Kodi mungakonze bwanji distal humerus fracture?

Kuti mupeze kukhazikika kokhazikika pakukhazikika kwa osteoporotic kapena fractures comminuted, njira yofananira ya mbale zochizira ma distal humeral fractures imachokera pa mfundo yolimbikitsira kukonza kwa ma fractures a distal. Chinsinsi cha kukhazikika kwa kamangidwe kameneka kameneka kamene kamagwirizanitsa mbali ndi kukhazikika kwa arch pamene kutsekereza zipilala zapakati ndi zam'mbali za distal humerus pamodzi.

Arch mlatho kapangidwe

Zomangira za zidutswa za distal zimatsekana wina ndi mzake, kupereka kukhazikika kwina kudzera mu 'mlatho wotsekedwa'. Kulumikizana kumatheka bwino polumikizana pakati pa zomangira. Zomangira zambiri zimawombana moyandikana, ndipo mafupa pakati pawo amapanga 'rebar' (konkriti yolimba).

Masitepe luso

Gawo loyamba: opaleshoni yochepetsera mafupa. Zidutswa zolumikizana zomwe zimakonda kuzungulirana wina ndi mnzake pa ndege ya axial zidachepetsedwa ndikukhazikika kwakanthawi ndi mawaya a Kirschner. Chofunika kwambiri, mawaya a K akuyenera kuyikidwa pafupi ndi mlingo wa subchondral kuti asasokoneze kuyika kwa wononga kotsatira komanso kutali ndi kumene mbale zimayikidwa pazitsulo zam'mbali ndi zapakati. Waya imodzi kapena ziwiri zoyikidwa moyenera za Kirschner zingagwiritsidwe ntchito kukonza kwakanthawi chophukacho chogwirizana ndi diaphysis.

Gawo lachiwiri: kugwiritsa ntchito mbale zachitsulo ndi kukonza kwakanthawi. Mabala apakati ndi apakati omwe amapangidwapo amaikidwa ndikukhazikika pa distal humerus, pamene gawo losalala la 2 mm kapena 2.5 mm limalowetsedwa kudzera mu dzenje la 2 (lomwe limawerengedwa kuti distal to proximal), epicondyle, ndi distal bone fragment mu mbale iliyonse. Zikhomo kuti zisungidwe kwakanthawi kwa mbale ndi kupunduka kwa distal. Zomangira zinayikidwa pabowo (bowo 5) mu mbale iliyonse, koma osamangika bwino, zomwe zimasiya ufulu kuti mbale isunthire pafupi ndi nthawi ya kupanikizana. Popeza m'munsi mwa mbale iliyonse ndi tubular kumapeto kwa metaphyseal ndi diaphyseal, kumangirira pang'ono kwa zomangira m'mabowo otsekedwa kumapereka kukhazikika kwakanthawi kwa distal humer yonse.

Khwerero 3: Kukonzekera pamodzi. Zowononga zimadutsa pabowo la nambala 1 mu mbale yakumbuyo, kupyola pachidutswa cha distal articular kuchokera kutsogolo kupita kukatikati, ndikumangika. Bwerezani izi pogwiritsa ntchito dzenje nambala 3 mkati. Odwala aang'ono, zomangira za 3.5 mm cortical zimagwiritsidwa ntchito (kuteteza fractures), pomwe odwala osteoporotic amagwiritsidwa ntchito zomangira zazitali za 2.7 mm. Chophimba cha distal chiyenera kukhala chachitali momwe chingathere ndipo chiyenera kudutsa zidutswa zambiri momwe zingathere.

Khwerero 4 A: Kuponderezana pa kondomu. Kupanikizana kwapakati pa fracture kumaperekedwa pamlingo wa suprahumeral pogwiritsa ntchito mphamvu zazikulu zochepetsera, ndi gawo lokhazikika lokhazikika poyamba. Ikani wononga mu dzenje 4 mu lateral mbale mu dynamic mode kupondereza (inset). Kulimbitsa kumapangitsanso kuponderezana kwa interfragmentary (muvi) pamtunda wa supracondylar, kuchititsa kutambasula (muvi) pamtunda wapakati wa supracondylar.

