Ukuphuka kwe-scaphoid
Ukuphuka kwe-scaphoid yi-carpal fracture evame kakhulu, kubalwa cishe amaphesenti angu-70 azo zonke izinhlobo ze-carpal bone fractures. Ngenxa yesimo sayo esiyingqayizivele se-anatomical ngaphakathi kokuhlelwa kwethambo le-carpal, ukuphuka kwe-scaphoid okusha kuvame ukuphuthelwa ekuxilongweni komtholampilo. Ngaphezu kwalokho, ukunikezwa kwe-vascular okungavamile kwe-scaphoid kubangela iziguli ezinkingeni ezifana ne-nonunion, i-avascular necrosis (AVN), nokungazinzi kwe-carpal ngezigaba zakamuva. Ngokomtholampilo, ukuphuka kwe-scaphoid kunzima ukwelapha futhi kuvame ukushiya ama-sequelae afana nobuhlungu besandla obuqhubekayo, uhla olulinganiselwe lokunyakaza, kanye nesifo samathambo sangemuva kwe-traumatic.
Indima Eyingqayizivele Ye-Anatomical ye-Scaphoid
I-scaphoid iyithambo elide kunawo wonke kumugqa we-carpal osondelene, elimise okwesikebhe esincane (ngakho igama elithi 'scaphoid'). Ihlukanisa phakathi kwemigqa ye-carpal eseduze ne-distal, idlala indima ebalulekile ekusimamiseni nasekuxhumaniseni imigqa yomibili. Ukunyakaza kwesandla okuvamile, okuhlanganisa ukugoba, ukunwetshwa, ukuchezuka kweradial, nokuchezuka kwe-ulnar, konke kuncike ekunyakazeni okuhlanganisiwe kwe-scaphoid. Uma iphukile, i-biomechanics yalo lonke ilunga lesihlakala iyaphazamiseka.
I-Fragile Vascular Supply
I-scaphoid ithola igazi eliphuma ikakhulukazi emagatsheni omthambo we-radial, lingena lisuka endaweni engemuva kanye ne-distal pole:
Cishe u-70-80% wokugeleza kwegazi ungena nge-distal tubercle, ugeleza ubuyela emuva ukuze ondle i-proximal pole.
Amagatsha ambalwa kuphela angena ngqo ku-proximal pole.
Imithelela:
Uma ukuphuka kuseduze ne-proximal pole, ingozi enkulu yokuphazamiseka kwe-vascular.
Uma ukugeleza kwegazi kuphazamisekile, isiqephu esiseduze sithambekele kakhulu ku-AVN kanye nokungavumelani.
I-Common Injury Mechanism
Indlela evame kakhulu yokulimala ukuwa phezu kwesandla eseluliwe (FOOSH) .Lapho uwa, abantu ngabanye banweba ingalo ngendlela engokwemvelo futhi basakaze iminwe ukuze imunce umthelela wesundu. Le nqubo yokulimala njalo idonse ukunakwa okukhulu komtholampilo nocwaningo, futhi kubhekiselwa kuyo kakhulu ngesifushaniso esithi FOOSH.
Ukuxilongwa Okubambezelekile Kwe-Scaphoid Fracture
Ukuphuka kwe-scaphoid kuvame ukubangelwa ukulimala kwe-FOOSH. Ezimweni ezibucayi, izimpawu zingase zikhawulelwe ebuhlungwini obuncane besandla, okuholela iziguli ekudebeseleleni ukufuna usizo lwezokwelapha. Ngisho nalapho kuthathwa ama-X-ray (AP kanye nokubukwa kwezinhlangothi), ukuphuka kungase kungabonakali ngokushesha. Iziguli zingase zibuye ngemva kwezinyanga ngobuhlungu besandla obuqhubekayo, lapho ukucabanga kuveza ukuphuka okungapheli kwe-scaphoid-okubambezeleka kakhulu ukuxilongwa nokulahlekelwa iwindi lokwelapha elilungile.
Izincomo ezibalulekile zokuxilonga:
Isithombe se-X-ray kufanele senziwe kukho konke ukulimala esihlakaleni, okuhlanganisa nokubukwa kwe-scaphoid lapho kusolwa ukuphuka.
Uma i-X ray inegethivu kodwa izinsolo zisekhona, kufanele kusetshenziswe ukuvimbela ukuhamba, kulandelwe ukuphinda ukuthwebula izithombe ngemva kwamaviki ama-2.
Ukunganyakazi kusenesikhathi kungasebenza njengesilinganiso sokuxilonga nesokwelapha.
Izinketho Zokwelashwa
Ukulungiswa Kwangaphandle
Ukuphuka okusha, okungashintshiwe kungelashwa ngokungakwazi ukuhamba. Kodwa-ke, ukulungiswa kufanele kube okuqinile ukuze kuqinisekiswe ukuphulukiswa. I-plaster ejwayelekile noma i-resin splints ingase ihluleke ukulawula ukujikeleza kwengalo nengalo, kunciphise ukuzinza.
I-Plaster Cast Immobilization:
I-spica cast yesithupha yengalo ende:
Ikhonjiswe ekuphukeni okusondele kokukodwa kokuthathu (ingozi ephezulu ye-AVN), imigqa yokuphuka eqondile/etshekile, nezimo zokuxilongwa kokuqala.
Iqinisa indololwane ku-90°, ingalo, isihlakala, nesithupha.
Inikeza ukuqina okukhulu ngokususa ukujikeleza kwengalo.
I-spica cast yesithupha yengalo emfushane:
Ifanele ukuphuka kwesithathu kwe-distal, ukuphuka kwe-tuberosity, nokuphuka okuzinzile kwamaphakathi okhalweni (isigaba sakamuva).
