Uyazi ukuthi ungalungisa kanjani ukwaphuka kwe-metacarpal?

Ama-metacarpophalangeal fractures angukuqhekeka okuvamile kokuhlukumezeka ngesandla, afaka imali cishe 1/4 yazo zonke iziguli zezandla zezandla. Ngenxa yokwakheka okubucayi futhi okuyinkimbinkimbi kwesandla nomsebenzi wayo wemoto enhle, ukuphathwa kokuqhekeka kwezandla kubaluleke kakhulu futhi kuyinkimbinkimbi ngokwezobuchwepheshe ukwedlula ukwelashwa kwamanye ama-tubular fractures amade.

Ukuqinisekisa ukuqina kokuqhekeka ngemuva kokubuyisela kabusha kuyisihluthulelo sempumelelo yokwelashwa kwe-metacarpophaleal kokuqhekeka. Ukuze ubuyisele umsebenzi wesandla, ukuqhekeka kuvame ukudinga ukulungiswa okufanele, kanye nokulungiswa kwangaphandle ngodaka noma isikhathi esingama-kirschner izikhonkwane okuhlangene, futhi kuvame ngenxa yokuvuselelwa okuhlangene, futhi okuvame ngenxa yokuvuselelwa kokusebenza okungafanele, okuletha ubunzima obuthile ekuvuseleleni okusebenzayo yesandla.

Izindlela zokwelashwa zanamuhla ziqala ukusebenzisa ukulungiswa kwangaphakathi okunamandla, okufana nokulungiswa kwesikulufu sepuleti ye-micro.

Izimiso zokwelashwa

Izimiso zokwelashwa zeMetaCarpal kanye ne-Phalangeal Fractures yesandla yilezi: Ukuphindisela kwe-anatomic, ukulungiswa okukhanyayo nokulungiswa okuqinile, ukuhamba kwangaphambi kwesikhathi nokuzivocavoca okusebenzayo. Imigomo yokwelashwa kokuqhekeka kwe-intra-articular kanye ne-periarar yesandla iyafana nalawo amanye ama-intra-articular fractures: Ukuvuselelwa kwe-anatomy yobuso bokuqala kanye nomsebenzi wokuqala. Ukwelashwa kweMetaCarpal kanye ne-Phalangeal Fractures yesandla kufanele balwele ukufeza ukuphindwaphindwa kwe-anatomic ngaphandle kokujikeleza, ukuzulazula kwe-lateral, noma ukuhanjiswa kwe-angular> 10 ° kuya esicini sesandla sesundu. Uma ukuphela kokuphela kwe-metacarpal kujikelezwa noma kuhanjiswa ngokuhamba kwesikhathi nge-angle, kuzoshintsha i-trajectory ejwayelekile yokuguquguquka nokuhamba komunwe, okwenza ukuthi kucindezele noma kuwa kusuka kumunwe oseceleni, okuthinta ukunemba komsebenzi womunwe; Ngenkathi ukuhanjiswa kwe-angular> 10 ° kuya ku-dorsum yesundu kuzobhubhisa indawo yokuxhumana yethambo kanye ne-tendon, ukukhulisa ukumelana kanye nobubanzi bokuhamba kwe-tendon nokunwebeka, nokubangela ingozi ye-tendon. ingozi yokuqhuma kwe-tendon.

Ama-metacarpal kanye ne-phacangeal fractures afana emandleni abo okubekezelela ukuguquguquka kokukhubazeka, ngenkathi i-metacarpal ibekezelela ukuncipha kokufudumala kanye nokuxoshwa kwe-angular okungcono kune-phalangeal. I-carpometacarpal kanye ne-metacarpophalangeal amalunga anganxephezela ukuqubuka kwe-metacarpal, futhi umunwe omncane womuntu omncane uvumelaniswe kangcono nokukhubazeka kwe-metacarpal kunomunwe ophakathi nendawo. Yehlisa amandla okubamba ngenxa yokufushanisa kwemisipha kwesandla esibonakalayo kubonakala kuphela lapho i-metacarpal ingena ngaphezulu kwama-30 ° kuya ohlangothini lwe-dorsal.

Indlela yokuhlinzwa

Indlela yokuhlinzwa yeMetaCarpal Fractures ilula futhi ngokuvamile isebenzisa indlela ye-dorsal, njengoba kukhonjisiwe kuMfanekiso 4-14. I-metacarpal yesibili ifakwe kakhulu ngenkathi i-metacarpal yesihlanu ifakwa i-ulnarly, kanti ama-metacarpal asesithathu nawesine avame ukufakwa ngaphakathi. Uma ama-metacarpals amabili asondelene nawo asetshenziswa ngasikhathi sinye, kusetshenziselwa ukuvela okwenziwe ngama-Median s-ancy ukubheka zombili iziza zokuhlinza.

