Kɔnɔbara karilenw sɛgɛsɛgɛli ni u furakɛli

Daminɛ kuma

Kɔnɔbara karilen ka teli ka kɛ, wa a ka ca a la, a bɛ sɔrɔ joginda tilennen walima joginda tilennen tɛ kamankun yɔrɔ la. Kɔlɔsili minnu kɛra san 1960 daminɛ na, olu y’a jira ko cɛya karilenw hakɛ min tɛ ɲɔgɔn ta ye, o hakɛ tun tɛ 1% bɔ, wa furakɛli kɛcogo kɔrɔlen ye banabagatɔ wasa kosɛbɛ; furakɛli yiriwali kɔsa in na , opereli furakɛli ye nafa caman sɔrɔ ; o de kama, dɔgɔtɔrɔ minnu bɛ baara kɛ kɛnɛyaso kɔrɔtɔlen na walima kɛnɛyaso bɛɛ lajɛlen na, olu ka kan ka joginda in taamasiɲɛw ni a gɛlɛyaw dɔn minnu bɛ sɔrɔ tuma caman na ani a furakɛcogo jɔnjɔnw.

Banakisɛw jɛnsɛnni dɔnniya

Kɔnɔbara karilenw bɛ kɛ 2,6%-5% ye balikuw ka karilenw bɛɛ la [1,2]. Erɔpu jamanaw ka sɛgɛsɛgɛli dɔ min kɛra ni kɔkili karilen 1000 tugu-tugulen ye, o y’a jira [3,4] ko kɔkili karilen 66% ni kɔ kɛra cɛya cɛmancɛ 1/3 la, 25% ɲɔgɔn kɛra kɛrɛfɛla 1/3 karilen ye, ani 3% ye cɛmancɛ 1/3 karilen ye. Kɔnɔbara karilenw sɔrɔli y’a jira ko a bɛ kɛ cogo fila la, o bɛ kɛ fɔlɔ cɛw la minnu si tɛ san 30 bɔ, o kɔfɛ, minnu si tɛmɛna san 70 kan.

Anatomie clinique (Anatomie clinique) ye

Adamaden koloci fɔlɔ min bɛ koloci daminɛ, o ye kɔkolo ye, o ye kolotuguda kelenpe ye min bɛ bolokɔni sanfɛla ni kɔkolo cɛ, o min bɛ ɲɔgɔn sɔrɔ yɔrɔjan fɛ ni acromion ye, acromioclaviculaire (AC) joint, ani proproximally ni sternum ye, sternoclavicular (SC) joint. O joli ninnu bɛ wele ko sinovial joints atypique barisa u bɛ lamini ni fibrocartilage ye sanni ka kɛ hyaline cartilage ye. Kɔnɔbara bɛ siri sɔgɔsɔgɔninjɛ la ni acromioclaviculaire ni rostroclaviculaire ligaments ye ani a bɛ nɔrɔ sternum la ni sternoclavicular ligament ye.

Kɔnɔbara bɛ 'S' cogo la. Proximle half-arc bɛ bɔ ɲɛfɛ, ka yɔrɔ to sanfɛyɔrɔ la neurovascular bundle la. Arc tilancɛ yɔrɔjan bɛ projɛ ka taa kɔfɛ (concave) ka sɔrɔ ka fara scapula kan (rostral process ani acromion). A ka c’a la, kɔkili kari bɛ kɛ kɔ fila ninnu ka ɲɔgɔn sɔrɔyɔrɔ la (kɔri cɛmancɛ), a ka ca a la o sababu bɛ bɔ sɔgɔsɔgɔninjɛ minnu bɛ nɔrɔ kɛrɛfɛ kolo la o yɔrɔ in na ani barisa a ye kɔkili yɔrɔ barikama ye. Ni cɛya karilen dɔ bɔra a nɔ na, a bɛ se ka fɔ ko a kɛrɛfɛyɔrɔ bɛ sama ka taa sanfɛ (cephalad) ni sternocleidomastoïde farikolo ye (min nɔrɔlen bɛ cɛya karilen kɛrɛfɛ) ani yɔrɔjan yɔrɔ bɛ wuli ka taa duguma (caudad) ni bolokɔni sanfɛla girinya ye, ani kɔkili bɛ teli ka 'kurun' (o kɔrɔ ye ko kari dakunw bɛ ɲɔgɔn cɛ), kɛrɛnkɛrɛnnenya la, a bɛ sɔrɔ subscapularis ni pectoralis major (min bɛ bolokɔni sanfɛla wuli kɔnɔna na) sɔgɔsɔgɔli fɛ. O bɛ sɔrɔ kɛrɛnkɛrɛnnenya la subscapularis ni pectoralis major muscles (minnu bɛ bolokɔni sanfɛla wuli kɔnɔna na k’a sama ka taa disi fan fɛ) sɔgɔsɔgɔli fɛ.

