Momwe mungakhazikitsire kuphulika kwapakati pa clavicle kuphatikiza ndi ipsilateral acromioclavicular dislocation?

Kuthyoka kwa clavicle pamodzi ndi ipsilateral acromioclavicular dislocation ndi kuvulala kosowa kwambiri muzochitika zachipatala.Pambuyo pa kuvulala, chidutswa cha distal cha clavicle chimakhala chosuntha, ndipo kusuntha kwa acromioclavicular komwe kumayenderana sikungasonyeze kusamuka kwawo, zomwe zimapangitsa kuti anthu asamadziwe bwino.

Pakuvulala kwamtunduwu, pali njira zingapo zopangira opaleshoni, kuphatikiza mbale yayitali ya mbedza, kuphatikiza kwa mbale ya clavicle ndi mbale ya mbedza, ndi mbale ya clavicle yophatikizika ndi screw fixation ku coracoid.Komabe, mbale za hook zimakonda kukhala zazifupi kutalika konse, zomwe zingayambitse kusakwanira kokwanira kumapeto kwa proximal.Kuphatikizika kwa mbale ya clavicle ndi mbale ya hook kungayambitse kupsinjika pamphambano, ndikuwonjezera chiopsezo cha refracture.

Kuthyoka kwa clavicle yakumanzere kuphatikiza ndi ipsilateral acromioclavicular dislocation, kukhazikika pogwiritsa ntchito kuphatikiza mbale ya mbedza ndi mbale ya clavicle.

Poyankha izi, akatswiri ena apereka njira yogwiritsira ntchito kaphatikizidwe ka mbale ya clavicle ndi zomangira za nangula pofuna kukonza.Chitsanzo chikuwonetsedwa pachithunzi chotsatirachi, chosonyeza wodwala wothyoka pakati pa shaft clavicle kuphatikiza ndi ipsilateral type IV acromioclavicular joint dislocation:

Choyamba, mbale ya clavicular anatomical imagwiritsidwa ntchito kukonza fracture ya clavicle.Pambuyo pochepetsa cholumikizira cha acromioclavicular chosunthika, zomangira ziwiri zachitsulo zachitsulo zimayikidwa munjira ya coracoid.Zomangira zomata zomangira za nangula zimamangidwa kupyola m'mabowo a kravicle mbale, ndipo mfundo zimamangidwa kuti zitetezedwe kutsogolo ndi kumbuyo kwa clavicle.Pomaliza, mitsempha ya acromioclavicular ndi coracoclavicular imapangidwa mwachindunji pogwiritsa ntchito sutures.

Isolated clavicle fractures kapena isolated acromioclavicular dislocations ndizovulala zofala kwambiri pazachipatala.Kuphulika kwa Clavicle kumapanga 2.6% -4% ya fractures zonse, pamene acromioclavicular dislocations amapanga 12% -35% ya kuvulala kwa scapular.Komabe, kuphatikiza kwa kuvulala konseko kumakhala kosowa.Zambiri mwazolemba zomwe zilipo zili ndi malipoti amilandu.Kugwiritsiridwa ntchito kwa TightRope system molumikizana ndi clavicle plate fixation kungakhale njira yatsopano, koma kuyika kwa mbale ya clavicle kumatha kusokoneza kuyika kwa TightRope graft, kubweretsa vuto lomwe liyenera kuthana nalo.

Komanso, ngati kuvulala kophatikizana sikungawunikidwe kale, tikulimbikitsidwa kuti nthawi zonse tiziyesa kukhazikika kwa mgwirizano wa acromioclavicular pakuwunika kwa fractures ya clavicle.Njira iyi imathandizira kuti musayang'anire kuvulala komwe kumachitika nthawi imodzi.