Kusweka kwa clavicle ndi chimodzi mwa zosweka zomwe zimafala kwambiri, zomwe zimapangitsa kuti 2.6%-4% ya zosweka zonse zichitike. Chifukwa cha mawonekedwe a pakatikati pa clavicle, kusweka kwa midshaft kumakhala kofala kwambiri, komwe kumabweretsa 69% ya zosweka za clavicle, pomwe kusweka kwa mbali ndi mbali zapakati za clavicle kumakhala 28% ndi 3% motsatana.
Popeza ndi mtundu wosowa kwambiri wa kusweka kwa mafupa, mosiyana ndi kusweka kwa clavicle ya midshaft komwe kumachitika chifukwa cha kuvulala kwa phewa mwachindunji kapena kufalikira kwa mphamvu kuchokera ku kuvulala kwa miyendo yakumtunda komwe kumanyamula kulemera, kusweka kwa gawo lapakati la clavicle nthawi zambiri kumagwirizanitsidwa ndi kuvulala kangapo. Kale, njira yochizira kusweka kwa gawo lapakati la clavicle nthawi zambiri imakhala yosamala. Komabe, kafukufuku wasonyeza kuti 14% ya odwala omwe ali ndi kusweka kwa mafupa apakati amatha kukhala ndi zizindikiro zosagwirizana. Chifukwa chake, m'zaka zaposachedwa, akatswiri ambiri akhala akugwiritsa ntchito njira yochizira kusweka kwa mafupa apakati omwe amakhudza cholumikizira cha sternoclavicular. Komabe, zidutswa za clavicle yapakati nthawi zambiri zimakhala zazing'ono, ndipo pali zoletsa pakukhazikika pogwiritsa ntchito mbale ndi zomangira. Kupsinjika kwa m'deralo kumakhalabe vuto lalikulu kwa madokotala a mafupa pankhani yokhazikitsa bwino kusweka ndikupewa kulephera kwa kukhazikika.
I.Distal Clavicle LCP Inversion
Mapeto akutali a clavicle ali ndi kapangidwe kofanana ka thupi ndi mapeto apafupi, onse ali ndi maziko otakata. Mapeto akutali a clavicle locking compression plate (LCP) ali ndi mabowo angapo otsekera, zomwe zimathandiza kuti chidutswa chakutali chikhazikike bwino.
Poganizira kufanana kwa kapangidwe kake pakati pa awiriwa, akatswiri ena aika mbale yachitsulo mopingasa pa ngodya ya 180° kumapeto kwa clavicle. Afupikitsanso gawo lomwe poyamba linkagwiritsidwa ntchito kukhazikika kumapeto kwa clavicle ndipo apeza kuti choyikamo chamkati chimakwanira bwino popanda kufunikira kupangidwa.
Kuyika mbali yakutali ya clavicle pamalo ozungulira ndikuyikonza ndi mbale ya fupa kumbali yapakati kwapezeka kuti kumapereka chikugwirizana bwino.
Pankhani ya wodwala wamwamuna wazaka 40 yemwe wasweka kumapeto kwa clavicle yakumanja, mbale yachitsulo yozungulira ya clavicle inagwiritsidwa ntchito. Kuwunikanso kotsatira patatha miyezi 12 kuchokera pamene opaleshoniyo inachitika kunasonyeza kuti wodwalayo wachira bwino.
Inverted distal clavicle locking compression plate (LCP) ndi njira yodziwika bwino yolumikizira mkati mwa thupi. Ubwino wa njira iyi ndikuti gawo la fupa la medial limagwiridwa ndi zomangira zingapo, zomwe zimapangitsa kuti likhale lolimba kwambiri. Komabe, njira yolumikizira iyi imafuna gawo lalikulu la fupa la medial kuti lipeze zotsatira zabwino. Ngati gawo la fupa ndi laling'ono kapena pali intra-articular comminution, mphamvu yolumikizira ikhoza kuchepetsedwa.
II. Njira Yokonzera Mapepala Awiri Oyimirira
Njira ya dual plate ndi njira yomwe imagwiritsidwa ntchito kwambiri pokonza ma fracture ovuta, monga ma fracture a distal humerus, ma fracture a fracture a radius ndi ulna, ndi zina zotero. Pamene ma fracture ogwira ntchito sangathe kuchitika mu plane imodzi, ma dual locking steel plates amagwiritsidwa ntchito pokonza ma vertical, ndikupanga kapangidwe kokhazikika ka dual-plane. Pa biomechanically, ma dual plate fixation amapereka ubwino wa makina kuposa ma single plate fixation.
Mbale yokhazikika pamwamba
Mbale yokhazikika pansi ndi kuphatikiza zinayi kwa makonzedwe awiri a mbale
Nthawi yotumizira: Juni-12-2023