Suguya

Kɔnɔbara kari furakɛli kun ye ka dimi dɔgɔya ani ka kolotugudaw baara kokura. Kɔnɔbara kari fanba bɛ furakɛ hali bi fɔlɔ ni kɔrɔlen ye (a ka ca a la u bɛ surunya ni milimɛtɛrɛ 15 ye); furakɛli minnu bɛ kɛ ni kɔrɔlen ye i n’a fɔ bandi minnu bɛ kɛ ni ja 8 ye, bolokɔnincininw, Sayre bandiw, Velpeau jɔli finiw, ani jɔli finiw. Suspension immobilisation bɛ kɛ waati jugumanba la, wa a ka ca a la, lamaga-lamagali daminɛni ni fanga degeliw bɛ kɛ dɔgɔkun 2-6 karilen kɔfɛ ni dimi banna. Bandi jate 8 tali man ɲi barisa a bɛ se ka kɛ sababu ye ka aksidan tansiyɔn joginda bila a la ani ka kari karilen fara ɲɔgɔn kan ka caya [5,6].

Tariku ni farikolo sɛgɛsɛgɛli

Kɔnɔbara karilen bɛ sɔrɔ ni a bɛ gosi a kamankun na binkanni kɔfɛ, wa a ka teli ka ye kɛnɛma farikoloɲɛnajɛw la denmisɛnninw na ani mɔgɔkɔrɔbaw ka binni na k’a sɔrɔ u ma a dɔn. A nafa ka bon ka joginda kɛcogo ɲɛfɔ. Jogin minnu fanga ka bon, olu bɛ se ka fara kunkolo ni disi joginw kan, k’a sɔrɔ kari minnu bɛ sɔrɔ joginda misɛnniw fɛ, olu bɛ se ka kɛ bana ye. Jogin minnu bɛ mɔgɔ hakili ɲagami, olu ka kan ka daminɛ joona ani ka disi kogow faranfasi ni hakili ye, ka joginw bɔ farikolo la ani joli siraw la. Kɛnɛyaso siratigɛ la, funu ni fɛnɲɛnamafagalan bɛ kɛ kariyɔrɔ la, o ni farikolojidɛsɛ ni sɔgɔsɔgɔninjɛ bɛ fara ɲɔgɔn kan. Aw ka kan ka aw janto farikolo yɔrɔ nɔgɔlenw na walasa ka jack up kɛ, o bɛ se ka kɛ sababu ye ka fari sɔgɔsɔgɔ ani ka kirinni bila a la.

Jaw tacogo

Kari fanba bɛ se ka dɔn ni ɲɛda ni kɔfɛla jateminɛ nɔgɔmanw ye. Kungolo kɔrɔtacogo 20° bɛ barajuru dawolo minnu bɛ ɲɔgɔn kan, olu nɔ bɔ. Banabagatɔw ka kan ka rezow ta u yɛrɛ dɛmɛyɔrɔ la walasa ka kariw jiginni ye ka ɲɛ. Kisɛya tali rezow la, o bɛ dɛmɛ don ka ɲɛgɛnɛsiralabanaw dafalen jateminɛ kɔkolo yɔrɔjan joginw na walima kolotugudaw joginniw na.CT bɛ dɛmɛ ka sɔgɔsɔgɔninjɛ jogin gɛlɛnw ye ani ka ɲɛdawolo yɔrɔ joginniw ye ka ɲɛ, minnu bɛ se ka kɛ sɔgɔsɔgɔninjɛ kolotugudaw la. Ni aw ye disi lajɛ, o bɛ dɛmɛ ka barajuru joginni dɔ bɔ a la, wa a surunyali bɛ se ka jateminɛ ni aw ye a suma ni kɔkili kɔkanna ye, ka fara a kan ka barajuru kogo faranfasi.

