Clavicle fractures sɛgɛsɛgɛli ni u furakɛli .

Daminɛ kuma

Clavicle fractures ka ca kosɛbɛ wa a ka c’a la, o bɛ bɔ joginda tilennen walima tilennen na ka taa a bila a kamankun yɔrɔ la. Kɔlɔsili minnu kɛra san 1960 daminɛ na, olu y’a jira ko clavicle fractures nonunion hakɛ ma se 1% ma, wa furakɛli kɔrɔlenw kɛra sababu ye ka banabagatɔ wasa kosɛbɛ; Furakɛcogo min kɛra kɔsa in na, opereli furakɛli ye se sɔrɔ kosɛbɛ; O la, dɔgɔtɔrɔ minnu bɛ baara kɛ kɛnɛyaso kɔrɔtɔlen na walima kɛnɛyaso bɛɛ lajɛlen na, olu ka kan ka nin joginni in jiracogo ni a gɛlɛyaw dɔn ani a furakɛli jɔnjɔn.

Epidemiologie .

Clavicle fractures bɛ kɛ 2,6%-5% ye balikuw ka kari bɛɛ la [1,2]. Erɔpu ka sɛgɛsɛgɛli dɔ min kɛra ni 1000 tugu-tugulen kariko banaw ye minnu sɔrɔla [3,4] ko clavicle fractures ka ca ni 66% ye clavicle cɛmancɛ 1/3 la, 25% ɲɔgɔn tun ye 1/3 kari 1/3 lateral ye, ani 3% tun ye 1/3 kari cɛmancɛ ye. Clavicle fractures sɔrɔli ye bimodali tilali jira, o bɛ sɔrɔ kɛrɛnkɛrɛnnenya la cɛw la minnu si tɛ san 30 bɔ, o kɔfɛ minnu si tɛmɛna san 70 kan.

Anatomie clinique .

Adamaden kolotuguda fɔlɔ min bɛ kololi daminɛ, o ye clavicle ye, o ye bolokɔni sanfɛla ni a jiribolo cɛ jɛɲɔgɔnya kelenpe ye, min bɛ akɔrimi (acromioclaviculaire) joli bɔ yɔrɔjan, ani a kɛrɛfɛ ni sternoclaviculaire (SC) joli ye. O jogindaw bɛ wele ko atypique synovial joints bawo u bɛ siri ni fibrocartilage ye sanni ka kɛ hyaline cartilage ye. Clavicle bɛ siri scapula la acromioclaviculaire ni rostroclaviculaire ligaments fɛ ani a bɛ siri sɔgɔsɔgɔninjɛ la ni sternoclaviculaire ligament ye.

Clavicle ye 's' cogoya ye. ARC tilancɛ proximal bɛ porozew kɛ ɲɛfɛ, ka yɔrɔ to sanfɛ dakunw ka neurovasculaire bundle ye. ARC tilancɛ yɔrɔjan bɛ kɔfɛ (concave) ka sɔrɔ ka scapula (rostral processus ani acromion) fara ɲɔgɔn kan. A ka c’a la, a ka c’a la, sɔgɔsɔgɔninjɛ kariw bɛ sɔrɔ arc fila (mid-ARC) ɲɔgɔndan na, a ka c’a la, a bɛ sɔrɔ ligaman minnu bɛ nɔrɔ kɛrɛfɛ kolo la nin mara in kɔnɔ ani k’a sababu kɛ o ye clavicle yɔrɔ barikama ye. Ni clavicle fracture (bololanɛgɛ karilen) bɛ wuli ka bɔ a nɔ na, a bɛ se ka kɛ ko proximal segment (yɔrɔ surun) bɛ sama ka taa san fɛ (kasikan na) Sternocleidomastoïde muscle fɛ (a nɔrɔlen bɛ clavicle (bololanɛgɛ) dakun proximal (kɛrɛfɛ) la) ani distal segment (yɔrɔ min bɛ kɛ ka ɲɛ) bɛ jigin ka jigin (caudad) ni bolokɔni sanfɛla girinya ye, ani clavicle (bololanɛgɛ) bɛ 'shor ka subscapularis ni pectoralis major (min kɔnɔna bɛ bolokɔni sanfɛla wuli). O bɛ sɔrɔ kɛrɛnkɛrɛnnenya la subscapularis ni pectoralis (pectoralis) farikolo yɔrɔbaw (minnu bɛ bolokɔni sanfɛla wuli k’a sama ka taa disi fan fɛ).

