I-humerus ye-Intramellary Nail: Isisombululo esisebenzayo sokunyanga ukwaphuka kwamakhaya

I-humersus ye-humerus, ithambo kwingalo ephezulu, inokuchaphazela kakhulu imisebenzi yomntu yemihla ngemihla kunye nomgangatho wobomi. Ukunyanga ezi qhekeza kufuna ukuqwalaselwa ngononophelo kwezinto ezahlukeneyo, kubandakanya uhlobo lokuqhekeka, indawo, kunye neempawu zonyango. Inketho enye yoqhaqho efumene ukuthandwa kwiminyaka yakutshanje kukusetyenziswa kwesikhonkwane se-humersus. Eli nqaku lichonga izibonelelo, ubuchule botyando, umngcipheko, kunye nokubuyisela kwimeko yesiqhelo okunxulunyaniswa nale ndlela yonyango.

Intshay

Xa iqhekeza lenzeka kwi-humerus, inokubangela intlungu enkulu, ukushukuma okulinganiselweyo, kunye nokungakhathali okusebenzayo. Iindlela zonyango zemveli, ezinjengokuphosa okanye ukubeka, zinokusikelwa umda, kunye nokukhangela izisombululo ezisebenzayo ezikhokelela kuphuhliso lwe-humersus.

Yintoni i-humerus ye- ilrary

Isikhonkwane se-humerus ye-humersus sisixhobo sezonyango esisetyenziselwa ukuzinzisa nokukhuthaza ukuphiliswa kwamaqhekeza kwi-quitharal shaft. Inentonga ende yentsimbi efakwe kwiZiko eliHlawulweni lethambo, linikezela uzinzo nenkxaso ngexesha lenkqubo yokuphilisa. Isikhonkwane senziwe ngentsimbi ye-titanium okanye intsimbi engenasibala kwaye iza ngobukhulu obahlukeneyo ukulungiselela i-anatomies eyahlukileyo.

Izalathiso ze-humerussus

Izipikili ze-humersus ze-humersus zisetyenziselwa ukusetyenziselwa unyango lweMidshaft kunye ne-proximal ficutures. Basebenza ngokukodwa kwifracture ezifuna ukulungiswa okuzinzileyo, njengokuqhekezwa kwezinto okanye ukwaphuka okuhambelana nokususwa okukhulu. Ukongeza, obu buchule bulungele izigulana ezinomgangatho wethambo olithambo okanye xa imeko engekho mzimba ifunwa.

Indlela ye-surgical ye-humerus ye-humersul

Ukucwangciswa kokukhetha

Phambi kotyando, ngokucokisekileyo kucwangciso lokwenziwa kwenkonzo kubalulekile. Oku kubandakanya uvavanyo olupheleleyo lwepateni yokuqhekeka, impilo ngokubanzi yesigulana, kunye nakuphi na ukwenzakala okunxulumene noko. I-X-rays, isikali se-CT, okanye i-MRI inokusetyenziselwa ukufumana ukuqonda okucacileyo kweempawu zokuqheuqa kunye nokucwangcisa indlela yotyando ngokufanelekileyo.

Isigulana isigulana

Ngexesha lotyando, isigulana sihlala sibekwe kwisitulo esisemaphandleni okanye kwisikhundla sikamva. Ukukhetha kuxhomekeke kukhetho loSurgen kunye nendawo yokuqhekeka. Ukuma ngendlela efanelekileyo kuqinisekisa ukufikelela ngokupheleleyo kwindawo ephukileyo kwaye wenza lula ukufakelwa kwesikhonkwane.

I-Action kunye nokufikelela

I-vemos yenziwa ngaphezulu kwendawo yoqhaqho ukufikelela kwithambo eliqholiweyo. Ubude kunye nendawo yokubekwa kwengcaciso ixhomekeke kuhlobo lweqhekeza kunye nendawo yayo ecaleni kwe-humerus. Ukuphathwa kwe-tissing ethambileyo kakhulu kubalulekile ukunciphisa umothuko kwaye unciphise umngcipheko wokosuleleka.