Suguw

AO/OTA Fracture Dislocation Typing : Kɔnɔbara karicogo kode 15 bɛ kɛ yɔrɔ saba ye: 15,1 proximal (medial), 15,2 diaphyse, ani 15,3 distal (lateral). Kɛrɛnkɛrɛnnenya la (cɛmancɛ) ni yɔrɔjan (kɛrɛfɛ) karilenw bɛ tila ka kɛ suguya A (kɛrɛfɛla), suguya B (a yɔrɔ dɔ ye bolokɔni kɔnɔ), ani suguya C (articulaire kɔnɔ pewu). Bagan karilenw bɛ tila suguya A (nɔgɔman), suguya B (wedge), ani suguya C (comminuted).AO/OTA ka karilenw ni u jiginniw danfara tɛ jateminɛ kɛ kariw jiginni hakɛ la, wa sisan a nafa ka dɔgɔn kɔkolo karilenw furakɛli la ani a ɲɛfɔli la.

Allman ka sɛbɛnni bɛ kɛ ka da kari yɔrɔ kan (I: cɛmancɛ, cadent 1/3, II: kɛrɛfɛ 1/3, III: cɛmancɛ 1/3) (Ja 7.2.1).

Craig ye nin danfara in nɔgɔya tugun ka da Allman kan, ni ne ye cɛya cɛmancɛ 1/3 ye; suguya II ye kɔkolo kɛnɛma 1/3 ye, o kɔfɛ, o tilalen don suguya 5 ye ka da a karilenw jiginni kan ani jɛɲɔgɔnya kan ni kɔkili rostral ligament ye; ani suguya III ye kɔkolo kɔnɔna 1/3 karilen ye, o min tilalen don suguya 5 ye ka da kari jiginni hakɛ kan ani ni kari kɛra joli kɔnɔ walima ni a ma kɛ.

Neer ka kɛrɛfɛla 1/3 karilenw suguya bɛ sinsin kɔkolo-kɔlɔsili-yɔrɔ nafa kan: suguya fɔlɔ bɛ kɛ kɔkolo-kɔlɔsili-yɔrɔ jan na, ni cɛmancɛ kari bloki bɛ wuli ka taa sanfɛ suguya II bɛ tali kɛ rostral-clavicular ligament la ani o bɛ na ni cɛmancɛ kari bloki bɛ wuli ka taa sanfɛ; ani suguya III bɛ taa fo acromioclaviculaire joli la ni rostral-claviculaire ligament bɛ to a cogo la.

Edinburgh typing ye diaphyse karilenw tilacogo ye ka kɛɲɛ ni u jiginni ni u sɔgɔli hakɛ ye.1 Kari suguya 1 bɛ tali kɛ cɛmancɛ dakun na, suguya 2 ye diaphyse karilenw ye ani suguya 3 ye kɛrɛfɛ dakun karilenw ye. Diaphyse karilenw bɛ tila ka kɛɲɛ ni cortical contact sɔrɔli walima a tɛ kɛ kari yɔrɔw ni ɲɔgɔn cɛ ka kɛ suguya A ni B. Kari suguya 2A bɛ tila ka taa a fɛ i n’a fɔ nondisplaced (type 2A1) ani angulated (type 2A2),2B fractures bɛ tila ka kɛ simple walima wedge-shaped (type 2B1) ani comminuted (type 2B2).3 Type 1 kariw bɛ kɛ ni diaphyse cɛmancɛ laban ye ani suguya 3 ye diaphyse kɛrɛfɛla laban ye. Cɛmancɛ ni kɔfɛla laban karilenw bɛ tila kulu fitinin 1 ni 2 ye ka kɛɲɛ ni kolotuguda kɛrɛfɛla sen bɛ o la.

O cogo kelen na, Rockwood sɛbɛnni, Jager sɛbɛnni ani Breitner sɛbɛnni fana bɛ yen.