Suguya

Clavicle kari furakɛli kuntilenna ye ka dimi dɔgɔya ani ka kolotugudaw baara lasegin. Clavicle fractures fanba bɛ furakɛ hali bi ni kɔrɔlen ye (a ka c’a la, u bɛ surunya ni milimɛtɛrɛ 15 ye); Furakɛli kɔrɔlenw i n’a fɔ bandi minnu bɛ kɛ ni ja ye, bolokɔniw, sayre bandiw, velpeau immobilisation suits, ani immobilisation. Suspension (sɔgɔli) jɔli bɛ kɛ a jugumanba la, wa a ka ca a la, lamaga dege ni fanga degeliw bɛ kɛ dɔgɔkun 2-6 kari kɔfɛ ni dimi bɛ ban. Bandi 8 ja tali man ɲi barisa a bɛ se ka kɛ sababu ye ka aksidan degunw sɔrɔ ani ka kariyɔrɔ caman sɔrɔ [5,6].

Tariku ni farikolo sɛgɛsɛgɛli .

Clavicle fractures bɛ sɔrɔ a nɔ na ka ɲɛsin a kamankun ma bin kɔfɛ ani a bɛ ye ka caya kɛnɛma farikoloɲɛnajɛw la denmisɛnw na ani binw na minnu ma kɛ ni laɲini ye mɔgɔkɔrɔbaw la. A nafa ka bon ka joginni kɛcogo ɲɛfɔ. Joginni minnu fanga ka bon, olu bɛ se ka fara ɲɔgɔn kan ni kunkolo ni disi joginw ye, k’a sɔrɔ kari minnu bɛ sɔrɔ joginda misɛnniw fɛ, olu bɛ se ka kɛ bana ye. Joginni minnu bɛ mɔgɔ hakili ɲagami, olu bɛ daminɛ joona ani ka sɔgɔsɔgɔninjɛ disi kogo danfara bɔ u la kosɛbɛ, ka farikolo ni jolisiraw jogin. Kɛnɛyako siratigɛ la, funu ni ecchymosis bɛ sɔrɔ kariyɔrɔ la, o bɛ fara ɲɔgɔn kan ni tiɲɛni ni dususuma ye. Aw ka kan ka jateminɛ kɛ farikolo yɔrɔ nugulenw na walasa ka u ja, o bɛ se ka kɛ sababu ye ka fari nekɔrɔsi ni kirinni bila mɔgɔ la.

ja lajɛ .

Kari fanba bɛ se ka sɔrɔ anteroposterior radiographiques nɔgɔmanw fɛ. 20° Kungolo kɔrɔtacogo radiyografuw bɛ barajuru laminiw ni ɲɔgɔn cɛ nɔ bɔ. Banabagatɔw ka kan ka u yɛrɛ dɛmɛ u yɛrɛ dɛmɛyɔrɔ la walasa ka kari jiginni yecogo ɲuman jira. Girinyali min bɛ kɛ radiyow la, o bɛ dɛmɛ don ka rostral clavicular ligament integrité jateminɛ distal clavicle walima acromioclaviculaire joint injuries.CT bɛ dɛmɛ ka scapular girdle joginw gɛlɛnw yecogo ɲɛ ani ka a jira ka ɲɛ ka ɲɛsin clavicle joginni ma min bɛ se ka kɛ sternoclaviculaire joli la. Ni aw ye disi lajɛ, o bɛ dɛmɛ ka barajuru joginni dɔ bɔ a la, wa a surunyali bɛ se ka jateminɛ ni a bɛ tali kɛ a la ni a bɛ se ka kɛ ko a bɛ se ka kɛ ni a ye, ka fara a kan, a bɛ se ka kɛ ka ɲɛgɛnɛsira kogow fara ɲɔgɔn kan.

suguyaw .

