5 Emisingi gy’okukozesa emisumaali egy’omu lubuto n’obukodyo bw’okulongoosa!

Emisingi emikulu egy’okukuba emisumaali mu mubiri .

1. Ebyafaayo by’okukuba emisumaali mu mubiri .

Mu 1910, emisumaali egya lilienthal aluminium intramedullary gyakozesebwa okujjanjaba okumenya kw’ekikondo ky’ekisambi.

Mu 1913, Schone yakozesa emisumaali egya ffeeza egy’omu lubuto okujjanjaba okumenyaamenya okw’omu maaso okw’omu maaso. 

Kuntscher (1900-1972) yakola kinene nnyo mu kunyweza emisumaali egy’omu lubuto. 

Emyaka gya 1960 ne 1970 gyali kiseera kya kukula mangu emisumaali egy’omu lubuto. 

Ensi yange ebadde ebakozesa mu bungi okuva mu myaka gya 1990.

2. Okukendeeza n’okukendeeza okuggaddwa mu lwatu .

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3. Kirungi okukozesa okukendeeza okuggaddwa nga bwe kisoboka. Ekikendeeza traction kisobola okukozesebwa, oba okusalako okutono kuyinza okukolebwa ku nnyonyi ekutuka oku pry n’okukendeeza, bwe kityo ne kikendeeza ku kutaataaganyizibwa kw’omusaayi ogugenda ku nkomerero y’okumenya.

4. Okusobola okukendeeza ku kukendeeza okuggaddwa, okufuumuula ebitundu by’amagumba oba okuboola ebitundu ebikyetoolodde, n’obutundutundu obunene obw’okumenya obusenguddwa, okukendeeza ku kulongoosa okuggule kuyinza okukozesebwa.

3. Enkola y’okunyweza omusumaali ogw’omu lubuto .

1. Enkola ya intramedullary nail internal fixation is symmetrical central internal splint fixation.

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4.Ebirungi by'emisumaali egy'omu lubuto .

1. Ebizibu Ebitono .

2. Obunene obugaziyiziddwa mu kulongoosa .

3. Okunyweza okunywevu .

4. Okutendekebwa mu kukola emirimu egy’awamu nga bukyali .

5. Okufuna obuzito nga bukyali .

6. esobola okukozesebwa nga egattibwa wamu n’okunyweza okulala okw’omunda .

Ebika n'obukodyo obukulu .

1. Emisumaali egy’okusibira n’egitalina kkufulu .

2. Emisumaali egy’okusibira mu mubiri egy’amaanyi n’egikyukakyuka .

3. Obukodyo bw’okugaziya n’okunyweza obutakwatagana mu medullary .

4. Obukodyo bw’okunyweza n’okuggalwa .

Okukwatagana n’obutakwatagana .

Emisumaali egya bulijjo egy’omu lubuto girina obutebenkevu obubi obw’ekyekulungirivu n’amaanyi g’okuwuuma okutono ennyo, naye girina obugumu obumu era gisobola okudda engulu oluvannyuma lw’okukyukakyuka, ekivaako okuseerera kw’omu lubuto okutono kwokka.

Emisumaali egy’omu lubuto egy’okukwatagana girina ebirungi ebiziyiza okukyukakyuka n’okulwanyisa okunyigirizibwa, okunyweza obulungi okunyweza, era nga zituukana n’omusingi gw’okunyweza ebiramu. Zikozesebwa nnyo mu magumba amawanvu ag’ebitundu by’omubiri. Naddala ku kumenya ebitundu ebitali bimu n’okumenya, zirina obutebenkevu obulungi okusinga emisumaali egya bulijjo egy’omu lubuto.

Dynamization ya static fixation .

Static locking intramedullary nails zifulumya stress masking ntono nnyo era mu kiseera kino zisinga kuwagirwa ebikolwa ebitali bya bulijjo eby’okukola amaanyi.

