Nyarewa a ɛma obi bubu ne ne ayaresa .

Nnianimu

Clavicle fractures abu so kakra na mpɛn pii no efi adwenemhaw a ɛba fam tẽẽ anaasɛ ɛnyɛ tẽẽ a ɛba mmati so no mu. Nhwehwɛmu ahorow a wɔyɛe wɔ 1960 mfe no mfiase mu hɔ no bɔɔ amanneɛ sɛ wɔn a wɔn ho abubu a ɛnyɛ nkabom no nnu 1%, na ayaresa a wɔde siw ano no maa ayarefo nyaa abotɔyam kɛse; Esiane sɛ nnuruyɛ ayɛ nnansa yi nti, oprehyɛn a wɔde sa yare no anya tumi kɛse; Enti, ɛsɛ sɛ ayaresabea adwumayɛfo a wɔyɛ adwuma wɔ dwumadibea a wɔhwɛ ayarefo a wɔwɔ ayaresa a egye ntɛmpɛ mu anaa ayaresabea a wɔhwɛ ayarefo a wɔda ayaresabea nyinaa no hu saa opira yi a wɔtaa da adi ne ɔhaw ahorow a ɛtaa ba ne ne di titiriw no yiye.

Epidemiology .

Clavicle fractures yɛ 2.6%-5% wɔ mpaninfoɔ a wɔn mu abubu nyinaa mu [1,2]. Europa nhwehwɛmu bi a ɛka ho ne 1,000 a ɛtoatoa so a ɛwɔ clavicle mu a ɛpaapaee [3,4] sɛ clavicle fractures bɛboro 66% sii wɔ clavicle no mfinimfini 1/3, bɛyɛ 25% yɛ lateral 1/3 fractures, na 3% yɛ medial 1/3 fractures. Nnipa dodow a wɔn mu apaapae no daa bimodal kyekyɛ adi, na ɛbae titiriw wɔ mmarima a wonnii mfe 30 mu, na wɔn a wɔadi boro mfe 70 na wodi akyi.

Ayaresa Ho Nimdeɛ .

Onipa nnompe a edi kan a wɔde fi ase yɛ nnompe no ne clavicle, nnompe a ɛda soro basa no ne dua no ntam nkutoo, a ɛne acromion, acromioclavicular (AC) nkwaa no hyia akyirikyiri, na ɛbɛn sternum, sternoclavicular (SC) nkwaa no. Wɔfrɛ saa nkwaa yi atypical synovial joints efisɛ ɛyɛ fibrocartilage na ɛhyɛ mu mmom sen hyaline cartilage. Acromioclavicular ne rostroclavicular ligaments no de clavicle no si scapula no so na sternoclavicular ligament no de bata sternum no ho.

Clavicle no yɛ 's' a wɔayɛ no sɛnea ɛte. Proximal half-arc no kyerɛ anim, na egyaw baabi ma ntini a ɛwɔ soro no mu a ɛyɛ bundle no. Arc no fã a ɛwɔ akyirikyiri no kɔ akyi (kɔntɔnkrɔn) na afei ɛka scapula (rostral process ne acromion) no ho. Mpɛn pii no, akisikuru no mu a ɛpaapae no ba wɔ arc abien no (mfinimfini arc) no nhyiam, na ɛda adi kɛse sɛ ntini ahorow a ɛbata nnompe a ɛbɛn ho wɔ saa ɔmantam yi mu no nni hɔ, na esiane sɛ ɛyɛ abon no fã a ɛyɛ mmerɛw sen biara nti. Sɛ clavicle fracture bi tu a, ɛkame ayɛ sɛ bere nyinaa sternocleidomastoid muscle (a ɛbata clavicle no awiei a ɛbɛn no ho) na ɛtwe proximal fã no kɔ soro (cephalad). a ɛwɔ subscapularis ne pectoralis major (a ɛdannan ne ho wɔ soro no mu). Eyi fi subscapularis ne pectoralis ntini atitiriw no a ɛtwetwe (a ɛdannan ne nsa wɔ soro no mu na ɛtwe kɔ ne moma so no titiriw).

