Clavicle a tichhia a ni.

Clavicle ruh tliak hi mi 100,000-ah 30-60 a ni a, mipa leh hmeichhia ratio chu 2:1 vel a ni a, fracture zawng zawng 5% atanga 10% leh shoulder joint injury 44% a ni. Clavicle hi mihring taksaa ossification nei hmasa ber a ni a, a ossification hi embryonic life kar nga-naah a intan a, chu chu tubular bone sei tak, intramembranous osteogenesis hmanga ossified thei awmchhun a ni. Primitive Ossification Center hi clavicle lai takah a awm a, kum 5 thlenga a lo thanlenna chhan a ni. Clavicle chhung leh pawn lam tawp tinah epiphyseal plate a lo thang lian zel a, mahse a tam zawkah chuan medial ossification center chauh hi X-ray hmangin hmuh theih a ni. Medial epiphyseal plate hian clavicle sei zawng 80% a tipung a, a ossification centre chu kum 13 atanga kum 19 inkar thlengin a lang tan tlangpui a, kum 22 atanga kum 25 inkar thlengin clavicle nen hian a fuse lo. Chuvangin, damlo naupangte sternoclavicular dislocation kan hriat hian medial clavicular epiphyseal injury atanga thliar hran a pawimawh hle.

Hnathawh dan (functional anatomy) .

Clavicle hi anterior-a en chuan a dik deuh a, mahse a sang zawka en chuan S-shaped a ni a, dorsally leh medially-ah ventral lam hawiin a curve a ni. A cross-section chu long axis-ah a inthlak a, a pawn lam chu 1/3 a ni a, muscle leh ligament pulling awm theihna turin a flatten a; Middle 1/3 chu tubular a lo ni ta a, a diameter a tlahniam a, a dang zawng aiin cortex leh ruh a denser zawk a, axial pressure leh tension awm theihna tur leh a hnuaia vascular nerve te venhim nan Inner 1/3 hi rhombic a ni a, sternum leh rib hmasa ber chu ligamentous tissue chak tak hmangin a inzawm a ni (Figure 1). Anatomical study-ah chuan hetah hian clavicle hi a chak lo ber tih hmuhchhuah a ni a, hei hi a lai leh pawn lam 1/3-a morphological variation vang a ni. Chu bakah, subclavian muscle stop-ah lateral-ah a awm a, muscular ligaments venhimna a tlachham a, hei vang hian fracture awmna hmun hlauhawm ber a ni a, hei hi clinical observation-in a tilang chiang hle.

Hliam tuar theihna mechanism .

Puitlinga clavicle fractures tan chuan clavicle fractures-a hliam awm dan tlangpui chu a hmain hyperextended position-a kut a tlak vang niin an ngai a, mahse Stanley et al. He inhliamna mechanism hian mid-clavicle fracture 6.3% chauh a nei a, distal clavicle fracture 5.9% chauh a awm tih hmuhchhuah a ni a, damlo zawng zawngah chuan hliam awm dan tlangpui chu direct forces atanga lo chhuak a ni a, chu chu shoulder joint-a hnathawk zawng zawng zingah a shoulder joint-a direct force awm tam ber a ni a, a tlangpuiin displacement lian tham nei lo emaw, mid displacement chauh emaw a awm lo.

Hyperextended position-a palm nei falls-ah chuan, a hliam hi a tlak hnua pawn lam force secondary-in a nghawng vang a ni fo thin. Indirect violence avanga fracture chi dang chu pawn lam thiltihtheihnain a kephah chungah a thawk a, chu chuan clavicle chu rib hmasa ber nen a nghawng a, chu chuan clavicle lai takah 1/3 lai takah spiral fracture a siam a ni. Chu bakah, tun hnaia lirthei accident a thlen fo avangin, car accident-a nghawng nasa tak a awm avangin, seat belt hian a kephah chhungah force of force a siam a, chu chuan clavicle lai takah transverse emaw oblique fracture a thlen fo thin a, chu chu miten seat belt fracture an ti thin. Trauma-a tharum thawhna a tam zawk avangin a ni mai thei, he fracture chi hi clavicle fracture pangngai aiin non-union a thlen awlsam zawk.

Tihdamna

A laizawn clavicle-a ruh tliak: 1.1.

