Ivunika rya clavicle, bakunze kwita collarbone yamenetse, mubisanzwe bibaho nyuma yo kugwa, gukomeretsa siporo, impanuka yamagare, cyangwa ingaruka zitaziguye ku rutugu. Ibice byinshi byavunitse bya clavicle birashobora kuvurwa nta kubaga. Ariko, aho kuvunika, kwimurwa, kugabanuka, imiterere yuruhu, ibikomere bifitanye isano, imyaka yabarwayi, hamwe nibikorwa bisaba byose birashobora guhindura gahunda yo kuvura.
Ubu busobanuro bushingiye ku bimenyetso busobanura ibimenyetso, gusuzuma, gushyira mu byiciro, kuvura bidakorewe, uburyo bwo kubaga, ingorane, hamwe no gukira kuvunika kwa clavicle. Igenewe uburezi rusange kandi ntisimbuza isuzumabumenyi ryinzobere mu buzima.
Ibyingenzi
Hagati ya gatatu, cyangwa igiti, nikibanza gikunze kuvunika clavicle.
Ibimenyetso bisanzwe birimo ububabare, kubyimba, gukomeretsa, ubwuzu, no kugora ukuboko.
Ikibaya X-imirasire nikizamini cyibanze cyerekana amashusho; CT irashobora gukoreshwa kubibazo bigoye, hagati, cyangwa mbere yo gutangira.
Ibice byinshi byimuwe byoroheje bivurwa hakoreshejwe umuhoro, gukurikirana amashusho, hamwe no gusubiza mu buzima busanzwe.
Gufungura kuvunika, uruhu rwugarijwe, gukomeretsa imitsi yimitsi, umukandara wigitugu udahungabana, hamwe n’imvune zatoranijwe zimuwe cyangwa zidahindagurika zishobora gusaba kubagwa.
Gukosora amasahani hamwe no gukosora birashobora gutanga ibisubizo byiza mubice byatoranijwe bikuze, ariko buriwese afite ibyiza nibibazo bitandukanye.
Gukira biratandukana bitewe n'imyaka, uburyo bwo kuvunika, uburyo bwo kuvura, uko itabi rimeze, nibimenyetso byo gukira amagufwa.
Ivunika rya Clavicle ni iki?
Clavicle ni igufwa rya S rihuza ururenda rwagati rwigituza na scapula ku rutugu. Ikora nk'isano yubatswe hagati yumutwe nigice cyo hejuru mugihe ifasha kurinda imitsi nimiyoboro yamaraso inyura munsi yacyo.
Clavicle anatomy hamwe nuburyo busanzwe bwo kuvunika.
Kuvunika clavicle bibaho iyo imbaraga zirenze imbaraga zamagufwa. Uburyo busanzwe burimo kugwa ku rutugu, kugwa ku kuboko kurambuye, kugongana mugihe cya siporo yo guhura, hamwe nigare rifite ingufu nyinshi cyangwa ihahamuka ryimodoka. Ku barwayi bakiri bato, izi nkomere zikurikira siporo cyangwa impanuka zo mu muhanda. Ku bantu bakuze, kugabanuka kwingufu zishobora kuba zihagije, cyane cyane iyo amagufwa agabanutse.
Ivunika rya Clavicle rifite hafi 3% kugeza 5% byimvune zikuze. Isaranganya rikunze gusobanurwa nka bimodal, hamwe nimpinga imwe mubyangavu nabakiri bato nindi mubantu bakuru.
