Engtik laiin nge fracture surgery i mamawh?

Fracture hi taksa peng dang hliam nen a inzawm tlangpui. Enkawlna kalpui danah chuan damlote chu a pum puia enkawl an ngai a ni.

Order of priority .

• nunna chhanhim .

• Save Limbs .

• Save Joints .

• Reconstruction hnathawh dan tur .

  
  

Emergency Surgery: Vascular injury, open fracture leh closed fracture te enkawl dan tur.

• Open reduction leh a hma thei ang bera internal fixation (6h chhung)

• 48h a ni.

• 3 ~ 7D: ARDS lo awm leh harsatna dang a thlen tam zawk ang.

• 7 ~ 10d: Endocrine reaction a tlahniam [a tui a reh a, inflammation a bo].

• Kar 2 aia tam: hnathawh harsatna a pung a, postoperative function a tlahniam bawk.

Collarbone fracture .

• Fracture block hian subclavian artery, vein leh brachial plexus a hliam chuan harsatna lian tak a nih thu leh hman nghal tur a ni tih an pawm a ni.

Proximal humeral fracture .

• Elastic return chu manual reduction hnua lo awm a nih chuan-biceps longus tendon, axillary nerve symptoms a lo lang thin.

Humeral shaft a fracture .

• Taksa enfiahnaah radial nerve injury symptoms hmuh a nih chuan operation chu tih nghal a ni ang.

distal humeral fracture .

• Hetiang chi ruh tliak hian elbow joint kal tlanga nerve emaw thisen kalna kawng emaw hliam eng pawh a thlen thei a ni. 

• Thisen kalna kawng a laceration hi a tlem hle a, mahse tension emaw compression emaw a awm thei. 

• Fascial Space Syndrome-Hriselna atana hman awlsam leh decompression.

Olecranon, radial head leh complex elbow joint hliam te.

• Kar khat chhungin operation chu tihfel vek tur a ni.

• 1 ~ kar 2 chhunga hnathawh khapna hun hman theih hun-myositis ossificans.

• Kar 2 chhungin surgery neih a ni ang.

  
  

Double forearm fracture .

• emaw open fracture chu hliam hnu 6 ~ 8h chhungin hman tur a ni.

• Delayed operation hian ulna leh radius inkarah bone bridge siam theihna a tipung thei a ni.

Distal radius a tlakbuak a ni.

• Taksa enfiahnaah chuan extensor pollicis longus tendon hliam leh median nerve compression symptoms te chu a lo lang nghal tih hmuhchhuah a ni-in surgery a ni.

Kut ruh tliak .

• Open leh closed fracture pahnih tan hian early reduction leh internal fixation hi ngaih pawimawh a ni a, a bik takin vascular, nerve emaw tendon injury buaithlak tak tak te tan chuan surgery tih nghal tur a ni.

  
  

A pelvic fracture .

• Pelvic fracture hi hmun dangah fracture nen an inzawm fo a, hei hian hemodynamic instability a thlen dawn a ni.

  
  

• Complex pelvic fracture enkawlna mode: 30min, thutlukna 3

• Thisen chhuah tihtawp nan surgical exploration nghal rawh .

• Pelvic fixation (C-shaped forceps emaw external fixator emaw) chu 10 ~ 15min-ah tihfel a ni.

• 10 ~ 15min chhung a enfiah hnuah pawh damlo chuan hemodynamic instability-operation a la nei reng a ni.

• Stable hemodynamics nei damlote tan chuan operation hi ni 7, a nih loh leh ni 7 ~ 14 chhungin tih tur a ni.

Proximal femoral fracture-intertrochanteric fracture .

• Damlo dinhmun tlangpui chu control a nih hnuah chuan internal fixation, DHS, DCS leh PFN te chu tih tur a ni.

Proximal femoral fracture-femoral neck fracture .

• Femoral neck fracture, a bik takin intracapsular fracture hian femoral head thisen supply a tichhe thei a, chuvangin a rang thei ang bera reduction leh internal fixation hawn a ngai a ni.

• A chhunga fixation: < kum 65 a ni.

• Joint thlak danglam: > Kum 65 mi

• Emergency surgery a awm theih loh chuan joint puncture leh intra-articular hematoma aspiration tih theih a ni a, hip joint chu semi-flexion leh external rotation posture-ah dah theih a ni bawk.

Distal femoral fracture .

• Soft tissue hliam na tak, open fractures nei, emaw operation-super-articular external fixator hmasa lama harsatna nei damlote.

• Hliam isolated-—DCS, retrograde intramedullary nail hmanga surgery hmanga enkawl nghal.

  
  

  

Patella a tichhia a ni.

• Damlo dinhmun tlangpui chu a nghet a, tualchhung vun dinhmun a phal a, operation chu tih nghal tur a ni.

Proximal tibial fracture .

• Hliam tharum thawhna awm dan tur chu ruat rawh .

• Energy sang tak hliam hi soft tissue hliam na tak nen a inzawm fo thin. A nihna takah chuan a ke ruh a ti na a, a hring a, a vun a ti na a, vun a ti na bawk. Hetih lai hian operation hi sawn hlat tur a ni. Chutih rual chuan fascial space syndrome leh vascular leh nerve injury te pawh a tel lo tur a ni.

Tibial shaft fracture .

• Anatomy-a thil awm dan (particularity)- soft tissue coverage pawimawhzia.

• A hmasa ber atan: 8h chhungin

• External fixator hi enkawlna hmasa atana duhthlanna hmasa ber atan ngaih a ni.

• Gypsum hmanga tanpui theih a ni.

• Calcaneal traction a ni a.

• Phase II: Kar 2 vel a ni.

• Systemic infection leh acute trauma langsar tak a awm lo.

• Hliam chu a hring emaw, a chhuahna emaw a awm lo.

• Blister hi a vawt a, swelling subsides a awm a, bony marker pawh a khawih theih bawk.

• Skin wrinkled, vun line a lang.

Distal tibia (pilon) a tihchhiat a ni.

Pilon fracture enkawlna result chu joint reconstruction quality leh soft tissue coverage dinhmun a zirin a innghat a ni.

Surgery neih hun tha ber chu soft tissue dinhmun a zirin a innghat a ni:

• Early stage: Operation hi 6 ~ 8h chhungin an ti a, chu chu 2 ~ 3h a ni.

• Delay: Ni 7 ~ ni 10, a hring a bo a, vun vun a lo lang.

Traditional principle pali, one-stage surgical reconstruction-a zawm tur:

• Fibula siam thar lehna .

• Tibial articular surface siam thar lehna .

• Ruh grafting a awm em?

• Bone Plate thlawpna .

Ankle a hliam .

• Ankle fracture hi intra-articular fracture a ni.

• Enkawlna tum ber chu joint-te anatomical structure pangngai siam that leh a ni.

• Surgery hun tur chu soft tissue dinhmun a zirin a innghat a ni.

• Surgery neih hun tha ber chu fracture area-a edema leh blisters a lo lang hmain a ni.

Ke ruh tliak .

• Mite ding leh kal theihna tur kephah lungphum a ni. Kea taksa peng hrang hrang (anatomical structure) siamhat leh hian mi dinhmun leh kal kawngah hmun pawimawh tak a chang a ni.

• Ankle fracture ang bawkin, operation hun tur chu soft tissue swelling degree leh state-ah a innghat a ni.

Spinal fracture .

• Taksa pum a nghet a nih chuan, a displaced fracture chu neurological symptoms a awm chuan hman nghal tur a ni.

  
  

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