Kuthyoka kwa bondo lamkati nthawi zambiri kumafuna kuchepetsedwa kwapang'onopang'ono ndi kukonza mkati, kaya ndi screw fixation yokha kapena kuphatikiza mbale ndi zomangira.
Mwachizoloŵezi, fractureyo imakonzedwa kwakanthawi ndi pini ya Kirschner ndiyeno imayikidwa ndi phula lopindika la theka la ulusi, lomwe limatha kuphatikizidwanso ndi gulu lolimba.Akatswiri ena agwiritsa ntchito zomangira zokhala ndi ulusi wokwanira pochiza ming'alu yapakatikati, ndipo mphamvu yake ndiyabwino kuposa zomangira zanthawi zonse zomangika.Komabe, kutalika kwa zingwe zomangira zonse ndi 45 mm, ndipo zimakhazikika mu metaphysis, ndipo ambiri mwa odwala adzakhala ndi ululu pamimba yamkati chifukwa cha kutuluka kwa mkati.
Dr Barnes, wochokera ku Dipatimenti ya Orthopedic Trauma pachipatala cha St Louis University ku USA, amakhulupirira kuti zomangira zopanda mutu zimatha kukonza zowonongeka zamkati zapafupa bwino, kuchepetsa kupweteka kwa mkati, ndi kulimbikitsa machiritso a fracture.Chotsatira chake, Dr Barnes adachita kafukufuku wokhudzana ndi mphamvu ya zomangira zopanda mutu pochiza fractures zamkati zamkati, zomwe zinasindikizidwa posachedwapa Kuvulala.
Phunziroli linaphatikizapo odwala 44 (zaka zapakati pa 45, zaka 18-80) omwe amachiritsidwa chifukwa cha fractures zamkati zamkati ndi zomangira zopanda mutu ku chipatala cha Saint Louis University Hospital pakati pa 2005 ndi 2011. Pambuyo pa opaleshoni, odwala anali osasunthika muzitsulo, zoponyera kapena zomangira mpaka zitakhalapo. umboni woyerekeza wa machiritso a fracture pamaso pa ambulation yolemera.
Zosweka zambiri zidachitika chifukwa chogwa poyimilira ndipo zina zonse zidachitika chifukwa cha ngozi zamoto kapena masewera ndi zina (Table 1).Makumi awiri ndi atatu a iwo anali ndi ma fractures awiri, 14 anali ndi fractures katatu ndipo otsala 7 anali ndi fractures imodzi (Chithunzi 1a).Intraoperatively, odwala 10 anachiritsidwa ndi phula limodzi lopanda mutu lopanda mutu chifukwa cha fractures yapakatikati, pamene odwala 34 otsalawo anali ndi zomangira ziwiri zopanda mutu (Chithunzi 1b).
Gulu 1: Njira zovulaza
Chithunzi 1a: Kuthyoka kwa bondo limodzi;Chithunzi 1b: Kuthyoka kwa bondo limodzi komwe kumathandizidwa ndi 2 zomangira zopanda mutu.
Pakutsata kwapakati kwa masabata a 35 (masabata a 12-208), umboni wojambula wa machiritso a fracture unapezedwa mwa odwala onse.Palibe wodwala amene amafunikira kuchotsa wononga chifukwa cha wononga wononga, ndipo wodwala m'modzi yekha anafunika kuchotsedwa chifukwa cha matenda a MRSA a m'munsi ndi postoperative cellulitis.Kuphatikiza apo, odwala 10 anali ndi vuto pang'ono pa palpation ya bondo lamkati.
Choncho, olembawo adatsimikiza kuti chithandizo cha fractures zamkati zamkati ndi zomangira zopanda mutu zomwe zinapangitsa kuti pakhale machiritso apamwamba a fracture, kuchira bwino kwa minofu, ndi kupweteka kochepa pambuyo pa opaleshoni.
Nthawi yotumiza: Apr-15-2024
