AC ihuriweho hamwe nuburyo Titanium Isahani ikora itandukaniro

Iyo uhuye na ac ihuriweho na disikuru, plaque ya titanium nibikoresho bigezweho byo gutunganya bitanga intambwe nini yo gusana. Ubu buryo buteye imbere buzana ituze rikomeye no gukira vuba kuruta tekiniki zishaje. Urashobora kumva ufite ikizere uzi ko abarwayi bavuwe na sisitemu nshya bafite amanota menshi yimikorere yigitugu hamwe nimpinduka nke zifatika mugihe.

• Abarwayi bakoresha uburyo bugezweho bwo gukosora nka MSTC bageze ku manota ya Constant-Murley ya 95.8, hejuru cyane ya 76.7 bagaragaye bafite ibyapa bishaje.

• 12.5% ​​gusa by'abarwayi bafite MSTC bahuye nimpinduka zifatika, ugereranije na 66.7% bafite ibyapa.

Urashobora kwizera ubwo buryo bushya bwo kubaga kugirango utange ibisubizo byizewe kandi byiza, ushireho itandukaniro rigaragara no gusana gakondo.

Ibyingenzi

• Gusana isahani ya Titanium itanga imbaraga zikomeye no gukira byihuse kuri ac gufatanya ugereranije nuburyo bukera.

• Abarwayi bakoresha tekinoroji igezweho batanga raporo yimikorere yigitugu amanota menshi hamwe nimpinduka nke zihuriweho mugihe.

• Kubaga birashobora gukenerwa kubikomeretsa bikabije, cyane cyane kubantu bakiri bato, bakora, mugihe ibikomere byoroheje bikunze gukira hamwe no kuvura indwara.

• Gusubiza mu buzima busanzwe ni ngombwa nyuma yo kubagwa; gukurikiza gahunda itunganijwe ifasha kwirinda gukomera no gushyigikira gukira.

• Gusobanukirwa inyungu n'ingaruka za gusana isahani ya titanium irashobora kugufasha gufata ibyemezo bijyanye nuburyo bwo kuvura.

AC ihuriweho na dislocation

Icyo aricyo

Urashobora kumva umuganga wawe avuga kubyerekeranye na ac gufatanya mugihe ukomeretse urutugu. Iyi mvune ibera ahitwa acromioclavicular (AC), aho collarbone yawe ihurira nu mwanya muremure wigitugu cyawe. Igice gifasha ukuboko kwawe kugenda kandi kugumisha urutugu rwawe.

• Imwe mu icumi yakomeretse ku rutugu ni ac gufatanya.

• Abaturage muri rusange babona abantu bagera kuri 3 kugeza kuri 4 buri mwaka.

• Kurenga kimwe cya kabiri cyimvune zibaho mugihe cya siporo, cyane cyane siporo.

• Abasore, cyane cyane abafite hagati yimyaka 10 na 30, bafite ibyago byinshi. Muri iri tsinda, hafi imwe kuri eshanu yakomeretse ku rutugu ni imvune ya ac.

Urashobora kubona ac gufatanya gutandukana kubintu byinshi:

• Gukubita bitaziguye hejuru yigitugu cyawe

• Kugwa cyane ku rutugu cyangwa ukuboko kurambuye

• Kuzamura ibintu biremereye cyangwa gukora ibikorwa byisubiramo

• Imvune za siporo, cyane cyane muri siporo

• Indwara ya rubagimpande cyangwa kuvunika birimo ingingo

Ingaruka ku rugendo

Mugihe ufite dislocation ac ac, birashoboka ko uzumva ububabare, cyane cyane iyo wimuye ukuboko hejuru yigituza cyangwa ukazamura hejuru. Ligaments ifata AC hamwe hamwe igira uruhare runini mugukomeza urutugu rwawe. Niba izo ligaments zikomeretse, urutugu rwawe rushobora guhinduka kandi rukababara.

