Izindaba - Izindlela zokulungisa zangaphakathi zokuphuka komkhawulo omaphakathi we-clavicle

I-Clavicle fracture ingenye yezifo ezivame kakhulu, ezibalelwa ku-2.6% -4% yazo zonke iziqephu.Ngenxa yezici ze-anatomical ze-midshaft ye-clavicle, ukuphuka kwe-midshaft kuvame kakhulu, kubala i-69% ye-clavicle fractures, kuyilapho ukuphuka kwe-lateral ne-medial ekupheleni kwe-akhawunti ye-clavicle ku-28% no-3% ngokulandelanayo.

Njengohlobo olungavamile lokuphuka, ngokungafani ne-midshaft clavicle fractures ebangelwa ukuhlukumezeka okuqondile kwehlombe noma ukudluliselwa kwamandla kusuka ekulimazeni okuthwala isisindo somzimba ophezulu, ukuphuka kokuphela kwe-clavicle okuphakathi kuvame ukuhlotshaniswa nokulimala okuningi.Esikhathini esedlule, indlela yokwelapha yokuphuka kwengxenye emaphakathi ye-clavicle ngokuvamile ibilokhu ilondoloza.Kodwa-ke, ucwaningo luye lwabonisa ukuthi i-14% yeziguli ezine-fractures ezisusiwe zokuphela kwe-medial zingase zithole ukungabonakali kwezimpawu.Ngakho-ke, eminyakeni yamuva nje, izazi eziningi ziye zancika ekwelashweni kokuhlinzwa ngenxa yokuqhekeka kwengxenye ephakathi nendawo okubandakanya ijoyinti ye-sternoclavicular.Kodwa-ke, izingcezu ze-clavicular ezimaphakathi ngokuvamile zincane, futhi kunemikhawulo yokulungiswa usebenzisa amapuleti nezikulufu.Ukugxiliswa kwengcindezi yendawo kuhlala kuyinselele kodokotela abahlinzayo bamathambo mayelana nokusimamisa ngempumelelo ukuphuka nokugwema ukwehluleka ukulungisa.

Ukuguqulwa kwe-I.Distal Clavicle LCP
I-distal end ye-clavicle yabelana ngezakhiwo ezifanayo ze-anatomical nge-proximal end, zombili zinesisekelo esibanzi.I-distal end ye-clavicle locking compression plate (LCP) ifakwe izimbobo zokukhiya eziningi, okuvumela ukulungiswa okusebenzayo kwe-distal fragment.

Ngokucabangela ukufana kwesakhiwo phakathi kwalokhu okubili, ezinye izazi ziye zabeka ipuleti lensimbi ngokuvundlile ku-engeli engu-180° ekugcineni kwe-clavicle.Baphinde bafinyeza ingxenye eyasetshenziswa ekuqaleni ukuzinzisa ukuphela kwe-distal ye-clavicle futhi bathola ukuthi ukufakelwa kwangaphakathi kufanelana kahle ngaphandle kwesidingo sokubunjwa.

Ukubeka i-distal end ye-clavicle endaweni ehlanekezelwe nokuyilungisa ngepuleti lethambo ohlangothini olumaphakathi kutholwe kunikeza ukulingana okwanelisayo.
Izindlela zokulungisa zangaphakathi 5

Endabeni yesiguli wesilisa esineminyaka engu-40 esine-fracture ekupheleni kwe-medial ye-clavicle yesokudla, i-distal clavicle steel plate inverted yasetshenziswa.Ukuhlolwa kokulandelela ezinyangeni ezingu-12 ngemva kokuhlinzwa kwabonisa umphumela omuhle wokuphulukisa.

I-Distal clavicle locking compression plate (LCP) eguquliwe iyindlela evame ukusetshenziswa yangaphakathi yokulungisa emisebenzini yomtholampilo.Inzuzo yale ndlela yukuthi isiqephu samathambo esiphakathi sibanjwe izikulufu eziningi, sinikeza ukulungiswa okuphephile.Kodwa-ke, le ndlela yokulungisa idinga ucezu lwamathambo aphakathi nendawo ukuze kube nemiphumela emihle.Uma ucezu lwethambo luncane noma kukhona ukuqhutshwa kwe-intra-articular, ukusebenza kahle kokulungiswa kungase kube sengozini.

II.I-Dual Plate Vertical Fixation Technique
Inqubo yepuleti elikabili iyindlela evame ukusetshenziswa yokuqhekeka okuyinkimbinkimbi, njengokuphuka kwe-distal humerus, ukuphuka okuhlangene kwe-radius ne-ulna, njalonjalo.Lapho ukulungiswa okusebenzayo kungenakufinyelelwa endizeni eyodwa, amapuleti ensimbi okukhiya okubili asetshenziselwa ukulungiswa okuqondile, okwenza isakhiwo esizinzile sezindiza ezimbili.Ngokwe-Biomechanical, ukulungiswa kwamapuleti amabili kunikeza izinzuzo zemishini ngaphezu kokulungiswa kwepuleti elilodwa.