Isu Lokuhlinza | “I-Kirschner Wire Tension Band Technique” Yokulungisa Kwangaphakathi Ekwelapheni Ukuphuka kuka-Bennett

Ukuphuka kuka-Bennett kubala u-1.4% wokuphuka kwezandla. Ngokungafani nokuphuka okujwayelekile kwesisekelo samathambo e-metacarpal, ukugudluka kokuphuka kwe-Bennett kuhluke kakhulu. I-proximal articular surface fragment igcinwa endaweni yayo yokuqala ye-anatomical ngenxa yokudonsa kwe-oblique metacarpal ligament, kuyilapho i-distal fragment, ngenxa yokudonsa kwe-abductor pollicis longus kanye ne-adductor pollicis tendon, ihlakaza i-dorsoradially kanye ne-supinates.

Ngokuphuka kwe-Bennett esusiwe, ukwelashwa kokuhlinzwa kuvame ukutuswa ukuze kugwenywe ukuphazamisa ukuqondanisa kwejoyinti le-carpometacarpal nokusebenza kwesithupha. Ngokuphathelene nezindlela zokwelapha zokuhlinza, izinhlelo zokulungisa ipuleti ne-screw, kanye ne-Kirschner wire fixation yangaphakathi, zisetshenziswa kabanzi emisebenzini yomtholampilo. Izazi zeSibhedlela Sesithathu sase-Hebei zenze isiphakamiso se-Kirschner wire tension band, ehilela ukusika okuncane ukuze kulungiswe ukuphuka kuka-Bennett, kuzuzwe imiphumela emihle.

Isinyathelo 1: Yenza ukusika okungu-1.3 cm ohlangothini lwe-radial lwejoyinti ye-carpometacarpal, hlinza ungqimba ngongqimba ukuze uveze indawo, uhoxise i-abductor pollicis longus ngasehlangothini lwe-ulnar, futhi uveze uhlangothi lomgogodla wejoyinti le-carpometacarpal.

Isinyathelo sesi-2: Sebenzisa ukudonsa ngesandla bese ubiza isithupha ukuze unciphise ukuphuka. Faka intambo ye-Kirschner engu-1 mm ekugcineni kokuphuka, ibanga elingu-1-1.5 cm ukusuka kwijoyinti ye-carpometacarpal, ukuze ulungise ucezu lwethambo oluseduze. Ngemuva kokuthi i-Kirschner wire ingene esiqeshini sethambo, qhubeka nokuya phambili ngo-1 cm.

Isinyathelo sesi-3: Thatha intambo bese uyiluphu ngephethini yesibalo-yesishiyagalombili emaphethelweni womabili wentambo ye-Kirschner, bese uyivikela endaweni.

Isu le-Kirschner wire tension band lisetshenziswe ezindaweni eziningi zokuphuka, kodwa ekwephuleni kuka-Bennett, ukusika okuncane kuvame ukuholela ekungabonakali kahle futhi kwenza inqubo ibe inselele. Ukwengeza, uma ukuphuka kwenziwa, intambo eyodwa ye-Kirschner ingase ingazinzisi ngempumelelo isiqeshana sethambo esiseduze. Ukusebenza kwayo emtholampilo kungase kube nomkhawulo. Ngaphandle kwendlela eshiwo ngenhla yokulungisa ibhande le-tension, kukhona nokulungiswa kocingo lwe-Kirschner okuhlanganiswe nendlela yebhendi ye-tension, nayo ebikiwe ezincwadini.