1.indications
1).
2) Kuchepetsa kwa pamanja kwalephera kapena kukonzekera kwakunja kwalephera kupitiriza kuchepetsa.
3).
4) mphuno. Mphepo Ili Panyumba ndi Kwina
2.Contraindications
Okalamba odwala omwe sioyenera kuchitidwa opaleshoni.
3.. Njira yopangira opaleshoni yakunja
1.
Malo Okonzekera:
Clebilial clexus enesthesia
Udindo wokhala ndi miyendo yomwe yakhudzidwa ndi mawonekedwe owonera pafupi ndi bedi
· Fustiness TOATETER ku 1/3 ya mkono wapamwamba
Kuwongolera Kupaleshoni
Njira Ya Opaleshoni
Kuyika kwa metacarpal screw:
Cholinga choyambirira chili m'munsi mwa fupa lachiwiri la metacarpal. Kukhazikika pakhungu kumapangidwa pakati pa chala chowonjezera cha chala cholozera ndi minofu yopanga mafupa oyamba. Minofu yofewa imasiyanitsidwa pang'ono ndi zopangira opaleshoni. Manja amateteza minofu yofewa, ndipo schanz ya 3mmm schanz imayikidwa. Zomangira
Malangizo a screw ndi 45 ° ku ndege ya kanjedza, kapena imatha kufanana ndi ndege ya kanjedza.
Gwiritsani ntchito chitsogozo choti musankhe malo achiwiri. Cholinga chachiwiri cha 3mmmm chimaperekedwa mu metacarpal wachiwiri.
Dongosolo la pini la metacarpals yosayenera liyenera kupitirira 3mm. Pini yosintha ili mu proximal 1/3. Kwa odwala omwe ali ndi mafupa ambiri, chomata kwambiri chimatha kulowa ma zigawo zitatu za cortex (fupa lachiwiri la metacarpal ndi theka la fupa lachitatu la metacarpal). Mwanjira imeneyi, screw mkono wokhazikika ndi furque yayikulu ikuwonjezera kukhazikika kwa pini yokonzekera.
Kuyika kwa zomata za radial:
Pangani khungu la m'mphepete mwa radius, pakati pa minofu ya brachioradials ndi ma encorr cartis chingwe cholumikizira cha mkono, ndikugwiritsa ntchito hefanele yolekanitsa minyewa yamtunda. Chisamaliro chimasungidwa kuti chiteteze nthambi zapamwamba za mitsempha yamasewera omwe ali m'derali.
Pa ndege yomweyo monga zomangira za metacarpal, zomangira ziwiri za 3mmm
· .Ffer reyection ndi kukonza:
Chithandizo cha chipongwe cha C-Arm fluoroscopy kuti muwone kuchepetsa kuwonongeka kwa kuwonongeka.
Kuphatikizika kwapakati pa dzanja lonse kumapangitsa kuti zikhale zovuta kubwezeretsanso makona a Palmar, kotero imatha kuphatikizidwa ndi kapandji kukathandizira kuchepetsa ndi kukonza.
Cifukwa · .For odwala omwe ali ndi zotupa za · mwinjiro wa rayloid, radial styloid masitere amatha kugwiritsidwa ntchito.
.Omwe akusungabe kuchepetsedwa, kulumikiza mawonekedwe a kunja ndikuyika malo osinthira a rectotor wakunja komwe kumachitika.
.
. Samalani ndi mawonekedwe a dziko la Woyang'anira, zomwe zimapangitsa iitrogenic zonunkhira za metacarpal.
Kugawa Radius Vunius Kuphatikizidwa ndi Ma Radial Radilnar Jount (Druj) Kupatukana:
Ma Drujs a Drujs amatha kuchepetsedwa zokha pakachepetsa radius yogawa.
Chidziwikire kuti Druj adasiyanitsidwabe pambuyo poti radius yogaya imachepetsedwa, gwiritsani ntchito makina osokoneza bongo ndikugwiritsa ntchito chingwe chakunja cha bulangeti yakunja.
· .Cor gwiritsani ntchito k-ma waya kuti alowetse arr mu osalowerera ndale kapena pang'ono.
Kuwonongeka kwa radius wowonjezera wophatikizidwa ndi ulnar styloid fractures: Onani kukhazikika kwa katchulidwe ka Druj mu Utchuri, osalowerera ndi kuthana ndi dzanja. Ngati kukhazikikako kumakhalapo, kuthandizidwa ndi mawaya a Kerchchner, kukonza kwa TFCC Vomere, kapena kusamvana kungagwiritsidwe ntchito pokonzekera ulnar stynar styloid njira.
Pewani Kukoka Kwambiri:
CHEKE ngati zala za wodwalayo zimatha kuchita zonse zosinthika popanda kusokonezeka; Fananizani malo olumikizira a radiololung ndi malo ophatikizika a Midcarpal.
Cheka ngati khungu pa msomali ndi lolimba kwambiri. Ngati zili zolimba kwambiri, pangani chidwi choyenera kuti mupewe matenda.
Odwala kusamukira zala zawo molawirira, makamaka kusinthana ndi kuwonjezera kwa metacarpophalaal zolumikizira zala zala, kusinthasintha kwa chala, ndi kubuka.
2. Kukonzekera kwa ma radius osokoneza bongo omwe sakuyang'ana kunja:
Udindo ndi kukonzekera: chimodzimodzi monga kale.
Njira Zopangira Opaleshoni:
Madera otetezeka a K-waya kumbali ya radius ya distal ndi awa: mbali zonse ziwiri za tubercle, mbali zonse ziwiri za onjezerani ma tendon.
Momwemonso, zomangira ziwiri za schanz zidayikidwa mu shaft ya radial ndikulumikizana ndi ndodo yolumikiza.
Kudzera mu malo otetezeka, zomangira ziwiri za schanz zidayikidwa mu chidutswa cha stall radius, imodzi kuchokera kumbali ya raineal ndi imodzi kuchokera kumbali ya dorsal, yokhala ndi 60 ° mpaka 90 ° mpaka 90 °. Cholinga chake chikuyenera kugwira corteleti, ndipo ziyenera kudziwitsidwa kuti nsonga ya Screed Sturter siyidutsa mu sigmoid notch ndikuyika cholumikizira cha Radioulnar.
Phatikizani schanz screw pa showe ya distal ndi cholumikizira chopindika.
Gwiritsani ntchito ndodo yapakati yolumikizira kuti mulumikizane ndi zigawo ziwiri zosweka, ndipo samalani kuti musatseke chuck kwakanthawi. Mothandizidwa ndi ulalo wapakati, chidutswa chofatsa chimachepetsedwa.
Pambuyo pokonzanso, tsekani chubu pa ndodo yolumikizira kuti mumalize komalizakukonza.
Kusiyana pakati pa osagwirizana ndi Span
Chifukwa zomangira zingapo za schanz zitha kuyikidwa kuti mumalize kuchepetsedwa ndi zidutswa za mafupa, zojambula zopangira zakunja zomwe sizigwirizana ndi zokongoletsera zakunja ndizopambana kuposa zomwe zimayambitsa kunja. Kuphatikiza pa zowonjezera zowonjezera, zimatha kugwiritsidwanso ntchito kwachiwiri kwachitatu. Kusokonekera pang'ono.
Wokondedwa wakunja wolumikizana umakonza cholumikizira cha mkono ndipo samaloleza zolimbitsa thupi zoyambirira, pomwe omwe sakuyenda molumikizana ndi omwe sakuyenda molowera amalola kuchita masewera olimbitsa thupi ochita masewera olimbitsa thupi.
Post Nthawi: Sep-12-2023