Opereli taamasiɲɛw

Kari kɛrɛnkɛrɛnnenw

1, da wulilen kari; 

2, jiginni >2 cm; 

3, ka surunya >2 cm; 

4, kari yɔrɔw tiɲɛni (>3); 

5, yɔrɔ caman karilen; 

6, duguma da wulilen kari ni farikolo yɔrɔ nɔgɔlen jogin; 

7, bɔgɔbɔgɔliba (bɔli ni surunyali); 

8, sɔgɔsɔgɔninjɛ joginni.

Joginw jugumanba

1, Ipsilateral sanfɛla joginni faralen ɲɔgɔn kan;

2, Jogin min bɛ kɛ kamankun na min bɛ panpan;

3, jogin caman sɔrɔli;

4, kari min faralen don ɲɔgɔn kan ni farikolojidɛsɛ jogin ye;

5, kɔkili caman karilenw ipsilateral faralen ɲɔgɔn kan ni disi kogo tiɲɛni ye;

6, cɛya surunyali ka kɛ kamankun ye min bɛ kɛ ni wulu ye;

7, Kɔnɔbara fila karilenw.

Banabagatɔw ka kow

1, Banabagatɔ minnu jogincogo caman bɛ u la, olu mago bɛ sanfɛla girinya ta joona;

2, Banabagatɔ minnu mago bɛ segin teliya la u ka baara la (misali la, farikoloɲɛnajɛ minnu bɛ kɛ mɔgɔba ni minnu bɛ ɲɔgɔn sɔrɔ).

Opereli kɛli waati

Opereli ka kan ka kɛ k’a sɔrɔ a ma mɛn ni opereli taamasiɲɛ dafalenw bɛ yen.

Ni opereli bɛ mɛn ka tɛmɛ dɔgɔkun 2-3 kan ni taamasiɲɛw ye minnu bɛ tali kɛ ɲɔgɔn na, o bɛ se ka dɔ fara kari dɔgɔyali gɛlɛya kan, kɛrɛnkɛrɛnnenya la ni aw bɛ aw labɛn ka kɔnɔnatumuni dagalen kɛ ni farikolojidɛsɛ fɛɛrɛw ye.

Opereli sɔrɔli

Banabagatɔ bɛ bila kɔgɔjida sigilan jɔyɔrɔ la walima a sigiyɔrɔ tilancɛ la. Kamankun min bananen don, o bɛ datugu a jukɔrɔ walasa ka bolokɔni kɔrɔta walasa opereli ka nɔgɔya, ani ka bolokɔni siri walasa ka a to a ka se ka lamaga opereli kɔnɔ. Tigɛ tigɛcogo min bɛ kɛ ka ɲɛsin kɔkolo janya ma walima tigɛcogo min bɛ kɛ ni saber ye min bɛ bɛn langer cogoya ma, o bɛ se ka sugandi.

Kɔlɔsili: Ni tigɛli bɛ kɛ ka tɛmɛ a kan, o bɛ janya caman di, ka sɔrɔ ni tigɛli janyalen don, o bɛ dɔ bɔ sɔgɔsɔgɔninjɛ sanfɛla joginni farati la, wa a bɛ mɔgɔ ɲɛnajɛ kosɛbɛ.

Kɔnɔna Labɛnni

3.5 Degun plati sigilenw, reconstruction plates, walima plastiki LCPw bɛ se ka kɛ ka cɛya karilenw labɛn. Farikoloɲɛnajɛw bɛ bila ka ɲɛ walima ka u bila ɲɛgɛnɛsira ɲɛfɛ walima a ɲɛfɛ. Fali fanga ka bon biyomekaniki joginw na ni u bilalen don sanfɛ, kɛrɛnkɛrɛnnenya la ni kari tigɛlen dɔ bɛ duguma, wa u yecogo ka nɔgɔn. Kurukuruw sirili bikɔritiki la, o ka kan, wa dingɛw ka kan ka sɔgɔ ni hakilijagabɔ ye kosɛbɛ, barisa farati bɛ se ka jogin farikolojidɛsɛ ni joli siraw la duguma. Nafa minnu bɛ a la: ka ɲɛfɛla plati sirilan foroko lakana, plati apposition, contouring nɔgɔn.

Kɔlɔsili: A ka ca a la, kolotuguda man kan ka kɛ wale fɔlɔ la; kɔnɔna jɔli kɔfɛ, a nafa ka bon ka ɲɛgɛnɛsira siri ka ɲɛ walasa ka plati datugu ani ka banakisɛw bali.

