Kuthyoka kwa clavicle, komwe kumatchedwa kolala yosweka, nthawi zambiri kumachitika pambuyo pa kugwa, kuvulala pamasewera, kugunda kwa njinga, kapena kugunda mwachindunji pamapewa. Ambiri amtundu wa clavicle fractures amatha kuchiritsidwa popanda opaleshoni. Komabe, malo ophwanyika, kusamutsidwa, kuyambika, khungu, kuvulala komwe kumachitika, zaka za odwala, ndi zofuna za zochitika zonse zimatha kukhudza dongosolo la chithandizo.
Ndemanga yozikidwa paumboniyi ikufotokoza za zizindikiro, matenda, magulu, chithandizo chosagwira ntchito, njira zopangira opaleshoni, zovuta, ndi njira yochira kwa clavicle fractures. Amapangidwira maphunziro wamba ndipo salowa m'malo owunikiridwa ndi katswiri wodziwa zachipatala.
Zofunika Kwambiri
Chapakati chachitatu, kapena shaft, ndi malo omwe amapezeka kwambiri a clavicle fracture.
Zizindikiro zodziwika bwino ndi zowawa, kutupa, kuvulala, kufewa, komanso kuvutika kusuntha mkono.
Ma X-ray osavuta ndiye mayeso oyamba a kujambula; CT ingagwiritsidwe ntchito pazinthu zovuta, zapakati, kapena zoyamba.
Zophwanyika zambiri zomwe zimasamutsidwa pang'ono zimathandizidwa ndi gulaye, kujambula kotsatira, ndi kukonzanso pang'onopang'ono.
Kuthyoka kotseguka, khungu loopsya, kuvulala kwa mitsempha, lamba la paphewa losakhazikika, ndi fractures zosankhidwa zosasunthika kapena zosakhazikika zingafunike opaleshoni.
Kukonzekera kwa mbale ndi intramedullary fixation kungapereke zotsatira zabwino muzowonongeka zamatabwa akuluakulu, koma aliyense ali ndi ubwino ndi zoopsa zosiyanasiyana.
Kuchira kumasiyanasiyana malinga ndi zaka, njira yothyoka, njira yochiritsira, momwe amasuta, komanso umboni wa machiritso a mafupa.
Kodi Kuphulika kwa Clavicle N'chiyani?
Clavicle ndi fupa lopangidwa ndi S lomwe limagwirizanitsa sternum pakatikati pa chifuwa ndi scapula pamapewa. Zimagwira ntchito ngati kugwirizana pakati pa thunthu ndi kumtunda pamene zimathandiza kuteteza mitsempha ndi mitsempha ya magazi yomwe imadutsa pansi pake.
Clavicle anatomy ndi mawonekedwe amtundu wa fracture.
Kuphulika kwa clavicle kumachitika pamene mphamvu imaposa mphamvu ya fupa. Njira zodziwika bwino zimaphatikizapo kugwa molunjika paphewa, kugwa pa mkono wotambasulidwa, kugundana pamasewera olumikizana, ndi njinga yamagetsi yamphamvu kwambiri kapena kuvulala kwagalimoto. Odwala achichepere, kuvulala kumeneku nthawi zambiri kumatsatira masewera kapena ngozi zapamsewu. Kwa okalamba, kugwa kwa mphamvu zochepa kungakhale kokwanira, makamaka pamene khalidwe la mafupa likuchepa.
Mitsempha ya Clavicle imakhala pafupifupi 3% mpaka 5% ya fractures akuluakulu. Kugawirako nthawi zambiri kumafotokozedwa ngati bimodal, ndi chiwopsezo chimodzi pakati pa achinyamata ndi achikulire ndi china mwa okalamba.
Zizindikiro za Clavicle Fracture
Zizindikiro zimadalira malo ndi kuopsa kwa kuvulala, koma nthawi zambiri zimaphatikizapo:
Kupweteka kofulumira pa collarbone pambuyo povulala
Kutupa, mikwingwirima, ndi kufewa komweko
Kupweteka pamene mukukweza kapena kusuntha mkono womwe wakhudzidwa
Kuphulika kowoneka, masitepe, kapena kusintha kwa mapewa
Kumverera kwakupera kapena kusuntha pamalo ophwanyika
Chizoloŵezi chothandizira mkono wovulala ndi dzanja lina
Zizindikiro Zochenjeza Zomwe Zikufunika Kuunika Mofulumira
Kuyeza kwachipatala mwamsanga n'kofunika pamene khungu likuphwanyidwa kapena kumangidwa mwamphamvu pa chidutswa chakuthwa; dzanja kapena mkono umakhala wotumbululuka, wozizira, wofooka, kapena dzanzi; kupuma kumakhala kovuta; kupweteka pachifuwa kulipo; kapena kuvulala kunatsatira kuvulala kwamphamvu kwamphamvu. Zotsatirazi zitha kuwonetsa kuthyoka kotseguka kapena kuvulala komwe kumakhudzana ndi mapapo, khoma la pachifuwa, mitsempha, kapena mitsempha yamagazi.