Inikeza ukunethezeka okwengeziwe kodwa ukuzinza okuncane.
Ukulungiswa Kwangaphakathi
I-Headless Compression Screw (Herbert Screw)
Njengamanje izinga legolide le-scaphoid waist fractures.
I-Herbert Cannulated Compression Screw
I-Bevelled Cannulated Herbert Screw
I-Kirschner Wire (K-wire) Ukulungiswa
Indlela yendabuko kodwa ewusizo, evame ukuhlanganisa.
Izinzuzo : eguquguqukayo, engabizi, ukuphazamiseka okuncane kwe-vascularity.
Ububi : ukuzinza kancane, kudinga ukulungiswa kwangaphandle, ingozi yokutheleleka, ukususwa okudingekayo ngemva kokuphulukiswa.
Izinkomba : ukuphuka kwezingane, ukulungiswa kwesikhashana kuyaqhubeka, okuhambisana nokulungisa isikulufu.
I-Cannulated Screw inentambo encane
I-Cannulated Screw inentambo encane
I-Scaphoid Nonunion
Ngenxa yokuhlinzekwa kwayo okuyingqayizivele kwemithambo, ukhalo lwe-scaphoid kanye nokuqhekeka okusondelene kuthambekele ekubeni i-nonunion kanye ne-AVN.
Ukwelashwa : Ukuxhunyelelwa kwethambo (okungeyona i-vascularized noma i-vascularized) kuhlanganiswe nokulungiswa kwangaphakathi (isikulufu sika-Herbert noma i-K-wire). Ukubekwa kwegraft okunembe kanye nokubuyiselwa kwe-articular surface bushelelezi kubalulekile. Kwezinye izimo, i-radial styloidectomy ingase idingeke uma ukugqama kwethambo kuphazamisa phakathi nokunyakaza kwesandla.
IGlobal Top 10 Herbert Screw Suppliers kanye ne-CZMEDITECH Uhlolojikelele Lomkhiqizo
Ukwelashwa kokuphuka kwe-scaphoid kubaluleke kakhulu—hhayi nje ukubuyisela ukusebenza kwesihlakala kodwa nokugcina izinga lempilo leziguli kanye nekhono lomsebenzi. Ukukhetha idivayisi efanele yokulungisa yangaphakathi kuyisihluthulelo sokuvimbela izinkinga, ukufeza ukulungiswa okunembile, kanye nokukhuthaza ukuhlunyeleliswa.
Phakathi kwama-implants ahlukahlukene, i I-Herbert Screw igqama ngenxa yedizayini yayo eyingqayizivele nokusebenza komtholampilo okuqinisekisiwe, okuyenza ibe elinye lamathuluzi abaluleke kakhulu ekulawulweni kokuphuka kwe-scaphoid.
Abahlinzeki be-Herbert Screw Abaphezulu Abayi-10 Emhlabeni Wonke
| Ilogo |
Lenkampani |
Yegama |
| 1 |
I-DePuy Synthes |
![I-Herbert Cannulated Compression Screw]() |
| 2 |
I-Stryker |
![I-Herbert Cannulated Compression Screw]() |
| 3 |
I-Zimmer Biomet |
![I-Herbert Cannulated Compression Screw]() |
| 4 |
I-Arthrex |
![I-Herbert Cannulated Compression Screw]() |
| 5 |
USmith & Umshana |
![I-Herbert Cannulated Compression Screw]() |
| 6 |
Iqembu le-Wright Medical |
![I-Herbert Cannulated Compression Screw]() |
| 7 |
Ukumangala |
![I-Herbert Cannulated Compression Screw]() |
| 8 |
Inani eliphakeme lempahla ye-Implantate AG |
![I-Herbert Cannulated Compression Screw]() |
| 9 |
I-Orthofix |
![I-Herbert Cannulated Compression Screw]() |
| 10 |
I-CZMEDITECH |
![I-Herbert Cannulated Compression Screw]() |
Imikhiqizo ye-CZMEDITECH Herbert Screw
Njengomkhiqizi ohamba phambili waseShayina kanye nomphakeli wezimila zamathambo, i-CZMEDITECH inikeza iphothifoliyo ebanzi ye-Herbert Screws eklanyelwe ukuphuka kwe-scaphoid nokunye ukulimala kwamathambo amancane.
Izici Eziyinhloko:
Idizayini yokucindezela engenakhanda: iqinisekisa ukulungiswa okuzinzile ngenkathi inciphisa ukucasuka kwe-articular cartilage.
Ukuzinza okuphezulu kwe-biomechanical: ukucindezela okuthembekile kwe-interfragmentary kukhuthaza inyunyana eqinile.
Izinketho zezinto ezibonakalayo: zitholakala ngensimbi engagqwali yezinga lezokwelapha kanye ne-titanium alloy, enokuhambisana okuhle kakhulu kwe-biocompatibility kanye nokumelana nokugqwala.
Ukuhambisana okuhlaselayo okuncane: kulungele kokubili izindlela ze-percutaneous nezivulekile.
Ukucaciswa okuningi: ububanzi obubanzi bobubanzi nobude ukuze kubhekwane nezidingo ezihlukahlukene zomtholampilo.
Izinzuzo Zomtholampilo:
Isiza ukuphulukiswa okusheshayo nokuthembekile kokuphuka kwe-scaphoid, ikakhulukazi okhalweni oluyingozi kakhulu kanye nokuphuka kwezigxobo eziseduze.
Inika amandla ukuhlanganisa isihlakala kusenesikhathi, yehlisa ukuqina futhi ithuthukise ukutakula kokusebenza.
Yehlisa kakhulu ingcuphe ye-nonnunion kanye ne-AVN uma kuqhathaniswa nezindlela zokulungisa zendabuko.
Imikhiqizo ye-CZMEDITECH