AO/Ota kari dislocation typing: Clavicle fracture code 15 bɛ kɛ yɔrɔ saba ye: 15.1 proximal (medial), 15.2 diaphysis, ani 15.3 distal (lateral). Kari minnu bɛ sɔrɔ yɔrɔ la (cɛmancɛ la) ani ka u fara ɲɔgɔn kan, olu bɛ tila ka kɛ suguya A ye (a bɛ kɛ ni fɛnɲɛnamafagalanw ye), suguya B (kɛrɛnkɛrɛnnenya la, a bɛ kɛ fɛnɲɛnamafagalanw kɔnɔ), ani C suguya ye (a bɛ kɛ ni fɛnɲɛnamafagalanw ye pewu). Banakisɛ karilenw bɛ tila suguya A (nɔgɔya), suguya B (Wedge), ani suguya C (Commuminuted).AO/Ota danfara kariw ni u jiginni tɛ jateminɛ kɛ kariyɔrɔ bɔli hakɛ la, wa sisan a nafa ka dɔgɔn kala kariw furakɛli la ani ka ɲɛfɔli kɛ ɲɛgɛnɛsiralabanaw furakɛli la.

Allman Typing sinsinnen bɛ kariyɔrɔ kan (I: cɛmancɛ, kaden 1/3, II: lateral 1/3, iii: cɛmancɛ 1/3) (Ja 7.2.1).

Craig ye nin danfara in nɔgɔya kokura Allman basigi kan, ni ne ye cɛmancɛ 1/3 ye clavicle la; suguya II ye clavicle kɔkanna 1/3 ye, o kɔfɛ a tilalen don suguya 5 ye ka da a ka kari jiginni kan ani a ni rostral clavicular ligament cɛ; ani suguya III ka kɛ dakun 1/3 kɔnɔna karilen ye, o min tilalen don suguya 5 ye ka da a karicogo jiginni hakɛ kan ani n’a karilen don walima n’a tɛ kɛ a la.

Neer ka 1/3 kariw lateral typing bɛ sinsin rostral-clavicular ligament nafa kan: suguya fɔlɔ bɛ sɔrɔ yɔrɔjan na ni rostral-claviculaire ligament ye, ni cɛmancɛ kari bloki bɛ wuli ka bɔ a nɔ na ka tɛmɛ suguya II bɛ kɛ ni rostral-clavicular ligament ye ani a bɛ na ni cɛmancɛ kari bloki ye min bɛ bɔ a nɔ na ka tɛmɛ; ani suguya III bɛ taa fo acromioclaviculaire joli la ni rostral-claviculaire ligament tora a cogo la.

Edinburgh Typing ye diaphyse fractures (diyafizi) kariliw danfaracogo ye ka kɛɲɛ ni displacement ni comminution (dafalen ni ɲɔgɔn cɛ) hakɛ ye.1 suguya 1 kariw bɛ tali kɛ cɛmancɛ cɛmancɛ la, suguya 2 ye diaphysis fractures ye ani suguya 3 ye lateral end fractures ye. Diafizi kariw bɛ tila ka kɛɲɛ ni kɔrimuguw ni ɲɔgɔn cɛ ka kɛ a ni B suguya A ni B ye. suguya 2A karilenw bɛ tila ka taa a fɛ i n’a fɔ jiginni tɛ yɔrɔ min na (suguya 2A1) ani dimi (suguya 2A2),2B kariw bɛ jate i n’a fɔ nɔgɔman walima fɛnɲɛnamafagalan (suguya 2b1) ani kɔmini (type 2b2). Diaphysis ni type 3 ye diaphyse kɛrɛfɛla laban ye. Cɛmancɛ ni kɔkanna dakun karilenw bɛ tila ka kɛ kulu fitininw ye 1 ani 2 ka kɛɲɛ ni joli kɛrɛfɛla ye.