Khwerero 4B: Momwemonso, gwiritsani ntchito mphamvu zochepetsera zazikulu kuti mupanikizike ndime yapakati ndikuyika wononga mu mbale yapakatikati mumayendedwe amphamvu. Ngati mbiri ya mbaleyo ili yocheperako pang'ono, cholumikizira chachikulu cha fupa chingagwiritsidwe ntchito kukanikizira motsutsana ndi metaphysis kuti ipitirire kupondereza kondomu.

Khwerero 5: Kukonzekera komaliza. Mawaya a K anachotsedwa ndipo zomangira zotsalazo zidalowetsedwa. Zomangira za distal zimasunthidwa kuti zikulitse kukhazikika kwa zidutswa za distal joint.

Kuwonongeka Kwambiri Kwa Mafupa - Kufupikitsa kwa Supracondylar

Ngati kutayika kwa mafupa a metaphyseal kapena comminution kumalepheretsa kumangidwanso kwa anatomical ndi kukhudzana kwa mafupa ndikwabwino, humerus ikhoza kufupikitsidwa pa malo ophwanyika a metaphyseal ndi kugwirizanitsa bwino ndi geometry ya distal humerus. Timatcha njira ina yomanganso njira iyi ya supracondylar shortening. Njira imeneyi ndi yothandiza makamaka pazochitika zophatikizana zofewa komanso kuwonongeka kwa mafupa. Kufupikitsa ≤1 masentimita sikumakhudza kwambiri mphamvu yowonjezera ya triceps terminal, ndipo ngati minofu yofewa kwambiri ndi kuwonongeka kwa mafupa, kufupikitsa mpaka 2 cm kumatha kulekerera popanda kukhudza kwambiri biomechanics ya chigongono.

Sinthaninso kumapeto kwa shaft ya humeral (kupatula gawo la articular) kuti muwonjezere kulumikizana pakati pa gawo la distal articular ndi diaphysis. Kawirikawiri, fupa laling'ono lokha limachotsedwa kumapeto kwa shaft humeral, ndipo nthawi zina kuchokera kumbali imodzi yake. B ndi C, kufupikitsidwa ndi malo ophwanyidwa kuti alole kupanikizana kwapakati pakati pa trochlear ndi distal diaphysis, pakati pa capitulum ndi distal diaphysis, ndi mbali ndi mbali. Malo awa akakanikizidwa ndi kutetezedwa ndi mbale zachitsulo, kukhazikika kumakhala kolimba mokwanira kuti asunthe ndi kukonzanso mwamsanga. Gawo la distal likhoza kumasuliridwa mozungulira kapena pambali, kapena pang'ono kutsogolo, ndikusunga kusinthasintha kozungulira ndi valgus.

6 zomangira ndi 2 mbale fixation zolinga

screw

1: Zowononga zilizonse zimadutsa mu mbale yachitsulo.

2: Chophimba chilichonse chiyenera kukonza chidutswa cha contralateral fracture.

3: Ikani zomangira zokwanira mu gawo la distal fracture.

4: Zowononga zilizonse ziyenera kukhala zazitali momwe zingathere.

5: Chophimba chilichonse chiyenera kukonza zidutswa zambiri momwe zingathere.

6: Zomangirazo ziyenera kutseka pamodzi podutsana, ndikupanga mawonekedwe okhala ndi ngodya yokhazikika.

mbale yachitsulo:

1: Kwa mbale zomwe zimagwiritsidwa ntchito pokonza, zolinga zoponderezedwa ziyenera kukwaniritsidwa pamlingo wa ma condyles a chikazi a mzere wapawiri.

2: Chitsulo chogwiritsidwa ntchito chiyenera kukhala cholimba komanso cholimba kuti chisaphwanyeke kapena kupindika.

Kodi Mungagule Bwanji Ma Implant a Orthopedic ndi Orthopedic Zida?

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Kuphatikiza apo, tadzipereka kupitiliza kupanga zinthu zatsopano ndikukulitsa mizere yazogulitsa, kuti tikwaniritse zosowa za maopaleshoni a madokotala ndi odwala ambiri, ndikupangitsanso kampani yathu kukhala yopikisana pamakampani onse apadziko lonse oyika mafupa ndi zida zamagetsi.

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