Humerus intramedullary nail: egbɔkpɔnu nyui aɖe si woatsɔ ada humeral fractures .

Akɔta ƒe gbagbã, si nye ƒu si le abɔta, ate ŋu akpɔ ŋusẽ ɖe ame ƒe gbesiagbedɔwo kple agbenɔnɔ ƒe nyonyome dzi vevie. Atikewɔwɔ na gbagbã siawo bia be woabu nu vovovowo ŋu nyuie, siwo dometɔ aɖewoe nye gbagbã ƒomevi, teƒe si wòle, kple dɔnɔa ƒe nɔnɔmewo. Amekoko ƒe mɔnu ɖeka si va xɔ ŋkɔ le ƒe ʋɛ siwo va yi mee nye humerus intramedullary nail zazã. Nyati sia ku ɖe viɖe, amekokomɔnu, afɔkuwo, kple gbugbɔgaɖɔɖo si do ƒome kple atikewɔwɔmɔnu sia ŋu.

Kpɔkplɔyiɖeme

Ne ƒu gbagbã aɖe dzɔ le akɔta la, ate ŋu ana ame nase veve vevie, wòaʋuʋu vie, eye wòagblẽ nu le eŋu. Se siwo wozãna tsã, abe atike si wotsɔna ƒua gbe alo plating ene, ƒe seɖoƒewo le wo ŋu, eye egbɔkpɔnu siwo wɔa dɔ nyuie wu didi na wova to humerus intramedullary nail la vɛ.

Nukae nye humerus intramed ullary nail?

Humerus intramedullary nail nye atikewɔnu si wowɔ be wòali ke ahadoe ɖe ŋgɔ le humeral shaft me. Gaku didi aɖe si wotsɔ dea ƒu ƒe titina si me do le me, si naa liƒo kple kpekpeɖeŋu le dɔyɔyɔ ƒe ɖoɖoa me lae le eme. Zi geɖe la, wotsɔa titanium alo gakpo si mexɔ dzo o wɔa lãgbalẽa eye woƒe lolome le vovovo be woawɔ dɔnɔ ƒe ŋutilã vovovowo.

Nusiwo fiaa humerus intramedullary nail .

Wozãa humerus intramedullary nails zi geɖe tsɔ daa midshaft kple proximal humeral fractures. Wowɔa dɔ nyuie ŋutɔ na gbagbã siwo hiã be woatsɔ aɖo wo nɔewo ŋu si li ke, abe ƒu ƒe gbagbã alo gbagbã siwo do ƒome kple ʋuʋu ɖedzesi ene. Tsɔ kpe ɖe eŋu la, mɔnu sia sɔ na dɔnɔ siwo ƒe ƒu ƒe nyonyome mede o alo ne wodi be woawɔ nɔnɔme si me kpekpeme mele o.

Amekokomɔnu na humerus intramedullary nail .

Ðoɖowɔwɔ do ŋgɔ na dɔwɔwɔ na ame .

Hafi woawɔ dɔ na amea la, ɖoɖowɔwɔ nyuie do ŋgɔ na amekokoa le vevie ŋutɔ. Esia lɔ alesi wodzroa ƒu ƒe gbagbã ƒe ɖoɖoa me tsitotsito, dɔnɔa ƒe lãmesẽ bliboa, kple abi ɖesiaɖe si do ƒome kplii la me ɖe eme. Woate ŋu azã X-ray, CT scan, alo MRI atsɔ ase ƒu ƒe gbagbã ƒe nɔnɔmewo gɔme nyuie eye woawɔ ɖoɖo ɖe amekoko ƒe mɔnu ŋu wòasɔ ɖe enu.

Dɔnɔwo ƒe Nɔnɔme .

Le amekokoa wɔɣi la, zi geɖe la, woɖoa dɔnɔa ɖe ƒutazikpui alo axadzi ƒe nɔnɔme si me woɖea ʋu le la me. Tiatia si woawɔ la nɔ te ɖe amekolaa ƒe didi kple afisi wòagbãe le dzi. Teƒe si woɖoa wo ɖo nyuie nana be woate ŋu age ɖe teƒe si wogbã la nyuie wu eye wònaa ɖaƒoƒoa nɔa bɔbɔe.

