Okuzuula n’okujjanjaba okumenya kw’omugongo .

Okwanjula

Emenyeka z’omugongo (clavicle fractures) zitera okubeerawo era ebiseera ebisinga ziva ku buvune obutereevu oba obutatereevu okutuuka mu kitundu ky’ebibegabega. Okunoonyereza ku ntandikwa y’emyaka gya 1960 kwalaga nti omuwendo gw’abantu abatali ba kibiina ky’abaana abamenyese mu kifuba gwali wansi wa 1%, era obujjanjabi obw’okukuuma bwavaamu okumatizibwa kw’abalwadde okungi; Olw’okukula kw’eddagala gye buvuddeko, obujjanjabi bw’okulongoosa bufunye obusobozi obw’amaanyi; N’olwekyo, abasawo abakola mu kitongole ky’abalwadde ab’amangu oba mu ddwaaliro ly’abalwadde abatali balwadde bonna balina okuba nga bamanyidde ddala okwolesebwa n’ebizibu ebitera okubaawo mu buvune buno n’enzirukanya yaakyo enkulu.

Epidemiology .

Emenyeka z’omugongo zikola ebitundu 2.6%-5% ku kumenya kwonna okw’abantu abakulu [1,2]. Okunoonyereza kwa Bulaaya okwalimu emisango 1,000 egy’okumenya ogw’omuddiring’anwa egy’omuddiring’anwa gyazuula [3,4] nti ebitundu ebisukka mu 66% eby’okumenya kw’omugongo (clavicle fractures) kwaliwo mu makkati 1/3 ku clavicle, nga 25% byali bya mbiriizi 1/3 eby’ebbali 1/3, ate 3% byali bimenya 1/3 eby’omu makkati. Obulwadde bwa clavicle fractures bwalaga nti bimodal distribution, nga bino bisinga kubeera mu basajja abali wansi w’emyaka 30, nga bigobererwa abo abasukka mu myaka 70.

Ensengeka y’omubiri mu bujjanjabi .

Ekisooka amagumba g’omuntu okutandika amagumba ge ga clavicle, akakwate kokka ak’amagumba wakati w’omukono ogwa waggulu n’omuti, ogulaga ewala ne acromion, acromioclavicular (AC) joint, era nga gumpi n’omugongo, sternoclavicular (SC) joint. Ebiyungo bino biyitibwa ebiyungo ebitali bya bulijjo (atypical synovial joints) kubanga bibaamu ebitundu by’omubiri ebiyitibwa fibrocartilage okusinga hyaline cartilage. Engo esimbibwa ku kifuba n’ennywanto ya acromioclavicular ne rostroclavicular era eyungibwa ku sternoclavicular ligament.

Engo eba 's' ekoleddwa. Ekitundu eky’okumpi ekya arc kifuluma mu maaso, ne kireka ekifo ky’ekibinja ky’emisuwa gy’obusimu (neurovascular bundle) eky’enkomerero ey’okungulu. Ekitundu eky’ewala ekya ARC kifuluma (concave) n’oluvannyuma ne kyegatta ku scapula (enkola ya rostral ne acromion). Okumenyeka kw’ekiwujjo kutera okubaawo ku nkulungo ya arcs ebbiri (mid-arc), okusinga kiyinzika olw’obutaba na binywa ebinywerera ku magumba agaliraanye mu kitundu kino era olw’okuba kye kitundu ekisinga obunafu mu kiwujjo. Bwe kimenyeka ekikutuse, ekitundu eky’okumpi kumpi bulijjo kisimbulwa waggulu (cephalad) ekinywa kya sternocleidomastoid (ekikwatagana ku nkomerero y’okumpi ey’omugongo) ate ekitundu eky’ewala kisengulwa wansi (caudad) ku buzito bwa upper ends ends ends ends ends), pertracs ends tends to 'shorten . wa subscapularis ne pectoralis major (nga munda akuba omukono ogwa waggulu). Kino kisinga kuva ku kukonziba kw’ebinywa ebikulu ebya subscapularis ne pectoralis (nga munda bikyusa omukono ogwa waggulu ne gusika okutuuka mu kifuba).

