmol/L.

6. Lãmetsi falɛfalɛwo ƒe ʋuʋu dzi kpɔkpɔ le dɔwɔwɔ na ame le dɔwɔwɔ nɛ me .

【Aɖaŋuɖoɖo】Na dɔnɔ siwo wowɔ dɔ na le tiatia me hena proximal humerus fracture la, wonaa ŋutilã me mɔnu geɖe be woatsɔ aɖe ʋuʋudedi dzi akpɔtɔ le dɔwɔwɔ na ame me. (Expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 98.5%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 80.9%)

7. Nuɖuɖu dzi kpɔkpɔ do ŋgɔ na dɔwɔwɔ na ame .

【Aɖaŋuɖoɖo】 Dɔnɔ siwo wowɔ dɔ na le tiatia me ate ŋu aɖu aha siwo me kɔ 2 h hafi woawɔ dɔ na wo eye nuɖuɖu siwo me starch le alo nyinotsinuwo 6 h hafi woawɔ dɔ na wo. (Expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 100%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 76.5%)

8. Aɖuɖɔtoe si me wowɔa dɔ le le dɔwɔwɔ na ame me .

【Wokafu akafu kafui be womeɖo aɖaŋu be woawɔ dɔ na ame le dɔwɔwɔ na ame me le dɔwɔwɔ na ame ƒe aɖuɖɔtoe me na humerus fracture surgery si le proximal humerus fracture o (expert composure rate: 100%; sesẽ kafukafu ƒe agbɔsɔsɔ: 78.6%)

9. Dɔlékuiwutikewo zazã le dɔwɔwɔ vɔ megbe ƒe mɔxexeɖedɔléle nu .

【Aɖaŋuɖoɖo】Le dɔnɔ siwo ƒe humerus ƒe gbagbã si te ɖe wo nɔewo ŋu siwo hiã endoprosthesis alo ƒunukpeƒewo ɖɔliɖɔli ta la, wokafu cephalosporin siwo nye dzidzime gbãtɔ kple evelia ƒe mɔxexeɖedɔléle nu ƒe mɔxexe ɖe dɔlékuiwo nu le dɔwɔwɔ le dɔwɔwɔ nɛ me. (Expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 97.1%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 73.5%)

10. Atike si wua alɔ̃dɔdɔ ƒe tiatia .

【Aɖaŋuɖoɖo】anesthesia wokafui be woaxɔ mɔnu si nye nutome block compound general anesthesia, tia atikewo be woaƒo asa na ɖoɖo ƒe ŋutinuwo ƒe dɔmawɔmawɔ nyuie na dɔnɔ tsitsiwo, eye woalé ŋku ɖe ŋusẽdodo ŋkuléle ɖe nu ŋu (expert kafukafu ƒe agbɔsɔsɔme: 100%; 71.4%).

11. Ʋu ƒe sisi le dɔwɔwɔ me le dɔwɔwɔ me .

[Aɖaŋuɖoɖo] Ele be woalé ŋku ɖe ʋu ƒe sisi dzi ɖeɖe kpɔtɔ le mɔ si sɔ nu ŋu be woaɖe ʋu ƒe sisi le dɔwɔwɔ me dzi akpɔtɔ le akɔta ƒe gbagbã si te ɖe eŋu ta, gake ele be dɔnɔ tsitsi siwo ŋu comorbidities geɖe le nalé ŋku ɖe ʋumenugbagbeviɣi ƒe liƒo me léle ɖe asi ŋu be woaƒo asa na lãmenugbagbeviwo kple ŋutinuwo ƒe agbɔsɔsɔ si mesɔ o: 100%.

12. Dɔwɔwɔ le dɔwɔwɔ me ƒe sesẽme dzi kpɔkpɔ .

[Aɖaŋuɖoɖo] Woawɔ tsidzikpɔkpɔ ƒe mɔnu si wotu ɖe taɖodzinu dzi ŋudɔ, eye woate ŋu ana atike siwo wɔa dɔ le ʋukawo me le atikewɔwɔ na ame le atikewɔwɔ me le atikewɔwɔ na wo katã me be woatsɔ axe mɔ ɖe tsi ƒe agbɔsɔsɔ fũ nu (expert kafukafu ƒe agbɔsɔsɔ: 100%; Kafukafu ƒe agbɔsɔsɔ sesẽ: 69.1%).