Su

Botae a ɛwɔ clavicle fracture treatment mu ne sɛ ɛbɛma ɛyaw so atew na ama nkwaa no ayɛ adwuma bio. Wɔda so ara yɛ clavicle fractures dodow no ara ho adwuma titiriw wɔ ɔkwan a ɛyɛ katee so (mpɛn pii no, ɛyɛ tiaa sen mm 15); Ayaresa a wɔde di dwuma wɔ ɔkwan a ɛyɛ kon eyi so te sɛ aduru a wɔde kyekyere nipadua no ho a ɛyɛ ne ho mfonini, nsateaa a wɔde hyɛ anim, sayre aduru a wɔde kyekyere nipadua no, velpeau a wɔde hyɛ nipadua mu, ne sɛnea wɔmma obi ntumi nkɔ baabiara. Wɔyɛ suspension immobilization wɔ acute phase, na ntɛm range ntetee ne ahoɔden apɔw-mu-teɛteɛ no taa yɛ 2-6 adapɛn akyi abubu bere a ɛyaw fi hɔ. Wɔnkamfo mfonini a wɔde aduru a wɔde kyekyere nipadua no 8 di dwuma efisɛ ebetumi ama axillary pressure sores ne union a ɛnyɛ union pii aba [5,6].

Abakɔsɛm ne nipadua mu nhwehwɛmu .

Clavicle fractures fi nkɛntɛnso tẽẽ a ɛba mmati so wɔ asehwe akyi na wɔtaa hu wɔ abɔnten agumadi mu wɔ mmofra a wɔanhyɛ da ne wɔn a wɔn mfe akɔ anim a wɔanhyɛ da no mu. Ɛho hia sɛ wɔkyerɛkyerɛ ɔkwan a wɔfa so pira no mu. Ebia apirakuru a ahoɔden kɛse wom ne ti ne koko mu apirakuru bɛka abom, bere a ebia akisikuru a ɛba obi mu a ɛyɛ yaw no bɛyɛ ɔyare. Apirakuru a ɛtwetwe adwene no hwehwɛ sɛ wofi ase ntɛm na wɔmfa ahwɛyiye nka scapular chest wall separation, neurologic ne vascular opira ho. Wɔ ayaresabea mu no, ɛho a ɛhoa ne ecchymosis wɔ baabi a abubu no, a ɛka ho ne dɛmdi ne ne mmɔbɔmmɔbɔ. Ɛsɛ sɛ wɔde wɔn adwene si ntini a ɛyɛ mmerɛw no so ma ɛyɛ jacking up, a ebetumi ama honam ani ayɛ mmerɛw na ayɛ kuru.

Mfoniniyɛ .

Wobetumi de afiri a wɔde hwɛ anim a ɛyɛ mmerɛw ahu sɛ abubu dodow no ara abubu. 20° ti a ɛdannan no fi hɔ no yi nkɛntɛnso a ɛwɔ thoracic cavities a ɛkata so no fi hɔ. Ɛsɛ sɛ wɔde radiograph yɛ ayarefo wɔ gyinabea a ɛboa wɔn ho wɔn ho mu na ama wɔatumi ahu mpaapaemu a ɛkɔ so no yiye. Mu duru a ɛwɔ radiographs mu no boa ma wɔsɔ rostral clavicular ligament no mudi mu kura wɔ distal clavicle anaa acromioclavicular joint injuries.CT mu.CT boa ma wotumi hu scapular girdle opira a ɛyɛ den no ho mfonini na ɛma wohu sɛnea ebetumi aba wɔ proximal clavicle apirakuru ho wɔ sternoclavicular joint no mu. Sɛ wofa afiri a wɔde yɛ koma mu mfonini a, ɛboa ma wogyae ahurututu mu opira a ɛbata ho no, na wobetumi asusuw ho sɛ wobɛtew so denam nea wɔde bɛtoto contralateral clavicle no ho, na woagyae scapulothoracic fasu mu mpaapaemu no nso.

ahorow ahorow .

