Anatomy ntawm Distal Humerus
Lub distal humerus muab faib rau hauv nruab nrab kem thiab lateral kem.
Medial Kem
Cov kab nruab nrab suav nrog qhov nruab nrab ntawm qhov metaphysis ntawm humerus, medial epicondyle, thiab medial condyle, suav nrog trochlea ntawm humerus.
Lateral Kem
Sab nraub qaum muaj xws li sab nraud ntawm lub metaphysis ntawm humerus, lateral epicondyle, thiab lateral condyle, nrog rau lub capitulum ntawm humerus.
Coronoid Fossa thiab Olecranon Fossa
Nyob nruab nrab ntawm ob kab yog lub anterior coronoid fossa thiab posterior olecranon fossa.
Distal Humeral Extraarticular Xauv Phaj
Cov phaj no yog tsim los rau cov pob txha pob txha extraarticular ntawm distal humerus, tsom rau thaj tsam metaphyseal yam tsis muaj kev sib koom ua ke. Nws cov locking screws muab angular stability, ua rau nws tshwj xeeb tshaj yog haum rau cov neeg mob osteoporotic los yog cov qauv tawg yooj yim.
Extraarticular Fixation
Multi-directional Locking Screws
Anatomic Contouring
Combination Qhov
Mechanism of Injury in Distal Humerus Fractures
Lub distal humerus muab faib rau hauv nruab nrab kem thiab lateral kem.
Yog vim li cas lub distal humerus yog fractures?
Raws li ib feem tseem ceeb ntawm lub luj tshib, cov pob txha humerus feem ntau tshwm sim los ntawm 'txoj kev raug mob' (xws li lub caij nplooj zeeg tsaws ntawm lub luj tshib) lossis 'kev raug mob tsis ncaj' (xws li kev sib tw lossis kev cuam tshuam).
- Muscle Pulling ForcesLateral Kem
Cov kab nruab nrab suav nrog qhov nruab nrab ntawm qhov metaphysis ntawm humerus, medial epicondyle, thiab medial condyle, suav nrog trochlea ntawm humerus. · Strong contraction of internal rotator nqaij · Strong contraction of luj tshib flexor nqaij
-High-Energy Trauma
Sab nraud quab yuam xws li kev sib tsoo tsheb los yog ntog los ntawm qhov siab tuaj yeem ua rau muaj kev puas tsuaj los yog cuam tshuam rau cov pob txha.
Coronoid Fossa thiab Olecranon Fossa
· Tsheb sib tsoo · Poob qhov siab
Distal Lateral Humeral Xauv Phaj
Tsim los rau sab nraub qaum pob txha, lub phaj no yog tsim rau cov pob txha capitellar lossis supracondylar pob txha, muab kev txhawb nqa tshuab los ntawm txoj hauv kev rau sab nraud los pab txhawb kev kho mob thaum ntxov.
Lateral Kem Stabilization
Articular Fragment Fixation
Radial Nerve Protection
Dynamic Compression
Kev faib tawm AO: Kev ntaus ntawv tseeb los qhia kev txiav txim siab phais
Raws li AO kev faib tawm qhov system, distal humerus fractures yog categorized raws li hauv qab no, ncaj qha cuam tshuam rau kev xaiv cov tswv yim kho mob:
Hom A: Extra-articular fractures
- A1: Kev puas tsuaj yooj yim, tsis muaj kev cuam tshuam ntawm cov leeg. - A2 / A3: cuam tshuam los yog hloov pauv metaphyseal pob txha, xav tau kev saib xyuas rau lub kaum sab xis deformities.
Hom B: Ib feem ntawm cov pob txha pob txha
Cov kab tawg muaj feem cuam tshuam rau qhov sib koom ua ke tab sis tsis muaj kev sib cais tiav; Kev txo qis hauv anatomical yog qhov tsim nyog los txhim kho kev sib koom ua ke.
Hom C: Ua tiav cov pob txha pob txha
- C1 / C2: Yooj yim intra-articular fractures nrog metaphyseal kev koom tes. - C3: Comminuted intra-articular fractures, qhov nyuaj tshaj plaws los kho; ruaj khov kho yog xav tau los txo cov kev pheej hmoo ntawm kev mob caj dab tom qab.. Loc
Qhov tseem ceeb ntawm Classification:
Kev faib tawm AO qhia meej txog qhov hnyav ntawm qhov tawg thiab muab kev taw qhia rau kev xaiv phaj (xws li, ib leeg thiab ob daim hlau, xauv ntsia hlau tsim) kom ntseeg tau tias ob qho tib si fixation lub zog thiab kev sib npaug ntawm cov roj ntsha.