Fixation intramédullaire (sɔgɔsɔgɔninjɛ) kɔnɔ

Sisan, ɲɛgɛnɛsira sirili minɛnw ye Kirschner pinɛw, Rockwood pinɛw, Hagie pinɛw, titaniyɔmu elastikiw kɔnɔbara kɔnɔ pinɛw, burusi kɔnɔna na, ani sɔgɔsɔgɔninjɛ sɔgɔlilanw ye misali la, titanium elastic nails tɛ sira di static locking ma, u tɛ a to ka janya ni jiginni kɔlɔsi, wa u bɛ se ka kɛ sababu ye ka surunya filanan kɛ ni u kɛra kari tigɛlenw na. Intramedullary nailing technique bɛ se ka kɛ dɔrɔn ni kɔkili karilen nɔgɔmanw, transversales walima oblique ye.

Nafa minnu b’a la

tigɛcogo fitinin, a cɛ ka ɲi, farikolo yɔrɔ nɔgɔlenw bɔli ka dɔgɔn, endophyte bɔli farati ka dɔgɔn, ani sabatili min bɛ tali kɛ sɔgɔsɔgɔninjɛ sɔrɔli la.

Nafa minnu bɛ a la

fari ŋɛɲɛ walima fiɲɛ bɛ don yɔrɔ min na.

Kɔlɔsili:Kɔnɔbara karilenw dɔgɔyali dadonni ka gɛlɛn tuma dɔw la ani baarakɛla bolo ka se ka fiɲɛ bila a la kojugu opereli kɛcogo la.

Plate fixation min bɛ kɛ ni fɛn ye min tɛ fɛn caman kɛ

A bɛ miiri ko sɔgɔsɔgɔninjɛ kolosinsinnan min bɛ kɛ ni plati ye min tɛ fɛn caman kɛ, o bɛ fanga caman di biyomekanikini ma ka sɔrɔ ka a yɛrɛ tanga plati da wulilen sirili walima ɲɛgɛnɛsira sirili nafaw ma.

3,5 sitɛmu LCP bilali opereli kɔnɔ kɔkili ɲɛfɛ, a ka fisa a ɲɛfɛla la kɔkili jukɔrɔ, o bɛ a to ka ɲɛsin kɔkili kɛnɛman ma, o bɛ a to a ka nɔgɔn ka kɔn ka plati cogoya kɛ ani ka kurukuru janya sɔrɔ.

Plate osteosynthèse min tɛ fɛn caman kɛ, o kɛli joona, o bɛ se ka kɛ ni supraclaviculaire nerve jogin ye, ni nɛgɛ fila-fila ma bɛn walima u surunyali min bɛ nɔ bila baara la, ani plati kuruli walima kari.

Kɔnɔbara kɔkanna dakun karilenw sirili plati la

Plate (plate) doncogo sugandili bɛ bɔ kɔkanna kolotuguda hakɛ la. Bicortical screws 3 a dɔgɔyalenba de ka kan ka kɛ kɛrɛfɛ kolo bloki la. A ka fisa, tension screws ka kan ka kɛ ni oblique fractures ye. Ni kolotuguda ka dɔgɔn kojugu fo a tɛ se ka a siri, a bɛ se ka kɛ ka ɲɛgɛnɛsira sɔgɔlan dɔ kɛ.

Acromioclaviculaire joint dislocation furakɛli

Acromioclaviculaire joint jogins bɛ kɛ 12% ye scapular girdle joginw na wa a ka ca a la a bɛ sɔrɔ farikoloɲɛnajɛla minnu falen don ɲɔgɔnkanu na.

Sìgiyɔrɔma-sɛnɛcogo min bɛ Kɛ kosɛbɛ o ye Rockwood ɲɛnajɛ-yɔrɔ ye. Sugu fɔlɔ ye acromioclaviculaire ligament sɔgɔsɔgɔninjɛ ye ni rostroclaviculaire ligament ma tiɲɛ; suguya II ye acromioclaviculaire ligament ɲɛji ye ni rostroclaviculaire ligament ma tiɲɛ; suguya III ye acromioclaviculaire ligament ni rostroclaviculaire ligament fila bɛɛ ɲɛjibɔ ye; suguya IV ye kɔkolo kɔkanna jiginni ye min bɛ trapezius gengen; suguya V ye acromioclaviculaire joli ni rostroclaviculaire ligament fila bɛɛ tigɛlen ye pewu, ni kolotuguda jiginni ka ca ni kɛmɛsarada la 100 ye; ani jogin suguya VI ka dɔgɔn kosɛbɛ, ni kɔkolo yɔrɔjan bɛ wuli ka taa duguma rostral processus jukɔrɔ.