Ebintu eby'enjawulo

Ekigendererwa ky’obujjanjabi bw’okumenya embuto kwe kukendeeza ku bulumi n’okuzzaawo enkola y’ennyondo. Ebisinga obungi ebikutukakutuka eby’omugongo bikyayisibwa okusinga mu ngeri ey’okukuuma (ebiseera ebisinga bifunzibwa nga tebisukka mm 15); Enzijanjaba ezikuuma nga ffiga-of-eight bandages, forearrm slings, sayre bandages, velpeau immobilisation suits, n’okuziyiza okutambula. Okuyimirizaawo okuyimirizaawo kukolebwa mu mutendera ogw’amaanyi, era okutendekebwa mu kutambula nga bukyali n’okukola dduyiro ow’amaanyi kutera okukolebwa wiiki 2-6 oluvannyuma lw’okumenya ng’obulumi buwedde. Okukozesa ekifaananyi kya bandage 8 tekiba kirungi kuba kiyinza okuvaako amabwa ga puleesa y’omu kifuba n’okusingawo okutali kwa kumenya [5,6].

Ebyafaayo n'okukeberebwa omubiri .

Okumenyeka kw’omugongo kuva ku kukuba obutereevu ku kibegabega oluvannyuma lw’okugwa era kutera okulabibwa mu mizannyo egy’ebweru mu bavubuka ne mu kugwa mu butali bugenderevu mu bakadde. Kikulu okunnyonnyola enkola y’obuvune. Obuvune obw’amaanyi amangi buyinza okugatta n’obuvune ku mutwe n’ekifuba, ate okumenyaamenya okuva ku buvune obutono buyinza okuba obw’obulwadde. Obuvune obuwugulaza bwetaaga okutongozebwa amangu n’okuggyako n’obwegendereza okwawukana ku bbugwe w’ekifuba eky’ekika kya scapular, obuvune mu busimu n’emisuwa. Mu bujjanjabi, waliwo okuzimba n’okuzimba ecchymosis mu kifo we bamenya, nga bigattiddwa wamu n’okulema n’obugonvu. Okufaayo kulina okussibwa ku bitundu ebigonvu olw’okusimbula, ekiyinza okuvaako okutta olususu n’amabwa.

Okukuba ebifaananyi .

Okumenyeka okusinga kuyinza okuzuulibwa n’ebifaananyi ebyangu eby’omu maaso eby’omu maaso. 20° head tilt radiographs zimalawo ekikolwa ky’ebituli by’ekifuba ebikwatagana. Abalwadde balina okulagibwa ku 'radiograph' mu mbeera ey'okweyimirizaawo okulaba obulungi okusengulwa kw'okumenya. Okuzitowa kw’ebifaananyi ku leediyo kuyamba mu kwekenneenya obulungi bw’omuguwa gw’omugongo ogw’ekika kya rostral mu bbanga ery’ekika kya distal clavicle oba acromioclavicular joint injuries.CT ayamba okulaba obuvune obuzibu obw’omusipi gw’omu kifuba (complex scapular girdle injuries) era kiwa okulaba obulungi obuvune obuyinza okubaawo mu kiwanga (proximal clavicle injuries) ku kinywa ky’omugongo (sternoclavicular joint). Okutwala ekifaananyi ky’ekifuba kiyamba okugaana obuvune bw’ekifuba obukwatagana, era okufunza kuyinza okwekebejjebwa nga tugeraageranya ku kiwujjo eky’oku mabbali, awamu n’okugaana okwawula bbugwe ow’ekika kya scapulothoracic.

Ebika .