Icyitonderwa: Abantu benshi babona ko ibikorwa bya buri munsi, nko kugera kubintu hejuru yikibuga cyangwa gukina siporo, bigoye nyuma yiyi mvune. Ndetse hamwe nubuvuzi bwumubiri, kutoroherwa no kugenda kugarukira birashobora gukomeza niba ligaments idakira neza.

Urashobora gusanga urutugu rwawe rwumva rufite intege nke cyangwa rudahungabana. Imirimo yoroshye, nko kwambara ishati cyangwa gutwara igikapu, irashobora kuba ingorabahizi. Igihe kirenze, niba ingingo idakira neza, urashobora guhura nububabare burigihe cyangwa ibibazo hamwe no kugenda hejuru.

Kuki kubaga?

Iyo bikenewe

Urashobora kwibaza igihe kubaga bihinduka amahitamo meza ya ac gufatanya. Abaganga bakoresha urutonde rwa Rockwood kugirango bahitemo niba ukeneye kubagwa. Sisitemu itandukanya ibikomere nukuntu ingingo yimutse nuburyo urutugu rwawe rwumva rudahungabana.

Niba ufite imvune yoroheje (Ubwoko I cyangwa II), mubisanzwe ntukeneye kubagwa. Kuruhuka, urubura, hamwe nubuvuzi bwumubiri bifasha abantu benshi gukira. Kubikomere byubwoko bwa III, imyaka yawe nibikorwa byurwego. Abakinnyi bato cyangwa abantu bafite ibibazo byinshi byumubiri barashobora kungukirwa no kubagwa. Ubwoko bwa IV na V hafi ya buri gihe bukenera gusanwa kubagwa kuko ingingo idahindagurika cyane cyangwa ntahantu.

Icyitonderwa: Ububabare bukabije, ubumuga bugaragara, cyangwa ikibazo ukoresheje ukuboko kwawe nibimenyetso byerekana ko kubaga bishobora kugufasha gusubira mubisanzwe byihuse.

Amahitamo yo kubaga

Ufite amahitamo menshi niba ukeneye kubagwa ac ac dislocation. Abaganga babaga barashobora gukoresha tekinike ifunguye cyangwa arthroscopique (minimally invasive). Ubwo buryo bwombi bugamije kugarura imyanya isanzwe yingingo zawe no kubaka ligaments zituma urutugu rwawe ruhagarara.

• Abaganga babaga bahitamo suture-buto yo kwiyubaka kugirango bakomeretse murwego rwo hejuru. Ubu buryo buguha imikorere myiza yigitugu no gusubira vuba muri siporo.

• Kubaga byombi na arthroscopic kubaga byerekana ibisubizo bisa. Umuganga ubaga azahitamo uburyo bwiza ukurikije ibikomere byawe.

• Gusana kijyambere byibanda ku kubaka byombi coracoclavicular na acromioclavicular ligaments. Ibi bifasha kugarura imbaraga no gutuza kurutugu rwawe.

Niba uhuye no kubagwa, umuganga wawe azagusobanurira amahitamo agufashe guhitamo gahunda nziza yo gukira kwawe.

Uburyo bwa gakondo bwo gusana

Ubuhanga busanzwe

Iyo urebye uburyo abaganga bakundaga kuvura ac gufatanya, uhasanga uburyo bwinshi bwo kubaga. Abaganga babaga bakunze gukoresha K-insinga, amasahani, cyangwa ibikoresho byo gukosora kugirango bafate ingingo mu mwanya. K-insinga ni ibyuma byoroheje bihuza amagufwa. Isahani ifata yicaye hejuru ya collarbone hanyuma ugafatira munsi ya acromion kugirango urugingo ruhamye. Ibikoresho byo guhagarika ibintu, nka sisitemu ya endobutton kare, koresha suture ikomeye na buto kugirango uhuze amagufwa hamwe.