Furakɛli min bɛ kɛ ni frein kuntaala surun ye ni kantilever sling ye, o ka ɲi jogin suguya fɔlɔ ni suguya filanan na. Jogin suguya sabanan furakɛcogo ye sɔsɔli ye, sɛbɛn dɔw b’a jira ko furakɛli kɛcogo kɔrɔlen ka kan ka kɛ baliku fitiniw ye minnu bɛ baara kɛ. Baarakɛcogo kɛnɛya ka ɲi hali ni a bɛ se ka kɛ ko a ɲɛda cogoya tɛ kelen ye. Jogin suguya IV - VI ka jugu kosɛbɛ wa opereli ka kan ka kɛ.

Sisan, opereli kɛcogo minnu bɛ kɛ ka caya, olu ye : Bosworth rostral locking screw technique ni ligament dilancogo kelen walima a tɛ dilan;, clavicle hook plate fixation, o bɛ tali kɛ clavicle fracture lateral end Tightrope ka tab plate fixation walima anchor pinning suture ka tɛmɛ arthroscope fɛ walima tigɛyɔrɔ fitinin dɔ fɛ; ani rostral locking ligament suture walima reinforced suspension, ni fɛn dilannen walima tendon ye rostral eminence ni clavicle cɛ.

A ma jɛya opereli fɛɛrɛ jumɛn de nafa ka bon, wa hali ni a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ.

Kɔnɔbara cɛmancɛ laban karilenw ni kɔkolo kolotugudaw bɔli furakɛli

O joginw man ca, wa tuguni furakɛli laadilikanw dɛsɛ bɛ yen minnu sinsinnen bɛ furaw kan minnu sinsinnen bɛ daliluw kan.

A ka ca a la, cɛya cɛmancɛ karilenw ye bolokɔni kɔkanna karilenw ye minnu bɛ wuli ka bɔ u nɔ na, ​​wa u bɛ se ka furakɛ ni kɔrɔlen ye. A ka ca a la, cɛya cɛmancɛ laban epifisi bɛ datugu ni a si bɛ san 23-25 ​​la, wa o ye epifisi laban ye min bɛ datugu farikolo la. O la, cɛmancɛ jogin caman ye tiɲɛ na Salter-Harris suguya fɔlɔ walima filanan ka epifisiyali plate karilenw ye. X-ray kɔrɔlenw sɛgɛsɛgɛli ka gɛlɛn, o nafa ye ko ni i ye kunkolo kɔrɔta 40° la ani ka a suma ni fan kɛnɛman ye, o bɛ se ka kɛ sababu ye ka cɛya cɛmancɛ dakun jiginni jira, wa CT bɛ sɛgɛsɛgɛli kɛcogo ɲuman di.

A ka ca a la, kari walima fɛn minnu bɛ bɔ ɲɛfɛ, olu bɛ se ka datugu ka bila yɔrɔ wɛrɛ la, nka a ka ca a la u tɛ sabati ani ka lobotomize walasa ka segin ka bɔ u nɔ na. Ladonni min bɛ kɛ ni farikolojidɛsɛ ye, o ka ɲi ni a bɛ to ka wuli walima ka a bila yɔrɔ wɛrɛ la barisa tuma caman na, o tɛ kɛ sababu ye ka baarakɛbaliya lase mɔgɔ ma. Kɔnɔbara cɛmancɛ laban bɔli kɔfɛ, a man teli ka kɛ sababu ye ka ɲɛgɛnɛsira sanfɛla jogin, o la, joli siraw joginni walima hali fiɲɛbɔyɔrɔw datuguli ani fiɲɛbɔyɔrɔw degun. Ni sɔgɔsɔgɔninjɛ ni kariw don, yɔrɔ minnu na cɛmancɛ yɔrɔ ka dɔgɔn kojugu, platiw bɛ se ka kɛ ka u siri kolotuguda la walasa ka u siri kɔkolo la.