Ibimenyetso byo kuvunika kwa Clavicle
Ibimenyetso biterwa n'ahantu n'uburemere bw'imvune, ariko mubisanzwe harimo:
Ububabare ako kanya hejuru ya collarbone nyuma yimvune
Kubyimba, gukomeretsa, hamwe n'ubwuzu bwaho
Kubabara iyo uteruye cyangwa wimura ukuboko kwanduye
Ikigaragara kigaragara, intambwe, cyangwa impinduka mubitugu
Ibyiyumvo byo gusya cyangwa kugenda kurubuga rwacitse
Impengamiro yo gushyigikira ukuboko gukomeretse ukoresheje ukuboko gutandukanye
Ibimenyetso byo kuburira bikeneye isuzuma ryihutirwa
Isuzuma ryihutirwa ryubuvuzi ni ngombwa mugihe uruhu rwacitse cyangwa rwashizwe hejuru cyane ku gice gityaye; ukuboko cyangwa ukuboko bihinduka ibara, ubukonje, intege nke, cyangwa gucika intege; guhumeka biragoye; ububabare bwo mu gatuza burahari; cyangwa igikomere cyakurikiranye ihahamuka ryinshi. Ubu bushakashatsi bushobora kwerekana kuvunika cyangwa gukomeretsa bifitanye isano n'ibihaha, urukuta rw'igituza, imitsi, cyangwa imiyoboro y'amaraso.
Isuzuma rya Clinical rigomba kuba ririmo uruhu, urutugu, kuzenguruka, n'imikorere y'imitsi.
Nigute Isuzuma rya Clavicle risuzumwa?
Gusuzuma bitangirana namateka yimvune no gusuzuma umubiri. Umuganga asuzuma aho ubwuzu bugaragara, ubumuga bugaragara, uko uruhu rumeze, kugenda ibitugu, hamwe no kuzenguruka no gukora imitsi yukuboko kwanduye. Mu gukomeretsa imbaraga nyinshi, igituza, ijosi, scapula, nibindi bice byumukandara wigitugu nabyo bisaba gusuzuma neza.
X-Ray
Amaradiyo yibibaya nibisanzwe umurongo wa mbere wibizamini. Bemeza ahantu havunitse kandi bifasha kwerekana kwimuka, kurakara, kugabanya, no gutangira. Amaradiyo adakwiye arashobora kwerekana kwimuka kuruta amashusho yafashwe numurwayi aryamye, cyane cyane kuvunika hagati ya clavicle.
CT hamwe nandi mashusho
Kubara tomografiya irashobora kuba ingirakamaro mugihe kuvunika birimo clavicle yo hagati cyangwa sternoclavicular ingingo, mugihe uburyo bwo kuvunika bigoye, mugihe gikekwa gukomeretsa igitugu-umukandara, cyangwa mugihe bikenewe gutegurwa mbere yo gutangira. Amashusho yinyongera yatoranijwe ukurikije gukekwaho gukomeretsa aho gukoreshwa buri gihe kumeneka ya clavicle.
Amaradiyo afasha gusobanura aho yavunitse, kwimurwa, kugabanuka, no gutangira.
Ubwoko na Ibyiciro byavunitse Clavicle
Intambwe yambere ifatika ni ugutondekanya kuvunika clavicle ukurikije ahantu:
| Ahantu | Ibisobanuro | Clinical Ibitekerezo |
|---|---|---|
| Kumeneka hagati | Harimo hagati ya gatatu ya clavicle kandi nuburyo busanzwe. | Gusimburwa, kugabanya, kugabanuka, imiterere yuruhu, nurwego rwibikorwa byabarwayi bifasha kuyobora ubuvuzi. |
| Kuvunika kure | Harimo impera yinyuma hafi ya acromioclavicular. | Guhagarara biterwa ahanini nubusabane hagati yo kuvunika hamwe na coracoclavicular ligament complex. |
| Kumeneka hagati ya clavicle | Harimo iherezo kuruhande rwa sternoclavicular hamwe kandi ntibisanzwe. | Kwimura inyuma bisaba gusuzuma neza kuko inzego zingenzi ziri inyuma ya clavicle yo hagati. |
Sisitemu Zisanzwe
Amatsinda ya sisitemu ya Allman avunika clavicle hagati-ya gatatu, intera-ya gatatu, na medial-gatatu. Sisitemu zirambuye zirimo Neer itondekanya kubice byavunitse bya clavicle, ibyiciro bya Robinson cyangwa Edinburgh, hamwe na AO / OTA. Izi sisitemu zisobanura ibintu nkaho biherereye, kwimurwa, kwiyemeza, uruhare rwamagambo, hamwe no guhagarara neza.
