Ukuphuka kwe-Clavicle kungenye yezindlela ezivame kakhulu zokuphuka kwezingalo eziphezulu emtholampilo, kanti ama-82% okuphuka kwe-clavicle kungama-fracture ase-midshaft. Iningi lokuphuka kwe-clavicle ngaphandle kokusuka okukhulu lingelashwa ngendlela egcinayo ngamabhandeshi ayisishiyagalombili, kuyilapho lawo anokusuka okukhulu, izicubu ezithambile ezihlanganisiwe, ingozi yokulimala kwemithambo yegazi noma yezinzwa, noma izidingo eziphezulu zokusebenza zingadinga ukufakwa kwangaphakathi ngama-plate. Izinga lokungahlangani ngemva kokufakwa kwangaphakathi kokuphuka kwe-clavicle liphansi kakhulu, cishe ama-2.6%. Ama-nonunion anezimpawu ngokuvamile adinga ukuhlinzwa kokubuyekezwa, kanti indlela evamile iwukuxhunyelelwa kwamathambo okukhanseliwe kanye nokufakwa kwangaphakathi. Kodwa-ke, ukuphatha ama-nonunion aphindaphindayo ezigulini esezike zahlolwa ukungahlangani kuyinselele enkulu futhi kuseyinkinga kokubili kodokotela kanye neziguli.
Ukuze kuxazululwe le nkinga, uprofesa eSibhedlela i-Xi'an Red Cross wasebenzisa ngendlela entsha i-autologous iliac bone structural grafting ehlanganiswe ne-autologous cancellous bone grafting ukwelapha ama-nonions angenakuphikiswa okuphuka kwe-clavicle ngemuva kokuhlinzwa kokubuyekezwa okuhlulekile, kwafezwa imiphumela emihle. Imiphumela yocwaningo yanyatheliswa kumagazini i-"International Orthopaedics".
Inqubo yokuhlinzwa
Izinqubo ezithile zokuhlinzwa zingafingqwa kanje:
a: Susa ukuqina kwe-clavicular kwasekuqaleni, susa ithambo le-sclerotic kanye nesibazi se-fiber ekugcineni okuphukile kokuqhekeka;
b: Kwasetshenziswa amapuleti okwakha kabusha i-clavicle epulasitiki, kwafakwa izikulufo ezikhiyayo emaphethelweni angaphakathi nangaphandle ukuze kulondolozwe ukuzinza okuphelele kwe-clavicle, kanti izikulufo azizange zilungiswe endaweni ezophathwa ekugcineni okuphukile kwe-clavicle.
c: Ngemva kokufaka ipuleti, bhoboza imigodi ngenaliti kaKirschler engxenyeni ephukile yokuqhekeka ngaphakathi nangaphandle kuze kube yilapho imbobo ikhipha igazi (uphawu lwepelepele elibomvu), okubonisa ukuthuthwa kwegazi elihle emathanjeni lapha;
d: Ngalesi sikhathi, qhubeka nokubhoboza ama-5mm ngaphakathi nangaphandle, bese ubhoboza imigodi emide ngemuva, okuhambisana nokuhlinzwa okulandelayo kwe-osteotomy;
e: Ngemva kokuhlinzwa kwe-osteotomy emgodini wokuqala wokubhoboza, hambisa i-cortex engezansi yethambo phansi ukuze ushiye umgodi wethambo;
f: Ithambo le-bicortical iliac lafakwa emseleni wamathambo, kwabe sekufakwa i-cortex engenhla, i-crest ye-iliac kanye ne-cortex engezansi ngezikulufo; Ithambo le-cancellous le-iliac lafakwa endaweni yokuqhekeka.
Okuvamile
amacala:
▲ Isiguli sasiyindoda eneminyaka engu-42 ubudala enokuphuka kwe-clavicle yesobunxele phakathi nesigaba okubangelwa ukulimala (a); Ngemva kokuhlinzwa (b); Ukuphuka okulungisiwe kanye nokungahlangani kwamathambo zingakapheli izinyanga ezingu-8 ngemva kokuhlinzwa (c); Ngemva kokuvuselelwa kokuqala (d); Ukuphuka kwepuleti lensimbi ezinyangeni ezingu-7 ngemva kokuvuselelwa kanye nokungapholi (e); Ukuphuka kwaphulukiswa (h, i) ngemva kokufakelwa kwamathambo okwakheka (f, g) kwe-ilium cortex.
Esifundweni somlobi, kufakwe amacala ayi-12 okungezwani kwamathambo okuphikiswa, wonke athola ukuphulukiswa kwamathambo ngemva kokuhlinzwa, kanti iziguli ezimbili zaba nezinkinga, icala elilodwa le-calf intermuscular vein thrombosis kanye necala elilodwa lobuhlungu bokususwa kwamathambo e-iliac.
Ukungasebenzi kahle kwe-clavicular nonion kuyinkinga enzima kakhulu emtholampilo, okuletha umthwalo onzima wengqondo kokubili iziguli nodokotela. Le ndlela, ehlanganiswe nokufakelwa kwamathambo kwesakhiwo sethambo le-cortical le-ilium kanye nokufakelwa kwamathambo e-cancellous, ifinyelele umphumela omuhle wokuphulukiswa kwamathambo, futhi ukusebenza kahle kunembile, okungasetshenziswa njengereferensi kodokotela.
Isikhathi sokuthunyelwe: Mashi-23-2024