Fixation fɛɛrɛ wɛrɛw

misali la kɛnɛma sirili ni stent ye, kɛnɛma sirili ni clavicle plate ye, a ɲɔgɔnnaw.

Opereli kɔfɛ furakɛli

Bolo sanfɛla ka kan ka jɔ sɔgɔsɔgɔninjɛ la ani kamankun pendule degeli ka kan ka daminɛ joona. Dɔgɔkun 2 o kɔfɛ, banabagatɔ ka kan ka tugu walasa ka joginda lajɛ ani ka rezow lajɛ, ka sɔrɔ bolokɔnincinin bɛ se ka bɔ ani ka kolotugudaw lamagacogo degeli daminɛ ni dan tɛ a la, nka a ka kan ka fɔ banabagatɔ ye ko a kana girinya kɔrɔta ni farikolo yɔrɔ min bananen don. Fanga degeliw bɛ se ka daminɛ dɔgɔkun 6 opereli kɔfɛ ni kolo kɛnɛya taamasiɲɛw bɛ ye. Spor minnu bɛ kɛ ni ɲɔgɔn ye walima farikoloɲɛnajɛ minnu ka jugu kosɛbɛ, olu ka kan ka kɛ kalo 3 opereli kɔfɛ fo ka se kari ka kɛnɛya pewu.

Gɛlɛya minnu bɛ sɔrɔ a la.

Gɛlɛya minnu bɛ sɔrɔ fɔlɔ

Joginda banakisɛ minnu bɛ sɔrɔ opereli kɔfɛ, olu bɛ se ka kɛ fo ka se 4,8% ma;

Kɔnɔbara basigilen yɔrɔ la, o ye gɛlɛya ye min ka teli ka sɔrɔ, ni tariku sɛgɛsɛgɛli kɛra banabagatɔ 83% kan minnu bɛ nin taamasiɲɛ in na, o bɛ dɔgɔya waati tɛmɛnen kɔfɛ, wa a tɛ na ni baarakɛbaliyaba ye, hali ni a bɛ se ka to sen na fo san 2 opereli kɔfɛ

Endophyte bɔli ni fari lamaga, o min ka teli ka kɛ ni plate voluminous walima nail tails kɛli ye ni farikolo yɔrɔ nɔgɔlenw datugucogo ɲuman tɛ;

kari seginni, o bɛ se ka kɛ opereli ni furakɛli kɔrɔlen fila bɛɛ kɔfɛ; opereli kɔfɛ joginni seginni bɛ se ka kɛ sababu ye ka endoprothèse kuru walima ka kari, walima ka endoprothèse lamini;

nonunion, ni 15% nonunion hakɛ ye ni furakɛli kɔrɔlen ye ani 2% nonunion hakɛ ni opereli furakɛli ye diaphyse karilenw na minnu bɔra u nɔ na pewu; kari bɛ wuli pewu, ka surunya ka tɛmɛ santimɛtɛrɛ 2 kan, sigarɛtimin, si hakɛ caya, jogin minnu fanga ka bon, kari seginni (masina basigibaliya), diaphyse bɛ wuli ka bɔ a nɔ na, ​​kolo jogo jugu, ani kolo bɔnɛ kojugu.

Gɛlɛya minnu bɛ sɔrɔ kɔfɛ

Acromioclaviculaire joint koloci bɛ kɛ ka caya ni kolotugudaw karilen don (Edinburgh type 3B2); ni taamasiɲɛw ni furakɛli kuntaalajan tɛ nafa sɔrɔ, kɔkili yɔrɔjan bɛ se ka tigɛ ni joli-sira-funu ye walima ni opereli dafalen ye;