Ku kumenya okutawona ku myezi 6 ku 8 oluvannyuma lw’okulongoosebwa, okusiba amagumba mu kifo oba okukyusa emisumaali egy’omu lubuto egyagaziyizibwa n’amaanyi kitera okukozesebwa.

Dynamization eyinza okukozesebwa ng’engeri y’okutumbula okuwona okumenya. Tekirungi bulijjo kubanga kiyinza okuvaako okufunza ebitundu by’omubiri n’okulema kw’enzitowerera.

Okugaziya obusigo n’okugaziya obutoffaali obutali bwa bugenyi .

Okugaziwa kw’obusigo kuyinza okuyingiza emisumaali egy’omu lubuto nga girina dayamita ennene n’amaanyi amangi, ekiyamba okutendekebwa mu kukola nga bukyali era kikendeeza ku sipiidi y’emisumaali egyamenyeka.

Okugaziwa kw’obusigo kuyinza okuvaamu ebisasiro by’amagumba bingi nga biriko osteoinductive effect, ekiyamba okuwonya okumenya.

Okugaziwa kw’obusigo kujja kwonoona omusaayi gw’emisuwa gy’ebiriisa n’olususu lw’omu lubuto, naye emisuwa giyinza okuddamu okukola ku kisenge ky’emisumaali egy’omu lubuto. Okugaziwa kw’obusigo era kuyinza okwongera ku ntambula y’omusaayi mu binywa ebigonvu ebikyetoolodde, bwe kityo ne kitumbula okuwona kw’okumenya.

Okugaziwa kw’obusigo kwongera ku mikisa gy’okukwatibwa obulwadde n’okusinda embolism, era kulina okukozesebwa n’obwegendereza ku kumenya okuggule, obuvune obuwera, n’obuvune obuzibu.

Ebirungi ebiri mu kugaziya medullary .

1 Oluvannyuma lw’okugaziya medullary, ekitundu ky’okukwatagana wakati w’omusumaali ogw’omu lubuto n’eggumba kyeyongera, ekitereeza obutebenkevu bw’okunyweza. 

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3 Ebifunfugu by’amagumba oluvannyuma lw’okugaziwa kw’amagumba (medullary expansion) bisobola okuleeta okutondebwa kw’amagumba amapya, ekintu ekiyamba okuwona okumenya.

Bw’ogeraageranya n’emisumaali egy’okugaziwa mu medullary, emisumaali egy’omu lubuto egitagaziyizibwa girina ebirungi bino wammanga .

1 Obudde obutono obw’okukola n’okuvaamu omusaayi omutono. 

2 Okutaataaganyizibwa okutono ku ntambula y’omusaayi endosteal mu mbeera nga waliwo obuvune obw’amaanyi mu bitundu ebigonvu.

Okusiiga omusumaali ogw’omu lubuto .

Omusumaali ogw’omu lubuto ogw’ekika kya humeral interlocking .

Ebiraga emisumaali egy'okuwummuza .

Ebiraga emisumaali egy’omu lubuto egy’okuwunyiriza mu kujjanjaba okumenya ekikondo ky’omugongo (humeral shaft fractures) bye bino: okumenya n’okwonooneka kw’emisuwa n’obusimu, obuvune obw’emirundi mingi, okumenya okutanywevu, okumenya kw’obulwadde, n’okumenyaamenya okw’okumpi.

Range eyinza okutereezebwa eva ku 2cm wansi w’omutwe gw’omugongo okutuuka ku 3cm waggulu wa olecranon fossa. Osobola okusalawo okugitereeza okuva ku kibegabega ng’okozesa omusumaali ogw’omu lubuto (antegrade intramedullary nail) oba okuva mu nkokola ng’ossaako omusumaali ogw’okudda emabega.

Ebifaananyi by’emisumaali egy’okuwuga .

Enkola z’okulongoosa okunyweza okumenya shaft shaft okusinga kwe kunyweza plate ne intramedullary nail fixation.

Okunyweza pulati kulina eby’amaanyi ebiziyiza okukyukakyuka n’okuziyiza okufuukuula era nga kunywevu, naye okulumwa kw’okulongoosa kuba kunene, emikisa gy’okukwatibwa giba mingi, era obusimu bwa radial bwangu okwonooneka.