Kuyeza kwachipatala kuyenera kuphatikizapo khungu, mapewa, kuzungulira, ndi ntchito ya mitsempha.
Kodi Kuphulika kwa Clavicle Kumadziwika Bwanji?
Kuzindikira kumayamba ndi mbiri yovulazidwa ndi kuyezetsa thupi. Kachipatala amawunika malo achifundo, chilema chowonekera, chikhalidwe cha khungu, kayendetsedwe ka mapewa, ndi kuyendayenda ndi mitsempha ya mkono wokhudzidwa. Pakuvulala kwamphamvu kwambiri, chifuwa, khosi, scapula, ndi mbali zina za lamba wamapewa zimafunikiranso kuwunika mosamala.
X-ray
Ma radiographs osavuta ndiye mayeso oyeserera a mzere woyamba. Amatsimikizira malo ophwanyidwa ndikuthandizira kuwonetsa kusamuka, kukhumudwa, kufupikitsa, ndi comminuation. Ma radiographs owongoka amatha kuwonetsa kusamuka kochulukirapo kuposa zithunzi zomwe zimatengedwa wodwala atagona, makamaka m'katikati mwa clavicle fractures.
CT ndi Zithunzi Zina
Computed tomography ingakhale yothandiza pamene fracture imaphatikizapo clavicle yapakati kapena sternoclavicular joint, pamene fracture ya fracture imakhala yovuta, pamene kuvulala kokhudzana ndi mapewa kumaganiziridwa, kapena pamene kukonzekera mwatsatanetsatane kusanachitike. Kujambula kowonjezera kumasankhidwa molingana ndi kuvulala komwe kumaganiziridwa m'malo mogwiritsidwa ntchito mwachizolowezi pa fracture iliyonse ya clavicle.
Ma Radiographs amathandizira kufotokozera malo ophwanyika, kusamuka, kufupikitsa, ndi kuyambiranso.
Mitundu ndi Magulu a Clavicle Fractures
Chinthu choyamba chothandiza kwambiri ndikuyika fracture ya clavicle ndi malo:
| Malo | Kufotokozera | Zoganizira Zachipatala |
|---|---|---|
| Kuphulika kwa Midshaft | Zimakhudza gawo lachitatu la clavicle ndipo ndilofala kwambiri. | Kusamuka, kufupikitsa, comminution, mawonekedwe a khungu, ndi mlingo wa zochitika wodwala zimathandiza kutsogolera chithandizo. |
| Distal clavicle fracture | Zimaphatikizapo mapeto ozungulira pafupi ndi mgwirizano wa acromioclavicular. | Kukhazikika kumadalira pang'ono mgwirizano pakati pa fracture ndi coracoclavicular ligament complex. |
| Kuphulika kwapakati kwa clavicle | Zimaphatikizapo mapeto pafupi ndi mgwirizano wa sternoclavicular ndipo ndizosazolowereka. | Kusamuka kwapambuyo kumafuna kuwunika mosamala chifukwa zida zofunika zili kumbuyo kwa clavicle yapakati. |
Common Classification Systems
Allman system imagawa ma clavicle fractures kukhala kuvulala kwapakati pachitatu, distal-third, ndi medial-third kuvulala. Machitidwe atsatanetsatane amaphatikizapo gulu la Neer la distal clavicle fractures, gulu la Robinson kapena Edinburgh, ndi gulu la AO/OTA. Machitidwewa amafotokoza zinthu monga malo, kusamuka, comminution, kukhudzidwa kwa articular, ndi kukhazikika kwa ligament.
Dzina logawika lokha silitanthauza chithandizo. Kachipatala ayeneranso kuganizira za khungu ndi minofu yofewa, chikhalidwe cha mitsempha, kuvulala komwe kumachitika, zaka za odwala, matenda, ntchito, ntchito, ndi zokonda zachipatala.
