Ukuphuka kwekhanda elikhazimulayo kanye nentamo eyi-radial kuwukuhlukana okujwayelekile kwendololwane, ngokuvamile okubangelwa amandla e-axial noma ukucindezeleka kwe-valgus. Lapho indololwane isendaweni enwetshiwe, amaphesenti angama-60 wamandla e-axial engalweni asakazwa ngokuseduze ngenhloko ye-radial. Ukulandela ukulimala kwekhanda elikhanyayo noma intamo ye-radial ngenxa yokuphoqelela, amandla okugunda angathinta i-capitulum ye-humerus, okungase kuholele ekulimaleni kwethambo ne-cartilage.
Ku-2016, u-Claessen uhlonze uhlobo oluthile lokulimala lapho ukuphuka kwekhanda / intamo ye-radial kuhambisane nokulimala kwamathambo / uqwanga ku-capitulum ye-humerus. Lesi simo sabizwa ngokuthi “isilonda sokuqabula,” kanye nokuphuka okuhlanganisa le nhlanganisela ebizwa ngokuthi “ukuphuka kokuqabula.” Embikweni wabo, bahlanganisa namacala ayi-10 okuphuka kokuqabulana futhi bathola ukuthi amacala ayi-9 abenokuphuka kwamakhanda okuyi-radial abizwa ngokuthi yi-Mason type II. Lokhu kuphakamisa ukuthi nge-Mason type II ukuphuka kwekhanda le-radial, kufanele kube nokuqwashisa okukhulu mayelana nokuphuka okungenzeka okuhambisana ne-capitulum ye-humerus.
Emisebenzini yomtholampilo, ukuphuka kokuqabula kujwayeleke kakhulu ekuxilongeni ngokungalungile, ikakhulukazi ezimeni lapho kukhona ukugudluka okuphawulekayo kokuphuka kwekhanda/intamo eyi-radial. Lokhu kungaholela ekubhekeni ukulimala okuhlobene ne-capitulum ye-humerus. Ukuze uphenye izici zomtholampilo nezehlakalo zokuphuka kokuqabulana, abacwaningi bakwamanye amazwe benze ukuhlaziya kwezibalo kusayizi wesampula omkhulu ngo-2022. Imiphumela imi kanje:
Ucwaningo lwaluhlanganisa inani leziguli ze-101 ezine-radial head / neck fractures ezaphathwa phakathi kwe-2017 ne-2020. Ngokusekelwe ekutheni babe ne-fracture ehambisanayo ye-capitulum ye-humerus ohlangothini olufanayo, iziguli zihlukaniswe ngamaqembu amabili: iqembu le-capitulum (Iqembu I) kanye neqembu elingelona i-capitulum (Iqembu II).
Ngaphezu kwalokho, ukuphuka kwekhanda elikhazimulayo kwahlaziywa ngokusekelwe endaweni yawo ye-anatomical, eyahlukaniswa yaba izifunda ezintathu. Eyokuqala iyindawo ephephile, eyesibili iyindawo ephakathi yangaphambili, kanti eyesithathu yindawo ephakathi nendawo engemuva.
Imiphumela yocwaningo iveze lokhu okulandelayo:
- Ukuphakama kwesigaba se-Mason sokuphuka kwekhanda eli-radial, ingozi enkulu yokuhambisana nokuphuka kwe-capitulum. Amathuba okuphuka kwekhanda le-Mason I-radial head ehlotshaniswa ne-capitulum fracture yayingu-9.5% (6/63); ohlotsheni lweMason II, kwakungama-25% (6/24); kanti ohlotsheni lweMason III, bekungama-41.7% (5/12).
- Lapho ama-radial head fractures anwetshwa ukuze afake intamo ye-radial, ingozi ye-capitulum fractures yehla. Izincwadi azizange zibonise noma yiziphi izimo ezizimele ze-radial neck fractures ezihambisana ne-capitulum fractures.
- Ngokusekelwe ezifundeni ze-anatomical ze-radial head fractures, ama-fractures atholakala ngaphakathi "kwendawo ephephile" yekhanda le-radial libe nengozi enkulu yokuhlotshaniswa nokuphuka kwe-capitulum.
▲ Ukuhlukaniswa kweMason kokuphuka kwekhanda elikhanyayo.
▲ Ikesi lokuqabula isiguli esaphuka, lapho i-radial head yayilungiswe nge-steel plate nezikulufu, kanye ne-capitulum ye-humerus ilungiswe kusetshenziswa izikulufo eziBold.
Isikhathi sokuthumela: Aug-31-2023