Incision kple Access .

Woɖea lãkusi aɖe ɖe amekokoƒea dzi be woate ŋu age ɖe ƒu si gbã la me. Alesi lãkusia ƒe didime kple afisi wòle la nɔ te ɖe eƒe gbagbã ƒomevi kple afisi wòle le humerus la dzi. Lãmetsi falɛfalɛwo zazã nyuie le vevie be woaɖe nuveviwɔame dzi akpɔtɔ eye woaɖe dɔlékuiwo xɔxɔ ƒe afɔkua dzi akpɔtɔ.

Nail ƒe tsɔtsɔ de eme .

Ne amekolaa wɔ afisi wògena ɖo vɔ la, etsɔa humerus intramedullary nail la dea humeral canal la me. Wozãa fluoroscopic mɔfiame tsɔ kpɔa egbɔ be woda wo ɖe teƒe ɖeka eye woɖo wo ɖe ɖoɖo nu pɛpɛpɛ. Wodoa ɖa la ɖe ŋgɔ to ƒu me, wogbugbɔa kakɛ ɖesiaɖe si woɖe ɖe vovo la ɖoa ɖoɖo nu, eye wògbugbɔa anatom si sɔ la ɖoa anyi .

Locking screws ƒe ɖoɖo .

Ne wonya ɖo atikplɔa ɖe teƒe nyuitɔ ko la, wotsɔa gavi siwo wotsɔna ƒoa gaviwoe la dea eme be woatsɔ abla ɖa la ɖe ƒua me. Gavi siawo nana woli kena ɖe edzi eye woxea mɔ na ʋuʋudedi ƒe kakɛawo ƒe tɔtrɔ alo axial ƒe ʋuʋu. Screw ƒe xexlẽme kple wo dada nɔ te ɖe eƒe gbagbã ƒe nɔnɔme kple amekolaa ƒe didi dzi.

abi ƒe nutsotso .

Ne ɖa kple gaviawo le wo nɔƒe nyuie vɔ la, wozãa sutures alo staples tsɔ xea mɔ si woɖe la nu. Abiwo tutu nyuie le vevie be woado gbedada ɖe ŋgɔ eye woaɖe dɔlékuiwo xɔxɔ ƒe afɔkua dzi akpɔtɔ. Emegbe wodoa awu na amekokoƒea, eye wotsɔa aŋekotoku alo nuwutike si me dɔlékui mele o la dea eme.

Viɖe siwo le humerus intramedullary nail ŋu .

Humerus intramedullary nail zazã naa viɖe geɖe le atikewɔwɔmɔnu xoxowo ŋu. Viɖe vevi siwo le eme dometɔ aɖewoe nye:

1. Liliɖe kple ɖoɖo ɖe ɖoɖo nu: Nail la naa fixation si li ke, si wɔnɛ be woate ŋu awɔ ɖoɖo nyuie ɖe fracture fragments ŋu, si doa dɔyɔyɔ nyuitɔ ɖe ŋgɔ.

2. Lãmetsi falɛfalɛwo ƒe tɔtɔ suetɔ kekeake: Ne wotsɔe sɔ kple atike siwo wotsɔna ƒoa nui la, lãkusi si le lãkusia me lɔ lãkusi suewo ɖe eme kple lãkusi falɛfalɛwo ƒe tɔtɔ, si ɖea kuxiwo ƒe afɔku dzi kpɔtɔna.

3. Early Mobilization: Nail la naa liƒo si sɔ be woaɖe mɔ na ʋuʋu kaba kple gbugbɔgaɖɔɖo, si doa hayahaya kabakaba kple dɔwɔwɔ gbugbɔgaɖɔɖo ɖe ŋgɔ.