AO/OTA fracture dislocation typing: Clavicle fracture code 15 no wɔ mmeae abiɛsa: 15.1 proximal (medial), 15.2 diaphysis, ne 15.3 distal (lateral). Wɔakyekyɛ proximal (mfinimfini) ne distal (lateral) fractures mu sɛ type A (extra-articular), type B (fã bi a ɛwɔ intra-articular mu), ne Type C (intra-articular koraa). Wɔakyekyɛ trunk a ɛpaapae mu sɛ type A (simple), type B (Wedge), ne Type C (commineted).AO/OTA nkyekyɛmu a ɛfa abubuw ne ntini a ɛpaapae ho no nsusuw sɛnea abubuw no tu no ho, na mprempren wɔde di dwuma kakraa bi wɔ abubuw a wɔde di dwuma ne sɛnea wɔde kyerɛ sɛnea wɔbɛkyerɛ wɔn anim no mu.

Allman typing gyina beae a fracture no wɔ so (I: medial, cadent 1/3, ii: lateral 1/3, iii: medial 1/3) (Mfonini 7.2.1).

Craig san yɛɛ saa nkyekyɛmu yi mu nsakraeɛ wɔ Allman so, a me yɛ clavicle no mfimfini 1/3; Type II a ɛyɛ clavicle no akyi 1/3, a afei wɔkyekyɛɛ mu yɛɛ no ​​ahorow 5 a egyina mpaapaemu a ɛkɔ fam ne abusuabɔ a ɛda rostral clavicular ligament no ntam so; na type III a ɛyɛ clavicle no mu 1/3 a ɛpaapae, a wɔkyekyɛɛ mu yɛɛ no ​​5 a egyina sɛnea mpaapaemu no kɔ so no so ne sɛ ebia na abubu no yɛ intra-articular anaasɛ ɛnte saa.

Neer typing of lateral 1/3 fractures si hia a rostral-clavicular ligament no ho hia so dua: Type I no ba akyirikyiri wɔ rostral-clavicular ligament no ho, na medial fracture block no tu kɔ soro sen biara; Type II no fa rostral-clavicular ligament no ho na ɛde medial fracture block no ba no si hɔ kɛse; na type III no trɛw kɔ acromioclavicular nkwaa no mu a rostral-clavicular ligament no da so ara yɛ nea ɛwɔ hɔ.

Edinburgh typing yɛ nhyehyɛe a wɔde kyekyɛ diaphysis fractures mu sɛnea ɛtu ne comminution.1 Type 1 fractures no fa medial end ho, type 2 yɛ diaphysis fractures na type 3 yɛ lateral end fractures. The fractures of the diaphysis are classified according to the presence or absence of cortical contact between the fracture fragments into types A and B. Type 2A fractures are further classified as nondisplaced (type 2A1) and angulated (type 2A2),2B fractures are classified as simple or wedge-shaped (type 2B1) and comminuted (type 2B2).3 Type 1 fractures involve the medial end a ɛwɔ diaphysis ne type 3 no yɛ diaphysis no akyi awiei. Wɔkyekyɛ mfinimfini ne akyi awiei abubu no mu akuwakuw nketewa 1 ne 2 sɛnea ɛte sɛ nea nkwaa a ɛbɛn no ka ho no.

Saa ara nso na rockwood a wɔrekyerɛw, Jager typing, ne Breitner a wɔrekyerɛw no wɔ hɔ.

Oprehyɛn ho nsɛnkyerɛnne .

Mmubui pɔtee bi .

1, abubu a ɛbue; 

2, tu a wotu fi baabi foforo >2 cm; 

3, a ɛyɛ tiaa >2 cm; 

4, abubuw asinasin (>3) a ɛyɛ fɛ; 

5, afã horow pii a ɛpaapae; 

6, a ɛhyɛ ase a ɛbue a ntini a ɛyɛ mmerɛw apira; 

7, dɛmdi a ɛho hia (atuo ne tiawa); 

8, scaphoid opira.

Compound opira .

1, a wɔaka abom ipsilateral soro extremity opira;

2, mmati mu opira a ɛsensɛn nsu so;

3, apirakuru pii;

4, akisikuru a ɛka bom yɛ ntini mu yare;

5, ipsilateral pii rib fractures a wɔaka abom ne koko fasu mu dɛmdi;

6, clavicle a ɛyɛ tiaa ma ɛyɛ mmati a ɛwɔ ntaban;

7, afã abien a ɛwɔ anim a ɛyɛ mmerɛw.

ayarefo nneɛma .

