Kuphulika kwa Scaphoid
Kuphulika kwa scaphoid ndikofala kwambiri kwa carpal fracture, yomwe imakhala pafupifupi 70% ya mafupa onse a carpal. Chifukwa cha mawonekedwe ake apadera a thupi mkati mwa dongosolo la mafupa a carpal, fractures zatsopano za scaphoid nthawi zambiri zimasowa pozindikira matenda. Kuphatikiza apo, kutulutsa kwapadera kwa mitsempha ya scaphoid kumapangitsa odwala kukhala ndi zovuta monga nonunion, avascular necrosis (AVN), ndi kusakhazikika kwa carpal pambuyo pake. Zachipatala, fractures za scaphoid zimakhala zovuta kuchiza ndipo nthawi zambiri zimasiya sequelae monga kupweteka kwa dzanja kosalekeza, kusayenda kosalekeza, ndi nyamakazi yoopsa.
Unique Anatomical Udindo wa Scaphoid
Skaphoid ndi fupa lalitali kwambiri pamzere wozungulira wa carpal, wopangidwa ngati bwato laling'ono (motero limatchedwa 'scaphoid'). Imadutsa pakati pa mizere yodutsa ndi distal carpal, imagwira ntchito yofunika kwambiri pakukhazikika ndi kulumikiza mizere yonse iwiri. Kuyenda kwabwino kwa dzanja, kuphatikizira kupindika, kukulitsa, kupatuka kwa radial, ndi kupatuka kwa ulnar, zonse zimadalira kayendedwe ka scaphoid kogwirizana. Akathyoka, biomechanics ya mgwirizano wonse wa dzanja imasokonezeka.
Fragile Vascular Supply
The scaphoid imalandira magazi makamaka kuchokera ku nthambi za mtsempha wamagazi, kulowa kuchokera ku dorsal ridge ndi distal pole:
Pafupifupi 70-80% ya magazi amalowa kudzera mu distal tubercle, akuyenda mobwerera kumbuyo kuti adyetse chigawo cha proximal pole.
Ndi nthambi zochepa zokha zomwe zimalowa mwachindunji pamtengowo.
Zotsatira zake:
Kuyandikira kwa fracture kumafika pamtunda wa proximal, chiopsezo chachikulu cha kusokonezeka kwa mitsempha.
Kuthamanga kwa magazi kukasokonezedwa, kachigawo kakang'ono kamene kamakhala kosavuta ku AVN ndi nonunion.
Njira Yovulazira Yodziwika
Njira yovulazidwa yofala kwambiri ndi kugwa pa dzanja lotambasula (FOOSH) .Akagwa, anthu mwachibadwa amatambasula mkono ndikutambasula zala kuti atenge mphamvu ndi kanjedza. Njira yovulazidwa kawirikawiriyi yakopa chidwi chachipatala ndi kafukufuku, ndipo imatchulidwa kwambiri ndi mawu akuti FOOSH.
Kuchedwa Kuzindikira kwa Scaphoid Fracture
Kuphulika kwa scaphoid nthawi zambiri kumabwera chifukwa cha kuvulala kwa FOOSH. Muzochitika zochepa, zizindikiro zimatha kukhala zowawa pang'ono, zomwe zimapangitsa odwala kunyalanyaza kupeza chithandizo chamankhwala. Ngakhale ma X-ray (AP ndi lateral view) atengedwa, zosweka sizingawonekere nthawi yomweyo. Odwala amatha kubwerera miyezi ingapo ndi kupweteka kwapang'onopang'ono kwa dzanja, panthawi yomwe kujambula kumasonyeza kuphulika kosalekeza kwa scaphoid-kuchedwetsa kwambiri kuzindikira ndi kusowa chithandizo choyenera chawindo.
Malangizo ofunikira pakuwunika:
Kujambula kwa X-ray kuyenera kuchitidwa pa zovulala zonse za dzanja, kuphatikizapo mawonedwe a scaphoid pamene akukayikira kuti fracture ikukayikira.
Ngati ma X-ray ndi oipa koma kukayikira kudakalipo, kuyenera kugwiritsidwa ntchito mobisa, ndikutsatiridwa ndi kubwereza kujambula pambuyo pa masabata awiri.
Kusasunthika koyambirira kumatha kukhala ngati njira yowunikira komanso yochizira.
Njira Zochizira
Kukonzekera Kwakunja
Zatsopano, zosweka osakhazikika zimatha kuthandizidwa ndi kusasunthika. Komabe, kukonza kuyenera kukhala kosasunthika kuti kuchiritsidwe. pulasitala wamba kapena utomoni zomangira zingalephere kuwongolera kuzungulira kwa dzanja ndi mkono, kuchepetsa kukhazikika.
Plaster Cast Immobilization:
Chojambula chamkono wautali cha spica:
Zimasonyezedwa chifukwa cha kusweka kwa gawo limodzi mwa magawo atatu (chiwopsezo chachikulu cha AVN), mizere yosweka / oblique yothyoka, ndi matenda oyamba.
Imasuntha chigongono pa 90 °, mkono, mkono, ndi chala chachikulu.
Amapereka kukhazikika kwakukulu pochotsa kuzungulira kwapamphumi.
Chojambula chamkono chachifupi cha spica:
Oyenera distal fractures wachitatu, tuberosity fractures, ndi khola pakati pa chiuno fractures (pambuyo pake).
