Iyo inogamuchirika maitiro ekurapa kwehuwandu hwehukama hwekupwanya hurefu hwekutambanudzwa-posterness of isingasviki makumi matatu Mumakore achangopfuura, nekuwedzera kwekuwedzera kwebasa rekumusoro uye nekutanga kupora muhupenyu hwezuva nezuva, kurapwa kwekuvhiya kwehukama hwehukama hwehukama hwakawedzera. Nzira dzekunakidzwa dzinosanganisira anterior, anteerolateral, kana posterior plater yekugadzirira yemukati yekugadziriswa, pamwe nemukati memukati. Zvidzidzo zvinoratidza kuti iyo isingaziveye chiyero chekudzikiswa kwekutanga kwemukati mafambiro ehukama anenge
Kuti udzivise iatrogenic radial nerve kukuvara uye kuderedza iyo nhamba yekuvhurika yekudzora, ichishandisa iyo nzira yeMippo yekugadzirisa humitera vhesi, uye yakawana mibairo yakanaka.
Maitiro ekuvhiya
Nhanho yekutanga: Positioning. Murwere ari munharaunda ye supine, aine ruoko rwakakanganisika rwakatora madhigirii makumi mapfumbamwe uye vakaiswa pane imwe nguva inotevera yekushandisa.
Nhanho yechipiri: Kuvhiya kwekuvhenekera. Mumufananidzo wechiitiko imwe chete-plate-plate fixation (Kanganai) kune varwere, maviri mitezo mitezo miviri ye3cm imwe neimwe yakaitwa padhuze neyekupedzisira. Iyo proximal incision inoshanda semukova wekusvika
▲ Schematic Diagram yeiyo Proximal Incision.
①: Kuvhiya kwekuvhenekesa; ②: cephalic vein; ③: pectoreralis mikuru; ④: Deltoid tsandanyama.
▲ Schematic dhizaini yeiyo distal incision.
①: Medhia nerve; ②: Ulnar nerve; ③: Brachialis muswe; ④: Kuvhiya kwekuvhenekera.
Nhanho yechitatu: Plate Kuisa uye Kugadziriswa. Iyo ndiro yakaiswa kuburikidza neiyo proximal incision, snug inopesana nefuma pamusoro, ichipfuura pasi pebrachialis tsandanyama. Iyo ndiro inotanga kuchengetedzwa kune iyo proximal kupera kweiyo humil shaft inopwanya. Pashure pacho, ine turnational traction pane yepamusoro gumbu, kupunzika kwakavharwa uye kwakabatanidzwa. Mushure mekudzikiswa kuderedzwa pasi peFluoroscopy, iyo screw yakaiswa kuburikidza neiyo distal incision yekuchengetedza ndiro inopesana nepfupa. Iyo screw inovhara inobva yasimbiswa, kupedzisa iyo plate yekugadziriswa.
▲ Schematic dhizaini yeiyo yepamusoro plate tunnel.
①: Brachialis muswe; ②: Biceps Brachii Musanduru; ③: miti yeMedial uye nerves; ④: pectoreralis yakakura.
▲ Schematic dhizaini yeiyo distal plate tunnel.
①: Brachialis muswe; ②: Medhia nerve; ③: Ulnar nerve.
Kutumira Nguva: Nov-10-2023