Modern humeral interlocking and self-locking nails overcome the shortcomings of ordinary intramedullary nails such as axial instability, poor rotation control, and the need for additional fixation, so that the fracture is firmly fixed, the blood loss is small, the soft tissue stripping is less, and the medullary expansion is equivalent to local bone transplantation, the load is evenly distributed, the callus appears early, and functional exercise can be started after surgery.

Omusumaali ogw’omu kifuba ogukwatagana n’omusumaali gw’omu lubuto .

Ebiraga emisumaali egy’okukwatagana n’ekisambi .

Ebika byonna eby’emmeeme 2cm wansi w’omugongo gwa trochanteric ate ​​ebisukka mu 9cm okuva mu kiyungo ky’okugulu.

okumenya okukadde okw’ekitundu eky’omu makkati eky’ekikondo ky’ekisambi.

Abalwadde abalina okunyweza okw’omunda okwa plate eremereddwa.

Ebifaananyi by'omusumaali ogukwatagana n'ekisambi .

Ebirungi eby'ebyuma .

Omukono gw’amaanyi ogw’omusumaali ogw’omu kifuba ogw’omu kifuba (femoral interlocking intramedullary nail) okutereeza okumenyaamenya guwanvu okusinga ogw’ebyuma, era empalirizo egabanyizibwa kyenkanyi ku kisenge eky’omu makkati eky’eggumba lyonna, ekitali kyangu kufukamira n’okuvunda.

Emisumaali egy’okusiba ku nkomerero zombi egy’omusumaali ogw’omu lubuto gifuula eggumba okutondebwa okuva waggulu okutuuka wansi, era emisumaali egy’okusiba ku nkomerero ey’ewala giyinza okukendeeza ku mukono gwa torque ogw’omusumaali ogw’omu lubuto mu ggumba, okuziyiza okukendeeza n’okuzimbulukuka, n’okutuuka ku kutebenkera okusingawo n’okunyweza okutereeza okumenyeka.

Omusumaali gwa Gamma ogw’omu lubuto .

Ebiraga Omusumaali gwa Gamma .

Ekwata ku bika eby’enjawulo eby’okumenyaamenya okw’ekika kya peritrochanteric, naddala okumenya kw’ebitundu eby’obutiti.

Omusumaali gwa gamma ogugaziyiziddwa (omusumaali gw'okuddamu okuzimba) Ebiraga .

Okumenyeka kw’ebitundu eby’obutiti okw’amaanyi, trochanteric nga kugatta wamu n’okumenya kw’ekikondo ky’ekisambi.

Ebirungi ebiri mu gamma nail .

Ekoleddwa nga egatta sliding hip screw ne intramedullary nail technology, omusumaali omukulu gubeera kumpi n’omunda mu medullary cavity okusinga dynamic hip plate, kale omusumaali gwa gamma gukola obuzito bw’omulwadde okumpi ne femoral calcar okusinga dynamic hip plate, ekyongera amaanyi g’ebyuma ag’ekintu ekiteekebwamu. Ku kumenya kwa subtrochanteric okuzingiramu medial cortical comminution, omusumaali gwa gamma gwewala obwetaavu bw’okumenya anatomy okuddamu okuzimba, kale kya mugaso eri intertrochanteric fractures oba subtrochanteric fractures.

Retrograde intramedullary femoral okukuba emisumaali .

Ebiraga emisumaali gy’amagulu egy’okudda emabega .

Okusinga ekozesebwa mu kumenya kw’ekisambi supracondy, omuli okumenya kwa supracondylar comminute ne intercondylar 'T' ne 'Y' okumenyeka okuzingiramu articular surface.

Era esobola okukozesebwa ku kumenya kw’ekisambi wansi w’ekisenge ky’omugongo.

femoral shaft, supracondylar femoral, ne intercondylar fractures mu 20cm okuva mu kiwanga ky’okugulu.