O cogo kelen na, rockwood typing, jager typing ani breitner typing fana bɛ yen.

Opereli taamasiɲɛw .

Kari kɛrɛnkɛrɛnnenw .

1, ka kari da wuli; 

2, jiginni >2; 

3, surunya >2 cm; 

4, karitigɛ yɔrɔw (>3) ; 

5, yɔrɔ caman kari; 

6, ka kari da wulilen jukɔrɔ ni farikolo yɔrɔ nugulama jogin ye; 

7, deformité significatif (displacement ani shortening); 

8, sɔgɔsɔgɔninjɛ joginni.

Joginni minnu bɛ kɛ ka caya .

1, sanfɛla sanfɛla joginni faralen ɲɔgɔn kan;

2, a bɛ panpan a kamankun na;

3, jogin caman;

4, kari min faralen don ɲɔgɔn kan ni joli-sira-funu joginni ye;

5, ipsilateral multiple rib fractures faralen ɲɔgɔn kan ni disi kogo tiɲɛni ye;

6, clavicle surunyali ka kɛ kamankun ye min bɛ kɛ ni wuluwulu ye;

7, fila-fila-kɔgɔ-kari-kari.

Banabagatɔw ka kow .

1, banabagatɔ minnu jogincogo ka ca, olu bɛ sanfɛla girinya daminɛ joona;

2, banabagatɔ minnu mago bɛ segin teliya la baarakɛcogo la (misali la, elit ani ɲɔgɔndan farikoloɲɛnajɛ).

Opereli waati .

Opereli ka kan ka kɛ ka sɔrɔ opereli taamasiɲɛ dafalenw bɛ yen.

Opereli kɔfɛ ka tɛmɛ dɔgɔkun 2-3 kan taamasiɲɛ danfaralenw na, o bɛ se ka dɔ fara kari dɔgɔyali gɛlɛya kan, kɛrɛnkɛrɛnnenya la ni aw bɛ a labɛn ka a labɛn ka ɲɛsin kɔnɔnatumuw ma minnu bɛ se ka dɔgɔya, ni u bɛ se ka u yɛrɛ tanga.

Opereli sɔrɔli .

Banabagatɔ bɛ bila kɔgɔjida la sigilan jɔyɔrɔ la walima a sigiyɔrɔ tilancɛ la. A kamankun min bananen don, o bɛ da jukɔrɔ walasa ka clavicle kɔrɔta walasa ka opereli nɔgɔya, ani bolokɔni bɛ tow la walasa ka se ka mobilizasiyɔn kɛ opereli kɔnɔ. Tigɛtigɛ min bɛ kɛ ka ɲɛsin clavicle janya ma walima saber tigɛcogo min bɛ bɛn langer pattern ma, o bɛ se ka sugandi.

KƆLƆSI: Tigɛtigɛ min bɛ kɛ ka tɛmɛ, o bɛ janya caman di, ka sɔrɔ tigɛ janya bɛ dɔ bɔ supraclavicular nerve joginni farati la ani a bɛ diya a ye kosɛbɛ.

Kɔnɔnafiliw .

3.5 Sisεmεti degun platiw, reconstruction plates, walima plastiki LCPw bɛ se ka kɛ ka clavicle fractures labɛn. Faliw bɛ bila ka ɲɛ sanfɛ walima ka u bila ɲɛfɛ ka taa a bila a ɲɛkisɛ la. Faliw barika ka bon biomekaniki joginw na ni u bilala ka ɲɛ, kɛrɛnkɛrɛnnenya la ni kari dafalen bɛ jukɔrɔ, wa u ɲɛ ka nɔgɔn. Bicortical fixation of the vises (bicortical fixation) ka kan, wa dingɛw ka kan ka don ni ladonniba ye, barisa farati bɛ a la ka joli ni joli siraw jogin. Nafaw: Anterior plate vis kanal, plate apposition, contouring nɔgɔman.

