Clavicle Fracture

Chiitiko cheClavicle Fracures ndeye 30,000 vanhu vechirume, vane murume wechikadzi huwandu hwenzvimbo dzinosvika 2: 1, accounting ye5% kusvika gumi muzana yezvakakuvara uye 44% yefudzi rakabatanidzwa. Clavicle ndiyo pfumo rekutanga kuti riwedzere kunyatsoita muviri mumuviri wemunhu, uye kujekeswa kwaro kunotanga muvhiki yechishanu yehupenyu hwembichana, uye ndiyo yega tambo yeTubular inowedzera kuburikidza neIntramembranous OsteoMembranous osteogeneis. Iyo yekutanga ossifitation conded inzvimbo iri pakati peClavicle uye ine mutoro wekukura kwe clavicle kusvika pamakore mashanu ezera. Kune iri kukura epiphyseal ndiro pane imwe yemukati uye ekunze magumo eClavicle, asi kazhinji chete iyo medial ossification centre inogona kuoneka ne x-ray. Iyo medial epiphyseal ndiro ine chekuita ne80% yekukura kwehurefu hweClavicle, uye nzvimbo yayo yekushongedza kazhinji haigoni kutanga kuoneka kusvika makore gumi nematanhatu, uye haina furavicle kusvika pamakore makumi maviri nemasere kusvika makumi maviri nemashanu kusvika makumi maviri nemashanu. Naizvozvo, pavanenge vachinyudza sternocalular dislocation muvarwere vechidiki, zvakakosha kuti uzvisiye kubva kuMocial Clavicular Epiphyseal kukuvara.

Inoshanda anatomy

Iyo Clavicle inenge yakatwasuka kana ichionekwa kunze, asi yakagadzirirwa s-yakaonekwa kana ichitariswa zvakanyanya, kudzikisira musoro uye nepakati kune ventral rutivi. Yayo muchinjiko-chikamu chinoshanduka pamwe neiyo axis refu, neyekunze 1/3 yakarongedzwa kuti igamuchire tsandanyama uye ligment kudhonza; Iyo yepakati 1/3 inova tubular, ine dhizaina cortex uye denser pfupa kupfuura zororo, kuti udzikise kudzvinyirira uye kuchengetedza masalents pasi payo; Iyo yemukati 1/3 iri rhombi uye inosanganiswa neiyo sternum uye yekutanga mbabvu ine yakasimba lig- yakasimba tishu (Mufananidzo 1). Anatomical zvidzidzo zvakaratidza kuti clavicle haina kusimba pano nekuda kwekusiyana kwemberi kwemukati mukati mepakati uye kunze 1/3. Uye zvakare, iri multral kune subclavan tsandanyama mira uye inoshaya dziviriro yemasuru masaini, ichiita kuti ive nzvimbo inonyanya kutambudzika yekupwanya, sezvinoonekwa nekiriniki yekucherechedzwa.

Michina yekukuvara

Kune Clavicle Fracures muvakuru, iyo inonyanya kujairika yekukuvara kweClavicle Fractures yaimbofungidzirwa kuti yakave mhedzisiro yekudonha neruoko mune hyperexted chinzvimbo, asi stanley et al. Vakawana kuti iyi mechanm yekukuvara yakarongedzwa chete

Panyaya yekudonha nechanza mune iyo hyperextendet chinzvimbo, kupwanya kunowanzo kukonzerwa nekukanganisa kwekunze kwesimba kune kudonha. Imwe mhando yekupwanya nekuda kwechisimba zvisina kunanga ndeyekunze kana simba rekunze riite pafudzi, zvichikonzera kuumbwa kwekutanga kupwanyika mukati mepakati 1/3 ye clavicle. Mukuwedzera, nekuitika kazhinji tsaona dzemotokari mumakore apfuura, nekuda kwekukanganisa kwakasimba mumotokari, iyo chigaro chechigaro chinoita kuti chibuke, icho chinodaidzira chakapwanyika, icho vanhu vanonzi vanhu belt belra. Pamwe nekuti mhirizhonga yekusafarira inowanzo kuve yakakura, iyi mhando yekukanganisa ndeyekuwedzera kusiri-mubatanidzwa pane zvakajairwa cracture.