Abaganga bamwe bagerageje kandi ibikoresho byubukorikori, nka LARS ligaments, cyangwa bakoresheje ibinyabuzima biva mumubiri wawe cyangwa umuterankunga. Ubu buryo bwari bugamije kubaka ligaments zacitse no kugarura ingendo zisanzwe.

Icyitonderwa: Bumwe muri ubwo buhanga bwagerageje kugarura ituze n'imikorere ku rutugu, ariko byaje bifite ibibazo byabo bwite.

Imipaka

Ugomba kumenya ko uburyo busanzwe bwo gusana bufite aho bugarukira. Abarwayi benshi bahuye nibibazo nyuma yo kubagwa, byagize ingaruka ku gukira kwabo nibisubizo byigihe kirekire.

• Tekinike ya K-wire akenshi itera ibibazo, nko kuvunika pin cyangwa guhinduka kwangirika.

• Sisitemu ya Endobutton rimwe na rimwe yananiwe gukomeza guhuza ingingo, hamwe n’ubushakashatsi bwerekana abarwayi bagera kuri 24% batakaza kugabanuka.

• Ibikoresho byo guhagarika ibicuruzwa byari bifite ibipimo byo kunanirwa kuva kuri 16,6% kugeza kuri 50%. Ibi bivuze ko umubare munini w'abarwayi bakeneye ubuvuzi bwinshi.

• Ligaments ya syntetique nka LARS yerekanye igipimo gito cyo kugorana cya 3.3% naho intsinzi yo hejuru ya 93.3%. Nyamara, ibinyabuzima bisanzwe bitanga ibisubizo byiza kubikomere bidakira.

Izi mbogamizi zatumye abaganga bashakisha uburyo bwiza bwo gucunga ac gufatanya. Ubuhanga bushya noneho bwibanda kubikosorwa bikomeye, ingorane nke, no gukira vuba.

Gusana isahani ya Titanium

Uburyo ikora

Mugihe ukeneye gucunga neza ac gufatanya dislocation, gusana isahani ya titanium itanga igisubizo cyizewe. Abaganga babaga bakoresha intambwe-ku-ntambwe kugirango bagarure urutugu n'imikorere. Dore ibyo ushobora kwitega mugihe gikurikira:

1. Wakira anesthesia rusange kugirango ukomeze neza.

2. Itsinda ryo kubaga rigushyira mu ntebe yinyanja. Ibitugu byawe birahinduka, kandi umutwe wawe uhengamye kuruhande rwiza.

3. Umuganga ubaga yerekana ubuso bwa coracoid yawe nimpera ya clavicle yawe.

4. Igice cya fluoroscopi gifasha itsinda kubona clavicle yawe neza.

5. Umuganga ubaga akora uruhu rwa cm 4-5 kuruhande rwimbere rwa acromioclavicular.

6. Uruhu nuduce byafunguwe kugirango bigere hamwe.

7. Ibice byashwanyaguwe neza. Clamp vasculaire yinjizwa kumurongo wuruhande rwibikorwa bya coracoid.

8. Umuganga ubaga akora umuyoboro kandi akerekana impera yinyuma ya clavicle yawe.

9. Ubuyobozi bwinjijwe mumpera yo hepfo ya coracoid yawe, ukurikira umuyoboro kumurongo wa clavicle.

10. Umwanya wuyobora uremezwa ukoresheje C-arm fluoroscopy.

Impanuro: Gusana isahani ya Titanium akenshi ikoresha inyubako idafite ipfundo kandi Umuyoboro wibanze kugirango ushire hamwe. Ubu buryo bugabanya ibyago byo kunyerera kandi bitezimbere igihe kirekire.

Wungukirwa nubuhanga bwibanda kumyanya nyayo no gukosorwa gukomeye. Gukoresha ibikoresho bya titanium bifasha gufatanya gukira mumwanya ukwiye kandi bigashyigikira kugenda kare.