KƆLƆSI: A ka ca a la, kolo sɔgɔli tɛ wajibiya furakɛli fɔlɔ la; Kɔnɔna fiɲɛbɔli kɔfɛ, a nafa ka bon ka miofascial layer sutura ka ɲɛ walasa ka plati datugu ani ka banakisɛ bali.

Fixation intramedullaire .

Sisan, a bɛ se ka kɛ ko Kirschner pins, rockwood pins, hagie pins, titanium elastic intramedullary pins, hollow screws, ani elastic locking intramedullary nails Misali la, titanium elastic nails tɛ a to ka a datugu cogo la min tɛ jɔ, a tɛ a to a ka janya ni a jiginni kunbɛn, wa a bɛ se ka kɛ sababu ye ka surunya filanan sɔrɔ ni a bɛ kɛ ka kariw tigɛtigɛ. Kɔnɔbara kɔnɔ nailing fɛɛrɛ bɛ se ka kɛ dɔrɔn ka kɛ karili nɔgɔmanw, transversale walima oblique la.

Nafaw .

Tigɛcogo ka dɔgɔn, a ka ɲi, a tɛ farikolo yɔrɔ dɔw bɔ, a bɛ endofite bɔli farati dɔgɔya, ani a sabatili min bɛ tali kɛ scab sɔrɔli la.

Nafa minnu bɛ sɔrɔ .

Fari dimi walima fiɲɛ bɛ don a la dondaw la.

KƆLƆSI:Kɔgɔjida karilenw dɔgɔyali dafalen bɛ gɛlɛya tuma dɔw la ani ka a tigi bolo ka tɛmɛ fiɲɛ kan, o bɛ kɔlɔsi opereli manɛw senfɛ.

Minimum invasive plate fixation .

A bɛ miiri ko fɛn min bɛ kɛ ka fɛn dɔ kɛ, o bɛ se ka kɛ sababu ye ka biomekanikini fanga bonya ka sɔrɔ ka a yɛrɛ tanga nafa ma min bɛ sɔrɔ plati da wulilen fiyɛli walima a fixation intramedullary kɔnɔ.

3.5 sitɛmu LCP ɲɛfɛla bilali opereli kɔnɔ, a ka fisa ka ɲɛfɛla jukɔrɔ, o bɛ se ka kɛ sababu ye ka ɲɛgɛn kɛnɛmanw lajɛ, o bɛ kɛ sababu ye ka kɔn ka tasa cogoya nɔgɔya ani ka kurukuruw dacogo jan sɔrɔ.

Osteynthèse min bɛ kɛ ka a kɛ fɛn ye min bɛ se ka don a la, o bɛ se ka kɛ sababu ye ka a ni supraclavicular nerve joginni kɛ, ka ɲɔgɔn sɔrɔ cogo jugu la walima ka nɛgɛ fila-fila surunya minnu bɛ nɔ bila baara la, ani ka plati biri walima ka kari.

Plate fixation de la qualité de latériel de la clavicle .

Falanfɛnw sugandili bɛ bɔ kolotuguda la min bɛ kɛ kɛrɛfɛ. Bicortical screws 3 de ka kan ka kɛ koloci lateral la. A ka fisa, tension screws ka kan ka kɛ ka kari oblique. Ni kolo bloki ka dɔgɔn kojugu walasa ka a siri, a bɛ se ka kɛ ka clavicle hook plate kɛ.

Acromioclaviculaire joint dislocation furakɛli .

Acromioclaviculaire joint joginw bɛ kɛ 12% ye scapular girdle joginw na ani a ka ca a la u bɛ sɔrɔ farikoloɲɛnajɛla minnu bɛ ɲɔgɔn sɔrɔ.

Staging system min bɛ Kɛ ka caya o ye rockwood staging ye. A suguya fɔlɔ ye acromioclavicular ligament sprain ye ni rostroclavicular ligament intact ye; A suguya II ye acromioclaviculaire ligament ɲɛji ye ni rostroclaviculaire ligament ma tiɲɛ; Sugu III ye acromioclaviculaire ligament ni rostroclaviculaire ligament fila bɛɛ ɲɛji ye; IV suguya ye kɔfɛla ye min bɛ trapezius (Trapezius) yɔrɔ janya; V suguya V ye acromioclaviculaire joint ni rostroclaviculaire ligament fila bɛɛ ɲɛji dafalen ye, ni joli bɛ bɔ a nɔ na kɛmɛsarada la; ani VI suguya joginw ka dɔgɔ kosɛbɛ, ni distal clavicle bɛ wuli ka jigin rostral taabolo jukɔrɔ.