Ukukhetha Kwendlela Elungisiwe

Kunezinto eziningi zokulungiswa kwangaphakathi zeMetacarPophalangeal Fractures, njengezikhonkwane ze-kirschner, izikulufo, amapuleti kanye namafreyimu wokulungiswa kwangaphandle, phakathi kwazo ama-kirschner PINs kanye nama-microplates asetshenziswa kakhulu. Okwe-metacarpal fractures, ukulungiswa kwangaphakathi nge-microplate kunezinzuzo ezisobala zokulungiswa kwezikhonkwane ze-kirschner futhi kungakhethwa; Okwe-proximal phalangeal fractures, i-microplate ngokuvamile iyathandwa, kepha uma kunobunzima ekubekeni izikulufa engxenyeni ye-distal ye-proximal pharangeal kanye nekhanda izikhonkwane, okulungiselelwe izikhonkwane ze-kirschner ezinqamukayo, okulungele kakhulu ekubuyiselweni komunwe othintekile; Ngokwelashwa kwama-partnangeal paractures, kufanele kukhethwe izikhonkwane ze-kirschner.

1, Inalithi kaKirschner: 

Ukulungiswa kwenaliti yangaphakathi kaKirschner kufakiwe emtholampilo iminyaka engaphezu kwengu-70 futhi kube yinto esetshenziswa kakhulu yokulungiswa kwangaphakathi kwama-metacarpophalangeal fractures, okulula ukusebenza, okusebenzayo, futhi kuyindlela yokulungiswa kwangaphakathi, njengoba kukhonjisiwe kuMfanekiso 4-15. Njengokulungiswa kwangaphakathi okuvame ukusetshenziselwa ukwelapha ama-partractures ezandla, kusasetshenziswa kabanzi. 

Izinzuzo zokulungiswa kwangaphakathi nezikhonkwane ze-kirschner:

① Kulula ukusebenza futhi okuguquguqukayo kakhulu kusetshenziswe; 

② Ukwehla kwezicubu ezithambile ezithambile, umthelela omncane ekuhambeni kwegazi ekupheleni kokuphela, ukuhliswa okuncane okuncane, futhi kuyathandeka ekuphulukisweni kwe-fracture; 

③ Ukubuyiselwa kwe-PIP kwesibili okulula; 

④ Izindleko eziphansi kanye nohlelo olubanzi, olusebenza ekuqhekekeni kwezandla eziningi (njengokuqhekeka kwesandla okuningi (okufana nokuqhekeka kwe-intra-articular, ukuphazamiseka okukhulu okubekiwe kanye nokuphela kwe-phacturel). 

Ubunzima bokulungiswa kwangaphakathi: 

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(2) Akukho okuzuzisa umphumela ekupheleni kokuphela; 

(3) indawo ehlanganyelwe ilinyazwe ngokulungiswa okuhlangene; 

(4) Ukulungiswa kokuhlanganiswa kanye ne-blockage ye-tendon kuvimbela ukuhlangana kwesandla kusuka ekuzivocavoca kusenesikhathi futhi kuthinte ukululama okusebenzayo.

Ngokuthuthuka okusheshayo kwamasu wanamuhla okulungiswa kwangaphakathi kanye nemishini, ukulungiswa kwangaphakathi nezikhonkwane ze-kirschner sekucwengiwe ngokwengeziwe, futhi iningi lazo lingalungiswa ngaphandle kokuwela okuhlanganisiwe, futhi ngaphandle kokuphoqelela ukuqeqeshwa kokuhlangana okuhlangene. Ngosizo lwe-C-AM X-Ray Machine, amanye amacala angafinyelela futhi ukuncipha okugculisayo ngokuncishiswa okuvaliwe kwezicubu zendawo, ukwehlisa umthelela ekunikezelweni kwegazi ekupheleni kokuphela, ngaleyo ndlela kuthuthukiswe ukuphulukiswa kokuphela. 

Izindlela zokuqapha zokulungiswa kwangaphakathi ngezikhonkwane zeKristen: 

① Lungisa amabhlogo amathambo amakhulu ngezikhonkwane ze-kristen ze-1.0 ~ 1,2 mm ububanzi, bese unquma iphuzu lokungena kanye nokuqondiswa kokungena ngokuya ngokuqondisa komugqa we-fracture; 

② ngenhloso yokubuyisela umugqa wamandla, ukuphahlakala kwe-intra-articular kumele kube yi-anatominal 

Akuwona wonke amabhulokhi amathambo adinga ukulungiswa ngezikhonkwane zeKristen, futhi ngaphansi kwesisekelo sokuthola ukuqina kokuphela kokuphela, ama-kristen poins kufanele asetshenziswe okuncane ngangokunokwenzeka; 

Izikhonkwane ze-Kristen azilungiswa ngolwelwesi lwe-tendon noma i-dorsal tendon membrane yomunwe ukudala ukuzivocavoca okusebenzayo ngangokunokwenzeka; 

 Kufanele kube nohlelo oluqinile lokusebenzisana futhi hhayi ukuphinda i-Operation Intraoperaitively, ngaphandle kwalokho ibhlokhi lokuphuka lingachotshozwa noma lingathandeki; 

⑥ Ngokuvamile iphini le-kirschner kufanele libekwe esikhunjeni ukuze linciphise ithuba lokutheleleka futhi akunzima ukuyikhipha.