4. Dɔlékuiwutikewo ƒe afɔku dzi ɖe kpɔtɔ: Mɔnu si wotu ɖe lãkusi me ƒe ƒoƒo dzi ɖea afɔku si le amekokoƒea ƒe dɔlékuiwo xɔxɔ me dzi kpɔtɔna ne wotsɔe sɔ kple mɔnu siwo dzi woɖea wo ɖokui ɖe aga le le ʋuʋu me kple esiwo wotsɔna ƒoa wo ɖokui ɖe eme.

Kuxiwo kple afɔkuwo .

Togbɔ be zi geɖe la, afɔkpodzi ƒe dɔwɔwɔ na ame ƒe vidzidɔ me dɔwɔwɔ le dedie eye wòwɔa dɔ nyuie hã la, kuxi siwo ate ŋu ado mo ɖa kple afɔku siwo ate ŋu ado tso eme la li. Ele vevie be nànya nu tso nu siawo siwo ate ŋu adzɔ ŋu hafi woawɔ atike nɛ. Kuxi siwo dona tso eme dometɔ aɖewoe nye:

Dɔdzedze

Amekoko ƒe ɖoɖo ɖesiaɖe hea dɔlékuiwo xɔxɔ ƒe afɔku vɛ. Togbɔ be dɔlékuiwo ƒe agbɔsɔsɔ le sue ŋutɔ le humerus intramedullary nailing me hã la, mɔnu nyui siwo me dɔlékui mele o kple beléle na ame le dɔwɔwɔ vɔ megbe le vevie ŋutɔ be woaɖe afɔku sia dzi akpɔtɔ. Ne dɔlélea dze ame dzi la, ate ŋu ahiã be woawɔ dɔlékuiwutike si sɔ eye ɖewohĩ woawɔ dɔ na ame.

Malunion alo Nonunion .

Le go aɖewo me la, ƒu gbagbãwo mate ŋu ahaya nyuie o, si ana woawɔ malunion (si mesɔ nyuie o) alo nonunion (dɔdada ƒe anyimanɔmanɔ). Nusiwo nye ƒu ƒe nyonyome manyomanyo, woƒe ʋuʋu nyuie o, alo ʋuʋu fũu akpa ate ŋu ana kuxi siawo nado mo ɖa. Kpɔkpɔ nyuie, sasrãkpɔ siwo wowɔna edziedzi, kple nudede nyawo me le ɣeyiɣi nyuitɔ dzi ate ŋu akpe ɖe ame ŋu woakpɔ nya siawo gbɔ ne wodo mo ɖa.

Ame ƒe lãmetutudɔ ƒe kpododonu .

Ƒã hafi nusi wotsɔ dea lãme na ame si wozãna tsɔ ƒoa nu ɖe ​​lãkusi me la ate ŋu ado kpo nu. Esia ate ŋu adzɔ le esi wodo ɖe lãme na ame, eƒe ʋuʋu, alo ʋuʋu ta. Atike si woatsɔ ade ame ƒe lãme nyuie tiatia, amekokomɔnu, kple beléle na ame le dɔwɔwɔ nɛ vɔ megbe ate ŋu aɖe afɔku si le ame ƒe lãme ƒe dɔmawɔmawɔ nyuie me dzi akpɔtɔ.

Nuveviwɔame le lãmekawo ŋu .

Le amekokoa me la, afɔku sue aɖe le lãmekawo ƒe abixɔxɔ me, si ate ŋu ana ame ƒe seselelãme alo mɔ̃ nabu. Amekolawo wɔa afɔɖeɖewo be woaƒo asa na lãmekawo ƒe dɔmawɔmawɔ nyuie, abe alesi woɖea wo ɖa nyuie kple ŋutilã ƒe wɔwɔme ŋuti sidzedze nyuie ene. Ele be woagblɔ dzesi ɖesiaɖe si ku ɖe lãmekawo ŋu la na atikewɔlawo enumake be woada wo kpɔ ahakpɔ wo dzi.

Gbugbɔgaɖɔɖo kple hayahaya .

