Kodi mukudziwa kukonzanso kufooka kwa metacarpal?

Mafuta a metacacallallaal ndi chofala chofala pamanja, amawerengera pafupifupi 1/4 mwa odwala onse ovutika ndi manja. Chifukwa cha mawonekedwe owoneka bwino komanso ovuta a galimoto yake yabwino, kasamalidwe ka zokongoletsera za manja ndi zofunika kwambiri komanso mwanzeru kuposa kuchitira mankhwala ena.

Kuonetsetsa kukhazikika kwa kusokonekera pambuyo pakubwezeretsanso ndikofunikira kwa kupambana kwa metacarpolaal fracture. Kuti mubwezeretse ntchitoyo, kuwonongeka nthawi zambiri kumafuna kukonzekera koyenera, ndipo m'mbuyomu, kukonza kwapakatikati kokhazikika, ndipo nthawi zambiri kumapangitsa kuti pakhale koyenera kogwirizana, ndipo amathandizanso kukhazikika kwa ma porchpolat cha dzanja.

Njira zamakono zamakono zimagwiritsa ntchito kusintha kwamphamvu kwamphamvu, monga mawonekedwe a micro.

Mfundo Zachidziwitso

Mfundo za chithandizo cha metacarpal ndi Phalaleral fractures am'mudzi ndi: matayala oyitanitsa, opepuka komanso okhazikika, oyenda moyambirira komanso masewera olimbitsa thupi. Mfundo za chithandizo cha intra-articular ndi periyarticular zofananira ndizofanana ndi zomwe zimachitika kwa maluso ena a intra-a intra. Chithandizo cha metacarpal ndi malalanje owoneka bwino a dzanja ayenera kuyesetsa kukwaniritsa mawonekedwe osakhazikika popanda kusintha, kuphatikiza, kapena kusamutsidwa ndi 10 kumodzi. Ngati kutha kwa metacarpal kumang'ambika kapena kusakazidwa pambuyo pake pamalo abwinobwino, kumapangitsa kuti zisanduke chala. Ngakhale atasamuka> 10 ° kupita ku dorrum ya kanjedza ndikuwononga kosavuta ndi kusungunuka kwa tendon ndi kuvulaza chiwopsezo cha chotupacho. chiwopsezo cha chotupa cha tendore.

Mafuta a meracarpal ndi a Phalangel ndi ofanana ndi kuthekera kwawo kupatsa mphamvu kuzungulira, pomwe metacarpal imalekerera kufupikirako ndikuthamangitsidwa kwabwino kuposa phalarolal. Kulumikizana kwa carpometacal ndi metacarpopharaal kumatha kulipirira kufooka kwa metacarpal, ndipo chala chaching'ono chalankhulidwe chimangosinthana ndi chivundikiro cha metacarpal kuposa chala chapakati. Kuchepetsa mphamvu chifukwa cha kufupika kwa minofu kumawonekera pokhapokha ngati metacarpal ikakhala yoposa 30 ° kumbali yotsatira.

Kuwongolera Zochita

Njira yochitira opaleshoni yam'madzi imakhala yosavuta ndipo nthawi zambiri imagwiritsa ntchito njira yopita, monga tikuonera Chithunzi 4 mpaka 14. Wachiwiri wa metacarpal wapangidwa mokwanira pomwe metacarpalpi yachisanu imalumikizidwa, ndipo chachitatu ndi chachinayi nthawi zambiri zimakhala zokhalamo. Ngati zitsulo ziwiri zoyandikana zimagwiridwa nthawi yomweyo, mawonekedwe owoneka bwino aukazi amagwiritsidwa ntchito poganizira mawebusayiti onse.

Njira Yosankhidwa

Pali zida zambiri zamkati zamafuta a metacarparal, monga zikhomo za mabungwe, zomangira, mafelemu akunja, omwe mapaipi a Kirchchner amagwiritsidwa ntchito kwambiri. Kwa kufooka kwa metacarpal, kukonza kwamkati ndi microplate kuli ndi maluso omwe ali ndi mapindu achilendo pakukonzanso zikhomo ndi mapins ndipo akhoza kusankhidwa; Kwa proxatheal promangel fractures, maikolofoni nthawi zambiri amakondedwa, koma pakakhala zovuta kuziyika magawo a proxangel ndi mitu yodutsamo. Zochizira a Phalangel fractures, ma pinslener zikhomo ayenera kusankhidwa.

1, singano ya Kirschner: 

Kukonzekera kwa Kirchchner Monga momwe zimagwiritsira ntchito mkati mwamwayi pochiza matenda a m'manja, amagwiritsidwabe ntchito kwambiri. 

Ubwino wa kusinthana kwamkati ndi ma pinschner:

① zosavuta kugwira ntchito komanso kusinthika kwambiri; 

② Zosachedwa minofu yocheperako, zimapangitsa kuchepa kwa magazi kumapeto, kuchepa kwa opaleshoni, komanso zabwino ku machiritso ochiritsa; 

③ Sakasavuta ndi chikhomo chobwezeretsanso; 

Mtengo wotsika mtengo komanso kugwiritsa ntchito kwakukulu, kugwiritsidwa ntchito pamanja ambiri (monga maluso a intra-articular, oponderezedwa ndi ma fractured and matenthedwe a Phalangeal fran). 

