Nhau - "Kugadziriswa kwemukati kwemapfupa ehumeral shaft uchishandisa nzira ye medial internal plate osteosynthesis (MIPPO)."

Zvinodiwa pakuporeswa kwemapfupa emutsipa wehumeral shaft inyaya yekuti mapfupa emutsipa wehumeral shaft ari pasi pe20°, mapfupa emutsipa wehumeral shaft ari pasi pe30°, kutenderera kwehumeral shaft kuri pasi pe15°, uye kupfupika kwehumeral shaft kuri pasi pe3cm. Mumakore achangopfuura, nekuda kwekuwedzera kwekushanda kwemakumbo ekumusoro uye kupora nekukurumidza muhupenyu hwezuva nezuva, kurapwa kwekuvhiyiwa kwemapfupa emutsipa wehumeral shaft kwave kwakajairika. Nzira huru dzinosanganisira anterior, anterolateral, kana posterior plating yekuisa mukati, pamwe ne intramedullary nailling. Zvidzidzo zvinoratidza kuti chiyero che nonion che open reduction internal fixation yemapfupa ehumeral shaft chiri pakati pe4-13%, ne iatrogenic radial nerve iatrogenic ichiitika muinenge 7% yezviitiko.

Kuti vadzivise kukuvara kwetsinga dzeropa dzinobva mumitsipa ye radial uye kuderedza mwero wekusabatana kwekudzikira kweropa, nyanzvi dzemuno muChina dzakashandisa nzira iyi, dzichishandisa nzira yeMIPPO kugadzirisa kuputsika kwetsinga dzeropa, uye dzakawana mhedzisiro yakanaka.

Maitiro ekuvhiya

Danho rekutanga: Kugara panzvimbo imwe chete. Murwere anorara akarara pasi, gumbo rakakuvara rakatorwa madhigirii makumi mapfumbamwe roiswa patafura yekuvhiyiwa.

Danho rechipiri: Kuchekwa kwepamuviri. Mukugadzirwa kwesimbi imwe chete (Kanghui) kwevarwere, kucheka kaviri kwepamuviri kweanenge 3cm kunoitirwa pedyo nemagumo eproximal nedistal. Kuchekwa kweproximal kunoshanda senzira yekupinda muchikamu chedeltoid nepectoralis major, nepo kuchekwa kwedistal kuri pamusoro pemedial epicondyle yehumerus, pakati pe biceps brachii netriceps brachii.

▲ Dhayagiramu yemufananidzo wechikamu cheproximal incision.

①: Kuchekwa kwepamuviri; ②: Mutsinga weCephalic; ③: Pectoralis major; ④: Tsandanyama dzeDeltoid.

▲ Dhayagiramu yemufananidzo wekucheka kwedivi.

①: Tsinga yepakati; ②: Tsinga yeUlnar; ③: Tsandanyama dzeBrachialis; ④: Kuchekwa kwepamuviri.

Danho rechitatu: Kuisa plate uye kuiisa. Plate inopinzwa nepaburi reproximal incision, yakanamatira pamusoro pemapfupa, ichipfuura nepasi pemhasuru yebrachialis. Plate inotanga yakabatana kusvika kumucheto weproximal wekutyoka kwehumeral shaft. Zvadaro, nekudhonza kwegumbo repamusoro, kutyoka kunovharwa uye kunonamirwa. Mushure mekuderedzwa kunogutsa pasi pe fluoroscopy, sikuruu yakajairika inopinzwa nepaburi re distal kuti isimbise plate pamusoro pemapfupa. Sikuruu inokiya inozosimbiswa, ichipedzisa kusungirirwa kweplate.