Kunze fixator

1.Intitect

Kugadziriswa kwekunze kunogona kushandiswa kuzadzisa Utachiona hwepafupi chiratidzo chikuru chekushandiswa kwekunze kugadzirisa. Kugadziriswa kwekunze kunogona kushandiswawo kune deformity kururamisa uye pfupa kubata.

2 .why shandisa Kugadziriswa kwekunze 

2.1 Kubatsira kwekunze kwekugadziriswa

- Kuvhiringidzika kudiki kweropa kuyerera kune pfupa.

- Yakaderera kukanganisa pane yakapfava tissue yekuvhara.

- inogona kushandiswa nekukurumidza mumamiriro ekukurumidzira.

- Kugadziriswa kwekuvhurika uye kwakasvibiswa zvikanganiso.

- inobvumira kugoverwa uye yakagadzikana yekugadziriswa kwekupwanya pasina kuvhiyiwa.

- kuvapo kwemuviri wevatakurwi kana uchitapurirana.

-Kunoda chiitiko chishoma uye hunyanzvi hwekuvhiya pane standard incisional kuderedza uye mukati mekugadziriswa kwemukati (ORIF).

- pfupa rinobata uye kureruka kururamisa kunogona kuitwa.

2.2 Zviratidzo zveKugadziriswa kwekunze

2.2.1 Vhura Fractures

Kugadziriswa kwekunze kwegadziriro ndeimwe yenzira dzekunyepedzera kana kutsanangurwa kusarudzika kwekuvhurika kwemaziso uye zvinonyatsoratidzwa pamberi pekukuvara kwakasimba kwakasimba. Kunze kwekugadziriswa kweBraces zvinobatsira kuti zvidimbu zvine njodzi huru yehutachiona, senge kunonoka kupinda mukiriniki uye / kana vanga kusvibiswa. Kugadziriswa kwekunze kwakareba kwave kuri nzira inobatsira pakukuvara kwakadaro uye kuchiri kuchiri kufungwa negoridhe chiyero.

2.2.2 Yakavharwa Fractures

Zviratidzo zvekushandiswa kwekugadziriswa kwekunze kuvharwa zvipfeko ndezvenguva pfupi kusvibiswa kwevarwere vane polytrauma yakakomba, uye yakanyanya kuvharika mapepa ekupokana kana kukuvara degloving. Mune zviitiko izvi, kusagadzikana kwechinguvana uchishandisa ficha yekunze kunogona kuitwa kure nenzvimbo yekukuvara, kunyanya kure nenzvimbo yekuvhiyiwa, kubata iyo yakapfava yekukuvara, yekukuvara kwerudzi rwekuchengetedza rumbidzo.

2.2.3 Kukuvara Kwakawanda

Iyo yekugadzirisa yekugadzirisa maitiro inofanirwa kutariswa kana ichiita kukuvara kwekudzivirira kwekuvhiya kwevarwere nevarwere vazhinji. Zvakanakisa zvakanakira kugadzirisa kwekunze zvinokurumidza kugadziriswa kwekupwanya, batsira kudzora kurwadziwa, kuderedza kubuda ropa, uye kuderedza systemic system syndrome yekushambadzira kwekuriridzika kwekutarisira kwekutarisira kwekuriridzika kwekutarisira kwekuriridzika kwekutarisira kwekuriridzika.

2.2.4 Intra-Articular Fractures

Kugadziriswa kwekunze kugadzirwa kunowanzove chiyero chenguva pfupi chinodzivirira kusasimba kwechidimbu tishu muvharo kusagadzikana kana kusagadzikana intra-antraxarts; Iyo zvakare sarudzo yekubatanidza dislocations kana ligament inogadzirisa iyo imwe-stage yakajeka yekugadziriswa kwemukati haina kugona. Zvese majoini makuru anogona kuvhiringidzwa nenzira iyi, asi kazhinji chiuno, ibvi, uye chinjo.

2.2.5 pfupa kana rakapfava tishu rakaremara

Mune varwere vane zvakakomba zvinyoro-nyoro uye zvipfuyo zvirema, zvekunze mafuremu zvinogona kushandiswa kupfupisa iyo nhanho mune imwe nhanho uyezve kudzorera kureba kwetsika osteogeneis mune yechipiri nhanho.