Zoyipa zakusintha kwamkati: 

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(2) Palibe zovuta pamapeto osokoneza bongo; 

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Ndi chitukuko chachangu cha njira zamakono zamakono zamakono, kusinthana kwamkati ndi ma pinschner kumakhala kovuta kwambiri, ndipo ambiri aiwo amatha kutsitsa minofu yolumikizirana, komanso osakhudza zoyambirira zolumikizirana. Mothandizidwa ndi makina a C-Ar-ray x-ray, milandu ina imathanso kukhala yokwanira kuchepetsedwa kwa mapangidwe amkati ndi makweredwe am'deralo kumapeto kwa magazi, motero kumalimbikitsa kuchiritsa. 

Kusamala kwa Kukhazikika Kwamkati ndi Kinsten Pin: 

① Konzani mikamba yokulirapo ndi mapisi a Kristen a 1.0 ~ 1.2 mm mulifupi, ndikusankha mfundo yolowera ndikulowera molingana ndi mzere wa kuwonongeka; 

Ndi cholinga chobwezeretsa mzere wamphamvu, ma asodzi-articular ayenera kulozedwa mwamphamvu komanso okhazikika; 

③ Osati mikanda yonse yamafupa kuti ikhazikike ndi zikhomo za Kristen, komanso pansi pa chidwi chokwaniritsa mathero a kuwonongeka, ma pini kuyenera kugwiritsidwa ntchito pang'ono; 

Mapazi a Kristen samakhazikika kudzera mu tendon kapena dorsal tendon nembanemba za chala kuti apange masewera olimbitsa thupi moyenera momwe mungathere; 

Payenera kukhala dongosolo lokhazikika lokhalokha ndipo osabwereza opareshoni, apo ayi bractore block ikhoza kuphwanyidwa kwambiri kapena osasunthika; 

Nthawi zambiri pini ya Kirschner iyenera kuyikidwa pakhungu kuti muchepetse mwayi wotenga matenda ndipo sizovuta kuzichotsa.

2, Mbeta ya Metacarpal: 

Kukhazikika Kwamphamvu kwa Manja ndi maziko a masewera olimbitsa thupi ndipo ndikofunikira kuti mugwiritse ntchito njira yabwino yamphamvu komanso yokhazikika. AO zimatsimikiziranso maopaleshoni osokoneza bongo omwe amayang'ana kwambiri pakusunga magazi. Kukhazikika kwamkati kwa dzanja la dzanja kumapereka zotsatira zokwanira pankhani ya mphamvu, kukhazikika kwa kutha kwa kuwonongeka kwa malekezero. Pankhani ya postoperatick yogwira ntchito, nthawi yochiritsa yochiritsa komanso kuchuluka kwa matenda opatsirana, nthawi yokwanira kwambiri kuposa kufupika kwa kerro tins mictanium pambuyo posinthana ndi wodwala.

Ubwino wamakolotemment mankhwala: 

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3. Microscrews.

Microscrecks ya kukhazikika kwa masikono kapena kutalika kofananira kukhala ndi mbale zofananira, koma minofu yofewa ndi malo otsekemera ndi yaying'ono kuposa kukhazikika kwa magazi, komwe kumapangitsa kutetezedwa kwa magazi ndi lingaliro la kuchitidwa kwamphamvu. Ngakhale pali zigawo za T - L-L-LOME zokhudzana ndi zowonjezera, ulendo wobwereza umakhala wosavuta kuposa zomwe zimasautsika kwambiri kuposa zomwe zimapangitsa kuti zikhale zowoneka bwino, ndipo microscrews ali ndi zabwino zambiri zakusintha kwa intra- ndi periyarticular. Zovala zotsekemera mu cortex imatha kupirira katundu wambiri, kotero kukonzekera ndi kokhazikika ndipo kumatha kuyikapo pakati pa kuwonongeka kwa kusokonekera kuti ubweretse magetsi ndikuwonetsa pa Chithunzi 4-18. Microscrews imagwiritsidwa ntchito makamaka ngati ma coccrauctures a diaphyys ndi intra-arsicular fractures a mafupa akuluakulu. Ndikofunikira kudziwa kuti kutalika kwa ulusi wa fracture uyenera kukhala kawiri kawiri m'mimba mwake mukamakonzekera miyala yamiyala yomwe imagwiritsa ntchito zingwe zopangira ma intralsion.

4..

Kuyamwa Metacacarsal fracrations nthawi zina kumakhala kovuta kubwezeretsa Anatomically ngakhale ndi opaleshoni kapena sangathe kukhazikitsidwa mwamphamvu chifukwa scaffold imawonongedwa. Kukongoletsa kwakunja kumapangitsa kuti khungu liziyenda bwino kuti muchiritse ndikusunga kutalika kwake komwe kumachitika, kusewera gawo lokhazikika, monga momwe chithunzi 4 mpaka 19. Kukhazikitsidwa kwa kukondera kwakunja kumasiyana ndi metacarpuls osiyanasiyana: metacarparpuls ya 1st ndi 2 ndi 5 ndi 5 ndi 5 ndi 5 ndi 5 zotsekera zimayikidwa pazinthu zolowera, ndipo kumverera malo olowera kuti mupewe kuvulaza tendon. Zotsekedwa zotsekedwa zimatha kutsekedwa ndi kukhazikitsidwa pansi pa X-ray, ndipo zingwe zazing'ono zimatha kupangidwira kuti zithandizire kubwezeretsanso ngati njira yomwe siyikuyatsa.

Zabwino zakuda zakuda.

(1) Ndiosavuta kugwira ntchito ndipo amatha kusintha zinthu zosiyanasiyana za kuwonongeka;

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