AO/OTA okumenya okuseeseetula Okuwandiika: Enkodi y’okumenya enseke 15 erimu ebifo bisatu: 15.1 eby’okumpi (eby’omu makkati), 15.2 diaphysis, ne 15.3 ewala (oludda). Okumenyeka okumpi (mu makkati) n’okw’ewala (oku mabbali) kugabanyizibwamu nga ekika kya A (eky’omu ttaka eky’enjawulo), ekika kya B (ekitundu ekiri munda mu langi), n’ekika kya C (mu kifuba ekijjuvu). Emmenya z’omugotteko zigabanyizibwamu nga ekika kya A (simple), ekika kya B (Wedge), era ekika kya C (comminute).Ekika kya AO/OTA eky’okumenya n’okuseeseetula tekitwala mu nkola eddaala ly’okusensera kw’okumenya, era mu kiseera kino kukozesebwa mu kujjanjaba okumenya kw’okuzaala n’okusalawo mu kiseera kino.

Okuwandiika kwa Allman kwesigamiziddwa ku kifo okumenya (I: Medial, Cadent 1/3, II: Lateral 1/3, III: Medial 1/3) (Fig. 7.2.1).

Craig yaddamu okulongoosa mu nsengeka eno ku musingi gwa Allman, nga I ndi wakati 1/3 ow’ekirawuli; Ekika kya II nga kiri ebweru 1/3 eky’ekiwuka ekiyitibwa clavicle, oluvannyuma ne kigabanyizibwamu ebika 5 nga byesigamiziddwa ku kusengulwa kw’okumenya n’enkolagana n’omuguwa gwa rostral clavicular; ne Type III nga emenyeka 1/3 ey’omunda ey’ekiwuka ekiyitibwa clavicle, eyagabanyizibwamu ebika 5 okusinziira ku ddaala ly’okusengulwa kw’okumenya n’okumanya oba okumenya kwali kwa munda oba nedda.

NEER’s typing of lateral 1/3 fractures eggumiza obukulu bw’omusipi gwa rostral-clavicular: ekika I kibaawo ewala eri omuguwa gwa rostral-clavicular, nga ekiziyiza eky’okumenya eky’omu makkati kisenguddwa waggulu; Ekika kya II kizingiramu omusipi gwa rostral-clavicular era kivaamu ekitundu ky’okumenya eky’omu makkati okusengulwa waggulu; era ekika kya III kigaziwa ku kiyungo kya acromioclavicular nga ekinywa kya rostral-clavicular kisigadde nga tekifudde.

Edinburgh typing ye nkola y’okugabanyamu ebitundu by’omubiri ebimenya ensengekera (diadiphysis fractures) okusinziira ku ddaala ly’okusengulwa n’okufukirira.1 Okumenya okw’ekika kya 1 kuzingiramu enkomerero ey’omu makkati, ekika kya 2 bimenyeka mu diaphysis ate ekika kya 3 bimenya enkomerero ez’ebbali. Ebimenyamenya eby’omubiri ebiyitibwa diaphysis bigabanyizibwa okusinziira ku kubeerawo oba obutabaawo kukwatagana kwa cortical wakati w’ebitundutundu by’okumenya mu bika bya A ne B. Ebimenya eby’ekika kya 2A byongera okugabanyizibwamu nga ebitaseereddwa (ekika 2A1) n’eby’okuziyiza (ekika kya 2A2),2B bikuŋŋaanyiziddwa nga bikubibwa mu ngeri ennyangu oba ey’ekika kya 2B1) nga bikubiddwa mu 1b1) nga bikubiddwa mu 1b1). wa diaphysis ne type 3 ye nkomerero y’ebbali eya diaphysis. Emmenya ez’enkomerero ez’omu makkati n’ez’ebbali zigabanyizibwamu ebitundu 1 ne 2 okusinziira ku oba ekiyungo ekiriraanyewo kizingirwamu.

Mu ngeri y’emu waliwo okuwandiika kwa Rockwood, okuwandiika Jager, n’okuwandiika Breitner.

