Ukuphuka kwe-Clavicle kungenye yezindlela ezivame kakhulu zokuphuka, okubalwa kuzo u-2.6%-4% wazo zonke izinhlobo zokuphuka. Ngenxa yezimpawu zokwakheka kwe-midshaft ye-clavicle, ukuphuka kwe-midshaft kuvame kakhulu, okubalwa kuzo u-69% wokuphuka kwe-clavicle, kuyilapho ukuphuka kwezingxenye ezisemaceleni neziphakathi ze-clavicle kubalwa u-28% no-3% ngokulandelana.
Njengohlobo olungavamile lokuphuka, ngokungafani nokuphuka kwe-clavicle ye-midshaft okubangelwa ukulimala kwehlombe okuqondile noma ukudluliselwa kwamandla okuvela ekulimaleni okuthwala isisindo esingaphezulu, ukuphuka kwengxenye ephakathi ye-clavicle kuvame ukuhlotshaniswa nokulimala okuningi. Esikhathini esidlule, indlela yokwelapha ukuphuka kwengxenye ephakathi ye-clavicle ngokuvamile yayihlala igcinwa. Kodwa-ke, izifundo zibonise ukuthi iziguli ezingu-14% ezineziphuphu eziphukile zengxenye ephakathi zingase zithole izimpawu zokungahlangani. Ngakho-ke, eminyakeni yamuva nje, izazi eziningi ziye zathambekela ekwelashweni kokuhlinzwa kokuphuka okuphukile kwengxenye ephakathi okubandakanya i-sternoclavicular joint. Kodwa-ke, izingcezu ze-clavicular ye-medial zivame ukuba zincane, futhi kunemikhawulo yokulungiswa kusetshenziswa amapuleti nezikulufo. Ukugxila kokucindezeleka kwendawo kusalokhu kuyinkinga eyinselele kodokotela abahlinzayo bamathambo maqondana nokuzinzisa ngempumelelo ukuphuka nokugwema ukwehluleka kokulungiswa.
I.Distal Clavicle LCP Inversion
Isiphelo esikude se-clavicle sabelana ngezakhiwo ezifanayo zomzimba nesiphetho esiseduze, zombili zinesisekelo esibanzi. Isiphelo esikude se-clavicle locking compression plate (LCP) sihlonyiswe ngezimbobo eziningi zezikulufo ezikhiywayo, okuvumela ukufakwa okuphumelelayo kwengxenye ekude.
Uma kucatshangelwa ukufana kwesakhiwo phakathi kwalezi ezimbili, ezinye izazi zibeke ipuleti lensimbi ngokuvundlile ekhoneni elingu-180° ekugcineni kwe-clavicle. Zifinyeze nengxenye eyayisetshenziswa ekuqaleni ukuqinisa ukuphela kwe-clavicle futhi zathola ukuthi i-implant yangaphakathi ifanelana kahle ngaphandle kwesidingo sokubumba.
Ukubeka ingxenye ekude ye-clavicle endaweni eguquliwe bese uyilungisa nge-bone plate ohlangothini oluphakathi kuye kwatholakala ukuthi kunikeza ukulingana okwanelisayo.
Esimweni sesiguli sesilisa esineminyaka engu-40 ubudala esiphuke engxenyeni ephakathi ye-clavicle yesokudla, kwasetshenziswa ipuleti lensimbi le-clavicle eliphambene. Ukuhlolwa okulandelayo ngemva kwezinyanga ezingu-12 kokuhlinzwa kwabonisa umphumela omuhle wokuphulukiswa.
Ipuleti lokucindezela i-distal clavicle locking compression (LCP) elisetshenziswa kakhulu ekwelapheni. Inzuzo yale ndlela ukuthi i-medial bone fragment ibanjwe ngezikulufo eziningi, okunikeza i-fixation ephephile. Kodwa-ke, le ndlela yokuqinisa idinga i-medial bone fragment enkulu ngokwanele ukuze kube nemiphumela emihle. Uma i-bone fragment incane noma kukhona i-intra-articular comminution, ukusebenza kahle kwe-fixation kungase kube sengozini.
II. Indlela Yokulungisa Okuqondile Yepuleti Eliphindwe Kabili
Indlela ye-dual plate iyindlela evame ukusetshenziswa kakhulu yokuqhekeka okuyinkimbinkimbi okuhlanganisiwe, njengokuqhekeka kwe-distal humerus, ukuqhekeka okuhlanganisiwe kwe-radius kanye ne-ulna, njalo njalo. Lapho ukulungiswa okuphumelelayo kungenzeki endaweni eyodwa, amapuleti ensimbi avalayo amabili asetshenziselwa ukulungiswa okuqondile, okudala isakhiwo esizinzile se-dual-plane. Ngokwe-biomechanics, ukulungiswa kwe-dual plate kunikeza izinzuzo zemishini ngaphezu kokulungiswa kwepuleti elilodwa.
Ipuleti lokuqinisa elingaphezulu
Ipuleti lokuqinisa elingezansi kanye nezinhlanganisela ezine zokucushwa kwamapuleti amabili
Isikhathi sokuthunyelwe: Juni-12-2023
