Engtin nge distal humerus fracture hi i siam that theih ang?

Osteoporotic emaw comminuted fracture setting-a stable fixation reproducible-a hmuh theih nan, distal humeral fracture enkawlna atana parallel plate technique chu distal fracture fixation tihchakna principle-ah a innghat a ni. He fixation structure stability atana pawimawh ber chu arch feature leh stability te chu a inzawm khawm a, chutih rualin distal humerus medial leh lateral column te chu a lock khawm a ni.

Arch bridge siam dan a ni

Distal fragment-te screw-te chu an inzawm khawm a, 'closed arch bridge' hmangin stability dang a pe bawk. Interlocking hi screw inkara inzawmna hmanga tih theih a tha ber. Screw tam tak chu a inzawm tlat a, an inkar ruhte chuan 'rebar' (reinforced concrete) type structure an siam a ni.

Technical lama hmalakna tur

A hmasa ber atan: ruh tihtlem surgery. Axial plane-a inzawmkhawma inher duhna joint fragment te chu anatomic reduced niin Kirschner wire hmangin hun eng emaw chen fixed an ni. Pawimawh tak chu K-wire te hi subchondral level hnaih takah dah tur a ni a, chu chuan a hnua screw dahna tur a tihbuai loh nan leh lateral leh medial column-a plate dahna hmun atanga hla takah dah tur a ni. Kirschner wire pakhat emaw pahnih emaw, a remchan dan anga dah chu diaphysis nena inmil distal fracture chu hun eng emaw chen atan siam that theih a ni.

Step hnihna: steel plate hnawih leh hun eng emaw chen atana fixation. Medial leh lateral preformed plate te chu distal humerus-ah dahin fixed a ni a, plate tinah No. 2 hole (numbered distal to proximal), epicondyle, leh distal bone fragment hmangin 2 mm emaw 2.5 mm segment smooth tak dah a ni bawk. Plate leh distal fracture te chu hun eng emaw chen atana fixation awm reng turin pin. Plate tin slotted hole (hole 5)-ah screw dah a ni a, mahse a khauh kim lo a, compression laiin plate chu proximally-a kal theihna turin zalenna engemaw chen a awm a ni. Plate tin hnuai lam chu metaphyseal leh diaphyseal tawp lamah tubular a nih avangin, slotted hole-a screw-te chu tlem tal tihkhauh chauhvin distal humerus pumpui chu temporary fixation tha tak a pe a ni.

Step 3: Joint fixation tih a ni. Screw chu lateral plate-a No. 1 hole kaltlangin, distal articular fragment kaltlangin lateral atanga medial thlengin a kal a, a tikhauh a ni. He step hi a chhunga hole number 3 hmangin ti leh rawh. Damlo naupang zawkah chuan 3.5 mm cortical screw (fracture ven nan) hman a ni a, osteoporotic damloah chuan 2.7 mm sei screw hman a ni thung. Distal screw chu a sei thei ang bera awm tur a ni a, a fragment tam thei ang ber kal tlang tur a ni.

Step 4 A: Condyle-ah compression a awm. Fracture sir zawng zawnga interfragmentary compression chu suprahumeral level-ah reduction forceps lian tak tak hmangin pek a ni a, lateral column chu fix hmasak a ni. Lateral plate-a hole 4-ah screw chu dynamic compression mode (inset)-ah dah rawh. A tihkhauh chuan supracondylar level-a interfragmentary compression (arrow) chu a tichak lehzual a, medial supracondylar ridge-ah stretch (arrow) engemaw zat a awm a ni.

Step 4B: Chutiang bawkin reduction forceps lian tak tak hmangin medial column chu compress la, screw chu medial plate-ah dynamic compression mode-in dah rawh. Plate profile chu suboptimal deuh a nih chuan bone clamp lian tak hmangin metaphysis-ah press theih a ni a, condyle chu compress lehzual theih a ni.

Step 5: Final fixation neih dan tur. K-wire te chu lakchhuah a ni a, screw la awmte chu an dah lut ta a ni. Distal screw te chu staggered a ni a, chu chuan distal joint fragment te fixation a ti tam thei ang.

Ruh chhiatna nasa tak - Supracondylar Shortening

Metaphyseal bone loss emaw comminution emaw hian anatomical reconstruction a tikhawlo a, bone contact a tha a nih chuan distal humerus overall alignment leh geometry dik tak nen metaphyseal fracture site-ah humerus chu tih tawi theih a ni. Hei hi alternative reconstruction technique hi supracondylar shortening kan ti a. He technique hi soft tissue leh ruh hloh inzawmkhawmah chuan a tangkai hle. ≤1 cm-a tawi hian triceps terminal extension force-ah nghawng a nei tlem hle a, soft tissue leh ruh hloh nasa tak a awm chuan cm 2 thlenga tawi hi elbow biomechanics nasa taka nghawng lovin tuar theih a ni.

Humeral shaft distal end (articular segment tel lovin) chu reshape la, distal articular segment leh diaphysis inkara inzawmna tichak turin. A tlangpuiin humeral shaft distal end atang hian ruh tlemte chauh lakchhuah a ni a, a then chu a sir khatah pawh lakchhuah a ni bawk. B leh C, fracture site hian a ti tawi a, trochlear leh distal diaphysis inkarah te, capitulum leh distal diaphysis inkarah te, leh a sir lehlamah interfragmentary compression a awm thei a ni. Heng leilungte hi steel plate hmanga compress leh secured a nih hnuah chuan a stability chu a nghet tawk a, chu chu a kal nghal thei a, a siamthat nghal theih bawk. Distal segment hi medial emaw laterally emaw, hmalam tlem emaw a letling thei a, chutih rualin rotational leh valgus alignment a vawng reng thei bawk.

Screw 6 leh plate fixation target 2 a awm bawk

inherh

1: Screw tin hi steel plate kaltlangin a kal vek a.

2: Screw tin hian contralateral fracture fragment chu a fix tur a ni.

3: Distal fracture segment-ah screw tling tawk dah tur a ni.

4: Screw tin hi a sei thei ang bera awm tur a ni.

5: Screw tin hian a fragment tam thei ang ber a siam tha tur a ni.

6: Screw te chu crisscrossing hmangin lock khawm tur a ni a, angle fixed nei structure siam tur a ni.

Steel plate hmanga siam:

1: Fixation atana hman plate tan chuan compression goal chu double column-a femoral condyles level-ah tihhlawhtlin tur a ni.

2: Steel plate hman tur chu a chhe thei lo tur leh a beng thei lo tur khawpa nghet leh nghet a ni tur a ni.

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