Clavicle fractures ndeimwe yeanowanzo tyoka nhengo dzepamusoro mukiriniki, uye 82% yeclavicle fractures iri midshaft fractures.Zvizhinji zveclavicle fractures pasina kutama kwakakosha kunogona kurapwa zvakachengetedzeka nenhamba-ye-esere mabhandeji, nepo avo vane kutama kukuru, interposed zvinyoro zvinyoro, njodzi yevascular kana neurological compromise, kana yakakwirira kushanda zvinodiwa zvingada kugadziriswa kwemukati nemaplate.Chiyero chisingaiti mushure mekugadzirisa mukati me clavicle fractures yakaderera, inenge 2.6%.Symptomatic nonunion dzinowanzoda kuvhiyiwa kudzokorora, uye nzira yakajairika iri cancellous bone grafting yakasanganiswa nemukati mekugadzirisa.Nekudaro, kubata anodzokororwa atrophic nonunion muvarwere vakatove nenonnunion revision yakaoma zvakanyanya uye inoramba iri dambudziko kune vese vanachiremba nevarwere.
Kugadzirisa nyaya iyi, mumwe purofesa paXi'an Red Cross Hospital akashandisa autologous iliac bone structural grafting yakasanganiswa ne autologous cancellous bone grafting kurapa kusawirirana kweclavicle fractures zvichitevera kutadza kuvhiyiwa kwekudzokorora, zvichiwana mhedzisiro yakanaka.Mhedzisiro dzekutsvaga dzakaburitswa mujenari "International Orthopedics".
Kuvhiya nzira
Iwo chaiwo ekuvhiya maitiro anogona kupfupikiswa semufananidzo pazasi:
a: Bvisa iyo yepakutanga clavicular fixation, bvisa sclerotic bone uye fiber scar pamucheto wakaputsika wekuputsika;
b: Plastic clavicle reconstruction plates yakashandiswa, zvivharo zvekuvhara zvakaiswa mukati memukati nekunze kwekunze kuchengetedza kugadzikana kwese kwe clavicle, uye zviputi hazvina kugadziriswa munzvimbo iyo inobatwa pamucheto wakaputsika we clavicle.
c: Mushure mekugadzirisa ndiro, chera maburi neKirschler tsono pamwe chete nemagumo akaputsika ekuputsika kusvika mukati nekunze kusvikira gomba rabuda ropa (chiratidzo chemhiripiri tsvuku), zvichiratidza kutakurwa kweropa remapfupa pano;
d: Panguva ino, ramba uchichera 5mm mukati nekunze, uye ugochera makomba akareba kumashure, iyo inobatsira kune inotevera osteotomy;
e: Mushure me osteotomy pamwe negomba rekutanga rekuchera, fambisa rezasi bhonzo cortex pasi kuti usiye bhonzo dhiri;
f: Bicortical iliac bone yakaiswa mubhonzo groove, uye ipapo iyo yepamusoro cortex, iyo iliac crest uye yakaderera cortex yakagadziriswa ne screws;Iyo iliac cancellous bone yakaiswa munzvimbo yekutyoka
Typical
nyaya:
▲ Murwere aiva murume ane makore 42 ane chikamu chepakati chekuputsika kwechiruboshwe che clavicle chinokonzerwa nekushungurudzika (a);Mushure mekuvhiyiwa (b);Yakagadziriswa kuputsika uye pfupa isiri-mubatanidzwa mukati memwedzi ye8 mushure mekuvhiyiwa (c);Mushure mekugadzirisa kwekutanga (d);Kuputsika kwesimbi ndiro 7 mwedzi mushure mekugadzirisa uye kusaporesa (e);Kutyoka kwakaporeswa (h, i) mushure mekugadzirwa kwebhonzo (f, g) yeilium cortex.
Muchidzidzo chemunyori, zvikamu zve 12 zverefractory bone nonunion zvakabatanidzwa, izvo zvose zvakawana kuporesa kwepfupa mushure mekuvhiyiwa, uye varwere ve2 vaiva nezvinetso, 1 nyaya yemhuru intermuscular vein thrombosis uye 1 nyaya ye iliac bone kubvisa kurwadziwa.
Refractory clavicular nonunion idambudziko rakaoma kwazvo mukuita kwekiriniki, izvo zvinounza mutoro unorema wepfungwa kune vese varwere uye vanachiremba.Iyi nzira, yakasanganiswa nekugadzirwa kwepfupa kusungirirwa kwe cortical bone yeilium uye kubvisa pfupa rekugadzirisa, yakawana mhedzisiro yakanaka yekuporesa kwemapfupa, uye kushanda kwacho kwakarurama, izvo zvinogona kushandiswa sechirevo kune varapi.
Nguva yekutumira: Mar-23-2024