Furakɛli min bɛ kɛ ni frein ye waati kunkurunnin kɔnɔ ni kantilever sling ye, o bɛ kɛ jogin suguya fɔlɔ ni suguya filanan ye. Joginni suguya III furakɛli ye sɔsɔli ye, ni sɛbɛn dɔw b’a jira ko furakɛli kɔrɔlen bɛ jira balikukalanden fitininw na minnu bɛ baara kɛ. Functional recovery ka ɲi hali ni a bɛ se ka kɛ ko a ɲɛda cogoya bɛ se ka kɛ fɛn caman ye. IV suguya - VI joginw ka jugu ani opereli ka ɲi.

Sisan, opereli minnu bɛ kɛ ka caya, olu ye: Bosworth rostral locking screw technique with one-stage repair or no repair of the ligament;, clavicle hook plate fixation, i n’a fɔ clavicle fracture lateral laban Tightrope ka tab plate fixation walima anchor pinning sutura ka tɛmɛ jolilabanaw fɛ walima tigɛ fitini dɔ fɛ; ani rostral locking ligament suture walima suspension barikama, ni fɛn dilannen walima senkɔni ye rostral eminence ni clavicle cɛ.

A ma jɛya ko opereli fɛɛrɛ jumɛn bɛ nafa sɔrɔ ka tɛmɛ, 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 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.

Furakɛli min bɛ kɛ ni a laban ye kariw ni sternoclaviculaire joints dislocations .

O joginw ka dɔgɔn kosɛbɛ, wa furakɛli sariyaw dɛsɛ bɛ yen ka da furakɛli kan min sinsinnen bɛ daliluw kan.

A ka ca a la, clavicle medial fractures (klaw ka kariw) ka teli ka kɛ fɛnɲɛnamafagalanw ye minnu bɛ bɔ ɲɔgɔn na, ni u bɛ bɔ u nɔ na, wa u bɛ se ka furakɛ ni kɔrɔlen ye. A ka c’a la, a ka c’a la, a ka epifizisi bɛ da a la ko a bɛ da a la ko a si bɛ san 23-25 la, wa ko a ye epifisisi laban ye min bɛ da farikolo la. O la, cɛmancɛ jogin caman ye tiɲɛ na epifizi plati karilenw ye Salter-Harris suguya fɔlɔ walima II. X-ray kɔrɔlenw sɛgɛsɛgɛli ka gɛlɛn, ni nafa ye ko 40° kunkolo kɔrɔtalen sɛgɛsɛgɛli ani ni a bɛ tali kɛ kɛnɛya fan fɛ, o bɛ se ka kɛ sababu ye ka clavicle cɛmancɛ laban jiginni jira, wa CT bɛ sɛgɛsɛgɛli jateminɛcogo ɲuman di.

A ka ca a la, kari walima ka bɔ u nɔ na, u bɛ se ka datugu ani ka u bila yɔrɔ wɛrɛ la, nka a ka ca a la, u tɛ sabati ani u bɛ wuli ka bɔ u nɔ na walasa u ka se ka bɔ u nɔ na kokura. Aw bɛ furakɛli kɛ ni farilajidɛsɛ ye, o bɛ kɛ ka ɲɛ ka taa a fɛ walima ka mɔgɔw bila yɔrɔ wɛrɛw la barisa a ka ca a la, u tɛ kɛ sababu ye ka baarakɛbaliya sɔrɔ. Kɔgɔjida cɛmancɛ laban bɔli kɔfɛ, o man teli ka kɛ sababu ye ka sanfɛla jogin, i n’a fɔ joli siraw jogin walima hali ka fiɲɛbɔlanw ni fiɲɛbɔyɔrɔw degun. Walasa ka jiginni ni kari yɔrɔ minnu na cɛmancɛ yɔrɔ ka dɔgɔn kojugu, platiw bɛ se ka siri joli la walasa u ka siri ka se cɛya ma.

