ʻO nā haki clavicle kekahi o nā haki o nā lālā luna maʻamau i ka hana lapaʻau, me 82% o nā haki clavicle he mau haki midshaft. ʻO ka hapa nui o nā haki clavicle me ka neʻe ʻole koʻikoʻi hiki ke mālama ʻia me ke akahele me nā bandages figure-of-eight, ʻoiai ʻo nā mea me ka neʻe nui, nā ʻiʻo palupalu i hoʻopili ʻia, ka pilikia o ka vascular a i ʻole neurological compromise, a i ʻole nā koi hana kiʻekiʻe e koi paha i ka hoʻopaʻa ʻana i loko me nā pā. ʻO ka helu nonunion ma hope o ka hoʻopaʻa ʻana i loko o nā haki clavicle he haʻahaʻa iki, ma kahi o 2.6%. ʻO nā nonunions hōʻailona e koi pinepine i ka ʻoki hoʻoponopono, me ke ʻano nui o ka cancellous bone grafting i hui pū ʻia me ka hoʻopaʻa ʻana i loko. Eia nō naʻe, ʻo ka mālama ʻana i nā nonunions atrophic recurrent i nā poʻe maʻi i hana mua i ka hoʻoponopono nonunion he mea paʻakikī loa ia a he pilikia mau ia no nā kauka a me nā poʻe maʻi.
No ka hoʻoponopono ʻana i kēia pilikia, ua hoʻohana hou kekahi polopeka ma ka Halemai ʻo Xi'an Red Cross i ka autologous iliac bone structural grafting i hui pū ʻia me ka autologous cancellous bone grafting e mālama i nā nonunions refractory o nā haki clavicle ma hope o ka hana hoʻoponopono ʻole ʻana, a ua loaʻa nā hopena maikaʻi. Ua paʻi ʻia nā hopena noiʻi ma ka puke pai "International Orthopedics".
Kaʻina hana ʻoki kino
Hiki ke hōʻuluʻulu ʻia nā kaʻina hana ʻoki kino e like me ke kiʻi ma lalo nei:
a: Wehe i ka hoʻopaʻa clavicular mua, wehe i ka iwi sclerotic a me ka ʻeha fiber ma ka ʻaoʻao haki o ka haki;
b: Ua hoʻohana ʻia nā papa hana hou ʻana o ka clavicle plastik, ua hoʻokomo ʻia nā wili laka i loko o nā wēlau o loko a me waho e mālama i ke kūpaʻa holoʻokoʻa o ka clavicle, a ʻaʻole i hoʻopaʻa ʻia nā wili ma kahi e mālama ʻia ai ma ka wēlau haki o ka clavicle.
c: Ma hope o ke kau ʻana i ka pā, e wili i nā lua me ke kui Kirschler ma ka ʻaoʻao haʻihaʻi o ka haki i loko a i waho a hiki i ka puka ʻana o ke koko i loko o ka lua (hōʻailona pepa ʻulaʻula), e hōʻike ana i ka lawe maikaʻi ʻana o ke koko iwi ma aneʻi;
d: I kēia manawa, e hoʻomau i ka wili ʻana i 5mm i loko a i waho, a wili i nā lua lōʻihi ma ke kua, kahi mea e kūpono ai i ka osteotomy aʻe;
e: Ma hope o ka osteotomy ma ka lua wili mua, e hoʻoneʻe i ka cortex iwi lalo i lalo e waiho i kahi ʻauwai iwi;
f: Ua hoʻokomo ʻia ka iwi iliac bicortical i loko o ke awāwa iwi, a laila ua hoʻopaʻa ʻia ka cortex o luna, ka iliac crest a me ka cortex o lalo me nā wili; Ua hoʻokomo ʻia ka iwi cancellous iliac i loko o ka hakahaka haki
Maʻamau
nā hihia:
▲ He kāne 42 makahiki ka mea maʻi me ka haki waena o ka clavicle hema i hoʻokumu ʻia e ka trauma (a); Ma hope o ke ʻoki ʻana (b); Ka haki paʻa a me ka hui ʻole o ka iwi i loko o 8 mau mahina ma hope o ke ʻoki ʻana (c); Ma hope o ka hoʻoponopono hou ʻana (d); Ka haki o ka papa kila 7 mau mahina ma hope o ka hoʻoponopono hou ʻana a me ka hoʻōla ʻole ʻana (e); Ua ho'ōla ʻia ka haki (h, i) ma hope o ke kāpili ʻana i ka iwi (f, g) o ka ilium cortex.
Ma ke aʻo ʻana a ka mea kākau, ua hoʻokomo ʻia he 12 mau hihia o ka nonunion iwi paʻakikī, a ua hoʻōla ʻia nā iwi a pau ma hope o ke ʻoki ʻana, a ua loaʻa i nā maʻi 2 nā pilikia, 1 hihia o ka thrombosis vein intermuscular bipi a me 1 hihia o ka ʻeha wehe iwi iliac.
He pilikia paʻakikī loa ka refractory clavicular nonunion i ka hana lapaʻau, kahi e lawe mai ai i ke kaumaha noʻonoʻo kaumaha i nā mea maʻi a me nā kauka. ʻO kēia ʻano hana, i hui pū ʻia me ka structural bone grafting o ka iwi cortical o ka ilium a me ka cancellous bone grafting, ua hoʻokō i kahi hopena maikaʻi o ka ho'ōla ʻana o ka iwi, a pololei ka pono, hiki ke hoʻohana ʻia ma ke ʻano he kuhikuhi no nā kauka.
Ka manawa hoʻouna: Malaki-23-2024
