Nhanganyaya yenzira yekutsvaga "radial nerve" mumashure ekusvika kune humerus

Kuvhiya kurapwa kwepakati-distal humerus fractures (yakadai seiya inokonzerwa ne "wrist-wrestling") kana humeral osteomyelitis inowanzoda kushandiswa kwenzira yakananga shure kune humerus.Njodzi huru inobatanidza neiyi nzira ndeye radial nerve kukuvara.Tsvagiridzo yakaratidza kuti mukana weiyo iatrogenic radial tsinga kukuvara kunokonzerwa neiyo posterior nzira kune humerus inotangira kubva ku0% kusvika 10%, ine zvachose radial tsinga kukuvara mukana kubva pa0% kusvika 3%.

Kunyangwe iyo pfungwa yeradial nerve chengetedzo, zvidzidzo zvakawanda zvakavimba nebony anatomical landmarks senge supracondylar region yehumerus kana scapula yekumisikidza intraoperative.Nekudaro, kutsvaga iyo radial nerve panguva yekuita kunoramba kwakaoma uye kwakabatana nekusagadzikana kwakakosha.

Mufananidzo weiyo radial nerve safety zone.Avhareji yedaro kubva kune radial nerve plane kuenda kune lateral condyle yehumerus inenge 12cm, ine nzvimbo yekuchengetedza inosvika 10cm pamusoro pe lateral condyle.

Panyaya iyi, vamwe vatsvakurudzi vakabatanidza mamiriro chaiwo emukati uye vakayera kureba pakati pemucheto we triceps tendon fascia uye radial nerve.Vakaona kuti chinhambwe ichi hachichinji uye chine ukoshi hwepamusoro hwekumisikidza intraoperative.Musoro wakareba we triceps brachii muscle tendon unomhanya wakatwasuka, ukuwo lateral musoro unoumba arc.Kupindirana kwematendon aya kunoumba muromo we triceps tendon fascia.Nekutsvaga 2.5cm pamusoro peyipi iyi, iyo radial nerve inogona kuzivikanwa.

 Positioning Method

Nekushandisa iyo apex ye triceps tendon fascia sereferensi, iyo radial nerve inogona kuwanikwa nekufamba ingangoita 2.5cm kumusoro.

Kuburikidza nekudzidza kunosanganisira avhareji yevarwere ve60, zvichienzaniswa neyakajairwa nzira yekuongorora yakatora maminetsi gumi nematanhatu, iyi yekumisikidza nzira yakaderedza kuchekwa kweganda kune radial nerve exposure nguva kusvika 6 maminetsi.Uyezve, yakabudirira kudzivirira radial nerve kukuvara.

Intraoperative fixation macroscopic mufananidzo wepakati-distal 1/3 humeral kuputsika.Nekuisa sutures mbiri dzinopinda dzinopindirana dzinenge 2.5cm kumusoro kwendege ye triceps tendon fascia apex, kuongorora kuburikidza neino mharadzano nzvimbo inobvumira kuratidzwa kweiyo radial nerve uye vascular bundle.
Nhambwe yataurwa ine chekuita nehurefu hwemurwere uye kureba kweruoko.Mukushanda kwekushanda, inogona kugadziriswa zvishoma zvichienderana nemuviri wemurwere uye zvikamu zvemuviri.