I-Proximal Humeral Greater Tuberosity Locking Plate

Iyini i-Proximal Humeral Greater Tuberosity Locking Plate?

Ukuphuka kwe-proximal humerus kuwukulimala okuvamile, okuhlanganisa cishe i-5% yazo zonke iziphuka. Cishe i-20% ihilela i-tuberosity enkulu futhi ngokuvamile ihlotshaniswa namazinga ahlukene okulimala kwe-rotator cuff. I-tuberosity enkulu iphoyinti lokunamathisela lekhafu elijikelezayo, elivame ukudonsa ukuphuka ngemuva kokuhushulwa. Iningi le-tuberosity fractures liyaphulukisa ngaphandle kokuhlinzwa, kodwa okunye ukuphuka okukhulu kwe-tuberosity kune-prognosis embi ngenxa yobuhlungu behlombe, ukunyakaza okulinganiselwe, ukufakwa kwe-acromion, ubuthakathaka bemilenze, nokunye ukungasebenzi. Izinketho eziyinhloko zokuhlinza zokuqhekeka kwe-avulsion elula ukulungiswa kwezikulufu, ukulungiswa kwehange lomthungo kanye nokulungiswa kwepuleti.

imininingwane

Imikhiqizo	REF	Ukucaciswa	Ubukhulu	Ububanzi	Ubude
I-Proximal Humeral Greater Tuberosity Locking Plate (Sebenzisa i-2.7/3.5 Locking Screw, 2.7/3.5 Cortical Screw/4.0 Cancellous Screw)	5100-1601	5 izimbobo L	1.5	13	44
	5100-1602	5 izimbobo R	1.5	13	44

I-Proximal Humeral Greater Tuberosity Locking Plate: Ukubuyekezwa Okuphelele

I-proximal humerus iyisakhiwo samathambo esibalulekile esidlala indima ebalulekile ekusebenzeni kwesitho esiphezulu. Ukuphuka kule ndawo kungaholela ekulimaleni okuphawulekayo kokusebenza nokukhubazeka. Eminyakeni yamuva, ukuthuthukiswa kwamapuleti okukhiya kuye kwaguqula ukuphathwa kwe-proximal humeral fractures. I-proximal humeral great tuberosity locking plate (PHGTLP) iwuhlobo lwepuleti lokukhiya elithole ukuduma eminyakeni yamuva nje ngenxa yemiphumela yalo emihle kakhulu yomtholampilo. Kulesi sihloko, sizohlinzeka ngesibuyekezo esibanzi se-PHGTLP, okubandakanya i-anatomy yayo, izinkomba, indlela yokuhlinza, imiphumela, kanye nezinkinga.

I-Anatomy

I-proximal humerus inezingxenye ezine: inhloko ye-humeral, i-tuberosity enkulu, i-tuberosity encane, kanye ne-humeral shaft. I-tuberosity enkulu iwukuvelela kwamathambo okutholakala eceleni kwekhanda elinomswakama, futhi inikeza indawo yokunamathisela yemisipha ye-rotator cuff. I-PHGTLP yakhelwe ukulungisa ukuphuka kwe-tuberosity enkulu, evamile ekuqhekekeni kwe-humeral eseduze.

Izinkomba

I-PHGTLP ikhonjiswe ukuphatha ukuphuka kwe-humeral okusondelene okubandakanya i-tuberosity enkulu. Lezi ziqhekeko zivame ukuhlotshaniswa nokulimala kwe-rotator cuff futhi kungaholela ekulimazeni okuphawulekayo kokusebenza. I-PHGTLP inikeza ukulungiswa okuzinzile, okuvumela ukuhlanganisa kusenesikhathi nokuvuselelwa.

I-Surgery Technique

Indlela yokuhlinzwa ye-PHGTLP ibandakanya indlela evulekile yokunciphisa kanye nendlela yokulungisa yangaphakathi. Isiguli sibekwe esihlalweni esisogwini noma endaweni ye-lateral decubitus, futhi indawo yokuhlinza ilungiswa nge-drapes oyinyumba. I-longitudinal incision yenziwa phezu kwe-tuberosity enkulu, futhi ukuphuka kuyancipha. I-PHGTLP ibe isibekwa engxenyeni engemuva yekhanda elinomvundla, bese izikulufi zishuthekwa ngepuleti zingene ethanjeni. Ipuleti inikeza ukulungiswa okuzinzile, okuvumela ukuhlanganisa nokuvuselela kusenesikhathi.

Imiphumela

I-PHGTLP ikhonjiswe ukuthi inemiphumela emihle kakhulu yomtholampilo ekulawuleni ukuphuka kwe-humeral proximal. Ucwaningo oluningana lubike amazinga aphezulu enyunyana yokuphuka, imiphumela emihle yokusebenza, namazinga aphansi ezinkinga. Ekubuyekezweni okuhlelekile kwezifundo eziyi-11, i-PHGTLP ihlotshaniswe nezinga lenyunyana elingama-95%, izinga lemiphumela elisebenza kahle elingu-92% noma elihle kakhulu, kanye nezinga lenkinga elingu-6%.

