I-Clavicle Fracture

Izigameko zeClavicle Fractures zingama-30-60 abantu abangu-100,000, abanowesilisa kuya kowesilisa olinganiselwa ku-2: 1, ababalwa ngo-5% kuya ku-44% ukulimala okuhlanganisiwe kwehlombe. I-Clavicle ilithambo lokuqala elizokwehluleka emzimbeni womuntu, futhi i-assafication yalo iqala ngeviki lesihlanu lempilo ye-embryonic, futhi ukuphela kwethambo elide le-tubletular elisansi ngokusebenzisa i-osteogeneis eyi-intramembranous. Isikhungo se-Ossification Primitive sitholakala maphakathi ne-Clavicle futhi sinesibopho sokukhula kwe-Clavicle kuze kube iminyaka engu-5. Kukhona ipuleti elikhulayo le-epiphyseal endaweni ngayinye yangaphakathi nangaphandle ye-clavicle, kepha imvamisa kuphela isikhungo se-medial ossification esingabonakala nge-X-ray. Ipuleti le-epiphyseal le-medial linesibopho sokukhula kobude be-clavicle, futhi isikhungo saso se-assification ngokuvamile asiqali ukuvela kuze kube yiminyaka eyi-13 kuye kwengama-19 ubudala, futhi ayifaki iminyaka engama-22 kuye kwangama-25. Ngakho-ke, lapho kutholakala ukuhlukaniswa kwe-sternocavicular ezigulini ezisencane, kubalulekile ukuhlukanisa ukulimala kwe-epiphyseal e-Medial Clavicular.

I-anatomy esebenzayo

I-Claviclecle cishe iqonde lapho ibukwa ingaphandle, kepha i-S-enziwe lapho ibukwa kakhulu, igawula i-dursally futhi i-mediorde to the ventral ohlangothini. Isigaba saso sesiphambano sishintsha ngendlela ende, ngabangaphandle 1/3 lithotshisiwe ukuze kuhlaliswe imisipha nokudonsa i-ligament; I-Middle 1/3 iba yi-tubular, enobubanzi obuncishisiwe kanye ne-cortex enkulu ye-cortex nethambo elincane kunalawo aphumule, ukuze kuvuleke ingcindezi ye-axial kanye nokungezwani nokuvikela izinzwa zangaphansi kwalo; I-INNER 1/3 iyi-rhombic futhi ihlotshaniswa ne-sternum kanye nembambo yokuqala ngesicubu esinamandla esise-ligament (Umdwebo 1). Izifundo ze-anatomical zikhombisile ukuthi i-Clavicle ibuthakathaka lapha ngenxa yokuhlukahluka kwe-morphological phakathi nangaphandle 1/3. Ngaphezu kwalokho, itholakala ngokulandela imisipha ye-subclavian imisipha futhi ayinakho ukuvikelwa kwama-ligaments ezimisipha, okwenza kube yindawo esengozini enkulu yokuqhekeka, njengoba kufakazelwa ukubonwa kwemitholampilo.

Indlela yokulimala

Okokuqhekeka kwe-Clavicle kubantu abadala, indlela ejwayelekile yokulimala kwama-clavicle fractures ngaphambili yacatshangelwa ukuthi ingumphumela wokuwa ngesandla esimweni se-hyreexted, kepha uStanley et al. Uthole ukuthi le ndlela yokulimala ibalwa ngamaphesenti angama-6,3 kuphela ama-clavicle aqhekeki kanye no-5.9% we-distal Clavicle Fravices, nakuzo zonke iziguli, okuvame kakhulu ukulimala okuphathelene nendlela ephathelene nehlombe ehlotshaniswayo, ngokuvamile ngaphandle kokufuduka okuthe xaxa noma ngokufuduka okuthe xaxa.

Endabeni yokuwa ngentende entendeni ese-hyperexted isikhundla, ukuqhekeka kuvame ukubangelwa umthelela we-Force yangaphandle kwesekondari ekuweni. Olunye uhlobo lokuqhekeka ngenxa yodlame olungaqondile yilapho amandla angaphandle enza ehlombe, okwenza i-clavicle ibe nomthelela ngebambo lokuqala, okuholela ekwakhekeni kokuqhekeka okulula okuphakathi kwe-1/3 ye-clavicle. Ngaphezu kwalokho, ngokuvela kaningi kwezingozi zomgwaqo eminyakeni yamuva, ngenxa yethonya elinamandla engozini yemoto, ibhande lesihlalo lakha amandla okugcwala ehlombe, okuvame ukuholela ekuphumeni kwamandla e-clavicle, abantu abakubiza ngokuthi yibhande lebhande lesihlalo. Mhlawumbe ngoba udlame lwenhlekelele luvame ukuba lukhulu, lolu hlobo lokuqhekeka luthambekele ekungangeni kobumbano kunokuqhekeka okujwayelekile kwe-clavicle.