Ukufakelwa kwesikhonkwane

Emva kokudala indawo yokungena, ugqirha utyando ufaka i-humersus ye-humersullay yekhonkco kwi-humel canal. Isikhokelo seFluoroscopic sisetyenziselwa ukuqinisekisa ukubekwa ngokuchanekileyo kunye nolungelelwaniso. Isikhonkwane siqhubekile kwithambo, sizuze naziphi na iziqwenga ezifudukayo, kwaye zibuyisele i-anatom efanelekileyo

Ukutshixa kwendawo yokubeka

Nje ukuba isikhonkwane sibekwe ngokuchanekileyo, isikrelemnqa sokutshixa sifakwa ukukhusela isikhonkwane ngaphakathi kwethambo. Ezi khokhwe zibonelela ngozinzo ezongezelelweyo kunye nokuthintela intshukumo ye-subreating okanye i-axial yeqhekeza le-phlire. Inani kunye nokubekwa kwezikrelemnqa kuxhomekeke kwipateni yokuqhekeka kunye nokukhetha ugqirha.

Ukuvalwa kwenxeba

Emva kwesikhonkwane kunye nezikrikhi zikhoyo ngokukhuselekileyo, i-vemoon ivaliwe kusetyenziswa amandla okanye izitampu. Ukuvalwa kwenyama echanekileyo kubalulekile ukukhuthaza ukuphilisa kunye nokunciphisa umngcipheko wokosuleleka. Indawo yotyando inxibe, kwaye i-bandile ye-steile okanye ingubo isetyenziswa.

Izibonelelo ze-humersus ye-humerus

Ukusetyenziswa kwe-humerussus ye-humerlary inika izibonelelo ezininzi kwiindlela zonyango zesiko. Ezinye izibonelelo eziphambili zibandakanya:

1. Uzinzo nolungelelwaniso: Isikhonkwane sinika ukulungiswa okuzinzileyo, ukuvumela ukulungelelaniswa okufanelekileyo kweziqwenga zokuqhekezwa, ezikhuthaza ukuphiliswa ngokugqibeleleyo.

2. Isiphazamiso esincinci esithambileyo: xa kuthelekiswa neendlela zokubeka, i-Intramelimenting ibandakanya isithuba esincinci kunye nokuphazamiseka okuthambileyo kokuphazamiseka, ukunciphisa umngcipheko wengxaki.

3. Ukuhambisa kwangoko: Isikhonkwane sinika uzinzo esaneleyo sokuvumela intshukumo kunye nokuhlaziywa kwakhona, ukukhuthaza ukubuyisela kwakhona kwakhona kunye nokubuyiselwa komsebenzi.

4. Ukunciphisa umngcipheko wosuleleko: Indlela evaliweyo ye-Inramedullary yanciphisa umngcipheko wosulelo lwendawo yosulelo luthelekiswa nokuncitshiswa okukhoyo kunye neendlela zokulungisa zangaphakathi.

Iingxaki kunye nengozi

Ngelixa i-humerussussussullary ye-Intramellary Nail ikhuselekile ngokubanzi kwaye isebenza, kukho iingxaki ezinokubakho kunye nemingcipheko enxulumene nenkqubo. Kubalulekile ukuba wazi ngezi zinto zinokwenzeka ngaphambi kokufumana unyango. Ezinye zeengxaki zibandakanya:

Usulelo

Nayiphi na inkqubo yoqhaqho ithwala umngcipheko wokosuleleka. Nangona amazinga osulelo aphantsi kakhulu enama-humersus ye-humerimes, ubuchule obufanelekileyo kunye nokhathalelo lweposi kubalulekile ukunciphisa lo mngcipheko. Kwimeko yosulelo, unyango olufanelekileyo lwe-antibiotic kwaye ungenelelo loyilo lunokufuneka.

I-AMARINIION okanye i-ENONION

Ngamanye amaxesha, ukwaphuka akunakuphilisa ngokufanelekileyo, kubangela ukungasebenzi (ulungelelwaniso olungalunganga) okanye olungalunganga (ukungabikho komtshato). Izinto ezifana nomgangatho wethambo kakubi, ukungasebenzi kakuhle, okanye intshukumo enkulu inokuba negalelo kwezi ngxaki. Ukubeka iliso ngokusondeleyo, utyelelo lokulandela rhoqo, ungenelelo olulandelayo unokunceda ukujongana nale micimbi ukuba bayavela.

