Ukuphuka kwe-clavicle kuhlanganiswe nokuhlukana kwe-acromioclavicular ipsilateral kuyimbangela engavamile kakhulu emtholampilo. Ngemva kokulimala, ingxenye ekude ye-clavicle iyahamba kancane, futhi ukuhlukana kwe-acromioclavicular okuhlobene nakho kungase kungabonakali ukugudluka okusobala, okwenza kube lula ukuthola ukuhlonza okungalungile.
Kulolu hlobo lokulimala, ngokuvamile kunezindlela eziningana zokuhlinzwa, okuhlanganisa ipuleti elide le-hook, inhlanganisela yepuleti le-clavicle kanye nepuleti le-hook, kanye nepuleti le-clavicle elihlanganiswe nokufakwa kwesikulufo enkambisweni ye-coracoid. Kodwa-ke, amapuleti e-hook avame ukuba mafushane ngobude obuphelele, okungaholela ekungangeni kahle kokufakwa ekugcineni kwe-proximal. Ukuhlanganiswa kwepuleti le-clavicle kanye nepuleti le-hook kungabangela ukugxilisa ingqondo endaweni yokuhlangana, okwandisa ingozi yokuphinda kusebenze.
Ukuphuka kwe-clavicle yesobunxele kuhlanganiswe nokuhlukana kwe-ipsilateral acromioclavicular, okuzinzile kusetshenziswa inhlanganisela ye-hook plate kanye ne-clavicle plate.
Ukuphendula lokhu, ezinye izazi ziphakamise indlela yokusebenzisa inhlanganisela yepuleti le-clavicle kanye nezikulufo ze-anchor ukuze kufakwe. Isibonelo siboniswe esithombeni esilandelayo, esibonisa isiguli esine-midshaft clavicle fracture ehlanganiswe ne-ipsilateral type IV acromioclavicular joint dislocation:
Okokuqala, kusetshenziswa ipuleti le-clavicular anatomical ukulungisa ukuphuka kwe-clavicle. Ngemva kokunciphisa i-acromioclavicular joint ephukile, kufakwa izikulufo ezimbili zensimbi ze-anchor enqubweni ye-coracoid. Izikulufo ezixhunywe kuzikulufo ze-anchor zibe sezifakwa ngentambo ngezimbobo zezikulufo zepuleti le-clavicle, bese amafindo aboshelwa ukuze aboshwe ngaphambili nangemuva kwe-clavicle. Ekugcineni, izikulufo ze-acromioclavicular kanye ne-coracoclavicular zithungwa ngqo kusetshenziswa izikulufo.
Ukuphuka kwe-clavicle okuhlukanisiwe noma ukuhlukana kwe-acromioclavicular okuhlukanisiwe kuyizingozi ezivame kakhulu emtholampilo. Ukuphuka kwe-Clavicle kubalwa u-2.6%-4% wabo bonke ukuphuka, kuyilapho ukuhlukana kwe-acromioclavicular kwakha u-12%-35% wokulimala kwe-scapular. Kodwa-ke, inhlanganisela yokulimala kokubili ayivamile. Iningi lezincwadi ezikhona liqukethe imibiko yamacala. Ukusetshenziswa kohlelo lwe-TightRope kanye nokulungiswa kwe-clavicle plate kungaba yindlela entsha, kodwa ukubekwa kwe-clavicle plate kungaphazamisa ukubekwa kwe-TightRope graft, okuletha inselele okudingeka ixazululwe.
Ngaphezu kwalokho, ezimweni lapho ukulimala okuhlangene kungenakuhlolwa ngaphambi kokuhlinzwa, kunconywa ukuhlola njalo ukuqina kwejoyinti le-acromioclavicular ngesikhathi sokuhlolwa kokuphuka kwe-clavicle. Le ndlela isiza ukuvimbela ukunganaki ukulimala kokuhlukana ngasikhathi sinye.
Isikhathi sokuthunyelwe: Agasti-17-2023