Splint fixation:Clavicle fractures te chu a la fixation chu 'gold standard' a la ni reng. Plate-ah hian 3.5mm LC-DCP, 3.5mm reconstruction plate, LCP locking plate, leh plate chi hrang hrang thenkhat te a awm a ni. Splints thatna chu: transverse fractures compression; oblique emaw butterfly fractures te chu tension screw leh neutralizing splints inzawmkhawm nen fixation; rotation control tha tak a nei a; Damlo nitin hnathawhna atana fracture chu secure fixation; Tin, splints te hi lak chhuah a ngai lo tlangpui bawk (operative-a thla 12 atanga thla 18 thleng lakchhuah a ngai a nih chuan).

distal clavicle fracture a ni a,

Clavicle hook splint hi indirect fixation method a ni a, a thatna chu a chhunga fixation awlsam zawka dah, repositioning dik zawka dah, acromioclavicular joint tihbuai loh, leh a chhehvela tissue-a slip lova internal fixation relative stability te chu traditional kyphotic pin angin a ni.

Proximal clavicle fracture a awm a, a chhe thei lo.

Literature-ah chuan he fracture chi hrang hrang tan hian nonoperative treatment hi duh zawk a ni a, cervical-wrist sling braking hmangin an duh zawk a ni. Incisional internal fixation chu vascular nerve injury a awm chuan ngaihtuah theih a ni a, a nih loh leh fracture chu posterior-a a inthlak a, damlo chu thawk emaw, ei emaw harsa a tih chuan, emaw, chutiang symptoms a awm loh chuan, mahse imaging chuan displaced fracture chuan posterior structure pawimawh takah a imping a, repositioning chu a inhmeh lo tih a hriat theih a ni. Fixation a theih loh chuan a tul chuan proximal clavicle chu lakchhuah theih a ni.

Complication 10 a awm.

• No healing:Tun hmaa literature-ah chuan clavicle fractures-ah hian non-healing rate 0.9% atanga 4% a ni tih an sawi a, tun hnaia bulk case survey-ah chuan non-healing rate tak tak chu mi pakhatin a beisei aia sang a ni tih hmuhchhuah a ni.

• Deformity Healing: Traditional view chu deformity healing of the clavicle hi aesthetic problem chauh a ni a, operation hnua non-healing a awm chuan deformity awm phalsak ai chuan result a tha zawk tih hi a ni. Mahse, tun hnaia thil hmuhchhuah a nih dan chuan cm 15 aia tam clavicle tih tawi hian a hnu lamah natna leh movement tihkhawtlai a thlen fo thin. Chu bakah, mithiam thenkhat chuan deformity healing enkawlnaah simple 'clavicle shaping' an rawt a, mahse he method hi a tha lo. Scab lo chhuak chauh paih chhuah hian clavicle chu a ti thim thei a, fracture hlauhawmna nasa takin a tipung thei a, clavicle deformity chu dimension pathum-ah a lang chhuak a, 'smoothing' horizontal plane-a clavicle chauh hian deformity chu a siam tha vek dawn lo. Chuvangin, a rintlak zawk dan chu nonunion enkawlna nen a inang a ni: incision hnua a tam thei ang ber bone scab lakchhuah, internal fixation stabilization leh one-stage bone grafting. Dik tak chuan damlo chu operation hmain non-union a awm theih dan tur hriattir a ngai a ni.

• Vascular nerve injury:Clavicle fracture hnua vascular nerve injury awm theihna hi a tir lamah a hniam a, secondary injury hi a tlangpuiin a hliam a, a hliam hi a tlak loh hnua vascular nerve space a san avangin, a tawp lamah chuan ruh hrual (bone scabs) a lo thang lian thei a ni. Chutiang a nih chuan surgical decompression a ngai fo thin.

• Traumatic arthritis:Traumatic arthritis hnua clavicle fracture hi clavicle pawn lam 1/3 a fracture hnuah acromioclavicular joint-ah a awm duh a, a chhan ber chu trauma hun laia tharum thawhna avanga he joint a tihchhiat vang a ni a, a then chu articular surface a fracture vang a ni. Closure a hlawk loh chuan clavicle distal 1 cm chu resected tur a ni a, rostral-clavicular ligament venhim nan intraoperative care lak a ngai a ni.

  
  

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