Izina ryihariye ryonyine ntirigena imiti. Umuganga agomba kandi gutekereza ku ruhu nuduce tworoshye, imiterere yimitsi itwara imitsi, ibikomere bifitanye isano, imyaka yumurwayi, ubuzima bwe, akazi, urwego rwibikorwa, hamwe nibyifuzo byo kuvura.
Sisitemu isanzwe ivunika ivangura isobanura ahantu, ituze, kwimurwa, hamwe no gutangira.
Kuvura bidakorewe kuvunika kwa Clavicle
Ivunika ryinshi rya clavicle ryacunzwe nta kubagwa, cyane cyane iyo guhuza byemewe kandi kuvunika biteganijwe ko bizakomeza guhagarara neza. Gukubita amaboko yoroshye muri rusange bikundwa kuruta igishushanyo-cyumunani kuko byoroshye kubishyira mubikorwa kandi akenshi biroroshye.
Kudaharanira inyungu bishobora kubamo:
Sling immobilisation kugirango ihumurizwe kandi ikingire
Kubabara ububabare buyobowe ninzobere mubuzima
Gukurikirana amavuriro na radiografiya bisanzwe
Kugenda kare kwinkokora, ukuboko, nintoki
Gutera imbere ibitugu mugihe ububabare no kuvunika bihamye
Gukomeza nyuma yubuvuzi na radiografiya yo gukira
Ibyiza byo kuvura bidakorewe harimo kwirinda gukomeretsa, anesteziya, ibyago byo kwandura, nibibazo bifitanye isano no guterwa. Ingaruka zishobora kubaho zirimo guhindagurika guhoraho, gutinda ubumwe, kudahuza, malunion, no gutinda hakiri kare gusaba akazi cyangwa siporo mubice byavanywe mu byabo.
Gukubita amaboko yoroshye bikoreshwa muburyo bwo guhumuriza no kurinda mugihe cyo kuvura hakiri kare.
Ni ryari kuvunika kwa Clavicle bikeneye kubagwa?
Kubagwa ntibisabwa kuri buri kuvunika kwa clavicle kwimuwe, kandi nta gipimo na kimwe kigomba gukoreshwa mu bwigunge. Umuti ugomba kwihererana binyuze mu gufata ibyemezo bisangiwe hagati yumurwayi nu kubaga bavura.
Ubuvuzi bwo kubaga bushobora gusabwa cyangwa gusuzumwa cyane mugihe hari:
Kuvunika
Uruhu rwangirika cyangwa amahema akomeye hejuru yacitse
Gukomeretsa bifitanye isano nimiyoboro y'amaraso cyangwa imitsi
Umukandara udakomeye cyangwa umukandara watoranijwe
Ikimenyetso cyo kwimurwa, kugabanya, cyangwa kugabanuka mukuvunika gukuze
Ivunika rya clavicle yimuwe idahungabana hamwe no guhagarika coracoclavicular ligament complex
Ibimenyetso simusiga cyangwa malunion
Gukenera kugarura guhuza no gutuza nyuma yo gusuzuma umwuga, siporo, ubuzima rusange, hamwe nibyifuzo byabarwayi
Ku bantu bakuru bafite imvune ya midshaft yimuwe, kuvura kubaga bifitanye isano n’ibiciro by’ubumwe ndetse n’ibisubizo byavuzwe n’abarwayi hakiri kare kuruta ubuvuzi budakorewe. Ibisubizo birebire no kunyurwa, ariko, birashobora kuba bisa nuburyo bumwe. Impirimbanyi ziratandukanye mubyangavu, bafite imbaraga zo gukira nini kandi kubagwa buri gihe kubuvunika bwimuka bwimuwe bwimuka ntibishobora gutanga inyungu zisobanutse neza.
