Ukwethulwa kwendlela yokuthola "i-radial nerve" endleleni yangemuva ye-humerus

Ukwelashwa kokuhlinzwa kwe-mid-distal humerus fractures (njengaleyo ebangelwa "i-wrist-wrestling") noma i-humeral osteomyelitis ngokuvamile idinga ukusetshenziswa kwendlela eqondile yangemuva ku-humerus. Ingozi eyinhloko ehlotshaniswa nale ndlela ukulimala kwenzwa ye-radial. Ucwaningo luye lwabonisa ukuthi amathuba okulimala kwenzwa ye-iatrogenic radial okubangelwa indlela yangemuva ye-humerus asukela ku-0% kuya ku-10%, okungenzeka kube nokulimala okungapheli kwe-radial nerve kusuka ku-0% kuya ku-3%.

Naphezu komqondo wokuphepha kwe-radial nerve, ucwaningo oluningi luye lwathembela ezimpawu zomhlaba ze-anatomical ezifana nesifunda se-supracondylar se-humerus noma i-scapula yokubeka ngaphakathi kokusebenza. Kodwa-ke, ukuthola i-radial nerve ngesikhathi senqubo kuhlala kuyinselele futhi kuhlotshaniswa nokungaqiniseki okubalulekile.

Umfanekiso wendawo yokuphepha ye-radial nerve. Ibanga eliphakathi ukusuka endizeni ye-radial nerve kuya ku-condyle eseceleni ye-humerus licishe libe ngu-12cm, nendawo yokuphepha enwebeka ngo-10cm ngaphezu kwekhondili engemuva.

Mayelana nalokhu, abanye abacwaningi baye bahlanganisa izimo zangempela ze-intraoperative futhi balinganisa ibanga phakathi kwesihloko se-triceps tendon fascia kanye ne-radial nerve. Bathole ukuthi leli banga alishintshile futhi linenani eliphezulu lokuma endaweni yokuhlinzwa. Ikhanda elide le-triceps brachii muscle tendon ligijima cishe libheke phezulu, kanti ikhanda elingemuva lakha i-arc elinganiselwe. Ukuphambana kwalawa ma-tendon kwenza ichopho le-triceps tendon fascia. Ngokuthola u-2.5cm ngaphezu kwaleli phuzu, inzwa ye-radial ingabonakala.

 Indlela Yokumisa

Ngokusebenzisa i-apex ye-triceps tendon fascia njengereferensi, i-radial nerve ingatholakala ngokuhamba cishe ngo-2.5cm phezulu.

Ngocwaningo olubandakanya isilinganiso seziguli ezingama-60, uma kuqhathaniswa nendlela yokuhlola yendabuko ethathe imizuzu engu-16, le ndlela yokumisa inciphise ukusika kwesikhumba kuya esikhathini sokuchayeka kwenzwa ye-radial yaba yimizuzu engu-6. Ngaphezu kwalokho, igweme ngempumelelo ukulimala kwezinzwa ze-radial.

Isithombe se-macroscopic sokulungiswa kwangaphakathi kokusebenza sokuqhekeka kwe-humeral okuphakathi nendawo oku-1/3. Ngokubeka ama-sutures amabili abambekayo anqamula cishe u-2.5cm ngaphezu kwendiza ye-triceps tendon fascia apex, ukuhlola ngale ndawo yokuhlangana kuvumela ukuchayeka kwe-radial nerve kanye ne-vascular bundle.
Ibanga elishiwo lihlobene ngempela nobude besiguli nobude bengalo. Ekusetshenzisweni okungokoqobo, ingalungiswa kancane ngokusekelwe kumzimba wesiguli kanye nezilinganiso zomzimba.