Fixation fɛɛrɛ wɛrɛw .

EG kɛnɛma fixation ni stent, kɛnɛma fixation ni clavicle plate, etc.

Opereli kɔfɛ ɲɛnabɔli .

Bolo sanfɛla ka kan ka lamaga sɔgɔlan na ani pendule shoulder kalan ka kan ka daminɛ joona. Dɔgɔkun 2 o kɔfɛ, banabagatɔ ka kan ka tugu a kɔ walasa ka joginda lajɛ ani ka a lajɛ ni a ɲɛda bɛ se ka bɔ, ka sɔrɔ bolokɔniw bɛ se ka bɔ ani ka joli lamagacogo kalan dan tɛ min na, o bɛ se ka daminɛ, nka a ka kan ka fɔ banabagatɔ ye ko a kana girinya kɔrɔta ni a farikolo yɔrɔ min bananen don. Fanga dege bɛ se ka daminɛ dɔgɔkun 6 opereli kɔfɛ ni kolo kɛnɛya taamasiɲɛw bɔra. Aw bɛ aw yɛrɛ tanga farikoloɲɛnajɛ walima farikoloɲɛnajɛ jugumanba ma kalo 3 opereli kɔfɛ fo ka se a ka kari ka kɛnɛya pewu.

Gɛlɛyaw.

Gɛlɛya fɔlɔw .

Opereli kɔfɛ joginda bɛ se ka sɔrɔ fo ka se 4,8% ma;

Kɔnɔnatumuw ka kirinni ye gɛlɛya ye min ka teli ka sɔrɔ, ni tariku sɛgɛsɛgɛli ye fo ka se 83% ma nin taamasiɲɛ in na, o min bɛ dɔgɔya waati tɛmɛnen kɔ, wa a tɛ kɛ sababu ye ka baarakɛbaliyaba lase mɔgɔ ma, hali ni a bɛ se ka to sen na fo san 2 opereli kɔfɛ

endofite protrusion ani skin agitation, min bɛ sɔrɔ plates voluminous walima nail kɔw tali la ni farikolo yɔrɔ nɔgɔlenw datugulen don koɲuman;

Segin-ka-bɔ, o bɛ se ka kɛ opereli ni furakɛli kɔrɔlen fila bɛɛ kɔfɛ; Opereli kɔfɛ joginni bɛ se ka kɛ sababu ye ka endoprothèse biri walima ka a kari, walima ka kari endoprothèse lamini na;

Nonunion, ni 15% tɛ kelen ye ni furakɛli kɔrɔlen ye ani 2% tɛ kelen ye ni opereli furakɛli ye diaphyseal fractures labɔlenw na pewu; Karili dafalen, ka surunya ka tɛmɛ santimɛtiri 2 kan, ka sigarɛti min, ka dɔ fara a si kan, ka fanga caman sɔrɔ, ka segin-ka-bɔ (mikaniki basigibaliya), ka diafise dislocations recalcitrant, kolo cogoya jugu, ani kolo bɔnɛ kojugu.

Gɛlɛya minnu bɛ sɔrɔ kɔfɛ .

Acromioclaviculaire joint (acromioclaviculaire) kolotuguda kolotugudaw bɛ sɔrɔ ka caya ni joli-sira-funu ye (Edinburgh suguya 3B2); Ni furakɛli taamasiɲɛw ni furakɛli kɔrɔlenw tɛ nafa sɔrɔ, o yɔrɔ jan bɛ se ka tigɛ jolilabanaw fɛ walima opereli dafalen fɛ;

