Njira Yopangira Opaleshoni | “Njira Yogwiritsira Ntchito Ma Waya a Kirschner” Yothandizira Kukonza Mkati mwa Msana Pochiza Kusweka kwa Bennett

Kusweka kwa Bennett kumabweretsa 1.4% ya kusweka kwa manja. Mosiyana ndi kusweka wamba kwa maziko a mafupa a metacarpal, kusuntha kwa kusweka kwa Bennett ndi kwapadera kwambiri. Chidutswa cha pamwamba cha proximal articular chimasungidwa pamalo ake oyamba chifukwa cha kukoka kwa ligament ya oblique metacarpal, pomwe chidutswa cha distal, chifukwa cha kukoka kwa abductor pollicis longus ndi adductor pollicis tendons, chimasweka dorsoradially ndi supinates.

Pa mabala a Bennett omwe achotsedwa, chithandizo cha opaleshoni nthawi zambiri chimalimbikitsidwa kuti chisasokoneze kulumikizana kwa cholumikizira cha carpometacarpal ndi chala chachikulu. Ponena za njira zochizira opaleshoni, makina olumikizira mbale ndi zomangira, komanso Kirschner wire internal fixation, amagwiritsidwa ntchito kwambiri muzochita zachipatala. Akatswiri ochokera ku Chipatala Chachitatu cha Hebei apereka njira yolumikizira waya ya Kirschner, yomwe imaphatikizapo kudula pang'ono pang'ono kuti akonze mabala a Bennett, zomwe zimapangitsa kuti zotsatira zake zikhale zabwino.

Gawo 1: Pangani chocheka cha 1.3 cm mbali ya radial ya cholumikizira cha carpometacarpal, dulani gawo ndi gawo kuti muwone malowo, bweretsani abductor pollicis longus kumbali ya ulnar, ndikuwulula mbali ya dorsal ya cholumikizira cha carpometacarpal.

Gawo 2: Ikani chingwe chokokera ndi manja ndikutulutsa chala chachikulu kuti muchepetse kusweka. Ikani waya wa Kirschner wa 1 mm kudzera kumapeto kwa kusweka kwakutali, mtunda wa 1-1.5 cm kuchokera pa cholumikizira cha carpometacarpal, kuti mukonze chidutswa cha fupa chapafupi. Waya wa Kirschner akalowa mu chidutswa cha fupa, pitirizani kuchipititsa patsogolo ndi 1 cm.

Gawo 3: Tengani waya ndikuuzungulira mozungulira mbali zonse ziwiri za waya wa Kirschner, kenako uukhazikitse pamalo ake.

Njira ya Kirschner wire tension band yagwiritsidwa ntchito m'mafupa ambiri osweka, koma pa mabala a Bennett, kudulako pang'ono nthawi zambiri kumapangitsa kuti munthu asaone bwino ndipo kumapangitsa kuti njirayi ikhale yovuta. Kuphatikiza apo, ngati kuswekako kwachotsedwa, waya umodzi wa Kirschner sungakhazikitse bwino chidutswa cha fupa chapafupi. Kugwiritsa ntchito kwake kuchipatala kungakhale kochepa. Kupatula njira yokhazikitsira tension band yomwe yatchulidwa pamwambapa, palinso Kirschner wire fixation pamodzi ndi njira yokhazikitsira tension band, yomwe yanenedwanso m'mabuku.