Ebiraga Okulongoosa .

Ebimenyese ebitongole .

1, okuggulawo okumenya; 

2, okusengulwa >2 cm; 

3, okufunza >2 cm; 

4, okufuga ebitundutundu by’okumenya (>3); 

5, okumenya ebitundu ebingi; 

6, okumenya okuggule okuli wansi nga kufunye obuvune mu bitundu ebigonvu; 

7, obulema obw’amaanyi (okusengulwa n’okufunza); 

8, Obuvune bwa Scaphoid.

Obuvune bwa compound .

1, okugatta obuvune obw’okungulu obw’oludda olwa waggulu nga bugatta;

2, obuvune ku kibegabega obulengejja;

3, ebisago ebingi;

4, okumenya nga kugattibwa wamu n’obuvune bw’emisuwa;

5, ipsilateral emirundi mingi emmeeri ezikutuka nga zigatta wamu n’okulema kw’ekisenge ky’ekifuba;

6, Clavicle ng’afunza okukola ekibegabega eky’ebiwaawaatiro;

7, okumenya kw’omugongo ogw’enjuyi ebbiri.

Ensonga z’abalwadde .

1, abalwadde abalina obuvune obuwerako beetaaga okusitula obuzito bwa waggulu nga bukyali;

2, abalwadde abeetaaga okudda amangu okukola (okugeza, Elite n’emizannyo egy’okuvuganya).

Ebiseera by'okulongoosa .

Okulongoosa kulina okukolebwa awatali kulwawo nga waliwo okulaga okutuufu okulongoosebwa.

Okulwawo okulongoosebwa okusukka wiiki 2-3 mu kulaga okw’enjawulo kuyinza okwongera ku buzibu bw’okukendeeza ku kumenya, naddala nga weetegekera okunyweza okw’omunda okuggaddwa okw’okukendeeza okuggaddwa olw’obukodyo obuyita mu lususu.

Okulongoosa okutuuka .

Omulwadde ateekebwa mu kifo ky’entebe ya bbiici oba ekifo ky’okutuula. Ekibegabega ekikoseddwa kipangiddwa wansi okusitula ekiwuka kino okusobola okulongoosebwa amangu, era omukono gusiigibwa okusobozesa okukunga abantu mu kulongoosebwa. Okusalako okuwanvuwa okuyita ku kisenge ekiwanvu eky’ekiwujjo oba ekitundu ekisala ekisambi ekifaanagana n’enkola ya langer kiyinza okulondebwa.

Weetegereze: Okusalako okusalasala kuwa okugaziwa okusingawo, ate okusala okumala ebbanga eddene kikendeeza ku bulabe bw’okulumwa obusimu obuyitibwa supraclavicular nerve injury era kinyuma nnyo mu ngeri ey’okulabika obulungi.

Okunyweza munda .

. Epulati ziteekebwa bulungi waggulu oba mu maaso ku kiwujjo. Plates zisinga amaanyi mu biomechanical injuries bwe ziteekebwa waggulu naddala singa wabaawo comminuted fracture wansi, era nga nnyangu okulaba mu birowoozo. Okunyweza ebikoola (bicortical fixation) kyetaagisa, era ebinnya birina okusimibwa n’obwegendereza bungi, kubanga waliwo obulabe bw’okulumwa obusimu n’emisuwa wansi. Ebirungi: Okusima mu ngeri ey’obukuumi omukutu gwa sikulaapu ogw’omu maaso ogw’omu maaso, okuteekebwako pulati, okukonkona okwangu.

Weetegereze: Okusimba amagumba ebiseera ebisinga tekyetaagisa ku nkola esooka; Oluvannyuma lw’okunyweza munda, kikulu nnyo okusobola okutunga mu ngeri emala layeri ya myofascial okubikka ku pulati n’okuziyiza okukwatibwa.

Okunyweza mu mubiri .

