Metacarpal fracture siamthat dan i hria em?

Metacarpophalangeal fracture hi kut natna vei zinga 1/4 vel a ni. kut chu a structure nalh leh buaithlak tak leh a fine motor function avang hian kut ruh tliak enkawlna hi long tubular fracture dang enkawlna aiin a pawimawh zawk a, technically a buaithlak zawk bawk.

Repositioning hnua fracture stability enfiah hi metacarpophalangeal fracture treatment hlawhtlinna kawngkhar a ni. Kut hnathawh that leh theih nan chuan fracture hi fixation dik tak a ngai fo thin a, tun hma chuan plaster hmanga external fixation emaw Kirschner pin hmanga internal fixation emaw hman thin a ni a, mahse fixation dik lo emaw fixation time rei tak avang hian a tam zawk a, hei hi postoperative joint rehabilitation hmasa ber atan a tha lo va, metacarpophalangeal functional recovery-ah nghawng lian zawk a nei bawk joint, kut hnathawh dan siamhatna kawngah harsatna engemaw zat a thlen a ni.

Tunlai enkawlna hmanruaah chuan internal fixation chak zawk, micro plate screw fixation ang chi te hman a ni nasa hle.

Enkawl dan tur thu bulte

Kut metacarpal leh phalangeal fracture enkawlna atana principle te chu: anatomic repositioning, light leh firm fixation, early mobility leh functional exercise te hi a ni. Kut intra-articular leh periarticular fracture enkawlna principle chu intra-articular fracture dangte nen a inang vek a: articular surface anatomy siamthat leh early functional activity. Kut metacarpal leh phalangeal fracture enkawlnaah hian kutphah dorsal aspect-a rotation, lateral angulation, emaw angular displacement >10° emaw awm lovin anatomic repositioning neih tum tur a ni. Metacarpal fracture end chu angle-a laterally-a rotate emaw displaced emaw a nih chuan finger flexion leh extension movement normal trajectory chu a thlak danglam ang a, flexion laiin a kianga finger atang chuan a nawr emaw a tla emaw a, finger function dikna a nghawng ang chutih laiin, kutphah dorsum-a angular displacement >10° chuan ruh leh tendon contact surface smooth tak chu a tichhia ang a, flexion leh extension-a tendon resistance leh range of motion a tipung ang a, tendon-ah hian chronic injury a thlen ang a, tendon rupture hlauhawmna a thlen ang. tendon rupture a awm theihna a ni.

Metacarpal leh phalangeal fracture te hi rotational deformity tuar theihnaah an inang a, metacarpal hian phalangeal aiin shortening displacement leh dorsal angular displacement a tuar tha zawk thung. Carpometacarpal leh metacarpophalangeal joint te hian metacarpal angular deformity chu a compensate thei a, annular little finger hi index middle finger aiin metacarpal angular deformity ah a insiamrem tha zawk bawk. Intrinsic hand muscle shortening avanga grip strength tlahniam hi metacarpal chu dorsal side-ah 30° aia tam angle a nih chauhvin a lang thei.

Surgery hmanga tih dan tur

Metacarpal fracture-a surgical approach hi a awlsam hle a, a tlangpuiin dorsal approach hman a ni a, Figure 4-14-a kan hmuh ang hian. Metacarpal pahnihna chu radial-a incised a nih laiin metacarpal pangana chu ulnarly-a incised a ni a, metacarpal pathumna leh palina chu medial-a incised a ni fo bawk. Metacarpal inhnaih tak pahnih chu a ruala operation a nih chuan surgical site pahnih ngaihtuah nan median S-shaped incision hman a ni.

Fixed method thlan dan tur

Metacarpophalangeal fracture atana internal fixation material tam tak a awm a, chungte chu Kirschner pin, screw, plate leh external fixation frame te an ni a, chung zingah chuan Kirschner pin leh microplate te hi hman a ni ber. Metacarpal fracture tan chuan microplate hmanga internal fixation hian Kirschner pin hmanga fixation aiin a thatna chiang tak a nei a, duhthusam a ni thei proximal phalangeal fracture tan chuan microplate hi a tlangpuiin duh zawk a ni a, mahse proximal phalangeal leh head fracture distal segment-a screw dah harsat a nih chuan internal fixation with crossed Kirschner pins hi duh zawk a ni a, hei hian a nghawng kut zungtang functional recovery atan a tha zawk a middle phalangeal fracture enkawlna atan chuan Kirschner pin hman tur a ni.