1, ayarefo a wɔapirapira pii no hia sɛ wonya wɔn mu duru a ɛwɔ wɔn atifi no so ntɛm;

2, ayarefo a wɔhwehwɛ sɛ wɔsan kɔ dwumadi mu ntɛmntɛm (sɛ nhwɛso no, agumadi a ɛyɛ fɛ ne akansi a wɔde si akan).

Bere a wɔde yɛ oprehyɛn .

Ɛsɛ sɛ wɔyɛ oprehyɛn a wɔrenkyɛ bere a oprehyɛn ho nsɛnkyerɛnne a edi mũ wɔ hɔ no.

Oprehyɛn a ɛkyɛ a ɛboro adapɛn 2-3 wɔ nsɛnkyerɛnne a ɛfa ho no betumi ama ɔhaw a ɛwɔ mu sɛ ɛbɛtew so no ayɛ kɛse, titiriw bere a wɔresiesie wɔn ho ama closed reduction internal fixation denam percutaneous techniques so no.

Oprehyɛn a wɔde kɔ nipadua mu .

Wɔde ɔyarefo no si mpoano agua so gyinabea anaasɛ ne gyinabea fã bi. Wɔde mmati a ɛho ayɛ fĩ no ahyɛ ase de ama clavicle no so sɛnea ɛbɛyɛ a ɛbɛyɛ mmerɛw sɛ wɔbɛyɛ no oprehyɛn, na wɔde wɔn nsa no to wɔn ho so na ama wɔatumi ayɛ oprehyɛn no wɔ oprehyɛn no mu. Wobetumi apaw transverse incision a ɛfa clavicle no axis tenten no ho anaasɛ saber ntwitwiridii a ɛne Langer nhyehyɛe no hyia.

Hyɛ no nsow: Transverse incision ma ntrɛwmu kɛse, bere a bere tenten mu ntwitwiridii ma asiane a ɛwɔ hɔ sɛ obi benya supraclavicular nerve opira no so tew na ɛyɛ fɛ yiye.

mu fixation .

3.5 Wobetumi de mprɛte a wɔde hyɛ mu, mprɛte a wɔde san yɛ nneɛma, anaa plastic LCP ahorow adi dwuma de asiesie clavicle fractures. Wɔde mprɛte sisi so yiye wɔ soro anaasɛ ɛwɔ anim a ɛwɔ anim no so. Mprɛte no mu yɛ den wɔ biomechanical opira mu bere a wɔde si hɔ no, titiriw sɛ comminit a ɛyɛ fracture wɔ ase hɔ a, na ɛyɛ mmerɛw sɛ wobetumi ayɛ ho mfonini wɔ wɔn adwenem. Ɛho hia sɛ wɔde ahwɛyiye kɛse tu nkɔnsɔnkɔnsɔn no mu den, na ɛsɛ sɛ wɔde ahwɛyiye kɛse tu ntokuru no, efisɛ asiane wɔ hɔ sɛ ntini ne mogya ntini a ɛwɔ ase no bepira. Mfaso: Safe drilling of the anterior plate screw channel, plate apposition, mmerɛw contouring.

Hyɛ no nsow: Mpɛn pii no, ɛho nhia sɛ wɔde nnompe a wɔde hyɛ nipadua mu no hyɛ mu ma adeyɛ a edi kan no; Bere a wɔde ahyɛ mu akyi no, ɛho hia kɛse sɛ wobɛhyɛ myofascial layer no yiye ma akata mprɛte no so na asiw ɔyare mmoawa no ano.

Intramedullary fixation .

Mprempren mfiri a wɔde hyɛ nipadua no mu no bi ne kirschner pin, rockwood pin, hagie pin, titanium a ɛyɛ elastic intramedullary pin, screws a ɛwɔ tokuru, ne elastic locking intramedullary nnadewa; s.e., titanium elastic nails mma kwan mma static locking, mma kwan sɛ ɛbɛhwɛ ne tenten ne ne rotation so, na ebetumi ama secondary shortening bere a wɔde di dwuma ma comminited fractures. Wobetumi de intramedullary nailing technique no adi dwuma wɔ clavicle fractures a ɛnyɛ den, transverse anaa oblique mu nkutoo.

Mfaso a ɛwɔ so .