13. Ʋudzikpɔkpɔ le dɔwɔwɔ na ame me .

[Aɖaŋuɖoɖowo] Womekafu ʋusɔgbɔdɔ si dzi wokpɔna le dɔwɔwɔ me na humeral fractures si te ɖe eŋu o, vevietɔ le dɔnɔ tsitsiwo ŋu, eye woate ŋu azã ʋudodo le dɔwɔwɔ me kple tranexamic acid. HGB <80G/L ƒe dodokpɔ le dɔwɔwɔ me kafui be woado ʋu si nye allogeneic (expert composure rate: 100%; 100 ƒe kafukafu ƒe agbɔsɔsɔ: 73.8%).

14. Mɔxexe ɖe dɔwɔwɔ na ame le dɔwɔwɔ me nu .

[Aɖaŋuɖoɖowo] Ele be dɔnɔ siwo ƒe humeral fractures proximal fractures nado ŋusẽ dɔwɔwɔ le dɔwɔwɔ me ƒe dzoxɔxɔ dzi kpɔkpɔ eye woawɔ afɔɖeɖe vovovowo be woalé dzoxɔxɔ vevi si wu 36°C ɖe te (expert kafukafu ƒe agbɔsɔsɔme: 100%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 76.2%).

15. Amekoko ƒe mɔnu tiatia .

(1) Afɔkpodzi ƒe akpa si le gbagbãm ƒe humerus .

[Aɖaŋuɖoɖo] Wokafu Neer ƒe fefewɔƒea na proximal humerus fracture staging (eŋutinunyalawo ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 100%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 83.3%).

(2) Amekoko ƒe mɔnu .

Ele be woatu amekoko ƒe ɖoɖoa ɖe gbagbã ƒe nɔnɔme, ƒu ƒe nyonyome, dɔnɔa ƒe ŋutilã kple susu ƒe nɔnɔme kple nu bubu siwo sɔ dzi.

[Aɖaŋuɖoɖo] Woate ŋu atia nusi wotsɔ blaa nu le ememe la le ƒu ƒe gbagbã ƒe ƒomevi kple ƒu ƒe kpekpeme nu, abe plate alo intramedullary nail ene; Le dɔnɔ tsitsi siwo ƒe ƒumeŋutetewo gbugbɔɖoɖo alo wo ɖɔɖɔɖo sesẽ gome la, le akpa 4 ƒe gbagbã (kple ƒu ƒe gbagbã), akpa 3 ƒe gbagbã si me ƒumeŋuɖui sesẽ le, ƒu ƒe gbagbã si me mã kple kɔmeƒu si wowɔ kple ŋutilã ƒe ƒuƒoƒo si wotsɔ ƒo ƒu ɖe megbe: 7.

Figure 1 Nyɔnu si xɔ ƒe 65 si ƒe akpa 4 ƒe gbagbã le proximal humeral adductor insertion kple allograft fibular implant plate fixation kple incision kple repositioning.

16. Abi ƒe tsidzɔƒe ƒe mɔ̃ ɖoɖo ɖe .

[Aɖaŋuɖoɖowo] Nusiwo woatsɔ awɔ tsidzɔƒewo ƒe mɔ̃wo manɔmanɔ: 1 Dɔwɔwɔ ƒe mɔnu siwo me wowɔa nu boo aɖeke le o (mippo kple intramedullary nailing); 2 Ʋu si le dodom le ame ŋu. Nusiwo fia be woatsɔ tsidzɔƒe ƒe mɔ̃ ade eme: 1 to pectoral deltoid tete ɖe ame ŋu, ʋuƒo si wotsɔ blaa nu alo abɔta ƒe ƒunukpeƒewo ɖɔliɖɔli; 2 Ʋu si le dodom le abi ƒe anyigba dzi (expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 100%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 71.4%).