1、Kirschner-a zungbun: 

Kirschner’s needle internal fixation hi kum 70 chuang zet clinic-ah hman a ni tawh a, metacarpophalangeal fracture-a internal fixation material hman tlanglawn ber a ni a, hei hi hman a awlsam a, a man tlawm a, a hmantlak bawk a, Figure 4-15-a kan hmuh ang hian internal fixation method classic ber a ni. kut ruh tliak enkawlna atana internal fixation hman tlanglawn ber a nih avangin hman a la ni reng a ni. 

Kirschner pin hmanga internal fixation hman thatna:

1 hman awlsam leh hman dan pawh a inthlak danglam thei hle; 

2 soft tissue stripping tlem zawk, fracture tawp lama thisen kal dan a nghawng tlem, surgical trauma tlem, leh fracture damna atana tha 

3 secondary pin lakchhuah awlsam tak; 

4 man tlawm leh hmanna zau tak, kut ruh tliak tam zawk (intra-articular fractures, severe comminuted fractures leh end phalangeal fractures ang chi)-ah hman theih a ni. 

Internal fixation-a harsatna awmte: 

(1) plate fixation nena khaikhin chuan a stability a tha lo va, shortening leh rotational displacement chu pin pakhatin a control thei lo va, a tlangpuiin cross fixation atan pin 2 aia tam a ngai thin 

(2) fracture tawp lamah compression effect a awm lo; 

(3) cross-joint fixation hmanga joint surface a chhiat chuan; 

(4) ruh (joint) fixation leh tendon blockage hian kut ruh chu exercise hmasa a neih loh nan a veng a, functional recovery a nghawng bawk.

Tunlai internal fixation technique leh hmanrua te lo thang chak tak avangin Kirschner pin hmanga internal fixation chu a thianghlim chho zel a, a tam zawk chu joint cross lovin fix theih a ni a, joint chhehvela soft tissue leh tendon te chu a tichhe tlem hle a, operation hnua joint function training hmasa ber pawh a nghawng lo. C-arm X-ray machine hmang hian case thenkhatah chuan Clinique pin hmanga internal fixation closed reduction hmangin result lawmawm tak a awm thei bawk a, hei hian local soft tissues chhiatna leh fracture end-a thisen supply-a nghawng a neih chu a ti tlem lehzual a, chu chuan fracture tihdamna a tichak a ni. 

Kristen pin hmanga internal fixation atana fimkhur tur: 

1 Bone block lian zawkte chu Kristen pin 1.0~1.2 mm diameter-a sei hmangin siam that la, fracture line lam hawi angin a luhna tur leh a luhna tur lam chu ruat rawh 

2 Force line siam that tumna nen, intra-articular fractures te chu anatomically repositioned leh strongly fixed a ngai a; 

3 Bone block zawng zawng hi Kristen pin hmanga fix vek a ngai lo va, fracture end stability neih theihna tur premise hnuaiah chuan Kristen pin hi a tlem thei ang bera hman tur a ni 

4 Kristen pins te hi a theih ang anga early functional exercise siam turin finger tendon emaw dorsal tendon membrane kaltlangin an fix lo va; 

5 preoperative plan khauh tak awm tur a ni a, intraoperative-ah operation tih leh loh tur a ni a, chutiang a nih loh chuan fracture block chu a chhe zawk emaw, siamthat theih loh emaw pawh a ni thei 

6 a tlangpuiin Kirschner pin hi vunah dah tur a ni a, chu chuan natna kai theihna a ti tlem a, lakchhuah a harsa lo.

2、Metacarpal micro plate ah hian a awm a: 

Kut tliakte chu a chhunga fixation chak tak hi a hmaa functional exercise neihna bulpui a ni a, kut hnathawh tha siam that leh nan a tul a ni.AO internal fixation technique hian fracture tawp chu precise anatomical repositioning leh fracture end chu functional state-a stabilization a mamawh a, hei hi strong fixation tia sawi tlangpui a ni a, chu chu early active movement phalsak nan a ni.AO hian minimally invasive surgical operations, thisen kal dan venhimna lam hawi an ni. AO hian thisen kal dan humhalhna lam hawia minimally invasive surgical procedure a ngaih pawimawh hle bawk. Microplate internal fixation of the hand fracture hian a chakna, a fracture tawp stability leh a tawp inkar pressure lamah result lawmawm tak a pe a ni. Postoperative functional recovery, fracture healing time leh infection rate te khaikhin chuan micro titanium plate te hi kerf pin aiin a that zawk nia ngaih a ni a, micro titanium plate fixation hnua fracture healing time hi fixation modalities dang aiin a rei zawk hle a, chu chuan damlo chu a nun pangngaia kir leh hmasak a awlsam phah a ni.