Abo abalemeddwa okunyweza pulati.

Ebifaananyi by’okusalako emisumaali egy’okudda emabega (retrograde femoral nailing) .

Supracondylar femoral fracture is a serious fracture with difficulty mu kusooka, okukendeeza n’ekyokubiri, okunyweza okw’omunda okw’amaanyi. Waliwo ebizibu ebingi nga okumenya okutali kwa kibiina n’okulwawo okuwona.

Retrograde interlocking intramedullary nailing ye nkola ekozesebwa ennyo okujjanjaba okumenya kw’omugongo ogw’ewala mu myaka egiyise, erimu okutebenkera okulungi okw’ebyuma, esobola bulungi okufuga okusengulwa okw’emabega n’okusengulwa kw’okuzimbulukuka kw’enkomerero ey’ewala ey’okumenya, n’okuyamba mu kutambula kw’ekiwanga okwasooka.

Supracondylar combined femoral stem fracture etereezebwa nga ewanvuye supracondylar intramedullary nailing, ekigonjoola ekizibu ekizibu okugonjoolwa nga interlocking intramedullary nailing of the femur. Ekintu kino kyangu okukola, nga kituufu mu kuteeka mu kifo, nga kyesigika mu kunyweza, era omulwadde asobola okukola dduyiro w’okugulu akola amangu oluvannyuma lw’okulongoosebwa.

Emisumaali egy’omu lubuto nga gikwatagana n’omugongo .

Ebiraga nti omuntu alina emisumaali gy’omugongo .

Okumenyeka okutebenkedde mu makkati 1/3 okw’ekisambi: okumenya okuyita mu bbanga, okumenya okumpi okuserengese, okulwala obulwadde bwa pseudarthrosis.

Okumenyeka okutali kwa ntebenkevu mu bitundu 60% eby’obuwanvu bw’ekisambi eky’omu makkati: okumenya okumpi ne metaphysis, okumenya okuwanvu okw’enkulungo, okumenya okw’ebitundu, okumenya okugatta, okumenya n’obulema bw’amagumba.

Ebifaananyi by’okukuba emisumaali gy’omugongo .

Okusiba emisumaali egy’omu lubuto egy’omu lubuto (intramedullary nailing of tibia) kusinga kukozesebwa ku kumenyeka kw’omugongo ogw’omu makkati.

Newankubadde nga era esobola okukozesebwa ku kumenyeka kw’omugongo ogw’okumpi n’ogw’ewala, omuwendo gw’ebizibu guba waggulu, Malunion ebaawo emirundi mingi, enkomerero y’okumenya erina ≧1cm ey’okutambula mu 1/2 y’emisango, ate 1/4 ey’okunyweza eremererwa.

Ebiwandiiko byalaga ebiva mu kumenya ebisambi eby’ewala okusinga okumenya kw’ekisambi eky’okumpi oluvannyuma lw’okunyweza ekisambi ekya bulijjo.

Obukodyo bw'okulongoosa .

Okuteekateeka ebyuma eby’enjawulo nga tebannaba kulongoosa .

ekitanda ky’amagumba (ekitanda ekisika) oba ekitanda eky’okulongoosa eky’omutindo ogwa fluoroscopic; ekizzaawo ssente; Ekifaananyi ekinyweza.

Okulonda okutuufu okw’obuwanvu bw’omusumaali ogw’omu lubuto (intramedullary nail length) ku endoprostheses nga tebannaba kulongoosebwa .

Ekifaananyi kya leediyo .

Okupima obuwanvu bw’ebitundu by’omubiri ogw’oku ludda olulala .

Obuwanvu bw’omusumaali ogw’omu lubuto .

Obugazi bwa X-ray Isthmus .

Okupima obuwanvu bw’omusumaali ogw’omu lubuto .

1.Okusalawo kw'omufuzi okutangalijja wansi w'ekyuma kya C-arm .

Enkomerero z’eggumba ez’ewala n’ez’okumpi zaali ku layini y’omusenyu wakati; Omufuzi yali akwatagana ne diaphysis.