Ntini a ɛyɛ nketenkete, afɛfɛde pii, ntini a ɛyɛ mmerɛw a woyi fi hɔ, asiane a ɛwɔ hɔ sɛ endophyte a ɛpuepue no so tew, ne sɛnea ɛyɛ den a ɛbata akisikuru a ɛba ho no so.

Mfomso ahorow .

Wora a ɛyɛ wo yaw anaasɛ sintɔ ahorow wɔ baabi a ɛrehyɛn mu no.

Hyɛ no nsow:Ɛtɔ mmere bi a, ɛyɛ den sɛ wɔbɛtew akisikuru a ɛwɔ akisikuru mu no so na wɔkwati sɛ wɔde mframa a ɛbɔ no ma ɛboro so bere a wɔreyɛ oprehyɛn no.

Mprɛte a wɔde hyɛ mu kakraa bi na ɛyɛ adwuma .

Wosusuw sɛ mprɛte no mu nnompe a ɛyɛ mmerɛw kɛse a ɛwɔ clavicle no mu no ma ɛyɛ biomechanical ahoɔden kɛse bere a ɛkwati sintɔ ahorow a ɛwɔ mprɛte a wɔabue mu a wɔde si hɔ anaasɛ intramedullary fixation mu no.

Intraoperative placement of the 3.5 system LCP anterior to the clavicle, a ɛyɛ papa sɛ ɛwɔ anim ase wɔ clavicle no ase no ma kwan ma wɔtwe adwene si clavicle a ɛwɔ apɔwmuden no so, na ɛma ɛyɛ mmerɛw sɛ wobedi kan ayɛ mprɛte no na wɔanya screw aperture a ɛware.

Ebia mprɛte a ɛnyɛ den pii a wɔde di dwuma ntɛm no ne supraclavicular nerve opira, nhama abien abien a ɛka dwumadi no a ɛnyɛ pɛpɛɛpɛ anaasɛ ɛyɛ tiaa, ne mprɛte no a wɔkotow anaasɛ ɛpaapae no wɔ abusuabɔ.

Mprɛte a wɔde si clavicle no akyi no mu abubu .

Mprɛte a wɔde hyɛ nipadua mu a wɔpaw no gyina akyi dompe a wɔde siw ano no kɛse so. Anyɛ yiye koraa no, 3 bicortical screws ho hia ma lateral bone block no. Sɛnea ɛbɛyɛ yiye no, ɛsɛ sɛ wɔde nhyɛso nkɔnsɔnkɔnsɔn di dwuma ma oblique fractures. Sɛ dompe block no sua dodo sɛ wɔde besiesie a, wobetumi de clavicle hook plate adi dwuma.

Acromioclavicular nkwaa a ɛpaapae no ayaresa .

Acromioclavicular nkwaa mu apirakuru yɛ 12% wɔ scapular girdle apirakuru mu na ɛtaa ba wɔ contact agumadifo a wɔahyɛ wɔn ma mu.

Staging nhyehyɛe a wɔtaa de di dwuma ne Rockwood staging. Type I yɛ acromioclavicular ligament no mu a ɛyɛ mmerɛw a rostroclavicular ligament no ntumi nyɛ adwuma yiye; Type II yɛ acromioclavicular ligament no a ɛtetew a rostroclavicular ligament no ntumi nyɛ hwee; Type III yɛ acromioclavicular ligament ne rostroclavicular ligament no nyinaa a wɔatetew; Type IV yɛ distal clavicle a ɛbɔ trapezius no ho ban no akyi kwan; Type V yɛ acromioclavicular nkwaa ne rostroclavicular ligament nyinaa a wɔatetew mu koraa, a nkwaa no bɛboro ɔha biara mu nkyem 100; Na type VI opira no ho yɛ na yiye, na distal clavicle no tu kɔ fam wɔ rostral nhyehyɛe no ase.

Wɔkamfo ayaresa a wɔde bere tiaa mu breki a wɔde cantilever sling di dwuma kyerɛ sɛ wɔmfa nni dwuma mma Type I ne Type II apirakuru. Apirakuru a ɛyɛ ɔkwan a ɛto so III no sohwɛ yɛ nea akyinnyegye wom, na nhoma ahorow bi kyerɛ sɛ wɔakyerɛ sɛ wɔmfa ayaresa a wɔde di dwuma wɔ ɔkwan a ɛfata so mma mmerante ne mmabaa a wɔadu mpanyin afe so a wɔyɛ nnam. Dwumadi mu ahotɔ ye ɛwom sɛ ebia ɛsono sɛnea ɛte wɔ ne hwɛbea mu de. Type IV - VI apirakuru no mu yɛ den kɛse na wɔkamfo kyerɛ sɛ wɔnyɛ oprehyɛn mfa wɔn ho nhyɛ mu.