Machitidwe odziwika bwino a clavicle fracture amafotokoza malo, kukhazikika, kusamuka, ndi comminuation.
Chithandizo chosagwira ntchito cha Clavicle Fractures
Ma fractures ambiri amtundu wa clavicle amayendetsedwa popanda opaleshoni, makamaka pamene kugwirizanitsa kuli kovomerezeka ndipo fracture ikuyembekezeka kukhala yokhazikika. Siling'i yapamkono nthawi zambiri imakonda kusiyana ndi zingwe zisanu ndi zitatu chifukwa ndi yosavuta kuyiyika ndipo nthawi zambiri imakhala yabwino.
Chisamaliro chosagwira ntchito chingaphatikizepo:
Sling immobilization kuti chitonthozo ndi chitetezo
Kusamalira ululu motsogoleredwa ndi katswiri wa zachipatala
Kutsata pafupipafupi kwachipatala ndi radiographic
Kusuntha koyambirira kwa chigongono, dzanja, ndi dzanja
Kuyenda kwapamapewa kopita patsogolo pamene ululu ndi kukhazikika kwa fracture kumalola
Kulimbitsa pambuyo pa zizindikiro zachipatala ndi radiographic machiritso
Ubwino wa chithandizo chosagwira ntchito ndi monga kupewa kudulidwa, kukomoka, chiopsezo chotenga matenda, komanso mavuto okhudzana ndi implant. Zoyipa zomwe zingatheke zimaphatikizapo kupunduka kosalekeza, kuchedwa kwa mgwirizano, kusagwirizana, malunion, ndi kubwerera pang'onopang'ono kuntchito yovuta kapena masewera muzowonongeka zosankhidwa.
Kuponyera m'manja kosavuta kumagwiritsidwa ntchito ngati chitonthozo ndi chitetezo panthawi ya chisamaliro choyambirira chosagwira ntchito.
Kodi Kuphulika kwa Clavicle Kumafunika Kuchita Opaleshoni Liti?
Opaleshoni siifunikira pamtundu uliwonse wosweka wa clavicle, ndipo palibe muyeso umodzi womwe uyenera kugwiritsidwa ntchito paokha. Chithandizo chiyenera kuchitidwa payekhapayekha popanga zisankho pakati pa wodwala ndi dokotala wochiza.
Chithandizo cha opaleshoni chingaperekedwe kapena kuganiziridwa mwamphamvu ngati pali:
Kuthyoka kotseguka
Kuwonongeka kwa khungu kapena kukhazikika kwakukulu pa chidutswa chosweka
Kuvulala kogwirizana ndi mitsempha yamagazi kapena mitsempha
Lamba wamapewa osakhazikika kapena mawonekedwe osankhidwa angapo ovulala
Kusamuka kozindikirika, kufupikitsa, kapena kusinthidwa pakathyoka pakati pa shaft wamkulu
Kusasunthika kosasunthika kwa distal clavicle fracture ndi kusokonezeka kwa coracoclavicular ligament complex
Symptomatic nonunion kapena malunion
Kufunika kobwezeretsanso kukhazikika komanso kukhazikika mukaganizira za ntchito, masewera, thanzi labwino, komanso zomwe wodwala amakonda
Kwa akuluakulu omwe ali ndi fractures ya midshaft, chithandizo chamankhwala chimagwirizanitsidwa ndi chiwerengero chapamwamba cha mgwirizano komanso zotsatira zabwino zomwe zimaperekedwa ndi odwala mofulumira kusiyana ndi chisamaliro chosagwira ntchito. Zotsatira za nthawi yayitali ndi kukhutira, komabe, zingakhale zofanana ndi njira iliyonse. Zomwe zimasiyanasiyana zimasiyana ndi achinyamata, omwe machiritso awo amatha kukhala aakulu komanso omwe maopaleshoni achizolowezi amtundu wapakati omwe ali ndi vuto lapakati sangapereke mwayi wogwira ntchito.
Makhalidwe ophwanyika ndi kuvulala kogwirizana kumaganiziridwa pamodzi posankha ngati opaleshoni ingakhale yoyenera.