2.Ekipimo ky'obuwanvu okusinziira ku bubonero bw'omubiri ku ngulu .

Femur: Ensonga ya Greater Trochanter → Ekifo ky’okugulu eky’ebbali oba ekikondo eky’okungulu ekya patella; Tibia: Ekifo ky’okugulu eky’omu makkati-oludda → eky’omu maaso eky’ekiwanga ky’enkizi mu kudda emabega kw’ekigere.

Enkola y'okuyingiza emisumaali mu mubiri - Enkola y'okuyingira mu kifo .

Longitudinal axis of the medullary cavity mu layini engolokofu .

Si kumpi nnyo n'ekifo ekiyingira .

Obuwanvu obutuufu: bugaziwa - obuwanvu; Undilated - short .

(Okukakasa okutali kwa butereevu ku kifo ekiyingira; tewali kugaziwa kwa pulp, tekyetaagisa kukuuma bitundu bigonvu)

Parallel femoral intramedullary omusumaali oguyingira .

Okuteekateeka ekifo ekiyingira ku musumaali ogw’omu kifuba ogufaanana .

Hip Flexion n'okugikolako .

Obuwanvu obusalako obuwanvu okutuuka ku trochanter omunene .

Si wala nnyo emabega .

Okuteeka ppini y’omulagirizi .

Okuteeka engabo y’ebitundu ebigonvu .

Retrograde femoral intramedullary omusumaali oguyingira .

30° Okugulu okufukamira .

Ekisiki ekiwanvu ekya ppini ekilungamya mu kkubo lye limu n’ekisenge ky’ekikolo ky’ekisambi eky’ewala eky’omubiri (distal femoral stem) .

Okuyingiza ppini ya Kirschner mu kisambi eky’ewala ng’oyita mu musipi gw’omugongo (patellar ligament) okuyita mu mukono ogw’obukuumi: orthogonal - wakati w’ekifo ekiyitibwa intercondylar fossa eky’omugongo; Layini y'ebbali - Blumensaat .

Entandikwa ya PCL nga tewali buvune .

Parallel tibial intramedullary omusumaali oguyingira .

Ku layini wakati w’ekituli kya Medullary .

anterior margin ya tibial plateau .

Nga bwe kisoboka nga tekyonoona kifo kya lusozi .

Maximum okugulu okufukamira .

Okutema tibial tuberosity-inferior pole ya patella ku kituli kya medullary .

Ggulawo ekituli kya medullary: Guide pin ku 15° ku nnyonyi ya sagittal ey’ekisenge ekiwanvu eky’ekikolo ky’omugongo .

Ekifo ky'ekintu ekinyweza ekifaananyi .

Obukodyo bw'okutomera .

Okukendeeza ku masanyalaze .

Okumenya okumenya .

Okukendeeza mu ngalo .

Okumenyeka okukadde n'obulwadde bwa pseudoarthrosis, sclerosis mu medullary cavity .

Tewali tourniquet wansi w'ebbeeyi y'ebintu .

Okutambula kw’omusaayi kye kisinga okunyogoza .

Obukodyo bw’okuddamu okuteeka mu kifo .

Parallel femoral intramedullary okukuba emisumaali .

Ensonga ezikuleetera obuzibu okuzzaawo okumenya kw’ekisambi .

Okuzinga ebitundu ebigonvu ebinene tekikkiriza kutuuka butereevu ku ggumba .

Ekifo ekiyingira empiso tekiyinza kulabibwa butereevu .

hip joint Adduction → Iliac fascia okusika → Okufunza okumenya .

Okukendeeza ku kumenyeka kw’omugongo .

Okukozesa obubi .

Okusinga subcutaneous ate nga nnyangu okukwata .

Okumenya okutebenkedde - Okumenya ekika kya A ne Distal A ne B .

Oblique okumenya - okutta ennyo .

Intramedullary Emisumaali→Ebikozesebwa mu kusengulwa .

Enkola z’okukendeeza ku buyambi .