Ebyuma ebinyweza ebiriwo kati mulimu ppini za Kirschner, ppini za rockwood, ppini za hagie, ppini za titastic elastic intramedullary, sikulaapu eziriko ebituli, n’emisumaali egy’okusibira mu mubiri (elastic locking intramedullary nails); EG, titanium elastic nails tezikkiriza kusiba static, tezikkiriza kufuga buwanvu na kuzimbulukuka, era ziyinza okuvaamu okufunza okw’okubiri nga zikozesebwa okumenya okumenya. Enkola y’okukuba emisumaali mu mubiri (intramedullary nailing technique) esobola okukozesebwa ku kumenyeka kw’omugongo okwangu, okuyita mu bbanga oba okuserengeta.

Ebirungi .

Okusalako okutono, okulabika obulungi, okuggyamu ebitundu ebigonvu ebitono, akabi akatono ak’okufuluma kw’omubiri (endophyte protrusion), n’okutebenkera okukwatagana n’okutondebwa kw’enkwaso.

Ebizibu .

Okunyiiga kw’olususu oba obulema mu kifo we bayingira.

NOTE:Okukendeera okuggaddwa kw’okumenya kw’ekikuta oluusi kizibu era okulaga ennyo omukono gw’omukozi okutuuka ku radiation kwewalibwa mu kiseera ky’okulongoosa.

Okunyweza pulati entono ennyo .

Minimal invasive plate osteosynthesis of the clavicle elowoozebwa nti egaba amaanyi amangi ag’obutonde ate nga yeewala ebizibu by’okunyweza pulati eziggule oba okunyweza mu memedullary.

Okuteeka mu nkola y’enkola ya 3.5 LCP anterior ku clavicle, okusinga mu maaso wansi w’omugongo, kisobozesa okujuliza ku clavicle ennungi, ekintu eky’angu okubumba plate nga bukyali n’okufuna screw aperture empanvu.

Okukozesa amangu amagumba agayingira mu mubiri (minimally invasive plate osteosynthesis) kuyinza okuba nga kukwatagana n’obuvune bw’obusimu obuyitibwa supraclavicular nerve injury, okukwatagana obubi oba okukendeeza ku waya bbiri ezikosa enkola, n’okubeebalama oba okumenya pulati.

Okunyweza ebbakuli y’emmeeme z’enkomerero ey’ebbali ey’ekiwuka ekiyitibwa clavicle .

Okulonda ebiteekebwa mu pulati kisinziira ku bunene bw’ekisenge ky’amagumba eky’ebbali. Ebikulu ebitakka wansi wa 3 bicortical screws byetaagibwa ku lateral bone block. Ekisinga obulungi, sikulaapu ezisika zirina okukozesebwa okumenya okuserengese. Singa bbulooka y’amagumba eba ntono nnyo okusobola okunyweza, ekyuma ekiyitibwa clavicle hook plate kiyinza okukozesebwa.

Okujjanjaba acromioclavicular joint dislocation .

Acromioclavicular joint injuries zikola ebitundu 12% ku buvune bw’omusipi gw’omugongo era zitera okubaawo mu bannabyamizannyo abakwatagana.

Enkola y’okuteeka ku siteegi esinga okukozesebwa ye Rockwood Staging. Ekika kya I kibeera kifuba kya acromioclavicular ligament nga ekinywa kya rostroclavicular tekifudde; Ekika kya II kikutuka kya acromioclavicular ligament nga omusipi gwa rostroclavicular tegufudde; Ekika kya III kikutuka ku byombi acromioclavicular ligament ne rostroclavicular ligament; Ekika kya IV kwe kusengulwa okw’emabega okw’ekiwuka ekiyitibwa distal clavicle ekikuba trapezius; Ekika kya V kikutuka ddala eky’ekiyungo kya acromioclavicular ne rostroclavicular ligament byombi, nga kirimu okusengulwa kw’ekiwanga okusukka mu bitundu 100 ku buli 100; era obuvune obw’ekika kya VI tebutera kubaawo nnyo, ng’ekiwujjo eky’ewala kisenguddwa wansi wansi w’enkola ya rostral.