Deformité healing, o bɛ kɛ hakɛ caman na kariw bɛɛ la minnu furakɛra ni kɔrɔlen ye; sɔgɔsɔgɔninjɛ surunyali ni ka fara yɔrɔjan karilen bloki jiginni kan, o bɛ se ka kɛ sababu ye ka kamankun fanga laban ni muɲuli dɔgɔya, kɛrɛnkɛrɛnnenya la kamankun minɛni na barajuru bɔyɔrɔ dɔgɔyali bɛ se ka kɛ sababu ye ka bolokɔniw degun taamasiɲɛw jira; ani sɔgɔsɔgɔninjɛ kogo kolotugudaw ma bɛn ɲɔgɔn ma, o bɛ se ka kɛ sababu ye ka ɲɛgɛnɛsira kɔrɔta ɲɛfɛ ani ka kamankun dimi ni ɲɛgɛnɛsiralabanaw bila mɔgɔ la, ni a jɛlen don ko a taamasiɲɛw bɛ bɔ sɔgɔsɔgɔninjɛ la Ni kɛnɛya kɛra, koloci ladilanni ni tabali sirili bɛ se ka kɛ ka kɛɲɛ ni banabagatɔ magow ye.

Prognose ani a kɔlɔlɔw

Sɛgɛsɛgɛli dɔ kɛra Erɔpu jamanaw na min bɛ tali kɛ o ko la, o y’a jira ko cɛya cɛmancɛ karilenw minnu bɔra u nɔ na, ​​olu furakɛli opereli ye nafa sɔrɔ, wa a ka meta-sɛgɛsɛgɛli y’a jira ko jɛɲɔgɔnya jugumanba min bɛ na ni karibaliya ye ani jɛɲɔgɔnya juguman min bɛ taamasiɲɛw lase, o hakɛ ka dɔgɔn kosɛbɛ opereli kulu la ka tɛmɛ kulu min furakɛra ni kɔrɔlen ye ni opereli ni furakɛli kɔrɔlen sumalen don ka fara o kan, opereli kulu tun ye dimi dɔgɔya a daminɛ na, wa Constant ni DASH baarakɛcogo jateminɛw ɲɛtaa tun ka bon kosɛbɛ.

Kuma surun kɛ

Kɔnɔbara kari fanba bɛ sɔrɔ fariya siratigɛ la walima fariya siratigɛ la, wa furakɛli bɛ se ka tila ka kɛ furakɛli kuntaalajan walima opereli ye. Furakɛli siratigɛ la, hali ni kɔkili karilen fanba minnu tɛ fɛn caman bɔ u la, olu bɛ se ka furakɛ ni kɔrɔlen ye, opereli furakɛli suguya min bɛ kɛ kariw la minnu bɛ wuli kosɛbɛ, sɔsɔli bɛ o kan. Ni kɔkolo karilenw bɔra u nɔ na, ​​opereli furakɛli bɛ kolo kɛnɛyali hakɛ caman sɔrɔ ani ka baara daminɛ joona ni i ye a suma ni furakɛli kɔrɔlen ye.

Sɛbɛn minnu bɛ tali kɛ o la

[1] Postacchini F, Gumina S, De Santis P, Albo F. Kɔnɔbara karilenw banakisɛw jɛnsɛnni. J Sɔgɔsɔgɔninjɛ Surg 2002; 11:452 la.

[2] Eiff, M. P., Hatch, ani a ɲɔgɔnnaw. Kɔnɔbara ni sɔgɔsɔgɔninjɛ karilenw. In: Kariw ɲɛnabɔli furakɛli fɔlɔ la, 2nan, W. B. Saunders, Filadɛlifi 2002. p.198.

[3] Robinson C. M. ye baara kɛ. Kɔnɔbara karilenw baliku la. Banakisɛw jɛnsɛnni ni u danfara. J Kolow Joli Surg Br 1998; 80:476.

[4] Neer CS 2nan ye. Kɔnɔbara basigilen sabanan karilenw. Clin Orthop ka baarakɛɲɔgɔnya 1968; 58:43 la.

[5] Andersen K, Jensen PO, Lauritzen J. Kɔnɔbara karilenw furakɛli. Jaa-8 bandi ni sɔgɔli nɔgɔman. Acta Orthop Scand ye san 1987 ye; 58:71.

[6] Ersen A, Atalar A. C., Birisik F, ani a ɲɔgɔnnaw. Boloci nɔgɔman ni bolokɔni 8 ja sumalen don cɛya cɛmancɛ karilenw na: sɛgɛsɛgɛli min kɛra ni mɔgɔw ye. Kolow Joli J 2015; 97-B:1562. Ɲɛjirali dɔw.