Ibiranga kuvunika hamwe nibikomere bifitanye isano bifatwa hamwe mugihe cyo guhitamo niba kubaga bishobora kuba byiza.
budakorwa hamwe nubuvuzi bwo kubaga
| Ubuvuzi | bukunze gutekerezwa kubishobora kuvamo | inyungu | zishobora kugarukira |
|---|---|---|---|
| Gukubita no gusubiza mu buzima busanzwe | Byinshi bidasimbuwe, byimuwe byoroheje, kandi byavunitse bihamye | Irinde kubaga hamwe ningaruka ziterwa no guterwa | Ivunika ryimuwe ryatoranijwe rifite ibyago byinshi byo kudahuza, malunion, cyangwa gutinda hakiri kare |
| Isahani hamwe na screw | Byatoranijwe bimuwe, bigufi, bigabanijwe, bifungura, cyangwa imvune zidahindagurika | Kugabanuka bitaziguye, gukosorwa gukomeye, hamwe nibiciro byubumwe | Inkovu, kwandura, kunanirwa, kumenyekanisha ibyuma, no gukuraho ibyatewe |
| Gukosora | Hatoranijwe clavicle shaft yamenetse hamwe nuburyo bukwiye | Uduce duto kandi tworoheje-tissue igaragara mubihe bimwe | Gutera kurakara, kwimuka, kuvanaho, hamwe no kudakwiranye nuburyo bumwe bwatangiye |
Amahitamo yo kubaga
Isahani hamwe
Kugabanya gufungura no gukosora imbere hamwe nisahani nuburyo busanzwe bwo kubaga kuvunika clavicle. Umuganga ubaga agarura guhuza kandi agakomeza kuvunika akoresheje isahani. Ibigezweho sisitemu yo gufunga isahani itanga sisitemu ihamye yo guhitamo kuvunika. Gukosora amasahani birashobora kuba ingirakamaro cyane mugihe kuvunika kugabanijwe cyangwa mugihe kubungabunga uburebure no kuzunguruka ari ngombwa.
Imbere-yashizwemo nka an S-clavicle ifunga isahani yagenewe gukurikiza ubugororangingo bwa clavicle, nubwo guhitamo kwa nyuma no guterwa biterwa na anatomiya kugiti cye no kuvunika. Ingaruka zishobora kuba zirimo kunanirwa hafi yo gutemwa, kumenyekana cyane, kurakara byoroshye-tissue, kwandura, hamwe nuburyo bwakurikiraho bwo gukuraho ibyuma byerekana ibimenyetso. Gukuraho kwimurwa ntabwo byanze bikunze bisabwa nyuma yo kuvunika gukize.
Gukosora amasahani bigarura guhuza kandi bigahindura clavicle mugihe kuvunika gukira.
Gukosora Intramedullary
Ibikoresho byinjizwamo byinjizwa mu muyoboro wa clavicle kugirango uhagarike ibice byatoranijwe. Ugereranije no gusya, ubu buhanga bushobora gukoresha uduce duto kandi bikagabanya ibintu byoroshye-tissue. Nyamara, ntabwo kuvunika kwose gukwiranye no gukosorwa, cyane cyane iyo comminution ituma uburebure cyangwa kugenzura bigoye. Isahani hamwe n'imisumari byombi bigize igice cyagutse sisitemu yo gukosora ihungabana.
Kuvunika kwa clavicle shaft ikuze, imisumari yimbere hamwe no gukosora isahani imwe irashobora gutanga umusaruro nkigihe kirekire cyamavuriro nigipimo cyibibazo. Gukosora ibyapa birashobora gutanga akarusho imbere ya comminution.
Intramedullary fixation irashobora gutekerezwa kubintu byatoranijwe clavicle shaft yamenetse.
Isahani yibasiwe na plaque Osteosynthesis
Isahani ntoya itera osteosynthesis ikoresha uduce duto kandi ntigaragara mugihe uhagaritse kuvunika hamwe nisahani. Tekinike igamije kubungabunga ibinyabuzima byoroshye no kuvunika ibinyabuzima, ariko kugabanya neza no kurinda imitsi ya supraclavicular ikomeza kuba ingenzi.
Ingero zo gukuramo plaque ntoya kugirango ikosore clavicle.
Ikirangantego cya Clavicle
Ivunika rya clavicle ritandukanye risaba gusuzuma aho yavunitse, ingano y'ibice, uruhare rwa arctular, hamwe nubusugire bwurwego rwa coracoclavicular. Amahitamo arashobora gushiramo a intera ya clavicle ifunga isahani , coracoclavicular stabilisation, cyangwa ubundi buryo bwo gukosora bwatoranijwe kuburyo bwihariye. Ibimenyetso ntibishyigikira tekinike imwe kuri buri kuvunika kure.
