Ukuqhekeka kwe-humerus, ithambo kwingalo ephezulu, inokuchaphazela kakhulu imisebenzi yemihla ngemihla yomntu kunye nomgangatho wobomi. Ukunyanga ezi fractures kufuna uqwalaselo ngononophelo lwemiba eyahlukeneyo, kubandakanywa uhlobo lokwaphuka, indawo, kunye neempawu zesigulana. Olunye ukhetho lotyando oluye lwafumana ukuthandwa kwiminyaka yakutshanje kukusetyenziswa kwesikhonkwane se-humerus intramedullary. Eli nqaku liphonononga izibonelelo, ubuchule botyando, imingcipheko, kunye nokubuyisela kwisimo sangaphambili esinxulumene nale ndlela yonyango.
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Intshayelelo
Xa ukuphuka kwenzeka kwi-humerus, kunokubangela intlungu enzima, ukuhamba okulinganiselwe, kunye nokukhubazeka komsebenzi. Izindlela zonyango zendabuko, ezifana nokuphosa okanye ukubethelwa, zinezithintelo zazo, kunye nokukhangela izisombululo ezisebenzayo ezikhokelela ekuphuhliseni i-humerus intramedullary nail.
Yintoni iHumerus Intramed ullary Nail?
I-humerus intramedullary isikhonkwane sisixhobo sonyango esenzelwe ukuzinzisa nokukhuthaza ukuphiliswa kweefractures kwi-humeral shaft. Iqukethe intonga ende yensimbi efakwe kwiziko elingenalutho lethambo, inika uzinzo kunye nenkxaso ngexesha lokuphulukisa. Isikhonkwane senziwe nge-titanium okanye intsimbi engenastainless kwaye iza ngobukhulu obahlukeneyo ukuze ikwazi ukwamkela izigulana ezahlukeneyo.
Iimpawu zeHumerus Intramedullary Nail
Izikhonkwane ze-Humerus intramedullary ziqhele ukusetyenziswa kunyango lwe-midshaft kunye ne-proximal humeral fractures. Zisebenza ngokukhethekileyo kwiifractures ezifuna ukulungiswa okuzinzile, ezifana nezahlulo ezidibeneyo okanye iifractures ezinxulumene nokufuduka okubalulekileyo. Ukongezelela, obu buchule bufanelekile kwizigulana ezinomgangatho ophantsi wamathambo okanye xa isimo esingenasisindo sifunwa.
Ubuchwephesha boTyando lweHumerus Intramedullary Nail
UCwangciso lwaphambi kokuSebenza
Ngaphambi kotyando, ucwangciso olucokisekileyo lwangaphambi kotyando lubalulekile. Oku kubandakanya uvandlakanyo olubanzi lwepateni yokwaphuka, impilo yesigulane ngokubanzi, kunye naluphi na ukonzakala okuhambelanayo. I-X-rays, i-CT scans, okanye i-MRI ingasetyenziselwa ukufumana ukuqonda okucacileyo kweempawu zokuphuka kunye nokucwangcisa indlela yotyando ngokufanelekileyo.
Ukubekwa kwesigulane
Ngexesha lotyando, isigulana sihlala sibekwe kwisitulo esiselwandle okanye kwindawo yedecubitus esecaleni. Ukhetho luxhomekeke kukhetho logqirha kunye nendawo yokuphuka. Ukumisa okufanelekileyo kuqinisekisa ukufikelela ngokufanelekileyo kwindawo eqhekekileyo kwaye kuququzelele ukufakwa kwesikhonkwane.
Ukusika kunye noFikelelo
Ukusikwa kwenziwa phezu kwendawo yotyando ukufikelela kwithambo elaphukileyo. Ubude kunye nendawo ye-incision ixhomekeke kuhlobo lokuphuka kunye nendawo yalo kunye ne-humerus. Ukuphatha iithishu ezithambileyo ngononophelo kubalulekile ukunciphisa umonzakalo kunye nokunciphisa umngcipheko wosulelo.
Ukufakwa Kwezikhonkwane
Emva kokudala indawo yokungena, ugqirha ufaka i-humerus intramedullary nail kwi-humeral canal. Isikhokelo seFluoroscopic sisetyenziselwa ukuqinisekisa ukubekwa okuchanekileyo kunye nokulungelelaniswa. Isikhonkwane sihamba phambili ngethambo, silungelelanisa nawaphi na amaqhekeza asusiweyo, kunye nokubuyisela i-anatom efanelekileyo.
