Humeral stem fracture leh technical point te surgery hmanga enkawl a ni.

Postoperative weight restriction hi a tam berah kilogram khatah fracture damna nasa tak a thlen hma loh chuan (a tlangpuiin thla thum) a awm tur a ni.Humeral stem fractures (HSF) hi a tam hle a, fracture zawng zawng zinga 1% atanga 5% vel a ni. Kum khat chhungin mi 100,000-ah 13 atanga 20 vel an awm a, kum upat dan azirin a pung tih hmuhchhuah a ni.HSF hian bimodal age distribution a nei a, high-energy trauma hnua mipa kum 21 leh 30 inkar zingah a sang ber a awm a, a tlangpuiin comminuted fracture leh a kaihhnawih soft tissue hliam a thlen thin. Second peak hi hmeichhia kum 60 leh 80 inkar zingah a awm a, a tlangpuiin low-energy trauma hnuah a awm thin.

Surgical hmanga enkawlna .

一 a ni. Incisional repositioning plate hmanga internal fixation siam a ni.

indication te:

• HSF-a radial nerve palsy (RNP) hi operation atan chuan a indication a ni lo a, a chhan chu spontaneous recovery rate sang tak nen a inzawm a ni (see also - complications/radial nerve below).

• A dang pawhin, vascular injury eng pawh repair emaw bypass emaw mamawh chu fracture surgical treatment atana absolute indication a ni a, rigid fixation hian vascular anastomosis a humhim avangin.

• Hetiang a nih chuan, plate hmanga internal fixation chu IMN aiin a rang zawk a, a rintlak zawk bawk a, a chhan chu vascular repair hi direct approach hmanga tih a nih avangin (a tlangpuiin medial approach) a ni.

• HSF proximal emaw distal intra-articular extension nei chu ORIF nei plate nei te chu a tha zawkna hmun dang a ni.

  
  

Surgical exposure a ni a, 1.1.

• Proximal leh/ emaw middle third-a awm fracture te chu classic anterolateral approach hmangin enkawl an ni.

• A tul hunah chuan he approach hi humerus pum pui pholanna atan distal-in a zau zel a ni.

• Mahse, he approach hi distal intra-articular fractures tan chuan a tha lo.

• Distal third-a fractures te hi triceps split approach hmangin an pholang tlangpui thin.

• Distal leh middle third fractures tan chuan Gerwin et al30-in a sawi modified posterior approach hian humerus 76-94% a pholang thei a (radial nerve release leh septal release a zirin).

  
  

Surgical technique hrang hrang:

• Damlo chu anterolateral approach atan beach chair position-ah dah a ni. Arm brace hman hian humeral stem alignment a vawng reng thei a ni. Posterior exposure atan chuan lateral position hi duh ber a ni.

• Optimal plate construction hi 4.5 mm steel plate emaw a tlukpui emaw a ni a, fracture na hmun chungah leh a hnuai lam cortices 6 tal a khuh tur a ni a, mahse cortices 8 chu a tha zawk.

• A tul hunah chuan fragment plate te tak te leh lian tak inzawmkhawm a tha a, chu chu repositioning vawng reng turin third tubular plate tawi te te (transverse fracture emaw butterfly fragment emaw) a ni a, chu chu fracture final fixation atan 4.5 mm plate tawi tak nen supplement a ni.

• Distal third fractures tan chuan epiphyseal fixation chak tak neih theih nan posterior lateral column preformed plate (3.5/4.5) hman a tha.

  
  

HSF-a locking screw hman hi sawisel a la ni reng a ni .

• Locking plate leh non-locking plate te chu comminuted fractures te ruh quality tha tak nei te nen khaikhin chuan, structure pahnih tan hian torsion, bending emaw axial stiffness ah biomechanical advantage a awm lo.

• A lehlamah chuan ruh quality tha lo tak tak an hmachhawn hunah chuan locking plate hman hi a hlawkpui thei bawk.

• Gardner leh a thawhpuiten an zirchiannaah chuan biomechanical study an nei a. A bik takin osteoporotic fracture model atan chuan non-locking structure 34 chu locking emaw hybrid structure emaw aiin a stable lo zawk tih a chiang hle.

Minimally invasive plate splicing hi surgical option a ni a, hlawhtlinna rate sang tak leh complication rate hniam tak a pe thei niin a lang. Mahse, damlo 76 te nena an zirchiannaah chuan Van de Wall et al. an hmuh dan chuan humeral stem fractures absolute stability chauh hian relative stability nena khaikhin chuan radiographic healing time nasa takin a ti tawi zawk tih an hmuchhuak.

Operation hnua enkawl dan: 1.1.

• A tlangpuiin plate hman hmangin stable fixation an hmu thin. Chutiang chuan damlo chu active leh active-assisted activities te chu range of motion of the shoulder emaw elbow hmanga tihkhawtlai lohvin a ti thei a ni.