2.2.6 Kunze kwekugadzirisa chimiro chinoshandiswa sechishandiso chekusanzwisisika reset

Mushure mekudzikiswa kwekunyepedzera, apo iyo yemukati gadziriso plate kana intramedularary chipikiri chakaiswa, chinzvimbo chetsika chinogona kuchengetwa nekuvhara kunze fixator. Dzimwe nguva ficha yekunze inogona kuchengetwa kwenguva yakati rebei kuti ipe mamwe gadziriso kana iyo yekugadziriswa kwemukati isina kusimba zvakakwana. Kunze kwekunze kana magetsi echikadzi akaratidzirwa kuve nebasa rakakosha panguva yeTibial intramoutulary chipikiri. Pini yeSchnee yakakwenenzverwa muDorsal Rutivi rweProximal Tibial Intramedeny Nail Nail Nail Kupinda Pfuma uye mune chitsitsinho pfupa, rakabatanidzwa netsvimbo refu. Izvi zvinopa huwandu hwakagadzirwa zvakanaka

Tibial intramellary zvipikiri zvechipikiri nekugadziriswa kwekunze kwekugadzirisa bracket kudzoreredzwa

3.Principles ye yekunze gadziriso brace application

3.1 Biomechanical zvinhu

Isa kanokwana maviri mapini pane huru bracture block kuburikidza neAnatomic yekuchengetedza nzvimbo, ine mapini akasungwa zvakanyanya sezvinobvira. Kana zvinyoro-nyoro mamiriro ezvinhu mvumo, mapini ekugadzirisa anofanirwa kuiswa sepedyo nekupwanya magumo sezvinobvira, asi haafanire kupinda mumapapiro ekupaza hematoma kana munzvimbo yeganda rekutsika kweganda. Kana yakawedzera kugadziriswa kwemukati kwakarongwa, mapini ekugadzirisa anofanirwa kudzivirira kuvhiya kwekuvhiya uye kuvhiya kuwana (nzvimbo yekuvhiya). Matombo ekubatanidza anofanirwa kuiswa padyo nepfupa sezvinobvira kuwedzera kugadzikana. Iko kusimba kwekunze fixator kunoenderana nezvinhu zvinotevera.

- Kutorwa kweiyo maPini ekugadzirisa kubva pakuputswa magumo: kuswededza kwakasimba.

- Kupararira kweiyo maPini yekugadzirisa mune yega yega bhaji block: iyo yakakura yakasimba.

- Kutenderera kweiyo refuitudinal inobatanidza tsvimbo kubva kune pfupa: kuswededza kune vakasimba.

- Nhamba yetsvimbo inobatanidza: Vaviri vane simba pane imwe.

- Kugadziriswa kweiyo yekunze yekugadzirisa chimiro (kubva kune yakaderera kusvika pakakwirira simba): ndege imwe / a-chimiro / biplane.

-Kugadziriswa Kwekunze Kugadziriswa kwakabatanidzwa pamwe chete nehurongwa hwemukati (tension scure)

- DIAMETER ye schanz screws kana schnee pini: 6mm ine kaviri simba rinosindimara re 5mm.

a. Unilateral single-ndege imwechete-batanidza kunze kwekugadzirisa ficha. Distance of Pino kubva kuFracture End (x).

Iko kuswededzwa, iyo yakawanda yakagadzikana. Kutama kwemapini akasiyana kubva kune huru bracture block (y): iyo kuregedza iyo yakagadzikana.

Kure kure, iyo yakagadzikana. Distance of the Longitudinal inobatanidza tsvimbo kubva pfupa (z): Iyo yakanyanya kugadzikana.

b. Iyo Unilateral, Uniplanar, 3-tsvimbo inosanganisa ekunze fixator ndeyekubatsira kuvaka kwakasiyana siyana kwezvinhu zvinoshamisa, kusanganisira kudzoreredza.