Ukusilela okuphezulu

Rhoqo, i-implatent isetyenziselwa ukubeka i-Intramellary inokusilela. Oku kungenzeka ngenxa yokuqhawula ukophula, ukukhulula, okanye ukufuduka. Ukukhetha okufanelekileyo okufanelekileyo, ubuchule bokhupha, kunye nokukhathalela i-PoistoPeative kunokunciphisa umngcipheko wokuphumelela.

Ukwenzakala kwe-nerve

Ngexesha lotyando, kukho umngcipheko omncinci wokwenzakala kwe-nerve, enokukhokelela kwimvakalelo okanye ithemba lemoto. Ugqirha uthatha amanyathelo okhuseleko ukuphepha ukonakala kwe-nerve, njengokuhlanjwa ngononophelo kunye nolwazi olufanelekileyo lwe-anatomical. Naziphi na iimpawu ezinxulumene ne-nerve kufuneka zinikwe ingxelo ngokukhawuleza kwiqela lezonyango ukuze kuvavanywe kwaye kulawulo.

Ukubuyisela kwimeko yesiqhelo

Emva kwe-humersus ye-humerus ye-huil ye-huil, inkqubo yokubuyisela kwimeko yesiqhelo ibaluleke kakhulu ekuvuseleleni kakuhle. Isicwangciso esiliqili sokubuyisela kwimeko yesiqhelo sinokwahluka ngokuxhomekeke kubungakanani bento yokuqhekeka kunye nezigulana. Ukuhlanganisa kwasekuqaleni, imithambo ye-gene-ye-monces, kunye nokuqiniswa kokuqiniswa ngokuthe ngcembe ukuze kuhlawulwe umsebenzi kunye nokuphucula amandla ezihlunu. Iiseshoni zokunyanga umzimba, ezikhokelwa ngugqirha wobungcali, zidlala indima ebalulekileyo kwinkqubo yokubuyisela kwimeko yesiqhelo.

Izifundo zeXesha kunye namabali ePhumelele

Izigulana ezininzi ziye zafumana iziphumo ezintle ngookhuphiswano lwe-humersus. Isifundo esinye sibandakanyeka umntu oneminyaka engama-45 ubudala onesisu esifudumeleyo se-hitral shaft. Emva kokuhlinzwa kunye nesikhonkwane se-intramelim, isigulana siphumelele ulungelelwaniso olusebenzayo, iphinde yabuyiselwa kwinqanaba elipheleleyo, kwaye ibuyiselwe kwinqanaba labo lokulimaza ngaphakathi kwiinyanga ezintandathu.

Thelekisa nezinye iindlela zonyango

Xa ujonga iindlela zonyango kwiindlela ze-quitharal, kubalulekile ukuthelekisa izibonelelo kunye nokusikelwa umda kwendlela nganye. Ngelixa ukusetyenziswa kwe-humersus ye-humersullary ibonelela ngeenzuzo ezininzi, ezinjengokuzinza, ukudityaniswa kwasekuqaleni, kunye nokuphazamiseka okuthambileyo okuthambileyo, kusenokungalungelanga ukuqhekezwa kwayo okanye isigulana. Iindlela ezizezinye, ezinjengokubeka okanye ukulungiswa kwangaphandle, kunokuthandwa kwiimeko ezithile. Ukubonisana nengcali yamathambo kuya kunceda ukumisela eyona ndlela ifanelekileyo yokunyanga esekwe kwiimeko zabantu.

Ukuqukumbela

Ukuqukumbela, ukusetyenziswa kwendlela ye-humersus ye-humersul ye-humeramerary iye yavela njengonyango olusebenzayo noluthembekileyo lonyango lwefrat. Le ndlela yokuhlisela inika ukulungiswa okuzinzileyo, ikhuthaza ukuqhubela phambili, kwaye inike izibonelelo ezininzi kwiindlela zemveli. Ngelixa kukho imingcipheko enokubakho kunye neengxaki ezinxulumene nenkqubo, ucwangciso loqhawulo-mveliso olufanelekileyo, ubuchule bokuqina, kunye nononophelo lwendawo olunokukunceda ukunciphisa ezi zinto zixhalabisayo. Ngoncedo olufanelekileyo kunye nokubek'esweni okufanelekileyo, abaguli banokufumana ukuphinda baphinde baphinde benze ubuchule babo.