Kusweka kwa clavicle ndi chimodzi mwa kusweka kwa miyendo ya pamwamba komwe kumachitika kawirikawiri m'chipatala, ndipo 82% ya kusweka kwa clavicle ndi kusweka kwa midshaft. Kusweka kwa clavicle komwe sikunasunthike kwambiri kumatha kuchiritsidwa mosamala ndi mabandeji asanu ndi atatu, pomwe omwe ali ndi kusunthika kwakukulu, minofu yofewa yolumikizidwa, chiopsezo cha kuwonongeka kwa mitsempha kapena mitsempha, kapena kufunikira kwakukulu kwa ntchito kungafunike kukhazikika mkati ndi mbale. Kuchuluka kwa kusagwirizana pambuyo pa kusweka kwa clavicle mkati kumakhala kotsika, pafupifupi 2.6%. Kusagwirizana kwa zizindikiro nthawi zambiri kumafuna opaleshoni yokonzanso, ndipo njira yayikulu ndi kulumikiza mafupa pamodzi ndi kukhazikika mkati. Komabe, kuthana ndi kusagwirizana komwe kumabwera mobwerezabwereza mwa odwala omwe adasinthidwa kale kusagwirizana ndizovuta kwambiri ndipo kumakhalabe vuto kwa madokotala ndi odwala.
Pofuna kuthetsa vutoli, pulofesa ku Xi'an Red Cross Hospital anagwiritsa ntchito mwaluso njira yatsopano yopangira mafupa a iliac pamodzi ndi njira yopangira mafupa a autologous cancellous kuti athetse kusweka kwa mafupa a clavicle pambuyo pa opaleshoni yokonzanso yomwe inalephera, zomwe zinapangitsa kuti zotsatira zake zikhale zabwino. Zotsatira za kafukufukuyu zinasindikizidwa mu magazini ya "International Orthopaedics".
Njira yochitira opaleshoni
Njira zenizeni zochitira opaleshoni zitha kufotokozedwa mwachidule monga chithunzi pansipa:
a: Chotsani chomangira choyambirira cha clavicular, chotsani fupa la sclerotic ndi chilonda cha ulusi kumapeto kwa kusweka;
b: Ma pulasitiki omangiranso clavicle anagwiritsidwa ntchito, zomangira zokhoma zinalowetsedwa kumapeto amkati ndi akunja kuti clavicle ikhale yolimba, ndipo zomangira sizinakhazikitsidwe pamalopo kuti zigwiritsidwe ntchito kumapeto kwa clavicle komwe kwasweka.
c: Mukamaliza kuyika mbale, bowolani mabowo ndi singano ya Kirschler kumapeto kwa fupa losweka mpaka mkati ndi kunja kwa dzenjelo litatulutsa magazi (chizindikiro cha tsabola wofiira), kusonyeza kuti magazi a m'mafupa ali bwino;
d: Pa nthawiyi, pitirizani kuboola 5mm mkati ndi kunja, ndikuboola mabowo aatali kumbuyo, zomwe zingathandize pa osteotomy yotsatira;
e: Pambuyo pa opaleshoni ya mafupa (osteotomy) m'bowo loyambirira, sunthani fupa la pansi kuti musiye fupa;
f: Fupa la Bicortical iliac linaikidwa mu fupa, kenako cortex yapamwamba, iliac crest ndi lower cortex zinakhazikika ndi zomangira; Fupa la iliac cancellous linayikidwa mu malo osweka.
Zachizolowezi
milandu:
▲ Wodwalayo anali mwamuna wazaka 42 yemwe anali ndi kusweka kwa clavicle yakumanzere pakati pa gawo chifukwa cha kuvulala (a); Pambuyo pa opaleshoni (b); Kusweka ndi kusalumikizana kwa fupa mkati mwa miyezi 8 pambuyo pa opaleshoni (c); Pambuyo pa kukonzanso koyamba (d); Kusweka kwa mbale yachitsulo miyezi 7 pambuyo pa kukonzanso ndi kusachira (e); Kusweka kunachira (h, i) pambuyo pa kulumikizidwa kwa mafupa (f, g) a ilium cortex.
Mu kafukufuku wa wolembayo, milandu yonse 12 ya kusalumikizana kwa mafupa osagwirizana inaphatikizidwa, yonse yomwe inachira mafupa pambuyo pa opaleshoni, ndipo odwala awiri anali ndi mavuto, mlandu umodzi wa thrombosis ya mitsempha ya m'mimba ya calf ndi mlandu umodzi wa ululu wochotsa mafupa a iliac.
Kusagwirizana kwa clavicular ndi vuto lovuta kwambiri pakuchita opaleshoni, zomwe zimabweretsa mavuto aakulu amisala kwa odwala ndi madokotala. Njirayi, kuphatikiza ndi kulumikiza mafupa a cortical bone ya ilium ndi kulumikiza mafupa a cancellous, yapeza zotsatira zabwino pakuchiritsa mafupa, ndipo kugwira ntchito kwake ndi kolondola, komwe kungagwiritsidwe ntchito ngati chitsogozo kwa asing'anga.
Nthawi yotumizira: Mar-23-2024