17. Abi ƒe nutsotso .

【Aɖaŋuɖoɖo】Wowu amekoko ƒe nutsotso nu to nutete bɔbɔe, ƒuƒoƒo-ɖe-ƒuƒoƒo me (expert kafukafu ƒe agbɔsɔsɔ: 100%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 76.2%).

18. Nuɖuɖu le dɔwɔwɔ vɔ megbe ƒe nuɖuɖu .

【Aɖaŋuɖoɖo】Dɔnɔwo ate ŋu aɖu aha siwo me dregs mele o to nu me ne wonya nyɔ le amekoko megbe ko, eye woagadze nuɖuɖu si sɔ gɔme le 1-2 h megbe ne nu gbegblẽ aɖeke mele wo ŋu o.

19. Dɔwɔwɔ vɔ megbe ƒe nɔƒe tiatia kple dɔwɔna gbãtɔ .

【Akafukafu】Dɔnɔwo mehiã be woamlɔ anyi ɖe aklala dzi le amekokoa megbe o, woate ŋu axɔ semi-recumbent nɔnɔme eye woate ŋu aʋuʋu le anyigba le nyɔnyrɔ̃ megbe. Ele be woatsɔ brek aɖo abɔta ƒe akɔtaɖonu si naa ame ƒe dzi gbãna la ŋu.

20. Analgesic ƒe dɔwɔwɔ le dɔwɔwɔ vɔ megbe .

【Akafuxɔxɔ】Algesia le dɔwɔwɔ na ame megbe le dɔnɔ siwo ƒe humeral fractures proximal fractures me be woazã regional blockade si wotsɔ 'background doses' si nye nSAIDs edziedzi, eye ne ehiã la, intravenous self-administered analgesia pumps alo perpepheal nerve nersely Ga home: 78.6%).

21. Mɔxexe ɖe dɔwɔwɔ vɔ megbe ƒe ʋuʋudedi kple ʋuʋudedi nu .

[Aɖaŋuɖoɖo] Ele be woana atike siwo tsia dzoxɔxɔ nu na dɔnɔawo katã 30 min hafi woawɔ dɔ na wo hafi woawɔ dɔ na wo. (Expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 97%; Kafukafu sesẽ ƒe agbɔsɔsɔ: 47.8%)

22. Dɔwɔwɔ ƒe gbugbɔgaɖɔɖo .

【Aɖaŋuɖoɖo】Dɔnɔ siwo si proximal humerus fractures siwo woɖo ɖi eye woli ke le la nadze kamededewo gbugbɔgaɖɔɖo gɔme kaba ale si woate ŋui le amekoko megbe. Gbugbɔgaɖɔɖo ƒe kamededewo kpena ɖe ame ŋu be woagbugbɔ abɔa ƒe akpa si le etame ƒe dɔwɔwɔ aɖo anyi nyuie wu (expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔ: 100%; Kafukafu ƒe agbɔsɔsɔ sesẽ: 92.9%).

23. Dzesiwo kple kplɔkplɔ ɖo .

【Ele be woaɖo aɖaŋuɖotakpekpe ƒe dzidzenuwo anyi, eye ele be woakplɔ dɔnɔwo ɖo edziedzi hena ɣleti 6 ya teti (expert ƒe aɖaŋuɖoɖo ƒe agbɔsɔsɔme: 100%; kafukafu ƒe agbɔsɔsɔ sesẽ: 83.3%).

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 ato atike yeyewo vɛ eye míakeke atikewo ɖe enu, ale be míakpɔ ɖɔkta kple dɔnɔ geɖe ƒe amekoko ƒe nuhiahiãwo gbɔ, eye míana míaƒe dɔwɔƒea hã nate ŋu aʋli ho 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 .

Ne èdi be yeanya nyatakaka bubuwo la,zi edzi CzmediTech be nàkpɔ nyatakaka bubuwo.