Ungazinzisa kanjani ukuphuka kwe-clavicle ephakathi kwe-midshaft kuhlanganiswe ne-ipsilateral acromioclavicular dislocation?

Ukuphuka kwe-clavicle kuhlanganiswe ne-ipsilateral acromioclavicular dislocation kuwukulimala okungavamile ekusebenzeni komtholampilo.Ngemuva kokulimala, i-distal fragment ye-clavicle iyahamba kancane, futhi ukukhishwa kwe-acromioclavicular okuhlobene kungase kungabonisi ukufuduka okusobala, okwenza kube lula ekuxilongweni okungalungile.

Ngalolu hlobo lokulimala, ngokuvamile kunezindlela ezimbalwa zokuhlinza, ezihlanganisa ipuleti elide lokudonsa, inhlanganisela yepuleti le-clavicle ne-hook plate, kanye nepuleti le-clavicle elihlanganiswe nesikulufu sokulungisa inqubo ye-coracoid.Kodwa-ke, ama-hook plates avame ukuba mfushane ngobude obude, okungaholela ekulungiseni okunganele ekugcineni okuseduze.Ukuhlanganiswa kwepuleti le-clavicle kanye ne-hook plate kungase kubangele ukugxila ekucindezelekeni lapho kuhlangana khona, okwandisa ingozi yokuhlehla.

Ukuphuka kwe-clavicle yesokunxele kuhlanganiswe ne-ipsilateral acromioclavicular dislocation, kuzinzile kusetshenziswa inhlanganisela ye-hook plate kanye ne-clavicle plate.

Ekuphenduleni lokhu, ezinye izazi zihlongoze indlela yokusebenzisa inhlanganisela yepuleti le-clavicle nezikulufu zehange ukuze kulungiswe.Isibonelo sikhonjiswe esithombeni esilandelayo, esibonisa isiguli esinokwephuka kwe-clavicle ephakathi nendawo kuhlanganiswe nohlobo lwe-IV lwe-acromioclavicular joint dislocation:

Okokuqala, ipuleti ye-clavicular anatomical isetshenziselwa ukulungisa ukuphuka kwe-clavicle.Ngemuva kokunciphisa i-acromioclavicular joint ehlukanisiwe, izikulufi ezimbili ze-anchor zensimbi zifakwa kunqubo ye-coracoid.Izintambo ezinamathiselwe ezikulungeni zehange zibe sezifakwa ezimbotsheni zezikulufu zepuleti le-clavicle, futhi amafindo ayaboshwa ukuze awavikele ngaphambili nangemuva kwe-clavicle.Ekugcineni, imigqa ye-acromioclavicular kanye ne-coracoclavicular ixhunywe ngokuqondile kusetshenziswa ama-sutures.

I-Isolated clavicle fractures noma i-acromioclavicular dislocations eyodwa ukulimala okuvamile kakhulu ekusebenzeni komtholampilo.I-Clavicle fractures yenza i-2.6% -4% yazo zonke iziqephu, kuyilapho i-acromioclavicular dislocation yenza i-12% -35% yokulimala kwe-scapular.Nokho, inhlanganisela yakho kokubili ukulimala akuvamile.Iningi lezincwadi ezikhona liqukethe imibiko yamacala.Ukusetshenziswa kwesistimu ye-TightRope ngokuhambisana nokulungiswa kwepuleti le-clavicle kungase kube indlela entsha, kodwa ukubekwa kwepuleti le-clavicle kungase kuphazamise ukubekwa kwe-graft ye-TightRope, kudale inselele okudingeka ixazululwe.

Ngaphezu kwalokho, ezimweni lapho ukulimala okuhlanganisiwe kungenakuhlolwa ngaphambi kokuhlinzwa, kunconywa ukuhlola ngokujwayelekile ukuqina kwe-acromioclavicular joint ngesikhathi sokuhlolwa kokuphuka kwe-clavicle.Le ndlela isiza ekuvimbeleni ukunganaki ukulimala kokugudluka ngesikhathi esisodwa.