Nyaya Yechidzidzo: Rib & Clavicle Fracture Fixation neChest Wall Stabilization muMexico

Clinical Signal

Mhosva iyi inosanganisira kusagadzikana kwemadziro echipfuva kunokonzerwa nekutyoka kwembabvu zvichitevera tsaona yemotokari ine simba guru. Kuvhiya chifuva madziro kugadzikana kwaidiwa kudzoreredza thoracic kutendeseka uye kunatsiridza kufema mechanics.

Nyaya pfupiso

Mumwe murwere ane makore 60 okukura anobva kuMexico akapinda mutsaona yakaipisisa yemotokari, zvichikonzera kutyoka kwakawanda kwe scapula, mbabvu, uye clavicle. Murwere airatidza kurwadziwa kwechipfuva, kusafamba zvakanaka kwekufema, uye kusashanda zvakanaka kwekeji yechipfuva.

Preoperative imaging yakasimbisa kuputika kwembabvu kwakabatana nekusagadzikana kwemadziro echipfuva, pamwe nekubatanidzwa kweclavicular. Zvichipa huwandu hwekuvhiringidzwa kweskeletal uye njodzi yekuputsika kwemhepo, kugadzikana kwekuvhiya kwakasarudzwa. Iyo nzira yakaitwa zvinobudirira naDr. Israel Eduardo, iine chinangwa chekudzorera thoracic alignment, kuvandudza ma mechanics ekufema, uye kupa kugadzirisa kwakagadzikana kwekutanga kupora kwekushanda.

Nyaya iyi inoratidzira dambudziko rinowanzoitika mukuvhiyiwa kwe thoracic trauma, apo hutungamiri hwekuchengetedza chete hungave husina kukwana muhupo hwekuputsika kwembabvu uye kusagadzikana kwemaitiro.

Preoperative Imaging Findings

Preoperative radiographic evaluation yakaratidza kutsemuka kwakawanda kwembabvu nezviratidzo zvinoenderana nekusagadzikana kwemadziro echipfuva. Kuvhiringidzwa kwekuenderera kwembabvu kwakaratidza kufamba kwe thoracic kusina kujairika, zvichiwedzera njodzi yekufema.

Kufungidzira zvakawanikwa zvakaita basa rakakosha mukusimbisa kuoma kwekukuvara uye yakatsigira sarudzo yekupindira kweanoshanda pane kwete yekuvhiya manejimendi.

Kuvhiya Chisarudzo Chikonzero

Kubva pakufungidzira-kusimbiswa kwembabvu kusimuka uye kusagadzikana kwechifuva madziro, kurapa kwekuchengetedza chete kwainzi hakuna kukwana. Kuvhiya chifuva madziro kudzikamiswa kwakasarudzwa kudzivirira kuwedzera kuderera kwekufema, kuderedza kusagadzikana kwe thoracic motion, uye kufambisa kukurumidza kuunganidza uye kugadziridza pulmonary.

Muzviitiko zvinoshungurudza zvinosanganisira kuputsika kwembabvu dzakawanda, kupindira kwekuvhiya panguva yakakodzera kunogona kuvandudza zvakanyanya thoracic mechanics uye kupora kwevarwere vose kana zviratidzo zvakakodzera zviripo.

  

Kuvhiya Technique Overview

Kuvhiya kwakanangana nekudzorera kugadzikana kwemadziro echipfuva kuburikidza nekugadziriswa kwemukati kwe sternum uye mbabvu zvikamu, zvakasanganiswa nekudzikamisa kweakabatana clavicular fractures painoratidzirwa.

Zvinangwa zvikuru zvemuitiro uyu zvaisanganisira:

• Kugadzirisazve thoracic cage alignment uye kuenderera mberi

• Kuderedza paradoxical chest wall kufamba

• Kuvandudza ma mechanics ekufema

• Kupa kugadzirisa kwakagadzikana kutsigira kutanga kwemashure ekuvhiya

Low-profile thoracic fixation implants yakashandiswa kuzadzisa anatomical conformity uku ichichengetedza yakakwana yemagetsi simba rekukuvara kwekushandisa.

Postoperative Imaging & Chigumisiro

Postoperative imaging yakasimbisa kugadziriswa kwakagadzikana kwezvikamu zvembabvu uye kudzorerwa kwe thoracic alignment. Iyo thoracic cage yakaratidza yakagadziridzwa kuvimbika kwechimiro pasina humbowo hwekuisa implant displacement.

Iyo yekugadziridza kuvaka yakapa kugadzikana kwakaringana kutsigira postoperative yekufema basa uye rehabilitation protocol.

Chisimbiso Chemhedzisiro

Mhedzisiro yekuvhiya yakaratidza kudzoreredzwa kweanatomical kurongeka uye kugadzikana kunoshanda kwemadziro echipfuva, zvichisimbisa kushanda kwekuvhiya chifuva madziro kudzikamiswa mune ino njodzi kesi. Imaging verification uye kliniki yekuvandudza yakaratidza kupindira kwakabudirira.