Gutandukanya intera ya clavicle byatoranijwe ukurikije ingano y'ibice hamwe na ligament ituje.
Kumeneka hagati ya Clavicle
Ibice byinshi byimuwe byimitsi ya clavicle birashobora gucungwa nta kubaga. CT akenshi ifite agaciro mugihe kwimurwa bigoye kubisobanura cyangwa mugihe gikekwa kwimurwa inyuma. Kubera ko trachea, esofagus, imiyoboro minini, hamwe nizindi nyubako ziciriritse ziryamye hafi, ibikomere byo hagati byimuwe inyuma bisaba isuzumwa ryihutirwa ryinzobere.
Ibikomere bigoye bya clavicle birashobora gusaba ingamba zo gukosora zijyanye no kuvunika kugiti cye.
Clavicle Kuvunika kuvunika no gusubiza mu buzima busanzwe
Nta ngengabihe imwe yo gukira kuri buri kuvunika clavicle. Imyaka, aho yavunitse, kwimurwa, uburyo bwo kuvura, uko itabi rihagaze, ibikomere bifitanye isano, hamwe no gukiza amaradiyo byose bigira ingaruka kumajyambere. Abarwayi benshi bagarura ibikorwa byingirakamaro mugihe cyibyumweru 6 kugeza 12, ariko gukira amagufwa yuzuye, gukira imbaraga, no gusubira mubikorwa bikenewe birashobora gufata igihe kirekire.
Icyiciro cyo kurinda: Slingi ikoreshwa muguhumuriza no kurinda. Kugenda kwamaboko, ukuboko, ninkokora mubisanzwe birashishikarizwa keretse ikindi gikomere kibujije.
Icyiciro cyambere cyo kugenda: Imyitozo yigitugu yoroheje irashobora gutangira mugihe ububabare bugabanutse kandi umuganga uvura yemeza ko kugenda bikwiye.
Icyiciro cyo gushimangira: Imyitozo yo kurwanya itangizwa nyuma yo gukira kwa kliniki ihagije.
Gusubira mu bikorwa icyiciro: Guterura biremereye, siporo ihuza, nibikorwa bifite ibyago byinshi byo kugwa bigomba gutegereza kugeza igihe kuvunika gukize kandi imbaraga nigikorwa kimaze gukira.
Gukurikirana ni ngombwa kuko kongera ubumuga, ububabare buhoraho, cyangwa kutagira amajyambere ya radiografiya bishobora kwerekana kwimuka, gutinda ubumwe, cyangwa kudahuza. Kunywa itabi birashobora kubangamira gukira kandi bigomba gukemurwa muri gahunda yo kuvura.
Ibishoboka
Ingorane Nyuma yo Kudavura
Nonunion: kuvunika kunanirwa gukira, bishobora gutera ububabare buhoraho cyangwa intege nke.
Malunion: kuvunika gukira mumwanya mugufi, urakaye, cyangwa wimuwe.
Ikigaragara kigaragara: igituba gishobora kuguma hejuru yivunika ryakize.
Gukomera ku bitugu cyangwa intege nke: gusubiza mu buzima busanzwe birashobora gusabwa kugarura imikorere.
Ibimenyetso bya Neurovasculaire: ibi ntibisanzwe ariko bisaba kwisuzumisha vuba.
Ingorane Nyuma yo Kubagwa
Kwandura ibikomere
Kwiyumanganya cyangwa guhindura ibyiyumvo bikikije incike
Kurakara ibyuma cyangwa kumenyekana
Kwimura, kunama, cyangwa kumeneka
Ubumwe bwatinze, kudahuza, cyangwa malunion
Kuvunika, harimo nyuma yo gukuraho
Ukeneye ikindi gikorwa, akenshi kubera ibyuma byerekana ibimenyetso
Ibyago bigoye biterwa no kuvunika numurwayi. Umubare munini w’ubumwe bwa radiografiya ntabwo bivuze ko kubagwa ari amahitamo meza kuri buri wese, nkuko kwirinda kubagwa bidakuraho amahirwe yo gutabarwa nyuma.