Ukutshixa izikrufu zokubeka
Nje ukuba isikhonkwane sibekwe ngokuchanekileyo, izikrufu zokutshixa zifakwa ukukhusela isikhonkwane ngaphakathi kwethambo. Ezi zikrini zibonelela ngokuzinza okongeziweyo kunye nokuthintela ukunyakaza okujikelezayo okanye kwe-axial yeeqhekeza zokuphuka. Inani kunye nokubekwa kwezikrufu kuxhomekeke kwipateni yokwaphuka kunye nokukhethwa ngugqirha wotyando.
Ukuvalwa Kwenxeba
Emva kokuba isikhonkwane kunye nezikhonkwane zigcinwe ngokukhuselekileyo, i-incision ivaliwe ngokusebenzisa i-sutures okanye i-staples. Ukuvalwa kwenxeba ngokufanelekileyo kubalulekile ukukhuthaza ukuphiliswa kunye nokunciphisa umngcipheko wosulelo. Indawo yotyando iyanxitywa, kwaye ibhandeji elingenazintsholongwane okanye isambatho esinxitywayo.
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Izinto eziluncedo zeHumerus Intramedullary Nail
Ukusetyenziswa kwe-humerus intramedullary nail kunika iingenelo ezininzi kwiindlela zonyango zendabuko. Ezinye zezibonelelo eziphambili ziquka:
Ukuzinza kunye nokulungelelaniswa: Isikhonkwane sibonelela ngokuzinza ngokuzinzile, ukuvumela ukulungelelaniswa okufanelekileyo kwamaqhekeza aqhekezayo, okukhuthaza ukuphilisa ngokufanelekileyo.
Ukuphazamiseka okuncinci kwezicubu ezithambileyo: Xa kuthelekiswa neendlela zokubethelela, ukubethelwa kwe-intramedullary kubandakanya ukunqunyulwa okuncinci kunye nokuphazamiseka okuncinci kwezicubu ezithambileyo, ukunciphisa umngcipheko weengxaki.
Ukuhlanganiswa kwangethuba: Isikhonkwane sibonelela ngokuzinza okwaneleyo ukuvumela ukunyakaza kwangaphambili kunye nokuvuselelwa, ukukhuthaza ukubuyiswa ngokukhawuleza kunye nokubuyiselwa komsebenzi.
Ukuncipha komngcipheko wosulelo: Ubuchule obuvaliweyo bokubethelwa kwe-intramedullary bunciphisa umngcipheko wosulelo lwendawo yotyando xa kuthelekiswa nokunciphisa okuvulekileyo kunye neendlela zokulungiswa kwangaphakathi.
Iingxaki kunye nemingcipheko
Ngelixa utyando lwezikhonkwane lwe-humerus lwe-intramedullary lukhuselekile kwaye luyasebenza, kukho iingxaki ezinokubakho kunye nemingcipheko ehambelana nenkqubo. Kubalulekile ukuzazi ezi zinto zinokwenzeka phambi kokuba ufumane unyango. Ezinye zeengxaki ziquka:
Usulelo
Naluphi na utyando lunomngcipheko wokosuleleka. Nangona amazinga osulelo esezantsi ngokwentelekiso kunye ne-humerus intramedullary nailing, ubuchule obufanelekileyo bonyumba kunye nokhathalelo lwasemva kotyando zibalulekile ukunciphisa lo mngcipheko. Kwimeko yosulelo, unyango olufanelekileyo lwe-antibiotic kunye nongenelelo olunokwenzeka lotyando lunokufuneka.
I-Malunion okanye i-Nonunion
Kwezinye iimeko, iifractures azikwazi ukuphilisa ngokufanelekileyo, okubangela i-malunion (ukulungelelaniswa okungafanelekanga) okanye i-nonunion (ukungabikho kokuphilisa). Izinto ezinjengomgangatho ophantsi wamathambo, ukungahambi ngokwaneleyo, okanye ukunyakaza okugqithisileyo kunokufaka isandla kwezi ngxaki. Ukubeka iliso ngokusondeleyo, ukutyelelwa rhoqo, kunye nokungenelela kwangethuba kunokunceda ukulungisa le miba ukuba ivela.