Implant Specifications Inoshandiswa Munyaya Iyi

Muchiitiko ichi, a Chest Wall Stabilization System yakashandiswa kugadzirisa mbabvu dzakatyoka uye kudzorera kugadzikana kwe thoracic. Iyo sisitimu yakanyatsorongedzerwa kune thoracic trauma kesi zvinosanganisira kutsemuka kwembabvu, kusagadzikana kwemadziro echipfuva, uye yakaoma skeletal kukuvara kwechipfuva.

Iyo mbabvu yekumisikidza system ine anatomically contoured rib plates uye inoenderana yekukiya screws, inobvumira kugadzika kugadzirisa uku uchichengetedza yakaderera-mbiri dhizaini. Mahwendefa anogona kutenderedzwa mukati mekushanda kuti aenderane neatomi yembabvu yega yega, zvichiita kuti ive yakakodzera kune anterior, lateral, uye posterior chipfuva madziro emadziro. Muchiitiko ichi, hurongwa hwakashandiswa kugadzirisa zvikamu zvembabvu zvakadzingwa uye kusimbisazve kuenderera mberi kwegomba re thoracic.

Mukuwedzera, a Clavicle Fixation Plate System yakashandiswa kugadzirisa yakabatana clavicular fracture. Kudzoreredza kurongeka kweclavicular uye kureba kwakabatsira kumadziro echifuva uye kugadzikana kwebhanhire remapfudzi, izvo zvinonyanya kukosha mune zvakasanganiswa thoracic trauma kesi.

Clinical mabhenefiti emaimplant masisitimu anosanganisira:

• Yakaderera-mbiri yeplate dhizaini kuti uderedze kupfava kwetishu

• Multiple plate saizi uye maumbirwo kuti agamuchire mbabvu uye clavicle anatomy

• Locking screw tekinoroji yekusimudzira kugadzirisa kugadzikana

• Kukodzera kune zvinoshungurudza mbabvu dzakatyoka uye chipfuva madziro kuvakazve

Chiridzwa Seta Muchidimbu

Kuti itsigire yakachengeteka uye inoshanda yekuvhiya mafambiro, a Yakatsaurirwa Rib Fixation Instrument Set yakashandiswa panguva yekuitwa. Ichi chiridzwa seti chakanyatsogadzirirwa kugadzirisa mbabvu yekutyoka uye chifuva madziro kudzikamisa kuvhiyiwa, kuvhara iyo yakazara maitiro ekushanda kubva pandiro contouring kusvika yekupedzisira screw fixation.

Iyo kit yezviridzwa inosanganisira plate benders, fracture reduction forceps, drill guides, drilling instruments, nekukiya screwdrivers, zvichiita kuti kunyatsobata kwembabvu ndiro munzvimbo shoma yekushanda yekuvhiya thoracic. Iyo yakarongeka marongerwo echiridzwa tireyi inofambisa yakatsetseka intraoperative shanduko uye inobatsira kuderedza operative nguva.

Muzviitiko zvekuputsika kwembabvu dzakawanda uye kusagadzikana kwemadziro echifuva, kushandiswa kwechiridzwa chakatsaurirwa kunogadzirisa kushanda kwekuvhiya uye kunotsigira kunyatsoiswa kwekuisa, iyo inokosha pakuwana kugadzirisa kwakagadzikana uye zvibereko zvekuberekwazve.

Zvinhu zvakakosha zvechiridzwa seti zvinosanganisira:

• Yakazara chiridzwa chembabvu ndiro contouring, kuderedza, uye kugadzirisa

• Ergonomic dhizaini yekudzora kubata mu thoracic maitiro

• Modular gadziriso inochinjika kune akasiyana mbabvu yekutyoka mapatani

• Inokodzera kune yakaoma thoracic trauma uye chest wall stabilization operation

Surgical Summary & Clinical Takeaways

Iyi Mexico-based trauma case inoratidza kuti, muvarwere vakasarudzwa vane mbabvu dzakadzimwa uye kusagadzikana kwemadziro echifuva, kugadzikana kwekuvhiya kunogona kunyatso kudzorera thoracic kutendeseka uye kunatsiridza kufema mechanics.

Kusarudzwa kwakakodzera kwemurwere, kugadziriswa kwakagadzikana, uye postoperative imaging assessment zvinhu zvinokosha pakuwana migumisiro yakanaka mukuvhiyiwa kwe thoracic trauma. Chest wall kugadzikana inoramba iri yakakosha sarudzo yekugadzirisa yakaoma mbabvu yekutyoka mapatani apo kurapwa kwekuchengetedza kusina kukwana.

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