Chisamaliro chosagwira ntchito motsutsana. Opaleshoni Yoyimitsa
| Chithandizo cha | Omwe Amaganiziridwa Kamodzi Pazabwino | Zomwe Zingatheke | Zomwe Zingatheke |
|---|---|---|---|
| Sling ndi kukonzanso | Ambiri omwe sanasamuke, osowa pokhala, komanso osweka bwino | Amapewa opaleshoni ndi zovuta zokhudzana ndi implant | Zophwanyika zosankhidwa zomwe zasamutsidwa zimakhala ndi chiopsezo chachikulu cha kusagwirizana, malunion, kapena kuchira msanga |
| Kukonza mbale ndi screw | Zodulidwa zosasunthika, zofupikitsidwa, zowonongeka, zotseguka, kapena zosakhazikika | Kuchepetsa kwachindunji, kukonza mwamphamvu, komanso kuchuluka kwa mgwirizano | Chipsera, matenda, dzanzi, kutchuka kwa hardware, komanso kuchotsedwa kwa implants zotheka |
| Kukonzekera kwa intramedullary | Osankhidwa clavicle shaft fractures ndi chitsanzo choyenera | Zong'onong'ono zazing'ono komanso kuwonetseredwa kwa minofu yofewa nthawi zina | Kukwiyitsa kwa implant, kusamuka, kuchotsedwa, komanso kusakwanira kwamapambo ena ophatikizidwa |
Njira Zopangira Opaleshoni
Plate ndi Screw Fixation
Kuchepetsa kotseguka ndi kukonza mkati ndi mbale ndi njira yodziwika bwino yopangira opaleshoni ya clavicle fractures. Dokotalayo amabwezeretsa kukhazikika ndikuteteza chophwanyikacho ndi mbale ndi zomangira. Zamakono Machitidwe a mafupa otsekera mbale amapereka njira zokhazikika zosankhidwa za fractures zosankhidwa. Kukonzekera kwa mbale kungakhale kothandiza makamaka pamene fracture ikuyendetsedwa kapena kusunga kutalika ndi kuzungulira ndikofunikira.
Ma implants opangidwa kale monga Chovala chotchinga chofanana ndi S chapangidwa kuti chitsatire kupindika kwa clavicle, ngakhale kusankha komaliza ndi kuyika kozungulira kumadalira momwe thupi limapangidwira komanso kamangidwe kake. Zoyipa zomwe zingatheke ndikuphatikizira dzanzi mozungulira pocheka, kutchuka kwa implant, kukwiya kwa minofu yofewa, matenda, komanso kuthekera kwa njira ina yochotsera zizindikiro za hardware. Kuchotsa implant sikofunikira kokha pambuyo povulala kulikonse.
Kukonzekera kwa mbale kumabwezeretsanso kugwirizanitsa ndikukhazikika kwa clavicle pamene fracture imachiritsa.
Kukonzekera kwa Intramedullary
Zida za intramedullary zimayikidwa mkati mwa ngalande ya clavicle kuti zikhazikike zosweka za shaft. Poyerekeza ndi plating, njira iyi ingagwiritse ntchito ting'onoting'ono tating'ono ndikuchepetsa kuwonekera kwa minofu yofewa. Komabe, si kuthyoka kulikonse komwe kuli koyenera kukhazikika kwa intramedullary, makamaka pamene comminuation imapangitsa kutalika kapena kuwongolera kozungulira kukhala kovuta. Mambale ndi misomali zonse zimapanga mbali yotakata orthopedic trauma fixation system.
Kwa akuluakulu a clavicle shaft fractures, intramedullary nailing ndi single-plate fixation ikhoza kubweretsa zotsatira zachipatala za nthawi yayitali komanso zovuta. Kukonzekera kwa mbale kungapereke mwayi pamaso pa comminution.
Kukonzekera kwa intramedullary kumatha kuganiziridwa pamapangidwe osankhidwa a clavicle shaft fracture.
Minimaally Invasive Plate Osteosynthesis
Osteosynthesis ya mbale yaing'ono imagwiritsa ntchito mapindikidwe ang'onoang'ono ndi kuwonetseredwa pang'ono pamene ikukhazikika pothyoka ndi mbale. Njirayi ikufuna kusunga minofu yofewa ndi biology yosweka, koma kuchepetsa molondola ndi kuteteza mitsempha ya supraclavicular imakhalabe yofunika.
Zitsanzo za kukonza mbale zong'onongeka pang'ono za ma clavicle fractures.
Distal Clavicle Fixation
Kuphulika kwa distal clavicle kumafuna kuunika kwa malo ophwanyika, kukula kwa zidutswa, kukhudzidwa kwapadera, ndi kukhulupirika kwa coracoclavicular ligament complex. Zosankha zingaphatikizepo a distal clavicle locking plate , coracoclavicular stabilization, kapena njira zina zokonzera zosankhidwa kuti zikhale ndi ndondomeko yeniyeni. Umboni sugwirizana ndi njira imodzi ya distal fracture iliyonse.