Mprempren, oprehyɛn akwan a wɔtaa de di dwuma ne: Bosworth rostral locking screw technique a ɛwɔ afã biako asiesie anaasɛ wɔrensiesie ligament no;, clavicle hook plate fixation, a ɛte sɛ lateral end of clavicle fracture; TightRope tab mprɛte a wɔde si hɔ anaasɛ ankora pinning suture a ɛnam arthroscope anaasɛ ntwitwiridii ketewaa bi so; ne rostral locking ligament suture anaasɛ suspension a wɔahyɛ no den, a wɔde nneɛma a wɔde ayɛ anaasɛ ntini a ɛwɔ rostral eminence ne clavicle no ntam.

Ɛnyɛ nea ɛda adi pefee sɛ oprehyɛn ho ɔkwan bɛn na ɛyɛ mfaso kɛse, na ɛwom sɛ ebia ɛbɛhwere nea ɛbɛsan aba no bi de, nanso sɛnea saa akwan yi nyinaa yɛ adwuma yiye koraa no yɛ nea abotɔyam wom.

Medial end clavicle fractures ne sternoclavicular joint dislocations a wɔde sa yare .

Saa apirakuru yi ho yɛ na, na bio ayaresa ho akwankyerɛ a egyina aduruyɛ a egyina adanse so so nni hɔ.

Medial clavicle fractures taa yɛ extra-articular fractures a ɛwɔ baabi a ɛnyɛ hwee na wobetumi ayɛ no wɔ ɔkwan a ɛyɛ katee so. Mpɛn pii no, epiphysis a ɛwɔ clavicle no mfinimfini awiei no mu no to mu bere a obi adi mfe 23-25 ​​na ɛyɛ epiphysis a etwa to a ɛto mu wɔ nipadua no mu. Enti, mfinimfini apirakuru pii yɛ epiphyseal plate fractures of saltter-harris type I anaa II ankasa. Ɛyɛ den sɛ wobehu x-ray a wɔtaa de di dwuma no, na mfaso wɔ so sɛ ebia 40° ti a wɔde si tilt radiograph ne ntotoho a wɔde toto ɔfã a ɛte apɔw no ho no bɛma wɔahu sɛ clavicle no mfinimfini awiei no akɔ baabi foforo, na CT de mfonini a eye sen biara a wɔde hu yare no ma.

Mpɛn pii no, wobetumi atoto abubu anaasɛ mpaapaemu a ɛkɔ anim wɔ anim no mu na wɔasan de asi baabi foforo, nanso mpɛn pii no entumi nnyina na wɔayɛ no lobotom ama no bio. Wɔkamfo ayaresa a ɛma obi ho tɔ no kyerɛ sɛ ɛnyɛ nea ɛkɔ so paapae anaasɛ ɛkɔ baabi foforo efisɛ mpɛn pii no ɛmma dwumadi no mu nyɛ den. Dislocation of the medial end of the clavicle akyi ntaa mma mfinimfini mfinimfini apirakuru, a nea ɛka ho ne ntini mu opira anaasɛ mpo tracheal obstruction ne mframa kwan mu nhyɛso. Wɔ mpaapaemu ne mpaapaemu a ɛwɔ baabi a mfinimfini asinasin no sua dodo no, wobetumi abɔ mprɛte no so wɔ nkwaa no so de ahyɛ akyi berɛmo no mu.

Akwan foforo a wɔfa so yɛ fixation .

s.e. abɔnten fixation ne stent, abɔnten fixation ne clavicle mprɛte, ne nea ɛkeka ho.

Oprehyɛn akyi nhyehyɛe .