Obujjanjabi obw’okukuuma n’okusimbula okw’ekiseera ekitono n’ekyuma ekiyitibwa cantilever sling kirungi ku buvune obw’ekika kya I n’ekika kya II. Enzirukanya y’obuvune obw’ekika kya III eriko okusika omuguwa, ng’ebiwandiiko ebimu biraga nti obujjanjabi obw’okukuuma bulagibwa eri abavubuka abakulu abakola ennyo. Okudda engulu mu nkola kirungi wadde nga wayinza okubaawo diguli ez’enjawulo ez’okulema mu ndabika. Obuvune obw’ekika kya IV - VI busingako nnyo era n’okulongoosebwa kirungi okulongoosebwa.

Mu kiseera kino, enkola z’okulongoosa ezitera okukozesebwa ze zino: enkola ya Bosworth Rostral Locking Screw Technique nga eddaabiriza omutendera gumu oba nga tewali kuddaabiriza musipi;, clavicle hook plate fixation, okufaananako n’enkomerero y’ebbali ey’okumenya clavicle; tightrope’s tab plate fixation oba anchor pinning suture okuyita mu arthroscope oba akatono akasaliddwa; ne rostral locking ligament suture oba reinforced suspension, nga waliwo ekintu eky’ekikugu oba omusuwa wakati w’obugulumivu bwa rostral ne clavicle.

Tekinnategeerekeka bukodyo ki obw’okulongoosa obusinga okuba obw’omugaso, era wadde nga wayinza okubaawo okufiirwa okutono okw’okuddamu okukola ku ngulu, obulungi obusembayo obw’obukodyo buno bwonna bumatiza.

Okujjanjaba okumenya enkomerero y’omu makkati (medial end clavicle fractures) n’okusannyalala kw’ennyondo z’omubiri (sternoclavicular joint dislocations) .

Obuvune buno tebutera kubaawo, era nate waliwo obutaba na ndagiriro za bujjanjabi nga zeesigamiziddwa ku ddagala eriweebwa obujulizi.

Okumenyeka kw’omugongo ogw’omu makkati kutera kuba kumenyeka okw’ebweru w’omubiri nga kulina okusengulwa okutali kwa maanyi era kuyinza okuyisibwa mu ngeri ey’okukuuma. Epiphysis y’enkomerero ey’omu makkati ey’ekiwujjo etera okuggalawo ku myaka 23-25 ​​era ye epiphysis esembayo okuggalawo mu mubiri. N’olwekyo, obuvune bungi obw’omu makkati mu butuufu bwa epiphyseal plate fractures of salter-harris type I oba II. X-rays eza bulijjo zizibu okuzuula, n’enkizo nti 40° head tilt radiograph n’okugeraageranya ku ludda olulamu kiyinza okulaga okusengulwa kw’enkomerero y’omu makkati ey’ekiwujjo, ate CT egaba okukuba ebifaananyi ebisinga obulungi okuzuula.

Okumenyeka oba okuseeseetula okusengulwa mu maaso ebiseera ebisinga kuyinza okuggalwa n’okuddamu okuteekebwa mu kifo, naye emirundi mingi nga tekunywevu era nga kufuulibwa lobotomized okuddamu okusengulwa. Obulabirizi bw‟okukkakkanya obulumi (palliative care) busemba ku kuseeseetula oba okusengulwa obutasalako kubanga emirundi mingi tebuvaamu kukosa mirimu. Okusengulwa kw’enkomerero ey’omu makkati ey’omugongo ogw’emabega tekitera kuvaamu buvune bwa waggulu mu mediastinal, omuli okulumwa emisuwa oba n’okuzibikira kw’omukka n’okunyigirizibwa kw’emikutu gy’empewo. Ku kuseeseetula n’okumenya nga ekitundu eky’omu makkati kitono nnyo, obubaawo busobola okuziba okuyita mu kiyungo okusobola okunyweza ku kifuba.