• He sling hi ni engemawzat chhung chu natna enkawlna atan hman theih a ni.

• Postoperative weight restriction chu a tam berah kilogram khat aia tam loah dah tur a ni a, chu chu fracture damna nasa tak a thlen hma loh chuan (a tlangpuiin thla thum) a ni.

• Damlo naupang zawkte chuan phalna an pekna hmunah (eg, kea kal a ngai) an rit phurh phalsak an ni a, mahse damlo kum upa zawkah chuan hei hi case-by-case basis-a sawiho tur a ni.

report a ni a .

• Plating hnua damna rate chu 87% atanga 96% inkar a ni a, a dam hun chhung chu kar 12 chhung a ni.

• Complication rates hi 5% atanga 25% inkar a ni a, nonspecific complication tam ber, infection, osteonecrosis, leh malunion te a awm bawk.

• medically derived RNP hi humeral stem approach tam zawk tan chuan risk a ni. Streufert et al50 chuan ORIF hmanga enkawl HSF case 261 an enfiah a, medically derived RNP chu anterolateral approach 7.1%, separed triceps approach 11.7%, leh preserved triceps approach 17.9% ah a awm tih an hmuchhuak.

• Chuvangin, open dissection zawng zawngah radial nerve hriatchhuah leh venhim a pawimawh hle.

  
  

二 chuan a ti a. Intramedullary nail .

indication te:

• Theory-ah chuan IMN hian biomechanical leh surgical benefits te chu plating aiin a tha zawk .

• Biomechanical lam atanga thlir chuan device intramedullary positioning chu humeral stem-a mechanical axis nen a inmil a ni.

• Hemi avang hian implant hi lower bending forces hnuaiah a awm a, load sharing tha zawk a awm thei bawk. Intramedullary nailing atana surgical indication te chu plating atan a inang vek a ni.

• Mahse, a hmaa kan sawi tawh ang khan fracture thenkhat chu nailing aiin plating atan a tha zawk.

• Fracture characteristics leh patterns IMN aiin a tha zawk tih hmuhchhuah te hi pathologic leh impending fractures, segmental lesions, leh osteoporotic fractures te an ni.

• Simple mid-third transverse fractures pawh IMN tan chuan indication tha tak a ni.

• Chu bakah, nail chu incision tlem zawk hmangin a dah theih bawk a, hei hian plating technique nena khaikhin chuan soft tissue stripping a ti tlem thei bawk.

• Hei hi Humerus-a middle third-a fracture-te tan chuan a dik hle.

Surgical technique hmangin:

• Hetiang tihna atana damlo dinhmun tha ber chu beach chair-ah a ni. Arm brace hman hi shaft alignment enkawlna atan a tangkai hle a, distal freehand locking screw te pawh a ti thei bawk.

• Point of entry chu nail design-ah a innghat a, mahse a tlangpuiin tuberosity lian zawk inzawmna leh humeral head articular surface-ah a awm a, chu chu rotator cuff muscles te chu a luh a ngai tihna a ni.

• Hetiang procedure atan hian supraspinatus tendon hmuh theihna turin deltoid division approach tih a tha.

• Dik tak chuan, supraspinatus tendon lai takah humeral head an luh chuan sagittal plane-ah chuan lu lai takah an inhmu ang.

• Fluoroscopy hmanga keratomile hman a pawimawh a, chu chuan entry point chu sagittal leh coronal plane-ah te pawh pawm theih a nih theih nan a pui a ni.

• Chumi hnuah chuan guide wire chu direct vision hnuaia supraspinatus tendon tendon longitudinally hawn hmain a hmasawn lehzual tur a ni.

• A dawt leh tur chu Kirschner needle hmanga canal hawn a, fracture chu traction leh/ emaw pawn lam manipulation nena inmil a nih theih nan leh chuta tang chuan intramedullary canal-a guide chu elbow thlenga hmasawn tir a ni.

• Reaming hi damlo naupang zawkte tan a tha tih hmuhchhuah a ni a, damlo kum upa zawkah chuan a tul reng reng lo.

• Distal bolt placement atan chuan AP locking hi a him zawk a, myocutaneous nerve injury hlauhawmna tihziaawmna turin 2-3 cm approach tlemte a ngai a ni.

• A tawp berah chuan, paralleling IMN hi retrograde IMN aiin a sang zawk a, a chhan chu a hnuhnung zawk complication bik avang hian medically induced supracondylar fractures, elbow extension hloh, leh heterotopic ossification te pawh a tel a ni.

  
  

Nail thlan rei zawng hi ngaihven bik a ngai a, nail rei lutuk hian technical error pahnih a thlen thei a ni:

• Impact nail laiin fracture site-a distraction .

• leh/ emaw, subacromial space-a chhuak nail te .