Ɛsɛ sɛ wɔma nsa a ɛwɔ soro no yɛ nea wontumi nkɔ so wɔ sling mu na ɛsɛ sɛ wofi ase tete pendulum wɔ mmati so ntɛm ara. Adapɛn 2 akyi no, ɛsɛ sɛ wodi ɔyarefo no akyi kɔhwɛ kuru no na ɔsan hwɛ x-ray no mu, bere a wobetumi ayi nsateaa no anim a ɛyɛ mmerɛw no na wɔafi ase ayɛ nkwaa a wɔde tu kwan a anohyeto biara nni ho, nanso ɛsɛ sɛ wɔka kyerɛ ɔyarefo no sɛ ɔmfa ne nsa ne ne nan no mma so. Wobetumi afi ahoɔden ntetee ase wɔ adapɛn 6 akyi wɔ oprehyɛn no akyi bere a nnompe a ɛsa yare ho sɛnkyerɛnne ahorow ba no. Ɛsɛ sɛ wɔkwati agumadi anaa agumadi a ɛyɛ hu a wɔde di nkitaho wɔ oprehyɛn no mu asram 3 wɔ oprehyɛn no akyi kosi sɛ akisikuru no bɛsa koraa.

Nsɛnnennen a ɛwɔ mu.

Nsɛnnennen a ɛba ntɛm .

Oprehyɛn akyi kuru mu yareɛ no tumi ba wɔ nsɛm a ɛkɔ 4.8% mu;

Ntini a ɛyɛ mmerɛw a ɛwɔ subclavian no mu no ne ɔhaw a ɛtaa ba, a abɔde ho abakɔsɛm mu nhwehwɛmu a ɛfa ayarefo a wɔwɔ saa sɛnkyerɛnne yi mu bɛyɛ 83% ho, a bere kɔ so no ɛso tew na ɛmma wontumi nyɛ adwuma yiye, ɛwom sɛ ebetumi atra hɔ mfe 2 wɔ oprehyɛn no akyi de;

Endophyte protrusion ne honam ani a ɛyɛ basaa, a ɛtaa ba bere a wɔde mprɛte a ɛyɛ kɛse anaa nnadewa dua di dwuma a enni ntini a ɛyɛ mmerɛw a ɛkata so yiye;

Re-fracture, a ebetumi aba wɔ oprehyɛn ne aduru a wɔde di dwuma wɔ ɔkwan a ɛyɛ mmerɛw so akyi; Oprehyɛn akyi a wɔsan pira no betumi ama wɔakotow anaasɛ wɔabubu endoprosthesis no, anaasɛ abubu atwa endoprosthesis no ho ahyia;

nonion, a 15% nonion rate a ɛwɔ ayaresa a ɛyɛ konservatif ne 2% nonion rate a oprehyɛn ayaresa ma diaphyseal a ɛpaapae koraa; Mmubui no a ɛkɔ akyiri koraa, ɛma ɛyɛ tiaa sen cm 2, sigaretnom, mfe a obi adi a ɛkɔ soro, ahoɔden a ɛkɔ soro apirakuru, nea ɛsan yɛ adwuma (mfiri a ɛma obi ho yɛ den), diphyseal a ɛyɛ den a ɛma ne ho yɛ den, nnompe a ɛnyɛ papa, ne nnompe a ɛyera dodo.

Nsɛnnennen a ɛba akyiri .

Nnompe mu yare a ɛwɔ acromioclavicular nkwaa mu no taa ba bere a ntini a ɛwɔ ntini no mu no mu paapae (Edinburgh Type 3B2); Sɛ ayaresa a ɛwɔ sɛnkyerɛnne ne nea wɔde siw ano no ntumi nyɛ adwuma yiye a, wobetumi atwa akyi berɛmo a ɛwɔ akyirikyiri no ntini mu anaasɛ wɔayɛ no oprehyɛn a ɛda adi pefee;

dɛmdi ayaresa, a ɛba wɔ ɔkwan a ɛsonosonoe so wɔ akisikuru a wɔatu afi hɔ a wɔayɛ ho adwuma wɔ ɔkwan a ɛyɛ katee so nyinaa mu; Scapular girdle a ɛyɛ tiaa a distal fracture block no di akɔneaba no betumi ama abati ahoɔden a etwa to no so atew ne boasetɔ, titiriw wɔ mmati a wɔkyere wɔn sie mu; Ahurututu no mu a ɛyɛ teateaa no betumi ama brachial plexus compression ho sɛnkyerɛnne aba; Na malalignment a ɛwɔ scapulothoracic fasuo nkwaa mu no betumi ama scapula no anim ayɛ mmerɛw na ɛde mmati mu yaw ne myalgias aba, sɛ ɛda adi pefee sɛ sɛnkyerɛnne no fi dɛmdi bere a ayaresa ba no a, osteotomy correction ne plate fixation yɛ nea wobetumi ayɛ a egyina ɔyarefo no ahiade so.