Izinkinga

Izinkinga ezihlotshaniswa ne-PHGTLP zifaka ukubhobozwa ngezikulufu, ukwehluleka kokufakelwa, okungeyona inyunyana, kanye nokutheleleka. Izehlakalo zezinkinga ziphansi, futhi eziningi ziyalawuleka ngokuphathwa okufanele. Ekubuyekezweni okuhlelekile kwezifundo eziyi-11, inkinga ejwayeleke kakhulu kwakuwukubhobozwa ngezikulufu, okwenzeke ku-2.2% wamacala.

Isiphetho

I-PHGTLP iyindlela ephumelelayo nephephile yokuphatha ukuphuka kwe-humeral okusondelene okubandakanya i-tuberosity enkulu. Ipuleti inikeza ukulungiswa okuzinzile, okuvumela ukuhlanganisa nokuvuselela kusenesikhathi. I-PHGTLP ikhonjiswe ukuthi inemiphumela emihle kakhulu yomtholampilo enamazinga aphansi ezinkinga. Ukusetshenziswa kwe-PHGTLP kufanele kucatshangelwe ekuphathweni kwe-proximal humeral fracture.

Imibuzo Evame Ukubuzwa

1. Kuthatha isikhathi esingakanani ukululama ekuqhekekeni kwe-humeral proximal ephethwe nge-PHGTLP?

• Isikhathi sokululama sincike ezicini eziningana, njengobunzima bokuphuka, ubudala besiguli, nezimo zezokwelapha ezivele zikhona. Ngokuvamile, iziguli eziningi zingalindela ukubuyela emisebenzini evamile phakathi nezinyanga ezingu-6-12 ngemva kokuhlinzwa.

2. Ingabe ukusetshenziswa kwe-PHGTLP kuhlotshaniswa nanoma yiziphi izinkinga zesikhathi eside?

• Izinkinga zesikhathi eside ezihlobene ne-PHGTLP azivamile. Kodwa-ke, iziguli kufanele ziqaphele ingozi yokwehluleka kokufakelwa, okungenzeka eminyakeni eminingana ngemva kokuhlinzwa. Ukulandelela njalo nodokotela owelaphayo kungasiza ekuboneni noma yiziphi izinkinga ezingase zibe khona futhi zixazulule ngokushesha.

Ingabe i-PHGTLP ingasetshenziswa kuzo zonke izimo zokuphuka kwe-humeral proximal?

             Cha, i-PHGTLP yakhelwe ngokuqondile ukulungisa ukuphuka kwe-tuberosity enkulu. Ezimweni lapho ukuphuka kuhilela ezinye izingxenye ze-proximal humerus, ezinye izinketho zokuhlinzwa zingadinga ukucatshangelwa.

    Yisiphi isikhathi sokululama seziguli ezihlinzwa nge-PHGTLP?

• Isikhathi sokululama siyahlukahluka kuye ngobukhulu bokuphuka, iminyaka yesiguli, nanoma yiziphi izimo zezokwelapha ezivele zikhona. Iziguli eziningi zingalindela ukubuyela emisebenzini evamile phakathi nezinyanga ezingu-6-12 ngemva kokuhlinzwa.

Iziguli zingakuthuthukisa kanjani ukululama kwazo ngemva kokuhlinzwa kwe-PHGTLP?

• Iziguli zingakwazi ukuthuthukisa ukululama kwazo ngokulandela uhlelo lokubuyisela esimweni esiklanywe udokotela wazo owelaphayo. Lokhu kungase kuhlanganise ukwelashwa ngokomzimba, izivivinyo zokuthuthukisa uhla lokunyakaza namandla, namasu okulawula ubuhlungu. Kubalulekile ukulandela yonke imiyalelo yangemva kokuhlinzwa enikezwa udokotela owelaphayo ukuze kuqinisekiswe ukululama ngempumelelo.

Sengiphetha, i-PHGTLP iyindlela ephephile nesebenzayo yokuphatha ukuphuka kwe-humeral okusondelene okubandakanya i-tuberosity enkulu. Ipuleti inikeza ukulungiswa okuzinzile, okuvumela ukuhlanganisa nokuvuselela kusenesikhathi, futhi kuboniswe ukuthi kunemiphumela emihle kakhulu yomtholampilo ngenani eliphansi lezinkinga. Iziguli kufanele zixoxe ngokusetshenziswa kwe-PHGTLP nodokotela wazo owelaphayo ukuze zinqume ukuthi ingabe iyindlela efanelekile yokuphuka kwazo okuthile. Ngokuphathwa okufanele nokulandelela, iziguli zingalindela ukubuyela emisebenzini evamile futhi zijabulele izinga elihle lempilo ngemva kokuhlinzwa okuseduze kwe-humeral fracture nge-PHGTLP.