Enkola endala ez'okunyweza .

eg external fixation ne stent, okunyweza ebweru nga olina clavicle plate, etc.

Enzirukanya y’emirimu oluvannyuma lw’okulongoosebwa .

Omukono ogwa waggulu gulina okutambuzibwa mu kutendekebwa kwa pendulum mu sling ne pendulum ku kibegabega kulina okutandika amangu ddala. Nga wayise wiiki 2, omulwadde alina okugobererwa okukebera ekiwundu n’okuddamu okwetegereza x-rays, ate nga sling y’omukono ogw’omu maaso esobola okuggyibwamu era okutendekebwa mu kutambula kw’ennyondo okutaliimu bukwakkulizo kuyinza okutandika, naye omulwadde alina okugambibwa obutasitula buzito n’ekitundu ekikosebwa. Okutendekebwa kw’amaanyi kuyinza okutandika ku wiiki 6 oluvannyuma lw’okulongoosebwa ng’obubonero bw’okuwona kw’amagumba bulabika. Contact Sports oba Extreme Sports olina okwewalibwa okumala emyezi 3 oluvannyuma lw’okulongoosebwa okutuusa ng’okumenya kuwonye ddala.

Ebizibu ebiva mu.

Ebizibu ebisooka .

Obulwadde bw’ebiwundu oluvannyuma lw’okulongoosebwa buyinza okubaawo mu bitundu 4.8%;

Okuzimba mu kitundu kya subclavia kye kisinga okuzibuwalirwa, nga waliwo okunoonyereza ku byafaayo by’obutonde ku balwadde abatuuka ku 83% abalina obubonero buno, ekikendeera mu bbanga era nga tekivaako buzibu bwa maanyi, wadde nga kiyinza okuwangaala okutuuka ku myaka 2 oluvannyuma lw’okulongoosebwa;

Endophyte protrusion and skin agitation, ekitera okubeerawo mu kukozesa ebipande ebiwanvu oba emikira gy’emisumaali awatali kubikka bulungi mu bitundu ebigonvu;

okuddamu okusereba, ekiyinza okubaawo oluvannyuma lw’okulongoosebwa n’okujjanjaba okukuuma; Okuddamu okulumwa oluvannyuma lw’okulongoosebwa kuyinza okuvaamu okufukamira oba okumenya endoprosthesis, oba okumenya okwetoloola endoprosthesis;

Nonunion, nga erina 15% nonunion rate nga erimu obujjanjabi obw’okukuuma n’omuwendo gwa 2% ogutali gwa kibiina nga balongooseddwa obujjanjabi bwa diaphyseal obusenguddwa ddala; Okusengulwa okujjuvu okw’okumenya, okukendeeza ku sentimita ezisukka mu 2, okunywa sigala, okweyongera emyaka, obuvune obw’amaanyi amangi, okuddamu okumenya (obutali butebenkevu mu makanika), okuseeseetula kwa diaphyseal okukyukakyuka, omutindo gw’amagumba amabi, n’okufiirwa amagumba okuyitiridde.

Ebizibu ebikeeredde .

Osteoarthritis of the acromioclavicular joint etera okubeerawo n’okumenya mu bitundu by’omubiri (Edinburgh type 3B2); Obujjanjabi obw’obubonero n’obukuuma bwe buba tebukola, ekiwuka ekiyitibwa distal clavicle kiyinza okusalibwako mu ngeri ya arthroscopic oba okulongoosebwa mu ngeri ey’olubeerera;