Nkɔmhyɛ ne nea ebefi mu aba .

Nhwehwɛmu bi a ɛfa ho wɔ Europa bɔɔ amanneɛ sɛ oprehyɛn a wɔde yɛɛ mfinimfini a ɛpaapae a wɔatu afi wɔn mu no yɛɛ adwuma yiye, na ne meta-nhwehwɛmu no kyerɛe sɛ malunion a ɛba a ɛde abubuw nonion ne malunion a ɛma sɛnkyerɛnne ba a ɛba no sua koraa wɔ oprehyɛn kuw no mu sen bere a wɔde oprehyɛn a wɔde siw ano no totoo ayaresa a wɔde siw ano no ho no; Nea ɛka ho no, na oprehyɛn kuw no atew ɛyaw so ntɛm, na nkɔso a ɛbae wɔ bere nyinaa ne DASH dwumadi mu no mu no daa adi kɛse.

Bɔ no mua .

Basabasayɛ a ɛba tẽẽ anaasɛ ɛnyɛ tẽẽ na ɛde akisikuru dodow no ara ba, na wobetumi akyekyɛ ayaresa no mu sɛ aduru a wɔde di dwuma wɔ ɔkwan a ɛyɛ mmerɛw so anaasɛ wɔde yɛ oprehyɛn. Wɔ ayaresa ho no, ɛwom sɛ wobetumi ayɛ clavicle fractures dodow no ara a enni hɔ kɛse no ho adwuma wɔ ɔkwan a ɛyɛ katee so de, nanso oprehyɛn ayaresa a wɔpaw ma akisikuru a ɛma ɛkɔ baabi foforo kɛse no yɛ nea akyinnyegye wom. Wɔ clavicle a ɛpaapae a ɛkɔ baabi foforo ho no, oprehyɛn ayaresa no nya nnompe a ɛsa yare no kɛse na ɛma ɛyɛ adwuma ntɛm bere a wɔde toto ayaresa a wɔde di dwuma wɔ ɔkwan a ɛyɛ mmerɛw so ho no.

Nsɛm a wɔde gyina hɔ ma .

[1] Postacchini F, Gumina S, de Santis P, Albo F. Nyarewa a ɛma obi ho kyere no. j mmati so nsateaa surg 2002; 11:452 na ɛwɔ hɔ.

[2] Eiff, MP, Hatch, ne afoforo. Clavicle ne scapula a ɛpaapae. Wɔ: akisikuru ho nhyehyɛe a wɔde hwɛ ayarehwɛ a edi kan, 2nd ed, WB Saunders, Philadelphia 2002. kr.198.

[3] Robinson CM. Clavicle no mu abubu wɔ ɔpanyin no mu. Epidemiology ne nkyekyɛmu. J nnompe nkwaa a ɛyɛ hyew BR 1998; 80:476 na ɛwɔ hɔ.

[4] Neer CS 2nd. Clavicle no nkyem abiɛsa mu biako a ɛwɔ akyirikyiri no mu abubu. Clin Orthop Relat Res 1968; 58:43 na ɛwɔ hɔ.

[5] Andersen K, Jensen Po, Lauriten J. Ayaresa a wɔde sa akisikuru a ɛma obi ho kyere no. Figure-of-eight bandage versus sling a ɛnyɛ den. Acta Orthop Scand 1987; 58:71 na ɛwɔ hɔ.

[6] Ersen A, Atalar AC, Birisik F, ne afoforo. Ntotoe a ɛfa abasa a ɛyɛ mmerɛw a wɔde hyɛ mu ne mfonini a ɛyɛ clavicular bandage awotwe ma midshaft clavicular fractures ho: nhwehwɛmu a wɔanhyɛ da ayɛ. nnompe nkwaa J 2015; 97-B:1562 na ɛwɔ hɔ.