Okukendeeza ku butundu .

Tibia; Okukozesa olususu oba ebiwundu .

Ebikozesebwa ebinene ebidda emabega (Braces) .

okulwawo okukendeeza; Okufunza ebitundu by'omubiri .

Sikulufu za Schanz ez'ekiseera .

1 femur, ekisambi ky’omugongo .

2 nga bwe kiri kumpi ne layini y’okumenya nga bwe kisoboka .

3 Proximal Fracture Okukozesa kw’ekitundu ky’omubiri ekimu (single cortical use) .

4 Kozesa universal chuck nga olina T-handle okusobola okukola maneuver mu ngeri ennyangu

Omusumaali gw'omuyimbi .

1 metaphyseal fracture (okutereeza layini y’amaanyi, okutebenkeza okuzzaawo, okuzzaawo okukola) .

2 Okumenya omusaayi ogw’ewala oba ekisambi eky’ewala (okunyigirizibwa kw’okusala → puleesa) .

3 Emisumaali egy’omu lubuto nga tegiri mu mbeera nnungi giyingira mu mukutu omukadde ogwa medullary mu kiseera ky’okulongoosebwa okw’okubiri .

4 Ekifo ekibi eky’okuyingira, okulaga obubi okumenya okumpi (Screw eteekeddwa nga yeesimbye ku kusengulwa okusoboka okw’ekimera ekiva mu mubiri)

Extra Wide Tourniquet .

1 Tibia .

2 Eyongezeddwayo nga traction oba retractor .

3 Kozesa n'obwegendereza mu buvune obw'amaanyi obw'ebitundu ebigonvu .

4 Kikuume nga kimpi .

5 Okuwera okugaziya medullary mu mbeera efukumuddwa .

Omutendera gw’okusiba emisumaali: ewala olwo okumpi .

Ebirungi .

okwanguyiza okukoona, okunyigiriza okumenya okumenya; okumalawo okwawukana; Emirimu gy’okukendeeza.

Obukodyo bw'okukendeeza ku kulwawo & nonunion surgery .

Ebizibu ebiyinza okusangibwa nga balongooseddwa nga balwawo .

Axial Deformity (okufunda, okukoonagana n’okusengulwa) .

Okukula mu of granulation tissue .

Ebikuta by’amagumba ebisooka .

sclerosis y’okumenya okumenya n’okuggalawo ekituli kya medullary .

Obulwadde bw’amagumba .

Ebizibu ebiyinza okubaawo mu kulongoosebwa .

Okukyama kw’ekintu ekigaziya n’omusumaali ogw’omu lubuto → Okuyingira kw’omusumaali ogw’omu lubuto ogw’omu lubuto ogw’omu lubuto .

Angular Deformity → Retractor .

Okuseeseetula enkomerero ezisaliddwako → Omusumaali gw’omuyimbi, okunyweza pulati .

Enkola ez’okuziyiza layini z’amaanyi ezitali za bulijjo .

Proximal - Ekifo ekituufu eky'okuyingira .

Distal - Omusumaali ogw'omu lubuto wakati mu kisenge kya medullary .

Ebizibu by’okukuba emisumaali mu mubiri .

★Okusiiga .

★Omuntu okwonooneka .

★Okuwonya okumenya okumenya .

★Ebitundutundu by'obusawo .

Enzirukanya ey’ebweru, torsion, valgus, okukyusakyusa munda, angulation .

★Obulumi bw'ekiwanga obuliraanye .

★Amasavu Embolism .

★Okuzimba amagumba mu kitundu ky'omubiri ekiyitibwa heterotopic .

★Okuzimba Embolism .

★Re-Fracture .

★Thrombosis .

★Obukakanyavu obukwatagana .

★Non-union of fracture, amagumba agatali ga kibiina .

★Okulemererwa okunyweza munda .

★Okufunza amannyo .

★Ebirala .

Ebizibu--okukwatibwa .

1.Early on, open fractures zaali zitwalibwa nga contraindication to intramedullary nailing.

