Umubare w'imvune za clavicle ni 30-60 ku bantu 100.000, aho abagabo n'abagore bagera kuri 2: 1, bangana na 5% kugeza 10% by'imvune zose na 44% by'imvune zo ku rutugu. Clavicle ni igufwa rya mbere ryakorewe umubiri wa muntu, kandi ihindagurika ryayo ritangira mucyumweru cya gatanu cyubuzima bwa urusoro, kandi niryo magufa maremare yonyine yigituba akoresheje osteogenezi idasanzwe. Centre ossification yibanze iherereye hagati ya clavicle kandi ishinzwe gukura kwa clavicle kugeza kumyaka 5. Hariho isahani ya epiphyseal ikura kuri buri gice cyimbere ninyuma ya clavicle, ariko akenshi ikigo cya ossifisiyasi yo hagati gishobora kugaragara na x-ray. Isahani yo mu bwoko bwa epiphyseal yo hagati ishinzwe 80% by'uburebure bwa clavicle, kandi ikigo cyayo cya osifasiyo ntikigaragara ko kigaragara kugeza ku myaka 13 kugeza kuri 19, kandi ntigihuza na clavicle kugeza ku myaka 22 kugeza kuri 25. Kubwibyo, mugihe usuzumye sternoclavicular dislocation ku barwayi bakiri bato, ni ngombwa kubitandukanya n’imvune zo mu bwoko bwa clavicular epiphyseal.
Imikorere ya Anatomy
Clavicle irasa neza iyo urebye imbere, ariko ifite S-iyo urebye neza, igoramye kandi igana kuruhande rwumuyaga. Igice cyacyo gihinduka ku murongo muremure, hamwe na 1/3 cyo hanze cyarambuye kugirango gikire imitsi n'imitsi; hagati ya 1/3 ihinduka igituba, hamwe na diametre yagabanutse hamwe na cortex nini cyane hamwe namagufa yuzuye kurusha ayandi, kugirango ihuze umuvuduko wa axial hamwe nimpagarara no kurinda imitsi y'amaraso munsi yacyo; imbere imbere 1/3 ni rombic kandi ifitanye isano na sternum nimbavu yambere hamwe ningingo zikomeye (Ishusho 1). Ubushakashatsi bwa Anatomical bwerekanye ko clavicle ifite intege nke hano kubera itandukaniro ryimiterere ya morphologie hagati na hanze 1/3. Byongeye kandi, iherereye kuruhande rwimitsi ya subclavian ihagarara kandi ikabura kurinda imitsi yimitsi, bigatuma iba ahantu hashobora kwibasirwa cyane no kuvunika, nkuko bigaragazwa nubuvuzi.
Uburyo bwo gukomeretsa
Kuvunika kwa clavicle kubantu bakuze, uburyo bukunze gukomeretsa kuvunika kwa clavicle mbere twatekerezaga ko ari ingaruka zo kugwa ukoresheje ukuboko mu mwanya urenze urugero, ariko Stanley n'abandi. yasanze ubu buryo bwo gukomeretsa bugera kuri 6.3% gusa yo kuvunika hagati ya clavicle na 5.9% by’imvune za kure, kandi mu barwayi bose, uburyo bukunze gukomeretsa bwaturutse ku mbaraga zitaziguye zikora ku rutugu Uburyo bukunze gukomeretsa ku barwayi bose ni imbaraga zitaziguye ku rutugu, ubusanzwe nta kwimuka gukomeye cyangwa kwimurwa byoroheje gusa.
Mugihe cyo kugwa hamwe nikigazi mumwanya wa hyperextended, kuvunika akenshi guterwa ningaruka zingufu zo hanze zongera kugwa. Ubundi bwoko bwo kuvunika kubera urugomo rutaziguye ni igihe imbaraga zo hanze zikora ku rutugu, bigatuma clavicle igira ingaruka ku rubavu rwa mbere, bikavamo kuvunika kuzenguruka hagati ya 1/3 cya clavicle. Byongeye kandi, hamwe n’impanuka zikunze kugaragara mu muhanda mu myaka yashize, kubera ingaruka zikomeye zabaye mu mpanuka y’imodoka, umukandara w’intebe ukora imbaraga nyinshi mu rutugu, ibyo bikaba akenshi biganisha ku kuvunika guhindagurika cyangwa guhindagurika hagati ya clavicle, abantu bita kuvunika umukandara. Birashoboka kubera ko ihohoterwa ry’ihungabana risanzwe ari ryinshi, ubu bwoko bwo kuvunika bukunze kwibasirwa n’ubumwe kuruta kuvunika clavicle bisanzwe.
