Nzira yekugadzirisa sei kuputsika kwe midshaft clavicle pamwe chete ne ipsilateral acromioclavicular dislocation?

Kutyoka kweclavicle pamwe chete ne ipsilateral acromioclavicular dislocation kukuvara kunowanzoitika muchipatara. Mushure mekukuvara, chidimbu che distal checlavicle chinenge chichifamba zvishoma nezvishoma, uye acromioclavicular dislocation ingave isingaratidzi kusuduruka pachena, zvichiita kuti ive nyore kuongororwa zvisizvo.

Pakukuvara kwerudzi urwu, kune nzira dzakasiyana-siyana dzekuvhiya, dzinosanganisira hook plate refu, musanganiswa weclavicle plate nehook plate, uye clavicle plate pamwe chete ne screw fixation kune coracoid process. Zvisinei, hook plates dzinowanzova pfupi pakureba, izvo zvinogona kukonzera kusakwana kwe fixation kumucheto weproximal. Musanganiswa we clavicle plate nehook plate zvinogona kukonzera kushushikana kwakanyanya panosangana mapfupa, zvichiwedzera njodzi ye refracture.

Kutyoka kwe clavicle yekuruboshwe pamwe chete nekutyoka kwe ipsilateral acromioclavicular, kugadzikaniswa uchishandisa musanganiswa we hook plate ne clavicle plate.

Mukupindura izvi, vamwe vaongorori vakapa nzira yekushandisa musanganiswa we clavicle plate ne anchor screws kuti zvigadzike. Muenzaniso unoratidzwa mumufananidzo unotevera, unoratidza murwere ane midshaft clavicle breakage pamwe chete ne ipsilateral type IV acromioclavicular joint dislocation:

Kutanga, ndiro yeclavicular anatomical inoshandiswa kugadzirisa kutyoka kweclavicle. Mushure mekuderedza acromioclavicular joint yakabviswa, masikuru maviri esimbi anopinzwa mu coracoid process. Masikuru akabatanidzwa kumasikuru eanchor anobva aiswa nepakati pemaburi e clavicle plate, uye mapfundo anosungwa kuti asimbiswe pamberi nepashure pe clavicle. Pakupedzisira, masikuru e acromioclavicular ne coracoclavicular anosundwa zvakananga uchishandisa masikuru.

Kutyoka kweclavicle yakapatsanurwa kana kutyoka kweacromioclavicular kwakasarudzika kukuvara kwakajairika mukiriniki. Kutyoka kweclavicle kunokonzera 2.6%-4% yekutyoka kwese, nepo kutyoka kweacromioclavicular kuchiita 12%-35% yekukuvara kwescapular. Zvisinei, kusanganiswa kwekukuvara kwese kuri kushoma. Mazhinji emabhuku aripo ane mishumo yezviitiko. Kushandiswa kweTightRope system pamwe chete ne clavicle plate fixation kungave nzira itsva, asi kuiswa kweclavicle plate kunogona kukanganisa kuiswa kweTightRope graft, zvichikonzera dambudziko rinofanira kugadziriswa.

Uyezve, kana kukuvara kwakabatana kusingakwanise kuongororwa usati wavhiyiwa, zvinokurudzirwa kuti uongorore kugara wakagadzikana kwejoini re acromioclavicular panguva yekuongorora kutyoka kwe clavicle. Iyi nzira inobatsira kudzivirira kutarisa kukuvara kwakabatana panguva imwe chete.