I-Case Study: I-Rib & Clavicle Fracture Fixation kunye ne-Chest Wall Stabilization eMexico

Umqondiso weklinikhi

Eli tyala libandakanya ukungazinzi kodonga lwesifuba ngenxa yokwaphuka kweembambo emva kwengozi yemoto enamandla kakhulu. Ukuzinzisa udonga lwesifuba sotyando kwakufuneka ukubuyisela ingqibelelo ye-thoracic kunye nokuphucula i-mechanics yokuphefumula.

Isishwankathelo seCase

Isigulane esineminyaka engama-60 ubudala saseMexico sabandakanyeka kwingozi enkulu yemoto, ekhokelela ekuqhekekeni okuphindaphindiweyo kwe-scapula, iimbambo kunye ne-clavicle. Isigulana sinikwe iintlungu zesifuba, ukungahambi kakuhle kokuphefumla, kunye nokungazinzi komsebenzi we-thoracic cage.

I-imaging preoperative iqinisekisile i-fractures yembambo efudukayo ehambelana nokungazinzi kodonga lwesifuba, kunye nokubandakanyeka kwe-clavicular. Ukunikezelwa komlinganiselo wokuphazamiseka kwamathambo kunye nomngcipheko wokungena komoya ophazamisekileyo, ukuzinza kokuhlinzwa kwakhethwa. Inkqubo yenziwa ngempumelelo nguDkt Israel Eduardo, ejolise ekubuyiseleni ukulungelelaniswa kwe-thoracic, ukuphucula i-mechanics yokuphefumula, kunye nokubonelela ngokuzinza kokulungiswa kokusebenza kwangaphambili.

Eli tyala libonisa umngeni oqhelekileyo kwi-thoracic trauma utyando, apho ulawulo olulondolozayo lulodwa lunokwanela xa kukho ukuphulwa kweembambo ezifudukayo kunye nokungazinzi kwesakhiwo.

Iziphumo zangaphambi kokusebenza komfanekiso

Uvavanyo lweradiyographic yangaphambi kokuhlinzwa lubonise ukwaphuka kweembambo ezininzi ezigxothiweyo ezineempawu ezihambelana nokungazinzi kodonga lwesifuba. Ukuphazamiseka kokuqhubeka kwembambo kubonise ukunyakaza okungaqhelekanga kwe-thoracic, kwandisa umngcipheko wokuphazamiseka kokuphefumla.

Ukufunyaniswa kwemifanekiso kudlale indima ebalulekileyo ekuqinisekiseni ubunzima bokulimala kunye nokuxhasa isigqibo sokungenelela ngokusebenza kunokulawula ukungabikho kokuhlinzwa.

Ingqiqo Yesigqibo Sotyando

Ngokusekelwe kwi-imaging-confirmed rib displacement kunye nokungazinzi kodonga lwesifuba, unyango olulondolozayo lodwa lwaluthathwa njengolunganelanga. Ukuzinziswa kodonga lwesifuba sotyando kwakhethwa ukukhusela ukuwohloka ngakumbi kokuphefumla, ukunciphisa ukunyakaza okungaqhelekanga kwe-thoracic, kunye nokuququzelela ukuhlanganiswa kwangaphambili kunye nokuvuselelwa kwemiphunga.

Kwiimeko ezibuhlungu ezibandakanya ukuphuka kweembambo ezininzi, ukungenelela ngexesha lotyando kunokuphucula kakhulu i-thoracic mechanics kunye nokubuyisela isigulane xa kukho izibonakaliso ezifanelekileyo.

  

UJongo lweTekhnoloji yoTyando

Inkqubo yokuhlinzwa igxininise ekubuyiseleni ukuzinza kwendonga yesifuba ngokulungiswa kwangaphakathi kwe-sternum kunye namacandelo eembambo, kudibaniswa nokuzinzisa ukuphulwa kwe-clavicular fractures ehambelanayo xa kubonisiwe.

Iinjongo eziphambili zenkqubo ziquka:

• Ukusekwa kwakhona ukulungelelaniswa kwe-thoracic cage kunye nokuqhubeka

• Ukunciphisa i-paradoxical chest wall motion

• Ukuphucula oomatshini bokuphefumla

• Ukubonelela ngolungiso oluzinzileyo ukuxhasa ukuhlanganisa kwangethuba emva kotyando

Ukufakelwa kwe-thoracic fixation ephantsi kweprofayili yayisetyenziselwa ukufezekisa ukuhambelana kwe-anatomical ngelixa kugcinwa amandla aneleyo omatshini kwizicelo zokulimala.

Umboniso wasemva kokusebenza kunye nesiphumo

I-postoperative imaging iqinisekisile ukulungiswa okuzinzile kwamacandelo eembambo kunye nokubuyiselwa kokulungelelaniswa kwe-thoracic. Ikheji ye-thoracic ibonise ukuphuculwa kwengqibelelo yesakhiwo ngaphandle kobungqina bokufuduswa kokufakelwa.

Ukwakhiwa kokulungiswa kwanikezela ukuzinza okwaneleyo ukuxhasa umsebenzi wokuphefumla emva kokusebenza kunye neeprothokholi zokuvuselela.

Isiqinisekiso sesiphumo

Isiphumo sotyando sibonise ukulungelelaniswa kwe-anatomical ebuyiselweyo kunye nokuzinza okusebenzayo kwindonga yesifuba, eqinisekisa ukuphumelela kokuqina kodonga lwesifuba kule meko yentlungu. Ukuqinisekiswa kwemifanekiso kunye nokuphuculwa kweklinikhi kubonise ukungenelela okuphumelelayo.

