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 hatsotsowo me toto
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, eƒe ŋutilã ƒe nɔnɔme si li ke, kple eƒe ɖɔɖɔɖo kaba.
5. Asixɔxɔ si le Dɔnɔdzikpɔƒe
Nusiwo wotsɔ xea mɔe naa biomechanical li ke nyuie wu, vevietɔ le ƒu si me ƒu le me.
6. CzmediTech plate ƒe kpɔɖeŋuwo .
CzmediTech na mɔ̃ etɔ̃: extraarticular (01.1107), lateral (5100-17), kple medial (5100-18) plates.
Nukatae akɔtaƒu si le didiƒe ʋĩ la te ŋu gbãna bɔbɔe?
Abe abɔta ƒe ƒunukpeƒe ƒe akpa vevi aɖe ene la, zi geɖe la, akɔta ƒe gbagbã le didiƒe tso 'nuveviwɔame tẽ' (abe anyidzedze ɖe abɔta ene) alo 'nuveviwɔame si metso tẽ o' (abe nuwɔna siwo wotsɔ trɔa asi le nu ŋu alo ƒua gbe ene) gbɔ.
- Lãmetsiheŋusẽwo
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 tete sesĩe
·Abɔta flexor lãmekawo ƒe tete 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 ƒe ƒuƒoƒo
· Ʋufɔkuwo .
·Edze anyi tso kɔkɔƒe
Atikewɔwɔ ƒe gɔmeɖosewo:
AO ƒe xexemenunya yometiti: 'anatomical reduction, stable fixation, kple dɔwɔwɔ ƒe kamedede gbãtɔ.'
Ŋusẽ Gã 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 .
Fixation si li ke
Dɔwɔwɔ ƒe Kamedede Gbãtɔ .
Amekoko ƒe Dzesiwo
Articular ƒe ʋuʋu >2mm
Gɔmeɖoanyi siwo le ʋuʋu ɖi .
Ahɔhɔ̃mekawo ƒe abixɔxɔ si wotsɔ ƒo ƒui
Atikewɔwɔ si m
Plate Fixation Mɔnu
Dual Plate ƒe Mɔnu
Esɔ na ƒomevi C ƒe gbagbãƒewo. Fixation tso titina (le kpɔɖeŋu me, anatomical locking plate) kple axadzi (le kpɔɖeŋu me, parallel plate) ƒe axawo siaa naa 3D li ke eye wòɖea afɔku si le dɔwɔwɔ vɔ megbe ƒe tɔtrɔ ƒe nɔnɔmetɔtrɔ 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 mɔe naa dzogoewo nɔa te, eye wòɖea vi na ƒumeŋuɖui dɔnɔwo vevietɔ.
Dɔwɔnawo Gbɔkpɔkpɔ ƒe Kakaɖedzi .
Ŋutilã ƒe wɔwɔme dzi ɖeɖe kpɔtɔ 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.
Wotrɔ asi le míaƒe distal humerus locking plate series ŋu etɔxɛe na distal humerus ƒe gbagbã sesẽwo. Esi wònye be wowɔa ŋutilã ƒe nɔnɔme, mɔ̃ɖaŋununya si nye gavi si wotsɔ xea nu, kple nɔnɔme vovovowo ta la, enaa nusiwo woatsɔ ablae ƒe kuxiwo gbɔ kpɔnu siwo le dedie, siwo li ke, eye woate ŋu atrɔ ɖe nɔnɔmewo ŋu na amekoko le kɔdzi.