Le humerus intramedullary nail courzionly megbe la, ɖoɖo si me wowɔa dɔ le bliboe le vevie hafi woate ŋu ahaya nyuie wu. Gbugbɔgaɖɔɖo ƒe ɖoɖo tɔxɛa ate ŋu ato vovo le alesi wòsẽe kple alesi wòsẽe kple alesi dɔnɔwo ƒe nɔnɔmewo le nu. Wotoa ameƒoƒo kaba, kamedede siwo me wowɔa nu le bɔbɔe, kple ŋusẽdodo ƒe kamededewo vɛ vivivi be woagbugbɔ awɔ dɔ eye woana lãmekawo ƒe ŋusẽ nanyo ɖe edzi. Lãmesẽnyawo gbɔ kpɔkpɔ ƒe ɣeyiɣiwo, si atikewɔla bibi aɖe fiaa mɔe la wɔa akpa vevi aɖe le hayahaya ƒe ɖoɖoa me.

Nudzɔdzɔwo me dzodzro kple dzidzedzekpɔkpɔ ŋutinyawo .

Dɔnɔ geɖe kpɔ nu nyui siwo do tso eme le humerus intramedullary tail amekoko ŋu. Nudzɔdzɔ ɖeka si wowɔ le nudzɔdzɔ aɖe me ku ɖe ame aɖe si xɔ ƒe 45 si ƒe akɔta ƒe asike vuvu si woɖe le eƒeme ŋu. Esi wowɔ dɔ na dɔnɔa vɔ la, dɔnɔa wɔ dɔ nyuie ŋutɔ, eye wògaɖo eƒe dɔwɔwɔ nyuie, eye wòtrɔ yi woƒe dɔwɔwɔ do ŋgɔ na abixɔxɔ me le ɣleti ade me.

Tsɔe sɔ kple atikewɔmɔnu bubu siwo woate ŋu azã .

Ne èle atikewɔwɔ ƒe tiatia siwo woawɔ na humeral fractures ŋu bum la, ele vevie be nàtsɔ viɖe kple seɖoƒe siwo le mɔnu ɖesiaɖe ŋu asɔ kple wo nɔewo. Togbɔ be humerus intramedullary nail zazã naa viɖe geɖe, abe lilili, ʋuʋu kaba, kple lãkusi falɛfalɛwo ƒe tɔtɔ suetɔ kekeake ene hã la, ɖewohĩ masɔ na gbagbã alo dɔnɔ ɖesiaɖe o. Woate ŋu adi mɔnu bubuwo, abe plating alo external fixation ene, le go aɖewo me. Tomeɖoɖo kple ƒumeŋuɖui ŋuti nunyala aɖe akpe ɖe ame ŋu woanya atikewɔwɔmɔnu si sɔ wu le ame ɖekaɖekawo ƒe nɔnɔmewo nu.

Nyanuwuwuw

Le nyataƒoƒo me la, humerus intramedullary nail zazã va zu atikewɔwɔ ƒe mɔnu nyui aɖe si ŋu kakaɖedzi le na humeral fractures. Amekokomɔnu sia naa ame ƒe susu nɔa te sesĩe, edoa amewo ƒe dɔwɔwɔ kaba ɖe ŋgɔ, eye wònaa viɖe geɖe tso mɔnu xoxowo ŋu. Togbɔ be afɔku kple kuxi siwo ate ŋu ado ƒome kple dɔdamɔnua li hã la, amekoko ƒe ɖoɖowɔwɔ nyuie, aɖaŋu si wozãna le dɔwɔwɔ me, kple beléle na ame le amekoko megbe ate ŋu akpe ɖe ame ŋu be woaɖe dzimaɖitsitsi siawo dzi akpɔtɔ. Ne dɔnɔawo gbugbɔa wo ɖo nyuie eye woléa ŋku ɖe wo ŋu nyuie la, woate ŋu akpɔ wo nyuie eye woƒe dɔwɔwɔ ƒe ŋutetewo agate ŋu akpɔ dzidzedze.