UkuFakelwa koMfakelo
Kunqabile, ukufakela okusetyenziselwa ukubethelwa kwe-intramedullary kunokusilela. Oku kunokwenzeka ngenxa yokuqhekeka kokufakelwa, ukukhulula, okanye ukufuduka. Ukukhetha okufanelekileyo kokufakelwa, ubuchule botyando, kunye nokhathalelo lwasemva kotyando kunokunciphisa umngcipheko wokusilela kokufakelwa.
Ukwenzakala Kwemithambo-luvo
Ngethuba lotyando, kukho umngcipheko omncinci wokulimala kwe-nerve, enokuthi iholele kwi-sensory okanye i-motor deficits. Oogqirha botyando bathabatha amanyathelo okuphepha ukonakala kwemithambo-luvo, njengokucazululwa ngocoselelo kunye nolwazi olufanelekileyo lwe-anatomical. Naziphi na iimpawu ezinxulumene ne-nerve kufuneka zixelwe ngokukhawuleza kwiqela lezonyango ukuze lihlolwe kunye nokulawula.
Ukubuyisela kwisimo sangaphambili kunye noBuyiselo
Emva kotyando lwe-humerus intramedullary nail, inkqubo yokubuyisela kwisimo sangaphambili ibalulekile ekubuyiseleni ngokugqibeleleyo. Isicwangciso esithile sokubuyisela kwimeko yesiqhelo sinokuhluka ngokuxhomekeke kubunzima bokuphuka kunye nezigulane. Ukuhlanganisa kwangethuba, umthambo othambileyo wokuhamba, kunye nemithambo yokomeleza ngokuthe ngcembe yaziswa ukubuyisela ukusebenza kunye nokuphucula amandla emisipha. Iiseshoni zonyango lomzimba, ezikhokelwa ngugqirha oqeqeshiweyo, zidlala indima ebalulekileyo kwinkqubo yokubuyisela.
Izifundo zeCase kunye neMpumelelo yamabali
Izigulana ezininzi ziye zafumana iziphumo ezilungileyo nge-humerus intramedullary nail surgery. Olunye uphononongo lwalubandakanya umntu oneminyaka engama-45 ubudala owaphukelwa yi-humeral shaft fracture. Emva kokwenza utyando ngesikhonkwane se-intramedullary, isigulane siphumelele ukulungelelaniswa kwe-fracture egqwesileyo, saphinda safumana uluhlu olupheleleyo lwentshukumo, kwaye sabuyela kwinqanaba labo lokulimala kwangaphambili kwisithuba seenyanga ezintandathu.
Ukuthelekiswa nolunye uKhetho loNyango
Xa uqwalasela ukhetho lonyango lwe-humeral fractures, kubalulekile ukuthelekisa izibonelelo kunye nemida yendlela nganye. Ngelixa ukusetyenziswa kwe-humerus intramedullary isikhonkwane kubonelela ngeenzuzo ezininzi, ezinjengozinzo, ukuhlanganiswa kwangethuba, kunye nokuphazamiseka okuncinci kwezicubu ezithambileyo, akunakulungela konke ukwaphuka okanye isigulana. Iindlela ezizezinye, ezifana ne-plating okanye ukulungiswa kwangaphandle, kunokukhethwa kwiimeko ezithile. Ukubonisana nengcali yamathambo kuya kunceda ukumisela eyona ndlela ifanelekileyo yonyango esekelwe kwiimeko zomntu ngamnye.
Ukuqukumbela
Ukuququmbela, ukusetyenziswa kwesikhonkwane se-humerus intramedullary kuye kwavela njengendlela yonyango esebenzayo kunye nethembekileyo yokuphulwa kwe-humeral fractures. Le ndlela yotyando ibonelela ngolungiso oluzinzileyo, ikhuthaza ukuhlanganisa kwangethuba, kwaye inika iingenelo ezininzi kwiindlela zesintu. Ngelixa kukho imingcipheko enokubakho kunye neengxaki ezinxulumene nenkqubo, ukucwangciswa okufanelekileyo kotyando, ubuchule obucokisekileyo, kunye nokhathalelo lwasemva kotyando lunokunceda ukunciphisa ezi nkxalabo. Ngokuvuselelwa okufanelekileyo kunye nokubekwa kweliso olusondeleyo, izigulana zinokufumana ukuchacha ngempumelelo kwaye ziphinde zifumane amandla azo okusebenza.
