Izikhali ezimbili zomlingo ze-trauma orthopedics, ipuleti kanye nezinzipho zangaphakathi. Amapuleti nawo asetshenziswa kakhulu ekuqiniseni kwangaphakathi, kodwa kunezinhlobo eziningi zamapuleti. Nakuba wonke eyingcezu yensimbi, ukusetshenziswa kwawo kungabhekwa njenge-Avalokitesvara ehlomile eyinkulungwane, okuyinto engabikezeleki. Uyazi konke lokhu?
- Ibhendi Yokucindezela
Ingabe ipuleti liyibhande lokucindezela?
Uma ukusebenza kwamathambo athile kushintshelwa ekuqineni okungavamile, ipuleti lensimbi liyibhande lokucindezela, njenge-femur, futhi ipuleti lensimbi kufanele libekwe ohlangothini lokucindezela.
2. Imodi Yokucindezela
Ipuleti elicindezelwe lenziwa ngokufaka isikulufu kukhiye we-slope, ongowesimiso sokushelela okuyindilinga.
Kodwa-ke, ingcindezi izokwenza ingcindezi ephakathi kwepuleti nethambo ibe nkulu kakhulu, futhi ngezinye izikhathi ithinte ukuphulukiswa kwethambo. Ngakho-ke, kusungulwe ipuleti lokucindezela elilinganiselwe elinokuxhumana okuqondile, okuyinto esivame ukuyibiza ngokuthi i-LCP.
Uma ufuna ukucindezela, lapho ubhoboza, udinga ukunaka iqiniso lokuthi ukubhoboza kudingeka kube seduze nohlangothi lwembobo yokhiye (phezulu), futhi ukubhoboza endaweni ephakathi ngeke kube nomthelela wokucindezela ingxenye ephukile (engezansi). Umphumela ungandiswa kuphela cishe ngo-1mm.
- Ipuleti lokukhiya
Ipuleti lokukhiya, okungukuthi, isikulufu kanye nepuleti ngaphambilini kuhlanganiswe ngendlela yokukhiya. Ngokuvamile imbobo yokukhiya kanye nembobo yokucindezela kuyahlanganiswa, kodwa imisebenzi yalokhu okubili ihluke ngokuphelele.
Izikulufo zokukhiya zingakhuphula ngempumelelo amandla okuqina kwangaphakathi, futhi ukumelana kwazo kokudonsa kungcono, ikakhulukazi izikulufo zokukhiya eziqinisa i-engela, okuphawuleka kakhulu yipuleti lokukhiya le-humeral philos eliseduze.
- Imodi Yokungathathi hlangothi
Ipuleti lokungaguquguquki alikhiqizi ukucindezela emaphethelweni okuqhekeka, kodwa liveza umphumela wokuxhuma emaphethelweni okuqhekeka. Ngoba amaphethelo okuqhekeka acindezelwa yizikulufo zokulaxaza, kodwa amandla ezikulufo zokulaxaza ngokumelene namandla okugoba, ukujikeleza, kanye nokusika anqunyelwe, ngakho-ke kudingeka ipuleti lensimbi ukuze kusizwe.
Epuletini lensimbi elingashintshiwe, amandla amakhulu yi-screw yokulaxaza. Uma umugqa wokuqhekeka umkhulu futhi umude, izikulufo zokulaxaza ezingu-2-3 zingasetshenziswa ukudonsa ziqonde ngqo kumugqa wokuqhekeka, bese zisizwa ngokufakwa kwepuleti lokungashintshi.
Amapuleti okungathathi hlangothi asetshenziswa kakhulu ekuqiniseni i-lateral malleolus kanye ne-clavicle.
- Ipuleti le-Buttress
Ungayifaka kanjani i-buttress kwezokwelapha ngamathambo? Ngokuyinhloko ukusetshenziswa kwayo kungokwezimfa ezimelene namandla okusika, abekwe ngendlela yokunyakaza okuhlobene. Ipuleti lensimbi elisekelayo akudingeki libe likhulu kangako uma liqhathaniswa namapuleti ensimbi avamile acindezelwe, futhi akudingeki ligcwaliswe ngezikulufo.
Ipuleti lensimbi kudingeka ligotshwe kusengaphambili, lifakwe izikulufo ze-cortical ngokujika kusuka kude kuya eduze, bese lisebenzisa izikulufo ze-cortical ukunamathisela ipuleti lensimbi. Ngenxa yokugoba kwalo okunwebekayo, ipuleti lensimbi livame ukuqhubeka nokugoba, futhi la mandla asetshenziswa ukwenza umsebenzi we-buttress.
- Ipuleti Lokulwa Nokushelela
Ngemva kokufakwa kwepuleti lensimbi, vimbela ibhulokhi lokuqhekeka ukuthi lingasheleli ngaphandle ngamandla ande. Isetshenziswa kakhulu ekugcineni okude kwe-fibula.
- I-Span Plating noma i-Bridge Plating
Lena inguqulo eguquliwe yepuleti yokungaphazamisi, ehloselwe ukuphuka okuhlanganisiwe kwe-cadre, ngokuqapha kwe-fluoroscopy, ipuleti liwela indawo yokuphuka futhi lilungise iziphetho eziseduze nezikude zokuphuka, futhi indawo yokuphuka ayilungiswanga.
Lolu hlobo lobuchwepheshe lugcizelela kakhulu ukuhambisana, ukuhambisana, ubude, kanye nokujikeleza. Ukuchoboza okuphakathi kungenziwa ngaphandle kokwelashwa, okungavikela ngempumelelo ukuphakelwa kwegazi kwengxenye ephukile yokuqhekeka. Kodwa-ke, kufanele kuqashelwe ukuthi ipuleti lensimbi kumele libe nobude obanele, futhi inani lezikulufu kuzo zombili izinhlangothi kumele futhi lanele. . Njengamanje, ezinye izinhlayiya zamathambo zivame ukwenzeka, okudingeka ziphathwe ngokucophelela.
Isikhathi sokuthunyelwe: Agasti-28-2023