IiNkcazelo zoMfakelo ezisetyenziswa kule meko

Kule nkqubo, a I-Chest Wall Stabilization System isetyenziselwe ukulawula ukwaphuka kweembambo ezigxothiweyo kunye nokubuyisela uzinzo lwethoracic. Inkqubo yenzelwe ngokukodwa iimeko ze-thoracic trauma ezibandakanya ukuphulwa kweembambo, ukungazinzi kodonga lwesifuba, kunye nokulimala okuyinkimbinkimbi ye-skeletal yesifuba.

Inkqubo yokulungisa iimbambo iqulethe iipleyiti zembambo ezijikekileyo kunye nezikrufu ezitshixayo ezihambelanayo, ezivumela ukulungiswa okuzinzileyo ngelixa ugcina uyilo olusezantsi. Iipleyiti zinokujikwa ngokudibeneyo ukuze zitshatise i-anatomy yembambo nganye, zizenze zilungele ukulungiswa kodonga lwesifuba sangaphambili, secala, kunye nasemva. Kule meko, inkqubo isetyenziselwe ukuzinzisa amacandelo eembambo ezifudukayo kunye nokuseka kwakhona ukuqhubeka kwe-thoracic cage.

Ukongezelela, i-a IClavicle Fixation Plate System yasetyenziswa ukulungisa i-clavicular fracture ehambelana nayo. Ukubuyisela ukulungelelaniswa kwe-clavicular kunye nobude negalelo eludongeni lwesifuba ngokubanzi kunye nokuzinza kwebhanti yamagxa, ebaluleke kakhulu kwiimeko ezidibeneyo ze-thoracic trauma.

Iinzuzo zeklinikhi zeenkqubo zokufakelwa zibandakanya:

• Uyilo lwepleyiti yeprofayili ephantsi yokunciphisa ukucaphuka kwezicubu ezithambileyo

• Ubungakanani beepleyiti ezininzi kunye neemilo ukulungiselela iimbambo kunye ne-clavicle anatomy

• Itekhnoloji yokutshixa isijivu sokuphucula uzinzo

• Ukufaneleka kokuqhekeka kweembambo ezibuhlungu kunye nokwakhiwa kodonga lwesifuba

Isixhobo Seti Isishwankathelo

Ukuxhasa utyando olukhuselekileyo nolusebenzayo, Iseti yesixhobo soLungiso lweRib ezinikeleyo kwasetyenziswa ngexesha lenkqubo. Esi sixhobo siphuhliselwe ngokukodwa ukulungiswa kokwaphuka kwembambo kunye notyando lokuzinzisa udonga lwesifuba, ukugubungela inkqubo epheleleyo yokusebenza ukusuka kwi-plate contouring ukuya kwi-screw fixation yokugqibela.

Ikhithi yesixhobo ibandakanya iiplate benders, iiforcep zokunciphisa ukwaphuka, izikhokelo zokuqhuba, izixhobo zokomba, kunye ne-screwdrivers ezitshixayo, ezivumela ukuphathwa ngokuchanekileyo kweepleyiti zembambo kwindawo encinci yokusebenza yotyando lwethoracic. Uyilo olucwangcisiweyo lwe-tray yesixhobo luququzelela utshintsho olulula lwe-intraoperative kwaye lunceda ukunciphisa ixesha lokusebenza.

Kwiimeko zokuqhekeka kweembambo ezininzi kunye nokungazinzi kodonga lwesifuba, ukusetyenziswa kwesixhobo esinikezelweyo kuphucula ukusebenza kakuhle kotyando kunye nokuxhasa ukufakwa ngokuchanekileyo kokufakelwa, okubalulekileyo ekufezekiseni ukulungiswa okuzinzile kunye neziphumo zokuvelisa.

Iimpawu eziphambili zeseti yesixhobo ziquka:

• Gqibezela i-instrumentation ye-rib plate contouring, ukunciphisa, kunye nokulungiswa

• Uyilo lwe-ergonomic yokuphathwa kokulawulwa kwiinkqubo ze-thoracic

• Ubumbeko lwemodyuli olulungelelanisiweyo kwiipateni ezahlukeneyo zokwaphuka kweembambo

• Ifanelekile kwi-trauma enzima ye-thoracic kunye notyando lokuzinzisa udonga lwesifuba

IsiShwankathelo soTyando kunye nokuthathwa kwezonyango

Le meko ye-trauma esekelwe eMexico ibonisa ukuba, kwizigulane ezikhethiweyo ezineentambo zembambo ezifudukayo kunye nokungazinzi kodonga lwesifuba, ukuzinzisa utyando kunokubuyisela ngokufanelekileyo ingqibelelo ye-thoracic kunye nokuphucula i-mechanics yokuphefumula.

Ukukhethwa kwesigulane esifanelekileyo, ukulungiswa okuzinzile, kunye nokuhlolwa kwe-imaging emva kokusebenza zizinto ezibalulekileyo ekufezekiseni iziphumo ezilungileyo kwi-thoracic trauma surgery. Ukuzinziswa kodonga lwesifuba kuhlala kulukhetho oluxabisekileyo lokulawula iipateni ezintsonkothileyo zokuqhekeka kweembambo xa unyango lolondolozo lungonelanga.

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