Kukonzekera kwa distal clavicle kumasankhidwa molingana ndi kukula kwa zidutswa ndi kukhazikika kwa ligament.
Matenda a Medial Clavicle
Ma fractures ambiri omwe amachoka pang'onopang'ono amatha kuyendetsedwa popanda opaleshoni. CT nthawi zambiri imakhala yamtengo wapatali pamene kusamuka kumakhala kovuta kufotokozera kapena pamene anthu akukayikira kuti akuthawa kwawo. Chifukwa trachea, esophagus, zombo zazikulu, ndi ziwalo zina zapakati zili pafupi, kuvulala kwapakatikati komwe kumachokera kumafuna kuunika kwachangu kwa akatswiri.
Kuvulala kovutirapo kwa clavicle kungafune njira yokonzekera yogwirizana ndi mtundu wa fracture wamunthu.
Clavicle Fracture Kubwezeretsa ndi Kukonzanso
Palibe nthawi imodzi yobwezeretsanso kuvulala kulikonse kwa clavicle. Zaka, malo ophwanyika, kusamuka kwawo, njira yochiritsira, momwe amasuta, kuvulala kogwirizana, ndi machiritso a radiographic zonse zimakhudza kupita patsogolo. Odwala ambiri amapezanso ntchito zothandiza mkati mwa masabata a 6 mpaka 12, koma machiritso athunthu a mafupa, kubwezeretsa mphamvu, ndi kubwerera kuntchito zomwe zimafuna kwambiri zingatenge nthawi yaitali.
Gawo lachitetezo: gulaye imagwiritsidwa ntchito potonthoza komanso chitetezo. Kusuntha kwa dzanja, dzanja, ndi chigongono nthawi zambiri kumalimbikitsidwa pokhapokha ngati kuvulala kwina kukulepheretsa.
Kumayambiriro koyambirira: Kuchita masewera olimbitsa thupi pang'onopang'ono kungayambe pamene ululu ukuchepa ndipo dokotala amatsimikizira kuti kuyenda kuli koyenera.
Gawo lolimbikitsa: Zochita zolimbitsa thupi zimayambitsidwa pambuyo pa machiritso okwanira azachipatala ndi ma radiographic.
Gawo lobwerera ku zochitika: Kukweza kwambiri, masewera okhudzana ndi masewera, ndi zochitika zomwe zimakhala ndi chiopsezo chachikulu chogwa ziyenera kudikirira mpaka fracture yachira ndipo mphamvu ndi kuyenda kwachira.
Kutsatira ndikofunikira chifukwa kuwonjezereka kwa kupunduka, kupweteka kosalekeza, kapena kusowa kwa radiographic kungasonyeze kusamuka, kuchedwa kwa mgwirizano, kapena kusagwirizana. Kusuta kungawononge machiritso a fracture ndipo kuyenera kuyankhulidwa ngati gawo la ndondomeko ya chithandizo.
Mavuto Otheka
Mavuto Pambuyo pa Chithandizo Chopanda Ntchito
Nonunion: fracture imalephera kuchiritsa, zomwe zingayambitse kupweteka kosalekeza kapena kufooka.
Malunion: fracture imachiritsa mufupikitsa, kukhumudwa, kapena kusuntha.
Kuwoneka kowoneka bwino: chotupa chikhoza kukhalabe pa kupasuka kochiritsidwa.
Kuuma kwa mapewa kapena kufooka: kukonzanso kungafunike kubwezeretsa ntchito.
Zizindikiro za neurovascular: izi sizachilendo koma zimafunikira kuunika mwachangu.
Mavuto Pambuyo pa Opaleshoni
Matenda a chilonda
Kumva dzanzi kapena kusintha kwakumva mozungulira pocheka
Kukwiya kwa Hardware kapena kutchuka
Implant kumasuka, kupindika, kapena kusweka
Kuchedwa kwa mgwirizano, kusagwirizana, kapena malunion
Refracture, kuphatikizapo pambuyo implant kuchotsa
Kufunikanso opareshoni ina, nthawi zambiri chifukwa cha zizindikiro za hardware
Chiwopsezo chazovuta chimadalira fracture ndi wodwalayo. Kuchuluka kwa mgwirizano wa radiographic sikutanthauza kuti opaleshoni ndiye chisankho chabwino kwambiri kwa aliyense, monganso kupewa opaleshoni sikuchotsa kuthekera kwa kulowererapo pambuyo pake.