Iterambere ryibinyabuzima

Gusana isahani ya Titanium igaragara kubera imbaraga za biomehanike. Ubona ituze mu ndege zombi kandi zisumba izindi, bivuze ko urutugu rwawe rushobora gukora ibikorwa bya buri munsi na siporo utanyerera cyangwa unaniwe.

• Isahani ya Titanium na suture-buto yubaka byombi bitanga gukosorwa gukomeye nyuma yo gupakira inshuro nyinshi.

• Gufunga-kuzenguruka kabiri Igishushanyo cya Endobutton gihuye nimbaraga za biomehanike ya sisitemu yubucuruzi ya cortical.

• Ufite ibyago byo kugabanuka kunyerera, bifasha kwirinda kugabanuka hamwe no gukenera kuvurwa.

Hano harugereranya imikorere ya biomehanike mubihe bitandukanye byo gupakira:

Icyitonderwa: Gusana isahani ya Titanium iguha gukomera no kurwanya kugenda mu ndege ya axial. Ibi bivuze ko igitugu cyawe kigumana umutekano mugihe cyo guterura, kugera, no kuzunguruka.

Ubushakashatsi bwibinyabuzima bwerekana ko plaque ya titanium hamwe na suture-buto yubaka itanga imitwaro isa no gutsindwa. Urashobora kwizera ibyo bikoresho kugirango ac ac dislocation yawe ihamye mugihe cyo gukira no hanze yacyo. Iyo uhisemo gusana isahani ya Titanium, ushora mubisubizo bishyigikira gukira gukomeye hamwe nigitugu kirambye.

Isahani ya Titanium

Gusubirana n'ibisubizo

Mugihe uhisemo Titanium Isahani yo gusana ac ac dislocation yo gucunga, uba wishyiriyeho gukira gukomeye nibisubizo byiza birebire. Ubu buryo buragufasha kugarura imbaraga nigitugu kugirango ubashe gusubira mubikorwa byawe bya buri munsi na siporo.

• Uzabona ububabare buke nuburyo bwiza bwo kugenda ugereranije nuburyo bukera.

• Nyuma yo kubagwa, abarwayi benshi bavuga ko banyuzwe cyane ku rutugu.

• Amanota ya Constant-Murley, apima imikorere yigitugu, yerekana ko isahani ya Titanium hamwe na tekinoroji ya kaseti ya Core bigufasha kugera kubisubizo byiza kuruta ibyapa bisanzwe.

• Urashobora kwitega kunoza imikorere mubikorwa byubuzima bwa buri munsi, nko kugera, guterura, no kwambara.

• Kujya imbere, cyangwa ubushobozi bwo kuzamura ukuboko, akenshi bitezimbere hamwe nubuhanga buhanitse. Abarwayi bakoresha suture-buto cyangwa Titanium Plate uburyo bagera kuri 172,6 °, mugihe abafite ibyapa bifata bagera kuri 166.0 °.

• Isuri ya Subacromial, ihinduka munsi yamagufwa yigitugu, irashobora kubaho hamwe nibikoresho bimwe, ariko mubisanzwe ntabwo bigira ingaruka kububabare bwawe cyangwa mumikorere yawe mugihe kirekire.

Impanuro: Abantu benshi bakira Titanium Isahani yo gusana ac ac dislocation basubira mubikorwa byabo byihuse kandi bafite ibibazo bike ugereranije nabavuwe nibikoresho bishaje.

Wungukirwa no gusana neza gushigikira kugenda kare. Ibi bivuze ko ushobora gutangira imyitozo yoroheje vuba, ifasha kwirinda gukomera no kwihutisha gukira kwawe.

Ingaruka no gutekereza

Kubaga buri gihe bizana ingaruka zimwe. Mugihe uhisemo Titanium Isahani yo gusana ac ac dislocation, ugomba kumenya kubyerekeye ingorane zishoboka. Umuganga ubaga azabiganiraho nawe mbere yuburyo bwawe.

• Gutakaza kugabanuka birashobora kubaho, bivuze ko ingingo ishobora kwimuka ikongera ikava ahandi.