Amapereka chitonthozo chochulukirapo koma osakhazikika.
Kukonzekera Kwamkati
Screw Wopanda Mutu (Herbert Screw)
Pakali pano muyezo golide wa scaphoid m'chiuno fractures.
Herbert Cannulated Compression screw
Bevelled Cannulated Herbert Screw
Kirschner Wire (K-waya) Kukonzekera
Njira yachikhalidwe koma yothandiza, nthawi zambiri yolumikizira.
Ubwino : kusinthasintha, kutsika mtengo, kusokonezeka kochepa kwa mitsempha.
Zoyipa : kusakhazikika, kumafuna kukhazikika kwakunja, chiopsezo cha matenda, kuchotsedwa kumafunika pambuyo pochiritsa.
Zizindikiro : kusweka kwa ana, kukonza kwakanthawi, kuphatikizira kukonzanso zomangira.
Cannulated Screw Pang'ono-ulusi
Cannulated Screw Pang'ono-ulusi
Scaphoid Nonunion
Chifukwa cha kupezeka kwake kwapadera kwa mitsempha, chiuno cha scaphoid ndi kupasuka kwapakatikati kumakhala kosavuta kusagwirizana ndi AVN.
Chithandizo : Kulumikiza mafupa (osakhala ndi vascularized kapena vascularized) kuphatikizapo kukonza mkati (Herbert screw kapena K-waya). Kuyika bwino kwa ma graft ndi kukonzanso kosalala kwa pamwamba ndikofunikira. Nthawi zina, radial styloidectomy ingafunike ngati kutchuka kwa fupa kumasokoneza pakuyenda kwa dzanja.
Otsatsa Padziko Lonse 10 Herbert Screw Suppliers ndi CZMEDITECH Chidule cha Zamalonda
Chithandizo cha fractures ya scaphoid ndi yofunika kwambiri-osati kungobwezeretsa kugwira ntchito kwa dzanja komanso kusunga moyo wa odwala ndi luso lantchito. Kusankha chipangizo choyenera chokonzekera mkati ndikofunika kwambiri popewa zovuta, kukwaniritsa kukonzedwa bwino, ndi kulimbikitsa kukonzanso.
Pakati pa ma implants osiyanasiyana, ndi Herbert Screw ndi wodziwika bwino chifukwa cha mapangidwe ake apadera komanso magwiridwe antchito otsimikizika, ndikupangitsa kuti ikhale imodzi mwazinthu zofunika kwambiri pakuwongolera fracture ya scaphoid.
Otsogola 10 A Herbert Screw Suppliers Padziko Lonse
| Lolemba |
la Kampani |
Dzina |
| 1 |
DePuy Synthes |
![Herbert Cannulated Compression screw]() |
| 2 |
Stryker |
![Herbert Cannulated Compression screw]() |
| 3 |
Zimmer Biomet |
![Herbert Cannulated Compression screw]() |
| 4 |
Matenda a nyamakazi |
![Herbert Cannulated Compression screw]() |
| 5 |
Smith & Nephe |
![Herbert Cannulated Compression screw]() |
| 6 |
Wright Medical Group |
![Herbert Cannulated Compression screw]() |
| 7 |
Acumed |
![Herbert Cannulated Compression screw]() |
| 8 |
Malingaliro a kampani Implantate AG |
![Herbert Cannulated Compression screw]() |
| 9 |
Orthofix |
![Herbert Cannulated Compression screw]() |
| 10 |
CZMEDITECH |
![Herbert Cannulated Compression screw]() |
CZMEDITECH Herbert Screw Products
Monga mtsogoleri waku China wopanga komanso wogulitsa Zoyikidwa m'mafupa , CZMEDITECH amapereka zolemba zonse za Herbert Screws zogwirizana ndi fractures ya scaphoid ndi kuvulala kwina kwa mafupa ang'onoang'ono.
Zofunika Kwambiri:
Mapangidwe oponderezedwa opanda mutu: amatsimikizira kukhazikika kokhazikika ndikuchepetsa kukwiya kwa cartilage.
Kukhazikika kwakukulu kwa biomechanical: kuponderezana kodalirika kwa interfragmentary kumalimbikitsa mgwirizano wolimba.
Zosankha zakuthupi: zopezeka muzitsulo zosapanga dzimbiri zachipatala ndi aloyi ya titaniyamu, zokhala ndi biocompatibility yabwino kwambiri komanso kukana dzimbiri.
Kugwirizana kocheperako pang'ono: koyenera njira zonse zowonekera komanso zotseguka.
Mafotokozedwe angapo: ma diameter osiyanasiyana ndi kutalika kuti athe kuthana ndi zosowa zosiyanasiyana zachipatala.
Ubwino Wachipatala:
Amathandizira kuchira mwachangu komanso kodalirika kwa scaphoid fracture, makamaka pachiwopsezo chachikulu cha m'chiuno komanso kupasuka kwapakatikati.
Imathandizira kulimbikitsana koyambirira kwa dzanja, kuchepetsa kuuma ndikuwongolera kuchira.
Amachepetsa kwambiri chiopsezo chosagwirizana ndi AVN poyerekeza ndi njira zachikhalidwe zokonzekera.
CZMEDITECH Zogulitsa