Ukwelapha

Ukuqhekeka kwe-Clavicle Ephakathi:

Ukulungiswa kwe-Splint: Ukulungiswa kwama-splint of clavicle fractures kusengu- 'GOLD CRELT '. Amapuleti afaka i-3.5mm LCP-DCP, amapuleti okwakhiwa kabusha ama-3.5mm, amapuleti okukhiya ama-LCP, kanye nezinye izinhlobo ezikhethekile zamapuleti. Izinzuzo zama-splints zifaka: ukucindezela kokuqhekeka okuguqukayo; Ukulungiswa kwe-oblique noma uvemvane ukuqhekeka ngezikulufo ezingezwani ezihlangene nezinhlaka ezingathathi hlangothi; Ukulawulwa okusebenzayo kokujikeleza; Ukulungiswa okuphephile kokuqhekeka kwemisebenzi yansuku zonke yesiguli; Futhi iqiniso lokuthi ama-splints ajwayele ukususwa (uma kufanele asuswe kuze kube yizinyanga eziyi-12 kuye kwezingu-18 esikhundleni).

I-distal clavicle dirt:

I-Clavicle HIOL SPLIT iyindlela yokulungiswa engaqondile, izinzuzo zazo ezibandakanya ukubekwa okulula kokulungiswa kwangaphakathi, ukugcinwa okuthe xaxa kokuphakanyiswa, kanye nokuqina okuhlobene nokuhlelwa kwangaphakathi ngaphandle kwe-kyphetic pin ezungezile.

I-Proximal Clavicle Fracture:

Izincwadi zibika ukuthi ukwelashwa okungabasebenzi kukhethwa ngalolu hlobo lokuqhekeka, nge-Cervical-Wrist Sling Braking. Ukulungiswa kwangaphakathi okungaphakathi kungabhekwa uma kulimala imizwa ye-vascular, noma uma ukuqhekeka kwe-vascular kwenzeke obala ukuthi isiguli sibe nobunzima bokuphefumula noma ukumgwinya, noma kungekho zimpawu ezinjalo kodwa ukucabanga kuveza ukuthi ukuqhekeka okubangelwa yisikhathi kungukuthi ukuphinda kube yiphutha. Uma ukulungiswa kungenzeki, i-proximal clavicle ingasuswa uma kunesidingo.

Ubunzima

• Akukho ukuphulukiswa: Izincwadi ezedlule zibike izinga elingelona elaliphulukisa elingu-0.9% libe ngu-4% lokuqhekeka kwe-clavicle, futhi inhlolovo ye-bulk yakamuva itholakale ukuthi izinga lokungabi nalutho liphakeme kakhulu kunoyedwa.

• Ukuphulukiswa Kokukhubazeka: Umbono wendabuko ukuthi ukuphulukiswa kokukhubazeka kwe-clavicle kuyinkinga yobuhle kuphela nokuthi uma kungaphuluki ngemuva kokuhlinzwa, umphumela ungcono kunokuvumela ukonakala ukuba kube khona. Kodwa-ke, ukubonwa kwakamuva kubonise ukuthi ukuncishiswa kwe-clavicle okungaphezulu kuka-15 cm kuvame ukuholela ezinhlungwini nasekukhawulweni kokunyakaza esiteji sekwephuzile. Ngaphezu kwalokho, ezinye izazi zihlongoze ukuthi zilula 'Clavicle ukwakheka ' ekwelapheni ukuphulukiswa kokukhubazeka, kepha le ndlela ayiluleki. Ukususa kuphela i-protruding scab engenza i-clavicle finner futhi yandise kakhulu ubungozi bokuqhekeka, futhi selokhu ubuhlakani be-clavicle bubonakaliswa ngobukhulu obuthathu, 'bushelelezi Ngakho-ke, indlela ethembekile ngokwengeziwe ifana nokwelashwa kwe-nonunion: ukususwa kwe-scab yamathambo ngokweqile ngangokunokwenzeka ngemuva kokuvela, ukuqina kokulungiswa kwangaphakathi kanye nokuxhumeka kwethambo elilodwa. Kuyiqiniso, isiguli kumele saziswe ngengozi yokungeyona inyunyana ngaphambi kokuhlinzwa.

• Ukulimala kwe-Vascular nerve: amathuba okulimala kwezinzwa ze-vascular ngemuva kokuqhekeka kwe-clavicle kuphansi ezigabeni zokuqala, kanti ukulimala kwesibili akuvamisile ukwenzeka ngenxa yokuchitheka kwesikhala sezinzwa ze-vascular ngemuva kokuphuka, lapho ukukhula kwama-scabs amathambo kungadala izimpawu zokufakwa. Uma lokhu kwenzeka, ukucindezelwa okuhlile kuvame ukudingeka.

• I-Traamatic Arthritis: I-Traamatic Arthritis ngemuva kokuqhekeka kwe-Clavicle kuvame ukwenzeka ekuhlanganiseni okuhlangene ngemuva kokuhlukaniswa kwe-Outer 1/3 ye-Clavicle Uma ukuvalwa kungasebenzi, i-distal 1 cm ye-clavicle kufanele iphinde ibhekwe, futhi ukunakekelwa kwe-intraperative kufanele kuthathwe ukuvikela i-rostral-clavicular ligament.

  
  

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