Okumenya kw’amagumba okumpi (proximal humerus fractures) kye kimu ku bisinga okumenya amagumba mu buvune, era okumenya kw’amagumba okusinga okumpi (proximal humerus fractures) kwe kumenya amagumba okw’amaanyi amatono mu bakadde.
Wadde ng’okumenya kw’omugongo okusinga obungi kuyinza okujjanjabibwa mu ngeri ey’okukuuma, ebitundu 10-15% eby’okumenya bikyalina obujjanjabi obw’okulongoosa, omuli okunyweza incisional reduction plate fixation, closed reduction intramedullary nail internal fixation, n’okukyusa ennyondo.
Okusalawo ku bujjanjabi kwetaaga okusinziira ku mbeera y’omubiri gw’omulwadde, endowooza ye, ebisuubirwa mu birowoozo, n’ekika ky’okumenya.
Okuddamu okuteekawo n’okutereeza okumenya okw’amangu
【Okuteesa】Ku proximal humeral greater tuberosity (NEER type 2 partial fracture) fractures nga zigatta wamu n'okusengulwa kw'ebibegabega, preoperative CT okukeberebwa, okuggyako okumenya mu kitundu ky'ensingo okulongoosa, repositioning ne braking n'okulumwa ekibegabega brace wansi w'amangu anesthesia (omukugu okuteesa omuwendo: 100%; amaanyi okuteesa rate:: 76.2%).
2. Okufuga obulumi obw’amaanyi nga tonnalongoosebwa
【Okuteesa】Abalwadde abalina okumenya kw’omugongo ogw’okumpi balina okwagala eddagala eriweweeza ku bulumi nga tebannalongoosebwa nga bakozesa eddagala lya acetaminophen oba NSAIDs, era opioids eziweebwa mu kamwa zisobola okugattibwako singa ekikolwa tekiba kirungi (omuwendo gw’okuteesa kw’abakugu: 100%; omuwendo gw’okuteesa okw’amaanyi: 73.8%).
3. Okusomesa abaminsani nga tebannalongoosebwa
[Ekiteeso] Okusomesa nga tonnalongoosebwa kulina okukolebwa mu ngeri ey’enjawulo era ey’engeri nnyingi. (Omuwendo gw’okuteesa kw’abakugu: 100%; omuwendo gw’okuteesa okw’amaanyi: 83.8%)
4. Okukebera endya nga tonnalongoosebwa n’obujjanjabi obuwagira
【Okuteesa】Okumaliriza okukebera endya y’abalwadde mu ssaawa 24 okuva lwe bayingizibwa mu ddwaaliro n’okuwa ebiyingizibwa mu by’endya eri abalwadde abali mu bulabe bw’endya. (Omuwendo gw’okuteesa kw’abakugu: 98.5%; omuwendo gw’okuteesa okw’amaanyi: 55.9%)
5. Okukebera glucose nga balongoosebwa n’okulung’amya mu mulwadde wa sukaali
【Ekiteeso】Ekigendererwa ekisemba eky’okufuga glycemic eri abalwadde ba sukaali abasinga obungi abalongoosebwa mu ngeri ey’okwesalirawo kiri 7.8 ku 10.0 mmol/L.
6. Enzirukanya y’okuzimba kw’ebitundu ebigonvu mu kiseera ky’okulongoosebwa
【Ekiteeso】Eri abalwadde abalongoosebwa mu ngeri ey’okulondako olw’okumenya kw’omugongo ogw’okumpi, enkola ez’omubiri eziwera ziweebwa okukendeeza ku kuzimba mu kiseera ky’okulongoosebwa. (Omuwendo gw’okuteesa kw’abakugu: 98.5%; omuwendo gw’okuteesa okw’amaanyi: 80.9%)
7. Enzirukanya y’emmere nga tonnalongoosebwa
【Ekiteeso】 Abalwadde abalongoosebwa mu ngeri ey’okulonda basobola okulya ebyokunywa ebitangaavu 2 h nga tebannalongoosebwa n’emmere erimu sitaaki oba ebiva mu mata 6 h nga tebannalongoosebwa. (Omuwendo gw’okuteesa kw’abakugu: 100%; omuwendo gw’okuteesa okw’amaanyi: 76.5%)
8. Okuddukanya omusulo gw’omusulo nga balongoosebwa
【Okuteesa】Okulongoosa omusulo mu kiseera ky’okulongoosebwa bulijjo tekiba kirungi ku kulongoosa okumenya omusuwa ogw’okumpi (Omukugu okuteesa: 100%; Strong recommendation rate: 78.6%)
9. Okukozesa eddagala eriweweeza ku buwuka mu kulongoosa
【Ekiteeso】Eri abalwadde abalina okumenya kw’omugongo ogw’okumpi nga kyetaagisa endoprosthesis oba okukyusa ennyondo, okukozesa okuziyiza cephalosporins ez’omulembe ogusooka n’ogw’okubiri kirungi okuziyiza yinfekisoni mu kiseera ky’okulongoosebwa. (Omuwendo gw’okuteesa kw’abakugu: 97.1%; omuwendo gw’okuteesa okw’amaanyi: 73.5%)
10. Okulonda eddagala eriwunyiriza
【Okuteesa】Okubudamya kirungi okwettanira enkola ya regional block compound general anesthesia, okulonda eddagala okwewala okusajjula enkola y’ebitundu by’omubiri obutakola bulungi mu balwadde abakadde, n’okufaayo okunyweza okulondoola (omuwendo gw’okuteesa kw’abakugu: 100%; omuwendo gw’okuteesa okw’amaanyi: 71.4%).