Distal Medial Humeral Xauv Phaj
Cov phaj no yog ib qho kev daws teeb meem sab hauv rau nruab nrab kem fractures ntawm distal humerus, muab kev txhawb nqa los ntawm txoj hauv kev nruab nrab los tiv thaiv varus deformity, feem ntau siv rau hauv cov xwm txheej nrog coronal dav hlau tawg.
Medial Kem Txhawb Nqa
Tsawg-profile Tsim
Coronal Plane Screws
Dual-plating Tau tshaj
Kev kho mob phais: Cov ntsiab lus zoo ntawm Plate Fixation
Txoj Cai Kev Kho Mob:
Ua raws li AO lub tswv yim: 'Anatomical txo, ruaj khov kho, thiab ua haujlwm thaum ntxov.'
High-Energy Trauma
Sab nraud quab yuam xws li kev sib tsoo tsheb los yog ntog los ntawm qhov siab tuaj yeem ua rau muaj kev puas tsuaj los yog cuam tshuam rau cov pob txha.
Txoj Cai Kho Mob
Kev phais mob
Articular tshem tawm> 2mm
Qhib pob txha
Combined neurovascular raug mob
Ua tsis tiav ntawm kev saib xyuas kev kho mob
Phaj Fixation Strategie
Haum rau hom C tawg. Kev kho los ntawm ob qho tib si medial (piv txwv li, anatomical locking phaj) thiab lateral (piv txwv li, parallel phaj) sab muab 3D stability thiab txo qhov kev pheej hmoo ntawm postoperative rotational deformity.
Siv rau hom A thiab ib nrab hom B puas. Pre-contoured daim hlau conforming rau distal humerus anatomy txo cov nqaij mos dissection.
Ua ke nrog percutaneous ntsia hlau tso kom txo tau cov kab mob thiab khaws cia cov ntshav periosteal.
Clinical nqi ntawm Plate Fixation
Biomechanical Advantage
Xauv daim hlau muab angular stability, tshwj xeeb tshaj yog zoo rau cov neeg mob osteoporotic.
Functional Recovery Guarantee
Kev txo qis hauv lub cev khaws cia lub luj tshib sib koom ua ke mus rau qhov loj tshaj plaws, txo cov teeb meem xws li nonunion lossis malunion.
Customized Tsim
Daim hlau zoo li rau cov pob txha pob txha tshwj xeeb (xws li, intercondylar ridge support plates) optimize force transmission and accelerate pob txha kho.
Anatomy ntawm Distal Humerus
Lub distal humerus muab faib rau hauv nruab nrab kem thiab lateral kem.
Medial Kem
Cov kab nruab nrab suav nrog qhov nruab nrab ntawm qhov metaphysis ntawm humerus, medial epicondyle, thiab medial condyle, suav nrog trochlea ntawm humerus.
Lateral Kem
Sab nraub qaum muaj xws li sab nraud ntawm lub metaphysis ntawm humerus, lateral epicondyle, thiab lateral condyle, nrog rau lub capitulum ntawm humerus.
Coronoid Fossa thiab Olecranon Fossa
Nyob nruab nrab ntawm ob kab yog lub anterior coronoid fossa thiab posterior olecranon fossa.
Anatomy ntawm Distal Humerus
Lub distal humerus muab faib rau hauv nruab nrab kem thiab lateral kem.
Medial Kem
Cov kab nruab nrab suav nrog qhov nruab nrab ntawm qhov metaphysis ntawm humerus, medial epicondyle, thiab medial condyle, suav nrog trochlea ntawm humerus.
Lateral Kem
Sab nraub qaum muaj xws li sab nraud ntawm lub metaphysis ntawm humerus, lateral epicondyle, thiab lateral condyle, nrog rau lub capitulum ntawm humerus.
Coronoid Fossa thiab Olecranon Fossa
Nyob nruab nrab ntawm ob kab yog lub anterior coronoid fossa thiab posterior olecranon fossa.
