1. Anatomy of the distal humerus .
Distal humerus la nye titina kple axadzi sɔtiwo, siwo dometɔ aɖewoe nye epicondyles kple condyles.
2. Nuveviwɔame ƒe mɔnu .
Distal humerus fractures tsoa nuveviwɔame tẽ (le kpɔɖeŋu me, anyidzedze) alo ŋusẽ siwo metso tẽ o gbɔ (le kpɔɖeŋu me, twisting alo lãmeka hehe).
3. AO ƒe hatsotso .
AO ƒe hatsotso la maa humerus siwo le didiƒe ƒe gbagbãwo ɖe ƒomevi vevi etɔ̃ me: A , B , kple C .
4. Amekoko ƒe atikewɔwɔ .
Amekoko ƒe atikewɔwɔ zɔna ɖe AO ƒe gɔmeɖosewo dzi: ŋutilã ƒe wɔwɔme dzi ɖeɖe kpɔtɔ, fixation si li ke, kple gbugbɔgaɖɔɖo kaba.
5. Asixɔxɔ le Dɔdaƒe .
Ne wotu agbawo la, wowɔa biomechanical ƒe liƒo si de ŋgɔ wu, vevietɔ le ƒumeŋuɖui ƒe ƒu me.
6. CzmediTech plate ƒe kpɔɖeŋuwo .
CzmediTech na mɔ̃ etɔ̃: extraarticular (01.1107), lateral (5100-17), kple medial (5100-18) plates.
Nukatae humerus si le didiƒe la te ŋu gbãna bɔbɔe?
Abe abɔta ƒe ƒunukpeƒe ƒe akpa vevi aɖe ene la, distal humerus ƒe gbagbã zi geɖe tso 'direct trauma' (abe fall landing on the elbow) alo 'indirect trauma' (abe twisting alo throwing actions ene).
- Lãmetsi hehe ƒe ŋusẽwo .
Medial column la ƒe akpa si le titina ƒe akpa si le humerus la ƒe metaphysis, medial epicondyle, kple medial condyle, si me trochlea si le humerus la hã le.
·Ememe rotator lãmekawo ƒe ʋuʋu sesĩe .
·Albow flexor lãmekawo ƒe ʋuʋu sesĩe .
- Ŋusẽ si me ŋusẽ le ŋutɔ ƒe nuveviwɔame .
Ŋusẽ siwo le gota abe ʋufɔkuwo alo anyidzedze tso kɔkɔme ene ate ŋu ana woagbã vuvu alo alɔ asikea ɖe eme.
Coronoid Fossa kple Olecranon Fossa .
· Ʋufɔkuwo .
·Anyidzedze tso kɔkɔƒe .
Atikewɔwɔ ƒe gɔmeɖosewo:
AO ƒe xexemenunya yometiti: 'anatomical reduction, stable fixation, kple dɔwɔwɔ ƒe kamedede gbãtɔ.'
Ŋusẽ si me ŋusẽ le ŋutɔ ƒe nuveviwɔame .
Ŋusẽ siwo le gota abe ʋufɔkuwo alo anyidzedze tso kɔkɔme ene ate ŋu ana woagbã vuvu alo alɔ asikea ɖe eme.
Atikewɔwɔ ƒe gɔmeɖosewo .
Anatomical dzi ɖeɖe kpɔtɔ .
Stable fixation .
Dɔwɔwɔ ƒe Kamedede Gbãtɔ .
Amekoko ƒe dzesiwo .
articular displacement >2mm
Gɔmeɖoanyi siwo le ʋuʋu ɖi .
Ahɔhɔ̃mekawo ƒe abixɔxɔ ƒokpli .
Atikewɔwɔ si me womezãa nusiwo wowɔna le mɔ gbegblẽ nu o ƒe kpododonu .
Plate fixation Strategie .
Dual Plate Technique .
Anyo na ƒomevi C gbagbã. Fixation tso medial (le kpɔɖeŋu me, anatomical locking plate) kple lateral (le kpɔɖeŋu me, parallel plate) ƒe axawo dzi naa 3D li ke eye wòɖea afɔku si le dɔwɔwɔ vɔ megbe ƒe tɔtrɔ ƒe nɔnɔme madeamedzi me dzi kpɔtɔna.
Single Plate Technique .
Wozãnɛ na ƒomevi A kple akpa aɖe ƒe ƒomevi B ƒe gbagbã. Plɛti siwo wowɔ do ŋgɔ siwo sɔ kple humerus ƒe ŋutilã ƒe wɔwɔme si le didiƒe la ɖea lãkusi falɛfalɛwo ƒe ʋuʋu dzi kpɔtɔna.
Mɔnu si me wowɔa nu boo aɖeke le o .
Wotsɔe kpe ɖe percutaneous screw placement ŋu be woaɖe dɔlékuiwo ƒe afɔku dzi akpɔtɔ eye woakpɔ periosteal ʋu ƒe sisi ta.
Biomechanical ƒe viɖe .
Plɛti siwo wotsɔ xea mɔ na wo la naa dzogoe ƒe liƒo nɔa anyi, vevietɔ be woaɖe vi na ƒumeŋuɖui dɔnɔwo.
Dɔwɔnawo Gbɔkpɔkpɔ ƒe Kakaɖedzi .
Anatomical reduction kpɔa abɔta ƒe ƒunukpeƒewo ƒe ʋuʋu ta vaseɖe afi aɖe, si ɖea kuxiwo abe nonunion alo malunion ene dzi kpɔtɔna.
Aɖaŋu si wowɔ ɖe ɖoɖo nu .
Plɛti siwo ƒe nɔnɔme wowɔ na ƒu ƒe gbagbã ƒomevi aɖewo koŋ (le kpɔɖeŋu me, intercondylar ridge support plates) naa ŋusẽ ƒe kaka nyona ɖe edzi eye wònaa ƒuwo daa dɔ kabakaba.
Míaƒe distal humerus locking plate series nye etɔxɛe wowɔ na complex distal humeral fractures. Le anatomical contouring, locking screw technology, kple nu geɖe ƒe nɔnɔmewo me la, enaa fixation solutions siwo le dedie, siwo li ke, eye woate ŋu atrɔ asi le wo ŋu hena amekoko le kɔdzi.