2, I-Metacarpal Micro Plate: 

Ukulungiswa okuqinile kwangaphakathi kokuqhekeka kwesandla kuyisisekelo sokuzivocavoca okusebenzayo futhi kuyadingeka ukubuyisela umsebenzi omuhle wesandla.Aoo Technical Technical Technical idinga ukubuyiselwa okusebenzayo kwe-Fracture esimweni sokusebenza, okuvame ukugcizelela imisebenzi yokuhlanza okuhlaselayo, okugxilwe ekuvikeleni ukugeleza kwegazi. I-AO ibuye igcizelele izinqubo zokuhlinza ezihlaselayo ezigxile ekulondolozeni ukuhamba kwegazi. Ukulungiswa kwangaphakathi kwangaphakathi kwesandla kwesandla kunikeza imiphumela egculisayo ngokuya ngamandla, ukuqina kokuphela kokuphela kanye nengcindezi phakathi kweziphetho. Ngokuya kokulungiswa kokusebenza okusebenzayo, isikhathi sokuphulukisa kokuphulukisa kanye nokutheleleka kokutheleleka kuqhathaniswa, ukusebenza kahle kwamapuleti amancane kaTitanium kubhekwa kakhulu kunalokho kwe-microsion plate fins, ngaleyo ndlela kusiza ukubuyela kokuqala kokuphila okujwayelekile kwesiguli.

Izinzuzo ze-Microplate Fovation Treatment: 

(1) qhathanisa nezikhonkwane ze-kerf, izikulufu ezincane ze-microplate zinokuvakasha okungcono nokuphendula kwezicubu; 

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3. Ama-Microscrews.

Ama-MicroSCREWS OF FRACTURE FRACTICE FRACTICE AMANDLA OKUFANELEKILE NJENGOBA amapuleti ensimbi, kepha indawo ethambile kanye ne-periosteal indawo yokuhlamba incane kunaleso sokulungiswa kwensimbi, okuhambisana nomqondo wokusebenza okuncane. Yize kukhona izinhlaka ze-T- kanye ne-L-TYPE ze-Proximal Joint Fractures, ukuvakasha kwe-postoperative ampofu kakhulu kunalokho kwama-diaphyseal fractures, kanye nama-microtha Izikulufa zifakwe e-cortex yamathambo zingamelana nomthwalo omkhulu wokuxineka, ngakho-ke ukulungiswa kuqinile futhi kungabeka ingcindezi phakathi kokuphulukisa ukuletha indawo yokuphulukisa ukuze akwazi ukuletha indawo yokuphulukisa, anciphise ukuphulukiswa kokuphulukisa, njengoba kukhonjisiwe kuMfanekiso 4-18. Ama-Microscrews asetshenziselwa ikakhulukazi ama-oblique noma i-spiral fractures of the diaphysis kanye ne-intra-arvicular avenusion roon fractures yama-mone amathambo amathambo. Kubalulekile ukuqaphela ukuthi ubude bentambo ye-fracture kufanele okungenani ibe kabili ububanzi bedayiso lapho kulungiswa ama-oblique noma ama-spiral fractures wesiqu sesandla sodwa, futhi okungenani ama-times ububanzi be-arvicular avicurter block.

4. I-Miniature Fixental Brace yangaphandle.

Ama-metacarpophalalalalis athule ngezinye izikhathi kunzima ukusetha kabusha ngokwezifiso ngisho nokuhlinzwa noma ngokuhluleka ukulungiswa ngaphakathi ngoba i-scaffold yabhujiswa. I-brace yangaphandle yokulungiswa kwangaphandle ivumela ukuqhekeka okususiwe ukuze kubuye futhi kugcinwe ubude bawo ngaphansi komphumela wokuqothuka, ukudlala indima egxilile, njengoba kukhonjisiwe kuMfanekiso 4-19. Ukubekwa kwe-brace yangaphandle kwe-metacarpals ehlukile: I-metacarpals yokuqala neyesi-2 ubudala ibekwa ohlangothini lwe-dorsal radial, futhi i-metacarpals yesi-4 ibekwe ohlangothini lwe-dorsal radial noma i-ulnar lide ngokuya ngesimo, inaka indawo yokungena ukuvikela ukulimala kwi-tendon. Ama-fractures avaliwe angavalwa futhi abuyiselwe ngaphansi kwe-X-ray, futhi ukungezwani okuncane kungenziwa ukusiza ekuhlolweni uma ukuphindwaphindwa kungalungile.

Izinzuzo ze-brace yangaphandle yokulungiswa kwangaphandle.

(1) Kulula ukusebenza futhi kungaguqula ukususwa okuhlukahlukene kokuphela kokuphela;

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(4) Ivumela izivivinyo zokusebenza kwangaphambi kokuzivocavoca komunwe othintekile ekuhlanganiseni okungafakwanga ukugwema ukuhlangana 

(5) Kungalungisa ngempumelelo ukuqhekeka kwesandla ngaphandle kokuthinta ukwelashwa okuphathelene nesilonda sesandla esithintekile.

Ungayithenga kanjani izimila zamathambo namathuluzi ama-orthopedic?

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