ʻO ka haʻihaʻi ʻo Clavicle kekahi o nā haʻihaʻi maʻamau, ʻo ia ka 2.6% -4% o nā haʻihaʻi āpau.Ma muli o nā hiʻohiʻona anatomical o ka midshaft o ka clavicle, ʻoi aku ka maʻamau o nā haʻihaʻi waena, e helu ana no 69% o nā haʻihaʻi clavicle, aʻo nā haʻihaʻi o ka ʻaoʻao ʻaoʻao a me ka waena waena o ka clavicle helu no 28% a me 3%.
Ma ke ʻano he ʻano haʻihaʻi maʻamau, ʻaʻole e like me nā haʻihaʻi midshaft clavicle i hana ʻia e ka ʻeha poʻohiwi pololei a i ʻole ka hoʻoili ʻia ʻana mai nā ʻeha kaumaha kaumaha o nā lālā o luna, ʻo nā haʻihaʻi o ka hopena medial o ka clavicle e pili pū me nā ʻeha he nui.I ka wā ma mua, ʻo ke ʻano lapaʻau no nā haʻihaʻi o ka ʻaoʻao waena o ka clavicle maʻamau he conservative.Eia naʻe, ua hōʻike ʻia nā haʻawina he 14% o nā maʻi me nā haʻihaʻi haʻihaʻi o ka hopena medial hiki ke loaʻa i ka symptomatic nonunion.No laila, i nā makahiki i hala iho nei, ua hilinaʻi nui ka poʻe loea i ka mālama ʻana i nā ʻokiʻoki no nā haʻihaʻi haʻihaʻi o ka hopena medial e pili ana i ka hui sternoclavicular.Eia nō naʻe, liʻiliʻi nā ʻāpana clavicular medial, a aia nā palena i ka hoʻoponopono ʻana me ka hoʻohana ʻana i nā papa a me nā wili.ʻO ke koʻikoʻi koʻikoʻi kūloko kahi pilikia paʻakikī no nā kauka orthopedic e pili ana i ka hoʻopaʻa pono ʻana i ka haʻihaʻi a me ka pale ʻana i ka hemahema.
I.Distal Clavicle LCP Inversion
Hoʻokaʻawale ka ʻaoʻao mamao o ka clavicle i nā ʻano anatomical like me ka hope proximal, me ke kumu ākea.Hoʻolako ʻia ka ʻaoʻao mamao loa o ka clavicle locking compression plate (LCP) me nā lua locking screw, e ʻae ana i ka hoʻoponopono pono ʻana i ka ʻāpana distal.
I ka noʻonoʻo ʻana i ke ʻano like o ke kūkulu ʻana ma waena o nā mea ʻelua, ua kau kekahi mau loea i kahi pā kila ma ke kihi 180 ° ma ka ʻaoʻao mamao o ka clavicle.Ua hoʻopōkole lākou i ka ʻāpana i hoʻohana mua ʻia no ka hoʻopaʻa ʻana i ka ʻaoʻao mamao o ka clavicle a ʻike ʻia ua pili pono ka implant kūloko me ka ʻole o ka hana ʻana.
Ua ʻike ʻia ke kau ʻana i ka wēlau o ka clavicle ma kahi hoʻohuli a hoʻopaʻa ʻia me ka pā iwi ma ka ʻaoʻao waena i loaʻa i kahi kūpono kūpono.
Ma kahi hihia o kahi maʻi kāne he 40 mau makahiki me ka haʻihaʻi ma ka ʻaoʻao waena o ka clavicle ʻākau, ua hoʻohana ʻia kahi pā kila clavicle inverted.Ua hōʻike ʻia kahi hoʻokolohua ma hope o 12 mau mahina ma hope o ke ʻoki ʻana i kahi hopena hoʻōla maikaʻi.
ʻO ka papa hoʻopaʻa paʻa ʻana o ka clavicle locking distal (LCP) kahi ʻano hana hoʻoponopono kūloko i ka hana lapaʻau.ʻO ka pōmaikaʻi o kēia ʻano hana ʻo ia ka paʻa ʻana o ka ʻāpana iwi medial e nā wili he nui, e hāʻawi ana i kahi paʻa paʻa.Eia nō naʻe, pono kēia ʻenehana hoʻoponopono i kahi ʻāpana iwi medial nui no nā hopena maikaʻi loa.Inā liʻiliʻi ka ʻāpana iwi a i ʻole ka hoʻokaʻawale intra-articular, hiki ke hoʻololi ʻia ka hana hoʻoponopono.
II.ʻenehana hoʻopaʻa paʻa paʻa paʻa pālua pālua
ʻO ka ʻenehana papa pālua he ʻano hana maʻamau no nā haʻihaʻi comminuted paʻakikī, e like me nā haʻihaʻi o ka humerus distal, nā haʻihaʻi comminuted o ka radius a me ka ulna, a pēlā aku.Ke hiki ʻole ke hoʻokō pono i ka mokulele hoʻokahi, hoʻohana ʻia nā papa kila paʻa ʻelua no ka hoʻopaʻa ʻana i ke kūpaʻa, e hana ana i kahi hoʻolālā paʻa pālua.ʻO ka biomechanically, hāʻawi ka hoʻopaʻa paʻa pālua ʻelua i nā pono mechanical ma mua o ka hoʻopaʻa ʻana o ka pā hoʻokahi.
ʻO ka pā paʻa luna
ʻO ka pā hoʻopaʻa haʻahaʻa a me nā hui ʻehā o nā hoʻonohonoho papa pālua
Ka manawa hoʻouna: Iune-12-2023
