Nūhou - "Hoʻoponopono i loko o nā haʻihaʻi humeral shaft me ka hoʻohana ʻana i ka ʻenehana medial internal plate osteosynthesis (MIPPO).

ʻO nā mea i ʻae ʻia no ka ho'ōla ʻana i nā haʻihaʻi o ka humeral shaft he angulation anterior-posterior ka liʻiliʻi ma lalo o 20 °, ka angulation lateral ma lalo o 30 °, ka hoʻololi ʻana ma lalo o 15 °, a me ka pōkole ma lalo o 3cm. I nā makahiki i hala iho nei, me ka hoʻonui ʻana i nā koi no ka hana ʻana o nā lālā o luna a me ka hoʻihoʻi mua ʻana i ke ola o kēlā me kēia lā, ʻoi aku ka maʻamau o ka mālama ʻana i nā haʻihaʻi humeral shaft. ʻO nā ʻano hana maʻamau ka mua, anterolateral, a i ʻole ka plating hope no ka hoʻoponopono kūloko, a me ke kui intramedullary. Hōʻike nā haʻawina ʻo ka helu nonunion no ka wehe ʻana i ka hoʻopaʻa ʻana i loko o nā haʻihaʻi humeral ma kahi o 4-13%, me ka ʻeha aʻalolo radial iatrogenic ma kahi o 7% o nā hihia.

No ka pale ʻana i ka ʻeha aʻalolo radial iatrogenic a hoʻemi i ka helu nonunion o ka wehe ʻana, ua hoʻohana nā loea kūloko ma Kina i ke ala medial, me ka hoʻohana ʻana i ka ʻenehana MIPPO e hoʻoponopono i nā haki humeral shaft, a ua loaʻa nā hopena maikaʻi.

Nā hana ʻokiʻoki

KaʻAnuʻu mua: Hoʻonohonoho. E moe ana ka mea ma'i ma kahi kupapa'u, me ka lala i hoopa'i 'ia i kailiia 90 degere a kau ma ka papa hana ma ka aoao.

KaʻAnuʻu ʻelua: ʻoki ʻokiʻoki. Ma ka hoʻoponopono ʻana i ka papa hoʻokahi medial maʻamau (Kanghui) no nā maʻi, ua hana ʻia ʻelua ʻoki longitudinal ma kahi o 3cm kēlā me kēia ma kahi kokoke i nā wēlau proximal a me distal. ʻO ka ʻoki kokoke i ke komo ʻana no ka ʻāpana deltoid a me ka pectoralis major approach, ʻoiai ka ʻoki distal aia ma luna o ka epicondyle medial o ka humerus, ma waena o ka biceps brachii a me triceps brachii.

▲ Hoʻolālā kiʻi o ka ʻoki kokoke.

①: ʻoki ʻokiʻoki; ②: ʻaʻa Cephalic; ③: Pectoralis major; ④: ʻiʻo Deltoid.

▲ Hoʻolālā kiʻi o ka ʻoki ʻoki.

①: Ke aʻalolo waena; ②: Ulnar nerve; ③: ʻiʻo Brachialis; ④: ʻoki ʻokiʻoki.

KaʻAnuʻu ʻekolu: Hoʻokomo ʻana i ka pā a me ka hoʻoponopono ʻana. Hoʻokomo ʻia ka pā ma ka ʻoki kokoke, pili i ka ʻili o ka iwi, e hele ana ma lalo o ka ʻiʻo brachialis. Hoʻopaʻa mua ʻia ka pā i ka ʻaoʻao kokoke o ka haki ʻana o ka humeral shaft. Ma hope iho, me ka traction rotational ma ka lālā luna, ua pani ʻia ka haʻi a hoʻopaʻa ʻia. Ma hope o ka hōʻemi maikaʻi ʻana ma lalo o ka fluoroscopy, hoʻokomo ʻia kahi wili maʻamau ma o ka ʻoki distal e hoʻopaʻa i ka pā i ka ʻili o ka iwi. Hoʻopaʻa ʻia ka wili laka, e hoʻopau ana i ka hoʻopaʻa ʻana o ka pā.