Maitiro ekugadzirisa Distal Humerus Fractures Uchishandisa Plates?

Displaced comminuted fractures ye distal humerus muvanhu vakuru idambudziko rakaoma nekuda kwezvakaoma anatomy yejoint yegokora, zvimedu zviduku zvakaputsika, uye zvishoma zvishoma zve subchondral bone. Iyo lateral uye yepakati makoramu ye distal humerus inoumba yakagadzikana yetriangular furemu. Iyi yakagadzikana yetriangular framework inokanganiswa mushure me distal humerus fractures, kunyanya yakaoma AO C-mhando fractures.

Origin

Mubhuku reAO Internal Fixation Technique rakabudiswa muna 1979, nokuda kwekutyoka kweiyo distal humerus, boka reAO rakakurudzira kuti mahwendefa aiswe 90 ° kune imwe neimwe, imwe yepakati kana lateral uye imwe shure (1).

Matanho ehunyanzvi (AO misimboti yekurapa kuputsika)

a: Kuvakwazve kwetrochlear uye capitellum.

bc: Mushure mekudzikisa matatu articular mapfupa zvimedu, chera Kirschner waya wakatarisana. Waya yeKirschner inogona kushandiswa sewaya yegwara kune 3.5mm cannulated screw, kana sikuruu inogona kuiswa inofambirana newaya yeKirschner.

d: Shandisa kwenguva pfupi Kirschner waya kubatanidza articular bone fragment kune humeral shaft

e: Kugadzirisa articular fragment kune humerus, LCP yeanatomic inofanira kutanga kuiswa pamusana wepamusoro wehumerus, uye ndiro inogona kuiswa shure kwe capitulum pasina cartilage. Iyo yepakati anatomical LCP inogona kuiswa pane yepakati crest yehumerus kuti iwedzere kugadzikana. Nekurasikirwa kwakanyanya kwepfupa kana kusimba kwemetaphyseal comminution, kuiswa kwemaLCP maviri pa90 ° kune mumwe nemumwe kunokurudzirwa, sezvo ichi chigadziro chinopa zviri nani biomechanical kugadzikana. Kuchengetedza kunofanirwa kutorwa kudzivirira kupinda mujoini kana uchishandisa angle yekudzikamisa screws.

humerus anatomy

Kuenzanisa kweparallel uye vertical simbi mahwendefa

Muchidzidzo cheMechanics cha1995 Kufananidza maPlates maviri ekurapwa kweDistal Humeral Fractures, mhedzisiro yekuiswa kweplate nhanhatu yakaenzaniswa (A, dual posterior plate; B, posterior ulnar plate, lateral kune radial plate; C, medial uye lateral ndiro; D, yepakati kune ulnar plate, posterior kune platerior ine radial-modhi yeradial modhi; fracture; F, muenzaniso wezvakanyanya comminuted fractures ne medial uye lateral screws), zvichiratidza kuti kuputsika kwakawanda kunogona kurapwa nemahwendefa maviri munzvimbo dzakasiyana-siyana kurapwa, asi nokuda kwekuputsika kwakanyanya, chidzidzo ichi chakagumisa kuti medial-lateral plate fixation yakasanganiswa ne screw fixation inovandudza zvakanyanya kuoma uye simba rekupedzisira (3).

Ata C (4) et al vakaratidza kuti ndiro yakamira ine posterolateral plate plus mana 2.7 mm distal screws yakanga ine kugadzikana kwakafanana neparallel plate system mukurapa kwe-intra-articular fractures ye distal humerus. Kusagadzikana kwemurwere nekuda kwekutsamwa kweganda kweplate lateral, kunyanya kuonda uye varwere vakwegura, vanogona kubviswa neplate ye posterolateral.

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