Kujambula kotsatira kungathandize kuzindikira zovuta zamachiritso ndi zovuta zokhudzana ndi implant.
Mafunso Ofunsidwa Kawirikawiri
Kodi fracture ya clavicle imatha popanda opaleshoni?
Inde. Ma fractures ambiri amtundu wa clavicle amachiritsidwa popanda opaleshoni ndipo amachiritsidwa ndi chithandizo cha gulaye, kutsata, ndi kukonzanso pang'onopang'ono. Kuthekera kwa kusamalidwa bwino kosagwira ntchito kumadalira kukhazikika kwa fracture, kusamuka, comminution, malo, zaka za odwala, ndi zina zachipatala.
Kodi fracture ya clavicle imatenga nthawi yayitali bwanji kuti ichire?
Odwala ambiri amayambiranso kugwira ntchito mwachizolowezi kapena pafupifupi pafupifupi masabata 6 mpaka 12, koma nthawi ya machiritso imasiyanasiyana. Akuluakulu, osuta fodya, anthu othawa kwawo kapena osweka kwambiri, komanso odwala omwe ali ndi matenda ena angafunikire nthawi yayitali. Kubwereranso kumasewera olumikizana nawo kumafuna machiritso otsimikizika komanso chilolezo chachipatala.
Kodi fracture ya clavicle yodziwika kwambiri ndi iti?
Midshaft clavicle fractures ndizofala kwambiri. Kuphulika kwa distal sikuchitika kawirikawiri, ndipo kuphulika kwapakati pakatikati kumakhala kosazolowereka.
Kodi kuphulika kowoneka pambuyo pa kusweka kwa clavicle ndikoyenera?
Kutchuka kowonekera kumakhala kofala panthawi ya machiritso ndipo kungakhalepo pambuyo pa mgwirizano wa fupa. Kwa ana ndi achinyamata amatha kukonzanso kwambiri pakapita nthawi. Kupunduka komwe kumakula, khungu lowopsa, kupweteka kowonjezereka, dzanzi, kapena kufooka kuyenera kuyesedwa nthawi yomweyo.
Kodi kukonza mbale kuli bwino kuposa intramedullary fixation?
Palibe njira yomwe ili yabwino kwa wodwala aliyense. Onsewa angapereke zotsatira zabwino za nthawi yayitali muzosankha zazikulu zothyoka shaft. Kukonza mbale kungakhale kwabwino pamapangidwe opangidwa, pomwe kukonza kwa intramedullary kungachepetse kukula kwa ming'alu yoyenera. Chigamulocho chimadalira fracture morphology, zochitika za opaleshoni, zofunikira za odwala, ndi zoopsa zokhudzana ndi implant.
Kodi zida za clavicle ziyenera kuchotsedwa nthawi zonse?
Ayi. Ma mbale, zomangira, ndi zida za intramedullary sizimachotsedwa nthawi zonse zikakhala kuti palibe zizindikiro ndipo fracture yachira. Kuchotsa kungaganizidwe chifukwa cha kupsa mtima kosalekeza, kutchuka, kupweteka, mavuto a implants, kapena zifukwa zina zachipatala pambuyo pokambirana za kuopsa kwa opaleshoni ina.
Kodi ndi zizindikiro ziti zomwe fracture ya clavicle sichiri kuchira?
Kupweteka kosalekeza pa malo ophwanyika, kusuntha kosalekeza kapena chifundo, kusintha kochepa kwa ntchito, ndi kusowa kwa patsogolo pamaganizidwe otsatila kungasonyeze kuchedwa kwa mgwirizano kapena kusagwirizana. Zizindikiro izi zimafunikira kuwunika kwa dokotala.
Mapeto
Chithandizo cha Clavicle fracture chimadalira zambiri kuposa mawonekedwe a X-ray imodzi. Ma fractures ambiri okhazikika kapena osasunthika pang'ono amatha kuyendetsedwa bwino popanda opaleshoni. Kuvulala kosasunthika kosankhidwa, kufupikitsidwa, kuchepetsedwa, kotseguka, kapena kosakhazikika kungapindule ndi kukonza kwa opaleshoni, makamaka kwa akulu. Kuwunika mosamalitsa mawonekedwe a fracture, khungu ndi mitsempha yamagazi, kuvulala kogwirizana, zaka za odwala, zofuna za ntchito, ndi zolinga za chithandizo ndizofunikira popanga zisankho zogawana.