• Kuvunika igihe, cyangwa gucika hafi yisahani, birashobora kubaho ariko bikomeza kuba bidasanzwe.

• Acromial cut-out, aho isahani inyura mumagufwa, ni ingaruka zidasanzwe.

• Rotator cuff impingement irashobora gutera imbere mugihe ibyuma bikanda kumitugu yigitugu.

• Abantu bamwe bafite ububabare buhoraho bwigitugu, nubwo benshi bakira neza.

• Acromial osteolysis, cyangwa amagufwa ahinduka hafi ya acromion, irashobora kugaragara mubihe bimwe.

Dore incamake yibibazo bijyanye nibikoresho:

Icyitonderwa: Muganga wawe arashobora kugusaba gukuraho ibyuma niba ufite ikibazo cyangwa niba isahani itera ibibazo. Abantu benshi ntibakeneye kubagwa bwa kabiri, ariko ni ngombwa gukurikira hamwe nitsinda ryanyu.

Ugomba kandi gusuzuma ikiguzi cyo gusana Titanium. Amafaranga yose yo kwivuza no kuguma mubitaro ni menshi kubuvuzi bukorerwa ugereranije no kutabagwa. Nyamara, wunguka neza hamwe nibikorwa, bishobora gutuma ishoramari rifite agaciro kubantu benshi bakora.

• Igiciro cya serivisi z'ubuvuzi kiri hejuru yo kubaga ($ 11,012.39) ugereranije no kutavurwa ($ 1,163.81).

• Ibitaro bimara igihe kinini kubarwayi babaga (iminsi 3.3) ugereranije nabavuwe batabazwe (iminsi 0).

• Igiciro cyose cyo kwivuza ni kinini mu gusana ibikorwa ($ 30.262.17) kuruta gucunga ibikorwa ($ 7.833.82).

Impanuro: Gupima inyungu zo kunoza imikorere yigitugu no gukira byihuse ugereranije nigiciro kinini hamwe ningaruka zishobora kubaho. Vugana nu muganga wawe ubaga amagufwa kugirango umenye niba gusana isahani ya Titanium aribwo buryo bwiza bwo gucunga ac hamwe.

Mugusobanukirwa inyungu ningaruka, urashobora gufata icyemezo cyuzuye kubijyanye no kwivuza kwawe. Tekinike ya Titanium na Core wire kaseti iguha igisubizo kigezweho, cyizewe cya ac gufatanya dislocation, bigufasha gusubira mubikorwa ukunda.

Uburambe bw'abarwayi

Icyo ugomba gutegereza

Mugihe witegura gusana isahani ya Titanium nkigice cyo gucunga ac guhuriza hamwe, urashobora kwitega inzira isobanutse kuva itangiye kugeza irangiye. Mbere yo kubagwa, itsinda ryita ku barwayi rizaguha amabwiriza ajyanye no kwiyiriza ubusa nigihe cyo kugera. Anesthetiste azasuzuma ubuzima bwawe kandi asobanure amahitamo yawe. Mucyumba cyo gukoreramo, uzashyiramo ECG electrode hamwe na cuff yumuvuduko wamaraso. Kubaga mubisanzwe bifata iminota 60 kugeza kuri 75.

Nyuma yo kubagwa, uzamara igihe mucyumba cyo gukira. Abaforomo bazagukurikirana kandi batange ogisijeni n'amazi kugeza igihe uzumva uhagaze neza. Ukuboko kwawe kuzaruhukira mu mugozi, kandi uzakira ububabare kugirango ubeho neza. Abarwayi benshi basubira murugo bamaze kumva bamerewe neza kandi barashobora gucunga ububabare hakoreshejwe imiti.

Abantu benshi babona iterambere ryinshi nyuma yo kubagwa. Urwego rw'ububabare rugabanuka kuva ku kigereranyo cya 4.9 mbere yo kubagwa kugeza 0.55 nyuma. Amanota yimikorere yigitugu azamuka kuva 32.8 agera kuri 95.5. Hafi ya bose basubira mumikorere myiza mumezi 15.