Okuwonya okulema, ekibaawo ku ddaala ery’enjawulo mu kumenya kwonna okujjanjabiddwa mu ngeri ey’obukuumi; Okufunza omusipi gw’ekisambi nga kiwerekerwako okuzimbulukuka kw’ekiziyiza eky’ewala eky’ewala kiyinza okuvaamu okukendeera kw’amaanyi g’ebibegabega n’okugumiikiriza naddala mu kuwambibwa kw’ebibegabega; Okufunda kw’ekifuba ekifuluma kiyinza okuvaamu obubonero bw’okunyigirizibwa kw’omukono ogw’omukono; Era malalignment y’ennyondo z’oku bbugwe w’ekisambi kiyinza okuleeta okuwuguka mu maaso kw’ekisambi n’okuleeta obulumi ku kibegabega ne Myalgias, bwe kiba nga kyeyoleka bulungi nti obubonero buva ku bulema ng’okuwona kubaawo, okutereeza amagumba n’okunyweza pulati bisoboka okusinziira ku byetaago by’omulwadde.

Okuteebereza n'ebivaamu .

Okunoonyereza okukwatagana mu Bulaaya kwalaga nti okulongoosa okujjanjaba okumenya kw’omu makkati g’omugongo kwali kukola bulungi, era okwekenneenya kwakwo kwalaga nti obungi bw’obuwuka obuyitibwa malunion obuvaako okumenya obutakwatagana n’obubonero obukola obubonero bwali wansi nnyo mu kibinja ky’abalongoosa okusinga mu kibinja ekyajjanjabwa mu ngeri ey’okukuuma nga okulongoosa kugeraageranyizibwa ku bujjanjabi obw’okukuuma; Okugatta ku ekyo, ekibinja ky’abalongoosa kyali kikendeezezza ku bulumi nga bukyali, era okulongoosa mu bubonero bw’emirimu obutakyukakyuka n’okukola ennyo kwali kwa maanyi nnyo.

Mu bufunze .

Okumenya kw’omugongo okusinga kuva ku butabanguko obutereevu oba obutatereevu, era obujjanjabi busobola okugabanyizibwamu ng’obujjanjabi obw’okukuuma oba obw’okulongoosa. Mu ngeri y’obujjanjabi, wadde ng’okumenya kw’omugongo okusinga awatali kusengulwa kwa maanyi kuyinza okujjanjabibwa mu ngeri ey’okukuuma, enkola y’okulongoosa ey’okulongoosa okumenya n’okusengulwa okw’amaanyi erimu okusika omuguwa. Ku kumenyeka kw’omugongo okusenguddwa, obujjanjabi bw’okulongoosa bulina omuwendo omunene ogw’okuwona kw’amagumba n’ebiva mu kukola nga bukyali bw’ogeraageranya n’obujjanjabi obukuuma.

Ebiwandiiko ebijuliziddwa .

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[2] Eiff, omubaka wa Palamenti, Hatch, et al. okumenya enseke n’okusalasala. Mu: Enzirukanya y’okumenya obujjanjabi obusookerwako, 2nd ED, WB Saunders, Philadelphia 2002. p.198.

[3] Robinson Cm. okumenya kw’ekiwuka ekiyitibwa clavicle mu muntu omukulu. Epidemiology n'okugabanya. J Ennyondo y’eggumba Surg BR 1998; 80:476.

[4] NEER CS 2nd. okumenya kw’ekitundu eky’okusatu eky’ewala eky’ekiwuka ekiyitibwa clavicle. Clin Orthop Relat Res 1968; 58:43.

[5] Andersen K, Jensen Po, Lauritzen J. Okujjanjaba okumenya kw’amaaso. Figure-of-eight bandage okusinziira ku sling ennyangu. ACTA orthop scand 1987; 58:71.

[6] Ersen A, Atalar AC, Birisik F, et al. Okugerageranya okusiba emikono okwangu n’ekifaananyi kya bandage munaana eza clavicular ku midshaft clavicular fractures: okunoonyereza okufugibwa okutali kwa bulijjo. Ekinywa ky’amagumba J 2015; 97-B:1562.