Nzira inogamuchirwa yekuporesa kwehumeral shaft fractures ndeye anterior-posterior angulation isingasviki 20 °, lateral angulation isingasviki 30 °, kutenderera kwepasi pe15 °, uye kupfupika kwepasi pe3cm.Mumakore achangopfuura, nekuwedzera kudiwa kwepamusoro nhengo yebasa uye kupora kwekutanga muhupenyu hwezuva nezuva, kurapwa kwekuvhiya kwehumeral shaft fractures kwave kuwanda.Nzira dzepamusoro dzinosanganisira anterior, anterolateral, kana posterior plating yekugadziriswa kwemukati, pamwe ne intramedullary nailing.Zvidzidzo zvinoratidza kuti chiyero chisiri chenyunion chekudzikisa kuvhurika kwemukati kugadzirisa kwehumeral fractures inenge 4-13%, ine iatrogenic radial nerve kukuvara kunoitika munenge 7% yezviitiko.
Kuti udzivise iatrogenic radial tsinga kukuvara uye kuderedza chiyero chisiri chenyunion chekudzikisa pachena, nyanzvi dzepamba muChina dzakatora nzira yepakati, vachishandisa nzira yeMIPPO kugadzirisa humeral shaft fractures, uye vakawana mhedzisiro yakanaka.
Kuvhiya maitiro
Danho rokutanga: Positioning.Murwere anorara panzvimbo yepamusoro, uye nhengo yakabatwa yakatorwa 90 degrees ndokuiswa patafura yekushanda.
Nhanho yechipiri: Kuvhiya kucheka.Mune yakajairwa medial single-plate fixation (Kanghui) yevarwere, mbiri dzelongitudinal incisions dzinenge 3cm imwe neimwe inoitwa padhuze neinoperera uye kure kure.Iyo proximal incision inoshanda semusuwo wechikamu chechikamu che deltoid uye pectoralis nzira huru, nepo distal incision iri pamusoro pepakati epicondyle yehumerus, pakati pebiceps brachii uye triceps brachii.
▲ Schematic dhayagiramu ye proximal incision.
①: Kuvhiya kucheka;②: Cephalic vein;③: Pectoralis huru;④: Deltoid tsandanyama.
▲ Schematic diagram ye distal incision.
①: tsinga dzeMedhia;②: Ulnar nerve;③: Brachialis tsandanyama;④: Kuvhiya kucheka.
Nhanho yechitatu: Kuisa ndiro uye kugadzirisa.Iyo ndiro inopinzwa kuburikidza neiyo proximal incision, yakanyura pakatarisana nepamusoro pebhonzo, ichipfuura nepasi pebrachialis tsandanyama.Iyo ndiro inotanga kuchengetedzwa kusvika kumagumo ekupedzisira kwehumeral shaft fracture.Zvadaro, nekutenderera kutenderera pachikamu chepamusoro, kuputsika kunovharwa uye kuenzaniswa.Mushure mekuderedzwa kunogutsa pasi pefluoroscopy, screw yakajairwa inopinzwa kuburikidza nedistal incision kuchengetedza ndiro pakatarisana nefupa repamusoro.Iyo yekukiya sikururu inozosimbiswa, ichipedzisa kugadzirisa ndiro.
▲ Schematic dhizaini yepamusoro peplate tunnel.
①: Brachialis tsandanyama;②: Biceps brachii tsandanyama;③: Mitsipa yepakati uye tsinga;④: Pectoralis chikuru.
▲ Schematic diagram ye distal plate tunnel.
①: Brachialis tsandanyama;②: tsinga dzeMedhia;③: Ulnar nerve.
Nguva yekutumira: Nov-10-2023