Deformity healing, o bɛ kɛ hakɛ caman na ka bɔ kariw bɛɛ la minnu furakɛra ni kɔrɔlen ye; Scapular girdle surunyali min bɛ taa ni distal fracture block jiginni ye, o bɛ se ka kɛ sababu ye ka dɔ bɔ a kamankun fanga ni a muɲuli laban na, kɛrɛnkɛrɛnnenya la a kamankunw minɛni na; Ni barajuru bɔyɔrɔ dɔgɔyara, o bɛ se ka kɛ sababu ye ka bolokɔniw degun taamasiɲɛw sɔrɔ; ani balabanaw ka balabanaw (scapulothoraciques) kogow jolilabanaw bɛ se ka kɛ sababu ye ka sɔgɔsɔgɔninjɛ ɲɛfɛla kɔrɔta ani ka kamankun dimi ni miliyasi bɔ, ni a jɛlen don ko a taamasiɲɛw bɛ bɔ nɔgɔli la ni kɛnɛya kɛra, kolotugudaw latilenni ni joli segincogo bɛ se ka kɛ ka kɛɲɛ ni banabagatɔ magow ye.

Prognose ani kɔlɔlɔ .

Sɛgɛsɛgɛli min kɛra Erɔpu jamanaw na, o y’a jira ko opereli furakɛli min bɛ kɛ ni midclavicular fractures displaquées ye, o bɛ se ka kɛ, wa a ka meta-analyse y’a jira ko balodɛsɛ sɔrɔli min bɛ na ni karibaliya ni bana taamasiɲɛw ye, o hakɛ tun ka dɔgɔn kosɛbɛ opereli kulu la ka tɛmɛ furakɛli kɔrɔlenw kan minnu furakɛra ni kɔrɔlen ye Ka fara o kan, opereli kulu tun ye dimi dɔgɔya joona, wa, ka ɲɛtaa sɔrɔ tuma bɛɛ ani ka baara kɛ ka ɲɛ, o tun bɛ ye ka ɲɛ.

Kuma surun .

Clavicle fractures fanba bɛ sɔrɔ fariya siratigɛ la walima farinya siratigɛ la, wa furakɛli bɛ se ka tila ka kɛ furakɛli ye min bɛ kɛ ni fɛn kɔrɔlen ye walima opereli ye. Furakɛli siratigɛ la, hali ni clavicle fractures fanba tɛ u la, ni u ma bɔ u nɔ na kosɛbɛ, opereli furakɛli sugandicogo kariw la minnu bɛ bɔ u nɔ na kosɛbɛ, o ye sɔsɔli ye. Walasa ka joli segin ka bɔ yɔrɔ la, opereli furakɛli bɛ kolo kɛnɛya hakɛ caya ani a ka baarakɛcogo fɔlɔw ni furakɛli kɔrɔlenw ye.

References .

[1] Postacchini F, Gumina S, de Santis P, Albo F. Kɔgɔjida karilenw jɛnsɛnni. J a kamankun kɔkili Surg 2002; 11:452.

[2] EIFF, MP, Hatch, et al. Clavicle ani scapula kariw. In: kari furakɛli furakɛli fɔlɔ la, 2nan ed, WB Saunders, Filadɛlifi 2002. ɲ.198.

[3] Robinson cm. Kɔgɔjida karili balikuw la. Banakisɛfagalanw ni u danfara. J kolo joli Surg BR 1998; 80:476.

[4] Neer CS 2nan. Clavicle ka distal sabanan kariw. Clin Orthop Relat Res 1968; 58:43.

[5] Andersen K, Jensen PO, Lauritzen J. Furakɛli min bɛ kɛ ka fɛnɲɛnamafagalanw kari. Jaa-ka-seegin bandi ni sling nɔgɔman ye. Acta Orthop Scand 1987; 58:71.

[6] Ersen A, Atalar AC, Birisik F, et al. Bolo sɔgɔli nɔgɔman ni ja min bɛ kɛ ni bandi 8 ye minnu bɛ kɛ ni klaviculaire claviculaire fractures ye: kalan min kɛra ni mɔgɔw ye minnu bɛ se ka kɛ ni mɔgɔw ye. Kolow J 2015; 97-B:1562.