Microplate chhunga fixation hmanga enkawlna thatna: 

(1) kerf pin nena khaikhin chuan microplate screw hian histocompatibility leh tissue response a nei tha zawk a; 

(2) plate nail fixation system stability leh fracture end-a pressure chuan fracture chu anatomical repositioning hnaih zawkah a siam a, fixation him zawk a siam a, chu chu fracture damna atan a tha a 

(3) microplate fixation hnuah early functional exercise hi phal a ni tlangpui a, hei hian kut hnathawh that lehna atan a tha hle. 

3. Microscrew hmanga siam a ni.

Spiral emaw long oblique fracture fixation atana microscrew te hian steel plate ang bawkin stability an nei a, mahse soft tissue leh periosteal stripping area chu steel plate fixation aiin a te zawk a, hei hian thisen kalna venna atan a tha a, minimally invasive operation concept nen a inmil hle. Proximal joint fracture atan T- leh L-type splint awm mahse, postoperative return visit hi diaphyseal fracture aiin a chhe zawk a, microscrew hian intra- leh periarticular fracture fixation atan hian thatna engemaw zat a nei bawk. Bone cortex-a screw screw-te hian stress load nasa zawk an tuar thei a, chuvangin fixation chu a nghet a, fracture tawp inkarah pressure a siam thei a, chu chuan fracture surface-te chu hnai takah a hruai thei a, hei hian dam hun a ti tawi a, fracture damna a ti awlsam a, Figure 4-18-a kan hmuh ang hian. microscrews hi diaphysis-a oblique emaw spiral emaw fracture leh ruh lian zawk intra-articular avulsion fracture-ah te hman a ni ber. Hriat tur pawimawh tak chu microscrew chauh hmanga hand stem oblique emaw spiral emaw fracture siam that hunah fracture thread sei zawng chu diaphysis diameter aiin a let hnih tal a ni tur a ni a, intra-articular avulsion fracture block fix hunah thread diameter zau zawng aiin a let thum tal a ni tur a ni.

4. Pawn lam fixation brace te tak te.

Comminuted metacarpophalangeal fractures hi surgical incision hmang pawhin anatomically reset a harsa thin emaw, bone scaffold a chhiat avangin a chhungah nghet taka fix theih a ni lo. External fixation brace hian comminuted fracture chu traction effect hnuaiah a recover thei a, a sei zawng chu a vawng reng thei a, Figure 4-19-a kan hmuh angin relatively fixed role a play a ni. External fixation brace dah dan hi metacarpal hrang hrang tan a inang lo: 1st leh 2nd metacarpals chu dorsal radial side-ah dah a ni a, 4th leh 5th metacarpals chu dorsal ulnar side-ah dah a ni a, 3rd metacarpal chu dorsal radial emaw dorsal ulnar side-ah a awm dan azirin dah a ni a, injury to ven nan entry point ngaihven a ni a tendon a ni. Closed fracture te chu X-ray hmangin khar leh reposition theih a ni a, repositioning a tha lo a nih chuan repositioning pui turin incision te te siam theih a ni bawk.

Pawn lam fixation brace hman thatna.

(1) hman a awlsam a, fracture end-a displacement hrang hrang a siamrem thei a;

(2) articular surface tichhe lovin metacarpal phalanges-a intra-articular fractures te chu tha takin a reset thei a, a fix thei bawk a, articular surface chu a distract thei bawk a, joint capsule leh lateral collateral ligaments te contracture a awm loh nan 

(3) anatomically reset theih loh comminuted fractures tan internal fixation limited nen a inzawm thei a, external fixation brace chuan force line chu a then a reset thei a, a maintain thei bawk 

(4) joint awm lohna turin unfixed joint-a finger natna chu a functional exercise hmasa ber a phalsak a ni 

(5) Kut ruh tliak chu a tha takin a siam tha thei a, kut natna hliam postoperative treatment a nghawng lo.

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