Ubuvanganzo buvuga ko ubuvuzi budakenewe buhitamo ubu bwoko bwo kuvunika, hamwe na feri y'inkondo y'umura. Gukosora imbere imbere birashobora gusuzumwa niba hari ibikomere byo mu mitsi y'amaraso, cyangwa niba kuvunika kwimuwe inyuma bigatuma umurwayi agira ikibazo cyo guhumeka cyangwa kumira, cyangwa niba nta bimenyetso nk'ibyo ariko amashusho yerekana ko kuvunika kwimuwe bigira ingaruka kumiterere yinyuma kandi ko gusubira inyuma ntacyo bikora. Niba gukosora bidashoboka, clavicle yegeranye irashobora gukurwaho nibiba ngombwa.
Ingorane
Nta gukira literature Ubuvanganzo bwabanje bwatangaje ko igipimo kidakiza kingana na 0.9% kugeza kuri 4% ku kuvunika kwa clavicle, kandi ubushakashatsi bwakozwe vuba aha bwagaragaje ko igipimo nyacyo kidakiza kiri hejuru cyane kuruta uko umuntu yabitekereza.
Gukiza ubumuga: Igitekerezo gakondo nuko gukiza ubumuga bwa clavicle ari ikibazo cyubwiza gusa kandi ko niba hari kudakira nyuma yo kubagwa, ibisubizo nibyiza kuruta kwemerera ubumuga kubaho. Nyamara, ubushakashatsi buherutse gukorwa bwerekanye ko kugabanya clavicle ya cm zirenga 15 akenshi bitera ububabare no kugabanya umuvuduko mugihe cyanyuma. Byongeye kandi, intiti zimwe zasabye ko 'clavicle shaping ' mu kuvura gukiza ubumuga, ariko ubu buryo ntabwo ari bwiza. Kuraho gusa igisebe gisohoka gishobora gutuma clavicle yoroha kandi ikongera cyane ibyago byo kuvunika, kandi kubera ko ubumuga bwa clavicle bugaragarira mubice bitatu, 'koroshya ' clavicle mu ndege itambitse yonyine ntabwo bizakosora rwose ubumuga. Kubwibyo, uburyo bwizewe burasa nubuvuzi bwo kudahuza: kuvanaho igisebe kirenze amagufwa ashoboka nyuma yo gutemwa, guhagarika imitekerereze yimbere hamwe no guteranya amagufa. Birumvikana ko umurwayi agomba kumenyeshwa ibyago byo kutabana mbere yo kubagwa.
Gukomeretsa kw'imitsi y'amaraso: Birashoboka ko imvune zo mu mitsi ziva mu mitsi nyuma yo kuvunika kwa clavicle ziri hasi mu ntangiriro, kandi igikomere cya kabiri ntigisanzwe kibaho bitewe no kwimuka kwavunitse kubera ubwiyongere bw'imyakura y'amaraso nyuma yo kuvunika, mu gihe mu bihe bitinze, imikurire y'amagufwa ishobora gutera ibimenyetso byo gufatwa. Iyo ibi bibaye, kubaga decompression akenshi birasabwa.
Ihahamuka: Indwara ya rubagimpande nyuma yo kuvunika clavicle ikunda kugaragara mu ngingo ya acromioclavicular nyuma yo kuvunika hanze ya 1/3 cya clavicle, ahanini biterwa no gusenya iyi ngingo hamwe n’urugomo mu gihe cy’ihungabana, kandi igice bitewe no kuvunika birimo ubuso bwa arctular. Niba gufunga ntacyo bivuze, cm 1 ya intera ya clavicle igomba gusubirwamo, kandi hagomba kwitabwaho ingamba zo gukingira indwara ya rostral-clavicular.
Nigute wagura imitekerereze ya orthopedie nibikoresho bya orthopedie？
