Kwemakumi mashoma apfuura makumi emakore, chiitiko cheProximal Humeral Fractures (PHF) yakawedzera neinopfuura 28%, uye chiyero chekuvhiya chakawedzera negumi muzana muvarwere vane makore makumi matanhatu nematanhatu uye vakuru. Zviripachena, kuderedza kupfupa kwepfupa uye kuwedzera huwandu hwedonha zvinhu zvikuru zvine njodzi mune huwandu hwevakuru. Kunyangwe kurapwa kwakasiyana-siyana kwekuvhiya kunowanikwa kune maneja adzingwa kana kusagadzikana maFF, hapana kubvumirana pane nzira yakanakisa yekuvhiya yevakuru. Iko kuvandudzwa kweAnlle Stabilation mahwendefa aipa sarudzo yekurapa kwekurapa kwekuvhiya kwePFF, asi iyo yakanyanya kutevedzera mwero kusvika kune 40% inofanira kutariswa. Izvo zvinonyanya kutaurwa zvinonyanya kufarirwa kudonha ne screw dislodgenment uye avascular necrosis (avn) yemusoro wemukuru.
Anatomical kuderedzwa kwekupwanya, kudzoreredzwa kwechinguva chidiki, uye kugadziriswa kwakakwana kwechidimbu chechifungo kunogona kuderedza matambudziko akadaro. Screw Kugadziriswa kunowanzooma kuwana nekuda kweiyo yakakanganisika yemhombwe yeiyo Proximal Humerus inokonzerwa neOsteoporosorosis. Kuti ugadzirise dambudziko iri, kusimbisa pfupa-screw interface emhando yemahombekombe nekushandisa polymethethacrylate (PMMA) Bone cement
Chidzidzo chazvino chakanangidzirwa kuongorora uye ongorora radiographic mhedzisiro yePhfer inobatwa nekona styled mahwendefa uye yekuwedzera screw tipe augmentation mune varwere vakura kupfuura makore makumi matanhatu.
Ⅰ.Zvinhu uye nzira
Varwere vane makumi matatu nevarwere vane makumi matatu vakapfeka kona.
All 24 mahfs akaiswa pachena kushandisa iyo Hgls Scastle System yakaunzwa neSukkthankar uye Herthankar uye Hertel vachishandisa preoperative ct scans. Radiwe radiworld Yakakwana Anatomic kuderedzwa kweiyo bracture yaionekwa kana iyo tuberi yemusoro wemusoro yakagadzirwazve uye yakaratidza isingasviki 5 mm yemasipi kana kuendesa. Adduction kuremara kwakarondedzerwa seyekuda kwemusoro wehuwandu hwehukama hwehukama hwehukama hwehuwandu hwekushaikwa kwegumi neshanu
Screw screw penetirnation yakatsanangurwa sezvo iyo screw tip inotanga muganho weiyo medullary cortex cortex yemusoro wemusoro wemusoro. Sekondari kutapudzwa kwakatsanangurwa sekutamiswa kweiyo yakaderedzwa tubibrosity yeanopfuura mashanu mm uye / kana shanduko inopfuura nekona yemusoro pane inotevera radiograph
Kuvhiya kwese kwakaitwa kuburikidza neyekunakidzwa nzira huru. Kuderedzwa kuderedza uye ndiro plate positi yakaitwa nenzira yakajairika. Screw-skmenti jojmentation maitiro anoshandiswa 0.5 ml yeiyo simende ye screw tip augmentation.
Kusaimbzi kwacho kwakaitwa postoperatively mune imwe tsika ruoko kupfura yefudzi kwemavhiki matatu. Kutanga kwekutanga uye kwakabatsira kufamba kwekurwadziwa nemucheto wekurwadziwa kwakatangwa mazuva maviri patsva kuti uwane huwandu hwakazara hwekufamba (rom).
Ⅱ.Mhedzisiro.
Mhedzisiro: Varwere makumi maviri nevana vakabatanidzwa, vane makore ezana ramakore makumi manomwe nemasere ((renzanga, makore makumi matanhatu nemashanu). Makumi maviri nerimwe aive mukadzi uye vatatu vaive vechirume. Shanu 2-chikamu zvikamu, 12 3-chikamu zvikamu, uye nomwe-zvikamu zvina-zvikamu zvakarapwa uchishandisa mahwendefa ekushushikana uye kuwedzera screw-skment jaine jactation. Matatu emakumi maviri nematatu emafreta aive humaleral mistell. Anatomic kuderedzwa kwakawanikwa muvarwere gumi nevaviri; Kufumiswa kwakazara kweMedial cortex kwakawanikwa mune gumi nemashanu evarwere gumi nevaviri (62,5%). Mumwedzi mitatu mushure mekuvhiyiwa, makumi maviri nevarwere (95.2%) anga awana bracture mubatanidzwa, kunze kwevarwere vatatu vaida kuvhiyiwa kwekutanga.
