Ukuphuka kwe-clavicle kungenye yezindlela ezivame kakhulu zokuphuka kwemilenze ephezulu ekusebenzeni komtholampilo, kanti ama-82% e-clavicle fractures ama-midshaft fractures.Iningi le-clavicle fractures ngaphandle kokususwa okuphawulekayo lingelashwa ngendlela evikelekile ngamabhandeshi ayisishiyagalombili, kuyilapho lawo anokususwa okuphawulekayo, izicubu ezithambile ezihlanganisiwe, ingozi ye-vascular or neurological compromise, noma izidingo eziphezulu zokusebenza zingadinga ukulungiswa kwangaphakathi ngamapuleti.Izinga le-nonnunion ngemva kokulungiswa kwangaphakathi kwe-clavicle fractures liphansi kakhulu, cishe i-2.6%.Izimpawu ezingezona inyunyana ngokuvamile zidinga ukuhlinzwa okubukeziwe, okuyindlela evamile yokuba ukuxhunyelelwa kwethambo okukhansela okuhlanganiswe nokulungiswa kwangaphakathi.Kodwa-ke, ukuphatha ama-atrophic nonunion aphindaphindekayo ezigulini esezike zabuyekezwa okungezona ezokwelashwa kuyinselele enkulu futhi kuseyindida kubo bobabili odokotela neziguli.
Ukuze kubhekwane nalolu daba, uprofesa waseSibhedlela i-Xi'an Red Cross wasebenzisa i-autologous iliac bone structural grafting ehlangene nokuxhunyelelwa okuzenzakalelayo kwethambo ukuze kwelaphe ukuqhekeka kwe-clavicle okungahambisani nokuqhekeka kwe-clavicle kulandela ukuhlinzwa kokubuyekezwa okuhlulekile, okube nemiphumela emihle.Imiphumela yocwaningo yanyatheliswa kujenali "International Orthopaedics".
Inqubo yokuhlinzwa
Izinqubo ezithile zokuhlinza zingafingqwa njengesibalo esingezansi:
a: Susa ukulungiswa kwe-clavicular yasekuqaleni, susa ithambo le-sclerotic kanye ne-fiber scar ekugcineni okuphukile kokuphuka;
b: Kusetshenziswe amapuleti okwakhiwa kabusha kwe-clavicle epulasitiki, izikulufu zokukhiya zafakwa emikhawulweni yangaphakathi nangaphandle ukuze kugcinwe ukuzinza okuphelele kwe-clavicle, futhi izikulufu azizange zilungiswe endaweni okufanele ziphathwe ekugcineni kwe-clavicle.
c: Ngemva kokulungiswa kwepuleti, bhoboza izimbobo ngenaliti ye-Kirschler ngasekugcineni okuphukile kokuphuka ukuya ngaphakathi nangaphandle kuze kube yilapho imbobo iphuma igazi (uphawu lukapelepele obomvu), okubonisa ukuhamba kahle kwegazi lamathambo lapha;
d: Ngalesi sikhathi, qhubeka ubhoboza 5mm ngaphakathi nangaphandle, futhi ubhoboze izimbobo ze-longitudinal ngemuva, okuhambisana ne-osteotomy elandelayo;
e: Ngemva kwe-osteotomy eduze kwembobo yokuqala, hambisa i-bone cortex phansi ukuze ushiye i-bone trough;
f: Ithambo le-bicortical iliac lafakwa emseleni wamathambo, kwase kuthi i-cortex engenhla, i-iliac crest kanye ne-cortex engezansi yafakwa ngezikulufo;Ithambo elikhansele iliac lafakwa esikhaleni sokuphuka
Okujwayelekile
amacala:
▲ Isiguli sasingumuntu wesilisa oneminyaka engu-42 ubudala ngokuhlukana kwesigaba esiphakathi kwe-clavicle kwesokunxele okubangelwa ukuhlukumezeka (a);Ngemva kokuhlinzwa (b);Ukuphuka okungaguquki kanye nokungahlangene kwethambo phakathi nezinyanga eziyi-8 ngemva kokuhlinzwa (c);Ngemva kokulungiswa kokuqala (d);Ukuphuka kwepuleti yensimbi izinyanga ezingu-7 ngemva kokulungiswa nokungaphuluki (e);Ukuphuka kwelapheka (h, i) ngemva kokuxhunyelelwa kwesakhiwo sethambo (f, g) le-ilium cortex.
Esifundweni somlobi, isamba se-12 amacala we-refractory bone nonnunion afakiwe, konke okuzuzwe ukuphulukiswa kwamathambo ngemva kokuhlinzwa, futhi iziguli ze-2 zazinezinkinga, icala le-1 lethole le-intermuscular vein thrombosis kanye ne-1 icala lobuhlungu bokususwa kwethambo le-iliac.
I-refractory clavicular nonunion iyinkinga enzima kakhulu ekusebenzeni komtholampilo, okuletha umthwalo osindayo ongokwengqondo kokubili iziguli nodokotela.Le ndlela, ehlangene nokuxhunyelelwa kwamathambo esakhiwo se-cortical bone ye-ilium kanye nokufakwa kwamathambo okukhansela, ifinyelele umphumela omuhle wokuphulukiswa kwamathambo, futhi ukusebenza kahle kunembile, okungasetshenziswa njengereferensi yabahlengikazi.
Isikhathi sokuthumela: Mar-23-2024