  
  

Proximal third helix emaw long oblique fractures emaw tan chuan ziaktute chuan fracture tihziaawmna turin miniature open approach an rawt a, chu chu ring tie wire hmanga fixation a ni. Dik tak chuan, he fracture subtype atan hian deltoid muscle hian proximal fracture fragment chu a rukbo duh a, pectoralis major chuan distal fracture fragment chu medially-in a chhuah tir a, chu chuan osseous nonunion emaw delayed healing emaw risk a tipung a ni.

Operation hunlai enkawl dan tur .

• Damlote chu an tuar theih angin active leh active-assisted movement-te chu an ke leh an elbow-ah an ti a.

• Slings hi ni engemaw zat chhung chu pain control nan hman theih a ni.

• Postoperative weight lifting restrictions chu a tam berah kilogram khat aia tam loah a awm a, chu chu fracture healing a lan hma loh chuan (a tlangpuiin thla thum) a ni.

• A tam zawkah chuan weight bearing hman phal a ni .

  
  

reported hmuhchhuah a ni:

• HSF enkawlna atana locking nail device hman chungchanga literature chu a inmil lo hle. Khawthlang lamah chuan bone nonunion report rate hi a danglam nasa hle (0% leh 14% inkar) a, nail thlah upa zawkte zingah a tam ber a ni. A lehlamah chuan, literature hmasaah khan shoulder complication (pain, impingement, motion hloh emaw, 6% atanga 100%) a thlen thu an sawi tawh bawk.

• Buaina thenkhat chu he isovascularity hmun pawimawh takah hian nail chhuak, scar tissue leh/ emaw rotator cuff injury avanga chronic tendon dysfunction avanga subacromial trauma hmanga sawifiah theih a ni.

• He hypovascular region pumpelh dan tur leh tendon hi fimkhur taka siamthat dan tur kawng hrang hrang ziaktu engemaw zatin an sawi a, chu chuan shoulder dysfunction rate a hniam zawk tih a lantir a ni.

  
  

HSF conservative treatment hian damlo 80% talin functional outcome tha tak leh healing rate sang tak a pe a ni. Hemi avang hian HSF tam zawk tan chuan enkawlna duh ber a la ni reng a ni. Alignment hi pawm theih loh a nih chuan surgery ngaihtuah a ngai a ni. Hei hi kum 55 chunglam damlote tan chuan proximal third oblique fracture (lower healing rate) neia present-te tan a dik hle. Surgical treatment chungchangah chuan literature hian plate leh IMN te hi healing rates emaw radial nerve complication emaw lamah danglamna lian tham an nei lo a, mahse IMN hian shoulder complication (impingement leh reduced range of motion) a nei tam zawk thung. Chuvangin, cuff chu a luhna hmunah leh a khar lai pawhin uluk takin enkawl a ngai a ni.

Lam CZMedItech 1000 a ni.

He planet-a mi tinte hian healthcare service tha zawk an phu tih rinnain a hruai a ni. CZMedItech hian  midangte hlauhawm lo taka nunpui turin passionate takin hna a thawk a ni. Kan thil siam leh kan ke penna avang hian ram 70 chuang zeta zau, damlo, doctor leh kawppuite pawhin an rinchhan a nih avangin damlo nasa tak leh nun tha zawk an neih chuan kan chhuang hle .  CZMedItech 1000 a ni. hma an sawn theih nan Kan siam orthopedic implant apiang hian quality standard sang ber a tlin vek a ni.

Kum 13 kalta khan orthopedic implant hmangin kan zinkawng mak tak mai chu kan tan a. Chutiang a nih lai chuan production line chu 2018 atan implant-ah a inthlak a ni. Spine ., lungchhiatthlak, Cranial-maxillofacial 1000 a ni., Prosthesis 1000 a ni., Power hmanrua, . Pawn lam fixator te ., arthroscopy  leh . veterinary care , bakah . Instruments te  chu a kaihhnawih surgical procedure-a hman thin a ni.

Kan raw material zawng zawng hi ram chhung leh ram pawna top quality supplier atanga lo kal a ni. Quality chungchang sawi dawn chuan kan mission-ah hian step khata awm reng turin costs kan spare ngai lo va, chu chuan raw material quality enfiah turin kanmahni test lab kan siam a ni. Kan production machine zawng zawng hi USA, Germany, Japan leh top brands atanga kan lakluh a ni a, chu chuan kan thil siam zawng zawng a dik leh dik loh a hriat theih nan a ni.

Hmasawnna zirchianna leh a tawp bera thil siam chhuah tihpunna kawngah hun leh tha tam tak seng a ni. Harsatna zawng zawng chinfelna tur leh after-sale service tha ber pek theihna turin quality tha ber leh kan sales team support neih theihna turin professional research team, production team leh QC team kan nei a ni.

Kan rinna hi kan ngaina hle a, khawvel puma kan client zawng zawngte tana quality sang tak, innovation product solution pe turin kan know-how ramri kan nawr chhunzawm zel a, mihring hriselna atana hmalakna tur dang pawh kan siam zel bawk.