Mumwe murwere akavandudza mangwanani-ngwanani (posterior kutenderera kwemusoro wehuwandu hwehukama) 7 vhiki mushure mekuvhiyiwa. Kudzokororwa kwakaitwa neyekudzokera kumashure kwefudzi reArthroplasty mwedzi mitatu mushure mekuvhiyiwa. Primary screw penetration nekuda kweshoma intraarticular siment leement Screw Penetation yakaonekwa muC layer yeAngle Stabilation Plate mu 2 varwere uye muE Dayer mune imwe (Fig. 3). 2 yeaya matatu varwere akazovandudzwa avascular necrosis (avn). Varwere vari pasi pekudzokorora kuvhiyiwa nekuda kwekuvandudzwa kwe AVN (tafura 1, 2).
Ⅲ.Kukurukurirana.
Izvo zvinonyanya kujairika kuenderana muProeral Humeral Fractures (PHFS), kunze kwekuvandudzwa kweVascular necrosis (AVN), iri screw disdodgement neyekutevera Adduction kudonha kweiyo humalate chitsidzo. Kudzidza uku kwakawana iyo simenti-screw-screw-screw yakakonzerwa mumubatanidzwa wemubatanidzwa we95,200 SIM Coming Inacrews yakakonzeresa muyero wechipiri wekutora Isu tinokurudzira zvakanyanya kuti kuedza kuitwe kuti uwane kurongeka kwakaringana kweatomic, kunyanya yeMedial Humer Cortex muCrate Plate Fiffation yePhfer. Kunyangwe kana imwe yekuwedzera screw tip austa inoshandiswa, inozivikanwa inogona kukundikana maitiro anofanirwa kutariswa.
Muyero wekudzokorora wokudzokorora. Hapana kumirira. Iyo inozotarisirwa, yakarongedzwa, yakadzora multicenter fundo yakaitwa naHengg et al. haina kuratidza kubatsirwa kwesimendi screw augmentation. Pakati pevarwere vane makumi matanhatu nevarwere vakapedza kutevera-makore ekutevera, kukundikana kwekutadza kwakaitika muvarwere gumi nevarwere uye 3 muGoogle Group. AVN yakaonekwa mune 2 varwere (10.3%) uye mune 2 varwere (5.6%) muboka risingafariri. Zvakare, pakanga pasina mutsauko wakakosha mukuitika kwezviitiko zvakashata uye zvibodzwa zvemapiriniki pakati pemapoka maviri aya. Kunyangwe izvi zvidzidzo zvakatarisana nemapuranga uye radiological nhepfenyuro, ivo havana kuongorora radiographs mune zvakadzama seichi chidzidzo ichi. Zvakawanda, zvinetso zvakaonekwa zvakaonekwa zvakafanana nezvakafanana nevaya muchidzidzo ichi. Hapana wezvidzidzo izvi akataurira intra-anticular sment leement, kunze kwekudzidza naHengg et al., Uyo akacherekedza chiitiko ichi chakashata mumurwere mumwe. Muchidzidzo chazvino, yekutanga screw penetirnation yakacherechedzwa kaviri paCreater C uye kamwechete padanho re, ine inotevera intra-litra-artular cement isina chero chinongedzo chisina basa. Kusiyanisa zvinhu zvakamiswa pasi peFluoroscopic kutonga kusati kwasimira kusimudzwa kwakaiswa kune imwe neimwe screw. Nekudaro, dzakasiyana radiographic maonero emaoko emaoko anofanirwa kuitwa uye kuongororwa nokungwarira kuti utonge kunze kwekutanga screw kupinza usati washandisa simende. Kupfuurirazve, simende kusimbiswa kwezviyero padanho c (screw divergent kurongwa) kunofanirwa kudzivirirwa nekuda kwengozi yakakwira yekupinda uye inotevera siment leement. SEMEN SCREE TIP AGELEMISTURAON HAZVINONZWA MUCHINYANYA NEZVINHU ZVINOGONESESA ZVINOGONESESWA KUTI UVEDZE MUCHENYORWA MUCHINYENGETEDZWA MUZVINHU ZVINOGONESWA (ZVINOGONESWA MUVANHU).
Vi. Mhedziso.
Mukurapa kwePhfer neAngle-Stabilised Mahwendefa weSitimu, SEMEN SCREE THE SEPNICATION SEPLATION SEPLATION SEPLATE RENYAYA YEMAHARA Kuenzaniswa nemabhuku aripo, kuwedzera huwandu hwevaVascular necrosis (AVN) zvakanyatsoonekwa mumatanho akanyanya kuvhiringidza uye izvi zvinofanirwa kuitirwa. Asati erineti yekushandisa, chero intraartular sment leement inofanira kunyatsosarudzika nekusiyana kwepamusoro manejimendi. Nekuda kwengozi yakakwira yeiyo intraarticular Skment Lemensi mumusoro wevhu, isu hatikurudzire cinement screw tip augmentation mune ino kupwanyika.
Kutumira Nguva: Aug-06-2024
