Engtikah nge fracture surgery i mamawh?

Fracture hi taksa peng dang hliam nen a awm tlangpui. Enkawlna kalpui dan zawng zawngah hian damlote chu a pum puia enkawl an ngai a ni.

Order of Priority tih a ni

• Nunna chhanhim rawh

• Limbs te chhanhim rawh

• Joints te pawh save rawh

• In sak tharna hnathawh

  
  

Emergency surgery: vascular injury, open fracture leh closed fracture te enkawlna principle te.

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

• 48h a ni

• 3 ~ 7d: ARDS leh harsatna dang a thlen tam phah ang.

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

• Kar 2 aia rei: operation harsatna a sang a, operation hnua hnathawh a tlahniam bawk.

Collarbone tihchhiat a ni

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

Humeral fracture hnaih ber a awm

• Manual reduction hnua elastic return a awm chuan-biceps longus tendon, axillary nerve symptoms a lo lang thin.

Humeral shaft a tliak

• Taksa enfiahnaah radial nerve hliam chhinchhiahna hmuhchhuah a nih chuan operation chu tih nghal a ni ang.

Distal humeral tihchhiat a ni

• Hetiang fracture hian elbow joint kal tlanga nerve emaw thisen kalna kawng emaw hliam eng pawh a thlen thei. 

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

• Fascial space syndrome-a incision nghal leh decompression.

Olecranon, radial head leh complex elbow joint hliam

• Kar khat chhungin operation chu ti zo rawh.

• Kar 1 ~ Kar 2 chhung operation hun khap tlat-myositis ossificans.

• Kar 2 chhungin surgery neih a ni ang.

  
  

Double forearm tihchhiat a ni

• A nih loh leh open fracture hi hliam hnu 6 ~ 8h chhungin operation tur a ni.

• Operation tihkhawtlai hian ulna leh radius inkarah bone bridge siam theihna a tipung thei a ni.

Distal radius a awm a ni

• Taksa enfiahnaah extensor pollicis longus tendon hliam leh median nerve compression symptoms a lo lang tih hmuhchhuah a nih chuan-operation nghal a ni.

Kut a tliak

• Open leh closed fracture-ah te pawh early reduction leh internal fixation hi ngaih pawimawh a ni a, a bik takin vascular, nerve emaw tendon hliam avanga buaina nei tan chuan operation tih nghal tur a ni.

  
  

Pelvic tihchhiatna (Pelvic fracture) a awm

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

  
  

• Complex pelvic fracture enkawl dan: 30min, thutlukna 3 siam

• Thisen chhuah tihtawp nan surgical exploration nghal

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

• 10 ~ 15min chhung enfiah hnuah pawh damlo hian hemodynamic instability-operation a la nei tho.

• Hemodynamics stable nei damlo tan chuan ni 7 chhung, ni 7 ~ 14 chhungin operation hi tih tur a ni.

Proximal femoral fracture-intertrochanteric ruh tliak a awm thin

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

Proximal femoral fracture-a ke ruh tliak

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

• Internal fixation: < kum 65 mi a ni

• Joint thlak danglam: > Kum 65 a upa

• Emergency surgery tih theih a nih 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 tihchhiatna (distal femoral fracture) a awm

• Soft tissue hliam na tak nei, open fracture, emaw operation hmasa lama harsatna nei damlo-Super-articular external fixator.

• Isolated injury-—DCS, retrograde intramedullary nail te chu surgery hmanga enkawl nghal.

  
  

Patella Fracture a awm

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

Tibial hnaih ber (proximal tibial fracture) a awm

• Injury violence awm dan tur chu ruat rawh

• Energy sang tak hliam hi soft tissue hliam na tak nen a inzawm fo thin. A taksa peng hrang hrang a hring, vun a hring, vun a hrual leh vun a tikehsawm a ni. Hetih lai hian operation hi sawn hlat tur a ni. Chutih rual chuan fascial space syndrome leh vascular leh nerve injury te pawh hi paih chhuah a ngai a ni.

Tibial shaft a tichhia a

• Anatomy particularity-soft tissue coverage pawimawhzia.

• A tir lamah: 8h chhungin

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

• Gypsum support a ni

• Calcaneal traction a ni

• Phase II: kar 2 vel a ni.

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

• Hliam chu a hring chhuak lo va, a chhuak lo bawk.

• Blister a vawt a, a hring a reh a, ruh chhinchhiahna te pawh khawih theih a ni.

• Vun hrual, vun line a lo lang.

Distal tibia (pilon) a tliak .

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

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

• Early stage: operation hi 6 ~ 8h chhungin tih a ni a, chu chu 2 ~ 3h chhung a ni.

• Delay: Ni 7 ~ 10 chhungin a hring a bo a, vun a rawn lang bawk.

One-stage surgical reconstruction-a zawm tur traditional principle pali:

• Fibula siam thar lehna

• Tibial articular surface siam thar lehna

• Ruh grafting a ni

• Bone plate a thlawp tlat

Ankle ruh tliak

• Ankle fracture hi intra-articular fracture a ni.

• Enkawlna hian a tum ber chu ruh (joint) taksa pianphung pangngai (normal anatomical structure) siam that leh a ni.

• Surgery hun chhung hi soft tissue dinhmun a innghat a ni.

• Surgery neih hun tha ber chu fracture area-a edema leh blisters a lo lan hma hi a ni.

Ke ruh tliak

• Mite ding leh kalna kephah lung a ni. Ke ruh (anatomical structure) pangngai siam that hian mi ding leh kalna kawngah hmun pawimawh tak a chang a ni.

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

Spinal ruh tliak (spinal fracture) a awm

• Taksa pumpui a stable chuan displaced fracture chu neurological symptoms a awm chuan operation nghal tur a ni.

  
  

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