Imibandela eyamukelekayo yokuphulukiswa kwe-shaft ye-shaft ethobekile ingukukhulisa okungemuva kokungemuva kokungaphansi kwama-20 °, ukujikeleza okungaphansi kuka-30 °, ukujikeleza okungaphansi kuka-15cm. Eminyakeni yamuva nje, ngezidingo ezikhulayo zomsebenzi ophezulu we-limb kanye nokululama kusenesikhathi empilweni yansuku zonke, ukwelashwa kokuhlinzwa komtholo shaft fractures sekuvamile. Izindlela ezijwayelekile zifaka i-anterior, antenterateral, noma i-posterior plating yokulungiswa kwangaphakathi, kanye nokukhalisela okuphakathi nendawo. Ucwaningo lukhombisa ukuthi izinga lokungazilongeli lokunciphisa ukuncishiswa kwangaphakathi kwama-sumeral fractures cishe ama-4-13%, ngokulimala kwezinzwa zezinzwa ze-Iatrogenic ze-radial zenzeke cishe ngamacala angu-7%.
Ukugwema ukulimala kwe-Iatrogenic Radial Nerve futhi kunciphise izinga lokuncishiswa okuvulekile, izazi zasekhaya eChina ziye zamukela indlela yokuphila, isebenzisa inqubo ye-MIPPO ukulungisa imiphumela emihle.
Izinqubo ezihlinza
Isinyathelo sokuqala: Ukubeka. Isiguli sisesimweni esinamandla, esine-lingb ethintekile ebambe amadigri angama-90 futhi sibekwe etafuleni elisebenzayo.
Isinyathelo Sesibili: I-incision yokuhlinzwa. Ku-Medial Medial Lingle-Plate Fiftation (Kanghui) yeziguli, ukufakwa kweziguli ezimbili ezinama-longitudinal acishe abe ngu-3cm ngamunye enziwa eduze kweziphetho ze-proximal nasekude. I-proximal incision isebenza njengomnyango wendlela enkulu ye-Deltoid ne-Pectoralis, ngenkathi incision distal itholakala ngenhla kwe-epicondyle ye-humerus, phakathi kwe-biceps brachii kanye ne-triceps brachii.
▲ umdwebo we-schematic we-proximal incision.
①: incision yokuvutha; ②: umthambo we-cephalic; ③: I-Pectoralis enkulu; ④: Imisipha ye-Deltoid.
▲ umdwebo we-schematic wokuvuselelwa kwe-distal.
①: I-Median nerve; ②: I-Ulnar nerve; ③: Imisipha ye-brachialis; ④: incision yokuhlinzwa.
Isinyathelo sesithathu: Ukufakwa kwepuleti nokulungiswa. Ipuleti lifakwe ngokuvela kwe-proximal incision, i-snug ngokumelene nethambo, lidlula ngaphansi kwemisipha ye-brachialis. Ipuleti livikelekile okokuqala ekupheleni komphetho we-Humeral Shaft Fracture. Kamuva, ngokuhamba ngokujikeleza emlenzeni ongenhla, ukuqhekeka kuvaliwe futhi kuqondaniswe. Ngemuva kokuncishiswa okugculisayo ngaphansi kwe-fluoroscopy, isikulufa esijwayelekile sifakwa ngokuvuselelwa kwe-distal ukuvikela ipuleti ngokumelene nethambo. Isikulufa sokukhiya bese siqine, siqedela ukulungiswa kwepuleti.
▲ Umdwebo we-Schematic womhubhe ophakeme wepuleti.
①: Imisipha ye-brachialis; ②: Imisipha ye-BRACHII ye-BRACHII; ③: Imikhumbi yempilo kanye nezinzwa; ④: Pectoralis okukhulu.
▲ Umdwebo we-Schematic womhubhe wepuleti ye-distal Plate.
①: Imisipha ye-brachialis; ②: I-Median nerve; ③: I-Ulnar Nerve.
Isikhathi sePosi: Nov-10-2023