Gukurikirana amashusho birashobora gufasha kumenya ibibazo byo gukiza hamwe ningaruka ziterwa no guterwa.
Ibibazo Bikunze Kubazwa
Ivunika rya clavicle rishobora gukira utabanje kubagwa?
Yego. Ibice byinshi byavunitse bya clavicle bivurwa nta kubaga no gukira hifashishijwe umugozi, kubikurikirana, no gusubiza mu buzima busanzwe. Birashoboka ko ubuvuzi butagenda neza buterwa no kuvunika, kwimuka, gutangira, aho uri, imyaka y’abarwayi, nibindi bintu bivura.
Kumeneka clavicle bifata igihe kingana iki kugirango ukire?
Abarwayi benshi bagarura imikorere isanzwe cyangwa hafi-isanzwe mugihe cyibyumweru 6 kugeza 12, ariko igihe cyo gukira kiratandukanye. Abakuze, abanywi b'itabi, abantu bavunitse cyane cyangwa bavunitse, hamwe n'abarwayi bafite ubundi burwayi barashobora gukenera igihe kirekire. Garuka kumikino isaba gukira byemejwe no kuvurwa.
Ni ubuhe bwoko bukunze kuvunika clavicle?
Imvune ya clavicle ya Midshaft niyo isanzwe. Ivunika rya kure ntirisanzwe, kandi kuvunika clavicle yo hagati ntibisanzwe.
Isasu rigaragara nyuma yo kuvunika clavicle nibisanzwe?
Ikigaragara kigaragara mugihe cyo gukira kandi gishobora kuguma nyuma yamagufwa. Mubana ningimbi birashobora kuvugurura cyane mugihe runaka. Ubumuga bugenda bwiyongera, uruhu rwugarijwe, ububabare bukabije, kunanirwa, cyangwa intege nke bigomba gusuzumwa vuba.
Gukosora amasahani biruta gukosorwa?
Nta buryo bwiza ari bwiza kuri buri murwayi. Byombi birashobora gutanga ibisubizo birebire byigihe kirekire mubice byatoranijwe bikuze. Gukosora amasahani birashobora kuba byiza kubishushanyo mbonera, mugihe gukosora imbere bishobora kugabanya ubunini bwibice mubice byavunitse. Icyemezo giterwa no kuvunika morphologie, uburambe bwo kubaga, ibyo abarwayi bashira imbere, hamwe ningaruka ziterwa no guterwa.
Ese ibyuma bya clavicle buri gihe bigomba kuvaho?
Oya. Amasahani, imigozi, nibikoresho byinjira ntibisanzwe bivanwaho mugihe bidafite ibimenyetso kandi kuvunika gukize. Kuvanaho bishobora gutekerezwa kubwo gukomeza kurakara, kumenyekana, kubabara, ibibazo byatewe, cyangwa izindi mpamvu zamavuriro nyuma yo kuganira ku ngaruka z’ikindi gikorwa.
Ni ibihe bimenyetso byerekana ko kuvunika clavicle bidashobora gukira?
Ububabare buhoraho kumwanya wavunitse, kugenda cyangwa ubwuzu bikomeje, kunoza imikorere mike, no kudatera imbere kumashusho yakurikiranwe bishobora kwerekana gutinda ubumwe cyangwa kudahuza. Ibyavuye mu bushakashatsi bisaba isuzumwa n’umuganga uvura.
Umwanzuro
Kuvura kuvunika kwa Clavicle biterwa gusa no kugaragara kwa X-ray imwe. Ibice byinshi byavunitse cyangwa byimuwe byoroheje birashobora gucungwa neza nta kubaga. Abatoranijwe bimuwe, bagufi, bagabanijwe, bafunguye, cyangwa badahungabana barashobora kungukirwa no gukosora ibikorwa, cyane cyane kubantu bakuru. Isuzuma ryitondewe ryuburyo bwavunitse, uruhu nu mitsi itwara imitsi, ibikomere bifitanye isano, imyaka yumurwayi, ibyifuzo byibikorwa, n'intego zo kuvura nibyingenzi mugufatira ibyemezo hamwe.