11. Contro ya puleesa mu kulongoosebwa
[Okuteesa] Okukendeeza puleesa okw’ekigero kulina okufaayo okukendeeza ku kufiirwa omusaayi mu kulongoosebwa olw’okumenya kw’omugongo ogw’okumpi, naye abalwadde abakadde abalina endwadde ezikwatagana eziwera balina okufaayo ku kukuuma obutebenkevu bwa hemodynamic okwewala okufuyira obutamala mu bitundu by’omubiri n’ebitundu by’omubiri (omuwendo gw’abakugu ogusemba: 100%; omuwendo gw’okuteesa okw’amaanyi: 61.9%).
12. Okuddukanya obuzito mu kulongoosa
[Okuteesa] Teeka mu nkola enkola y’okuddukanya amazzi ng’egenderera ekiruubirirwa, era eddagala erikola ku misuwa liyinza okuweebwa mu ngeri ey’okuziyiza mu kiseera ky’okubudamya okuziyiza okuyitirira kw’amazzi (omuwendo gw’okuteesa kw’abakugu: 100%; omuwendo gw’okuteesa okw’amaanyi: 69.1%).
13. Enzirukanya y’omusaayi mu kulongoosa
[Ebiteeso] Puleesa efugirwa mu kulongoosebwa tekiba kirungi ku kumenya kw’omugongo ogw’okumpi naddala mu balwadde abakadde, era okuteekebwamu omusaayi mu kulongoosebwa ne asidi wa tranexamic bisobola okusiigibwa. Okukebera HGB <80g/L mu kulongoosa kuteesa okuteekebwamu omusaayi ogwa allogeneic (omuwendo gw’abakugu gwe bateesa: 100%; omuwendo gw’okuteesa okw’amaanyi: 73.8%).
14. Okuziyiza obulwadde bw’okukendeera kw’ebbugumu mu kulongoosebwa
[Ebiteeso] Abalwadde abalina okumenya kw’omugongo ogw’okumpi balina okunyweza okulondoola ebbugumu mu kulongoosebwa n’okukola ebikolwa eby’enjawulo okukuuma ebbugumu ery’omusingi nga lisukka 36°C (omuwendo gw’okuteesa kw’abakugu: 100%; omuwendo gw’okuteesa okw’amaanyi: 76.2%).
15. Okulonda enkola y’okulongoosa
(1) Okumenya emitendera gy’okumenya kw’omugongo ogw’okumpi
[Okuteesa] Neer’s staging is recommended for proximal humerus fracture staging (omuwendo gw’abakugu gwe bateesa: 100%; omuwendo gw’okuteesa okw’amaanyi: 83.3%).
(2) Enkola y’okulongoosa
Enteekateeka y’okulongoosa erina okulondebwa okusinziira ku nkula y’amagumba, omutindo gw’amagumba, embeera y’omulwadde mu mubiri n’eby’omwoyo n’ensonga endala ezikwatagana.
[Ekiteeso] Ekintu ekinyweza munda kiyinza okulondebwa okusinziira ku kika ky’okumenya n’obugumu bw’amagumba, gamba nga plate oba intramedullary nail; ku balwadde abakadde abalina obulwadde bw’amagumba abazibu okuddamu okuteekawo oba okutereeza, okumenya kw’ebitundu 4 (n’okumenya kw’amagumba), okumenya ebitundu 3 n’okumenya amagumba okw’amaanyi, okumenya kw’amagumba okwawukana n’okumenya ensingo mu mubiri, okukyusa ekinywa ky’ekibegabega eky’ekikugu kirondebwa, era okukyusa ekinywa ky’ekibegabega mu ngeri ey’ekikugu kirungi singa kigatta n’obuvune bw’omukono gwa rotator (omuwendo gw’abakugu bwe guteesa::: 100% (Omuwendo gw’okuteesa ogw’amaanyi: 71.4%).
![Okumenya kw’omugongo ogw’okumpi]()
Ekifaananyi 1 Omukazi ow’emyaka 65 ng’alina okumenya ebitundu 4 eby’okuyingiza ekitundu ky’omugongo ekiyitibwa proximal humeral adductor insertion n’okunyweza allograft fibular implant plate nga bamusala n’okuddamu okuteekebwa mu kifo.