Kurapwa

Kupwanyika kweiyo yepakati clavicle:

Splint Fixation: Splint Fixation yeClavicle Fractures ichiri 'Goridhe Chiyero '. Mahwendefa anosanganisira iyo 3.5mm LC-DCP, 3.5mm Kuvakazve mahwendefa, LCP Locking mahwendefa, uye mamwe mafomu akakosha emaketeti. Zvakanakira zvidimbu zvinosanganisira: kumanikidzwa kwekutapurudzira mapundu; Kugadziriswa kweOblique kana butterfly fractures nekonyeti screws yakasanganiswa nezvipfanyitsi zvisina kurerekera; kudzora kunoshanda kwekutenderera; Kugadziriswa kwakachengetedzeka kwekupwanya kwemabasa ezuva nezuva emazuva ese; Uye chokwadi chekuti splts kazhinji haafanire kubviswa (kana ikabvisirwa kusvika pamwedzi gumi nemaviri kusvika gumi nemasere postoperatively).

Distal Clavicle Fracture:

Iyo Clavicle Hook Splint maitiro asina kugadziriswa, izvo zvakanakira kuiswa kwekugadziriswa kwemukati kwekugadziriswa kwemukati, nekukanganiswa kweiyo mamiriro emukati pasina mitezo yakapoteredzwa seyakagwinya kayphotic Pin.

Proximal Clavicle Fracture:

Mabhuku anoshuma kuti kurapa kwekusarongeka kunoonekwa kune urwu rudzi rwekupwanya, ine cervical-wrist shling braking. Inconsaal yemukati yekugadziriswa inogona kutariswa kana paine kusarongeka kwekukuvara, kana kukanganisika kwacho kuchinge kwatanga kuita kuti murwere azivise kuti kukanganisa kwakadzorwa kuri kusimbisa chinhu chakakosha pakurarama uye kuisazve hakuna basa. Kana kugadziriswa kusiri kuitika, iyo proximal clavicle inogona kubviswa kana zvichidikanwa.

Zvinetso

• Hakuna kupora

• Kuremara kurapa Nekudaro, kucherechedzwa kwazvino kwakaratidza kuti kupfupikisa clavicle yeanopfuura ma cm inopfuura gumi nemashanu kunoitika pakurwadziwa uye kusimudzwa kwekufamba mune imwe nhanho yekufamba. Uye zvakare, vamwe vadzidzi vakarangarira zviri nyore 'Clavicle Sping ' mukurapa kwekuremara kupora, asi nzira iyi haina zano racho. Kubvisa chete scaburding scab kunogona kuita kuti clavicle yakaonda uye inowedzera njodzi yekukanganisa, uye kubvumidzwa kwezvinhu zvitatu, 'zvinonyara Naizvozvo, nzira yakavimbika yakafanana neyekubata kwekunzwisisa Ehezve, murwere anofanira kuziviswa nenjodzi yekusa-mubatanidzwa asati avhiya.

• Vascular nerve kukuvara kweLave kukuvara nerve kukuvara mushure mekuraswa kwemasumbu. Ndichiri mumatanho ekunonoka Kamwe izvi zvikaitika, kusiya kwekuvhiya kunowanzodiwa.

• Kurera Arthritis: Kuramba Arthritis Mushure meClavicle Fract Kana kuvharwa kwacho kusingabatsiri, iyo distal 1 cm ye clavicle inofanira kuganhurirwa, uye intrapaepemerative hanya inofanira kutorwa kuti igone kuchengetedza rostral-clavicular ligament.

  
  

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