• Birashoboka ko uzumva ububabare buke kandi ukimura urutugu byoroshye.

• Ingorane ntizisanzwe, hamwe nibibazo bike gusa byibibazo bihuriweho.

• Abarwayi benshi basubira ku kazi n'ubuzima bwa buri munsi vuba.

Gusubiza mu buzima busanzwe

Gusubiza mu buzima busanzwe bigufasha kugarura imbaraga no kugenda nyuma yo gusana isahani ya Titanium. Itsinda ryita kubitaho rizakuyobora muri buri cyiciro. Utangira imyitozo yoroheje no gutera imbere mubikorwa byinshi.

Urashobora kwitega gusubira mubikorwa bisanzwe bisanzwe mumezi 2 kugeza 3. Abantu benshi basubukura siporo cyangwa imirimo iremereye amezi 6. Umuganga wawe ashobora gukoresha Core wire hamwe na Titanium Plate kugirango aguhe gusana bihamye, bifasha gukira neza kandi bihamye.

Inama: Kurikiza hafi gahunda yawe yo gusubiza mu buzima busanzwe. Ibi bifasha kwirinda gukomera kandi bigashyigikira gukira gukomeye nyuma yo gucunga dislokisiyo.

Urashobora kubona uburyo Plate ya Titanium na Core wire kaseti bigira itandukaniro nyaryo mugucunga ac dislocation. Ibi bikoresho byateye imbere biguha gutekana neza, gukira vuba, hamwe nibibazo bike ugereranije nuburyo bukera. Imbonerahamwe ikurikira irerekana uburyo tekinike zigezweho zitezimbere ibisubizo byawe:

Amabwiriza ya orthopedie yerekana ko isahani ikomeza kuba amahitamo, ariko akenshi bisaba kubagwa bwa kabiri kugirango ikurweho. Buri gihe vugana na orthopedic umuganga wawe kugirango ubone gahunda nziza yo guhuriza hamwe gahunda yo gucunga ibyo ukeneye.

Ibibazo

Ni izihe nyungu nyamukuru za Plate ya Titanium mu micungire ya dislocation?

Urabona imbaraga, zihamye hamwe na Titanium. Iki gikoresho gifasha urutugu rwawe gukira muburyo bukwiye. Ifasha kugenda hakiri kare kandi igabanya ibyago byo kunyerera ugereranije nuburyo bukera.

Nigute Core ya kaseti itezimbere ibisubizo byo kubaga?

Umuyoboro wibanze wongeyeho imbaraga zo gusana. Ifata amagufwa hamwe. Ibi bigufasha gukira vuba kandi bigabanya amahirwe yo guhurira hamwe nyuma yo kubagwa.

Nzakenera gukuramo Isahani ya Titanium nyuma yo gukira?

Abantu benshi ntibakeneye gukuraho amasahani. Muganga wawe arashobora kuguha inama niba wumva bitameze neza cyangwa niba isahani itera ibibazo. Buri gihe ukurikirane nitsinda ryanyu ryita kubuyobozi bwiza bwa ac dislocation.

Ni kangahe nshobora gusubira muri siporo nyuma yo kubagwa ac gufatanya dislocation?

Mubisanzwe usubira mumikino idahuye mumezi agera kuri 3. Kumikino yo guhuza, ushobora gutegereza amezi 6. Umuganga ubaga hamwe numuvuzi wumubiri azayobora kugaruka kwawe gushingiye kumajyambere yawe.

Isahani ya Titanium isanwa neza kumyaka yose?

Isahani ya Titanium ikora neza kumatsinda myinshi. Muganga wawe azareba imyaka yawe, urwego rwibikorwa, nubwoko bwimvune. Ibi biragufasha kubona ibisubizo byiza kuri ac ihuriweho na dislocation.