16. Okuteeka ekyuma ekifulumya amazzi mu biwundu
[Ebiteeso] Ebiraga obutateeka ttanka ezifulumya amazzi: 1 Obukodyo bw’okulongoosa obutayingirira nnyo (MIPPO n’okukuba emisumaali mu nnyindo); 2 Okuvaamu omusaayi omutono. Ebiraga okuteeka ttanka y’okufulumya amazzi: 1 okuyita mu nkola ya pectoral deltoid, okunyweza ekipande ekisiba oba okukyusa ekiyungo ky’ebibegabega; 2 okuvaamu omusaayi omunene okuva ku ngulu w’ekiwundu (omuwendo gw’abakugu gwe bateesa: 100%; omuwendo gw’okuteesa okw’amaanyi: 71.4%).
17. Okuggalawo ebiwundu
【Okuteesa】Ekifo eky’okulongoosa kyaggalwawo n’emisono egyangu egyataataaganyizibwa, egy’omutendera ku layeri (omuwendo gw’okuteesa kw’abakugu: 100%; omuwendo gw’okuteesa ogw’amaanyi: 76.2%).
18. Endya y’okuwona oluvannyuma lw’okulongoosebwa
【Okuteesa】Abalwadde basobola okumira ebyokunywa ebitaliimu musulo nga bayita mu kamwa nga bazuukuse oluvannyuma lw’okulongoosebwa, ne baddamu okulya emmere eya bulijjo oluvannyuma lwa ssaawa 1-2 singa tewabaawo buzibu bwonna.
19. Okulonda ekifo oluvannyuma lw’okulongoosebwa n’okukola emirimu nga bukyali
【Ekiteeso】Abalwadde tebeetaaga kugalamira ku mutto oluvannyuma lw’okulongoosebwa, basobola okwettanira embeera ya semi-recumbent era basobola okutambula wansi oluvannyuma lw’okuzuukuka. Ekisiba ekibegabega ekivumirira kirina okuteekebwako buleeki.
20. Ebipimo by’eddagala eriweweeza ku bulumi oluvannyuma lw’okulongoosebwa
【Okuteesa】Okukendeeza obulumi oluvannyuma lw’okulongoosebwa mu balwadde abalina okumenya kw’omugongo ogw’okumpi kirungi okukozesa regional blockade nga egattibwa wamu ne 'background doses' eza bulijjo eza NSAIDs, era bwe kiba kyetaagisa, ppampu z'obulumi eziweebwa mu misuwa oba ppampu z'obulumi ez'okwewa obusimu obw'okumpi (peripheral nerve block self-administration rate: 100%; okuteesa okw'amaanyi omuwendo: 78.6%).
21. Okuziyiza okuziyira n’okusiiyibwa oluvannyuma lw’okulongoosebwa
[Ekiteeso] Abalwadde bonna balina okuweebwa eddagala eriweweeza ku kuzimba nga wabulayo edakiika 30 okulongoosebwa okuggwa. (Omuwendo gw’abakugu abasemba: 97%; omuwendo gw’okuteesa okw’amaanyi: 47.8%)
22. Okuddaabiriza emirimu
【Recommendation】Abalwadde abalina fixed and stable proximal humerus fractures balina okutandika okukola dduyiro okuddaabiriza nga bukyali oluvannyuma lw’okulongoosebwa. Dduyiro w‟okuddaabiriza ayamba okuzzaawo obulungi enkola y‟ekitundu eky‟okungulu (Okugu okuteesa: 100%; Strong recommendation rate: 92.9%).
23. Emisingi gy’okusiibulwa n’okugoberera
【Okuteesa】Emisingi egy’omugaso egy’okusiibulwa girina okuteekebwawo, era abalwadde balina okugobererwa bulijjo okumala waakiri emyezi 6 (omuwendo gw’okuteesa kw’abakugu: 100%; omuwendo gw’okuteesa okw’amaanyi: 83.3%).
Engeri y'okugulamu ebyuma ebiteekebwa mu magumba n'ebikozesebwa mu kulongoosa amagumba?
A CZMEDITECH , tulina layini y’ebintu ebijjuvu ennyo eby’ebiteekebwa mu kulongoosa amagumba n’ebikozesebwa ebikwatagana, ebintu omuli okuteekebwamu omugongo, emisumaali egy’omu lubuto (intramedullary nails)., essuuka y’okulumwa, ebbakuli y’okusiba, cranial-maxillofacial mu maaso, okuzimba omubiri (prosthesis)., ebikozesebwa eby’amasannyalaze, ebinyweza eby’ebweru, okukebera ebinywa, okulabirira ebisolo n’ebikozesebwa byabwe ebibiwagira.
Okugatta ku ekyo, twewaddeyo okugenda mu maaso n’okukola ebintu ebipya n’okugaziya layini z’ebintu, tusobole okutuukiriza ebyetaago by’okulongoosa eby’abasawo n’abalwadde bangi, era n’okufuula kkampuni yaffe okuvuganya ennyo mu mulimu gwonna ogw’ensi yonna ogw’okussaamu amagumba n’ebikozesebwa.
Tutwala ebweru w’eggwanga mu nsi yonna, kale osobola tukwatagane ku email address song@orthopedic-china.com okufuna quote ku bwereere, oba weereza obubaka ku WhatsApp okufuna eky'amangu +86- 18112515727 .
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