2.Obulwadde bw’okukwatibwa oluvannyuma lw’okulongoosebwa mu kumenyeka okuggule businziira ku mbeera y’obuvune bw’ebitundu ebigonvu n’obucaafu .

Obulwadde bw’okukwatibwa oluvannyuma lw’okumenya okuggule businziira ku mbeera y’obuvune bw’ebitundu ebigonvu n’obucaafu wamu n’engeri ekitundu ekigonvu gye kiddukanyizibwamu.

3.Twamusa emisumaali egy’omu lubuto (intramedullary nails) kyongera emikisa gy’okukwatibwa obulwadde; Non-expandated locking intramedullary nails fixation is relatively poor, era enkomerero z’amagumba zirina .

Okunyweza emisumaali egy’omusumaali egy’omu lubuto nga tegigaziyiziddwa kibi nnyo, nga entambula ya microscopic ey’enkomerero y’eggumba eyamenyeka awamu n’ekituli ekisigadde, eky’angu okukula kwa bakitiriya.

4. Okukozesa okunyweza medullary okugaziwa n’okugaziwa tekikoma ku kulongoosa nnywevu y’okumenya, naye era kwewala okutondebwawo ekifo ekifu.

Obulwadde bw'okusannyalala .

1.Obulwadde bwa FES obw’okumenya amagumba amawanvu (long tubular bone fractures) buli 0.5% ku 2%.

2. Okugaziya medulla n’obutagaziwa kwa medulla tekirina kinene kye kikola ku kussa empewo mu mawuggwe.

3.Bw’ogaziya medulla, obukodyo buno bulina okuba nga bufumbiddwa mpola, nga weewala amaanyi mangi nnyo n’okukola obubi.

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Okulwawo okuwonya okumenya n’obutagatta magumba .

Ensonga ez’enjawulo zikwata ku kuwonya okumenya oluvannyuma lw’okunyweza omusumaali ogw’omu lubuto, era ebivaako biyinza okwekenneenyezebwa bwe biti.

1.Soft tissue eteekeddwa mu nkomerero y'okumenya .

2. Okwawula okumenya okuwanvuwa enkomerero .

3. Emyaka gy’omulwadde egy’edda .

4. Open fracture, serious soft tissue injury, okusannyalala okw’amaanyi mu kitundu oba okukwatibwa obulwadde.

5. Okunyweza emisumaali mu kunywa emisumaali mu ngeri embi .

6. Endwadde za sukaali ezigatta oba endwadde endala ezikozesa.

Okumenya obujjanjabi mu by’obujjanjabi .

Okumenyaamenya okuleetebwa abasawo okusinga kuba kumenyeka kwa kubiri okuva ku kukyusakyusa mu ngeri etali ntuufu mu kiseera ky’okunyweza omusumaali ogw’omu lubuto.

Okufaayo mu kulongoosebwa kulina okussibwa ku .

1. Okulonda okutali kutuufu okw’ekifo ekiyingira omusumaali kuyinza okuvaako okumenya okumpi.

2. Tonyigiriza n’amaanyi mu kugaziya medulla.

3. Omulyango oguyingira mu kugaziwa kw’ebikuta gulina okuba mu ludda lwe lumu n’oludda lw’okuyingiza omusumaali.

4. Tokozesa maanyi ng’oyingiza emisumaali egy’omu lubuto mu nkomerero ey’ewala.

Obulumi mu binywa ebiriraanye .

1. Okuteeka omusumaali ogw’omu lubuto kizingiramu ebitundu ebigonvu n’okutuuka ku nnyindo y’ekiwanga mu kitundu ekiriraanye ekiwanga ekitakka wansi wa 1.

. Singa ekifo we bakuba emisumaali kiba kumpi nnyo n’okungulu oba dayamita y’omusumaali ogw’omu lubuto guba munene nnyo, kiyinza okuleeta okwonooneka kw’ensengekera z’omu lubuto, ekivaamu okulumwa okugulu oluvannyuma lw’okulongoosebwa.

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