Model yehuwandu hwakawanda hwekushandisa, kusanganisira kugadzirisa maitiro.

c. Unilateral uniplanar maviri-batanidza kunze kwekunze gadziriso.

d. Unilateral Bilate Kugadziriswa (▲ Kugadziriswa).

e. Bilateral kugadziriswa neyekupenya fixation pini. Ikozvino kashoma kushandiswa.

Kusagadzikana kwekunze kwekugadziriswa kunononoka kupora kurapa maitiro, asi ndizvo zvinoita kuti awedzere kuomarara kunze kwekugadzirisa maitiro.

Dzimwe nguva zvinodikanwa kuroverera kugadzirisa kwakagadzikana uye kuwedzera mutoro nekuparadza kana zvakakwana uremu kutakura uye / kana kuchinja kurongwa kweiyo yekugadzirisa yekugadzirisa.

3.2 Yakagadziridzwa sindano yekuisa nzira

-Kujaira iwe neanatomy kuti udzivise kukuvara kune mitsipa, mitsipa yeropa uye tendons.

- Usabvumire mapini ekugadzirisa kana zvidimbu kuti apinde mubatanidzwa.

- Ngwarira kupwanya magumo uye hematomas.

- Dzivisa nzvimbo dzeganda rekunyepedzera kana kuwirirana.

- Pre-Drill the Bone Cortix kuti udzivise kupatsanura kukuvara (kutungamira kurira necrosis).

-Kugadzirisa mapini kunofanirwa kunge kuri kwehurefu hwakakodzera kuvaka chimiro chakakodzera.

3.2.1 Backbone

Iyo inopinza iyo yekudhira kana gadziriso pini, iyo isinganyanyo kupisa ichagadzirwa. Inokurumidza kusimuka, iyo yepamusoro tembiricha ichasimuka. Kukuvadzwa kwePfupa kune pfupa kune izvi kunetseka sezvo izvi zvinogona kutungamira mukuumbwa kweiyo yakanyorwa pfupa rakafa, iyo inogona kukonzera kusasunungurwa uye / kana hutachiona. Nenzira chaiyo akaisa maPini ekugadzirisa anofanira kuve neyakanaka kubata pane ese maachiresi, nepo tip kana harifanire kupinda mukati mer.

3.2.2 diaphysis

Mune epipphysis, kugadzirwa kwekupisa haisi dambudziko. Inogona kunge yakachengeteka kushandisa zviyero zvekuzvichera panguva ino, sezvo zviri nyore kupotsa maburi ekudhonzwa pre-akadhirowa paunenge uchisvetuka mumakwenzi. Fixiation PIN yekupinda mubatanidzwa inofanira kudzivirirwa sezvo paine njodzi yekutsvaira turakiti kutonhora kubereka mubatanidzwa.

3.2.3 nzvimbo dzekuchengetedza

Kuti udzivise kukuvara kune mutsipa, mitsipa yeropa, tendon, uye mhasuru, iyo yekuvhiya inofanira kujairwa neanatomy yegumbo rose-zvikamu uye shandisa nzvimbo yekuchengetedza yekuiswa kwemapini ekugadzirisa.

Mufananidzo 3.3.3-2 Safe Zone yeKutambanudzirwa kwekunze Pin Kuiswa.

mukadzi femur.

Mufananidzo 3.3.3-2 (kuenderera mberi)

b tibia.

Mufananidzo 3.3.3-2 (kuenderera mberi)

c humerus, posterior maonero.

Kana ichishandiswa mune imwe ndege, haina kudikanwa kutyaira iyo schanz screw in the anterior tibial crest. Iyo anterior tibiel crest ine pfupa rakakomberedza uye kudhiraivha kuchaita kupisa kwakanyanya, izvo zvinogona kukonzera sekondari osteonecrosis. MuTibia yeTibia, pane njodzi yekukuvadza iyo anterior tibialis tendon uye extnsor digitorum tsandanyama.

4. Zvikamu

4.1 tube-tsvimbo system

4.1.1 Schhanz screws 

SChanz screws ndeye chikamu chidimbu chakarukwa fixation pini. Ivo vanowanikwa mune dzakasiyana madhiri, kureba (tsvimbo refu, tambo kureba) uye dzakasiyana matipi. Iyo tipe yeiyo standard schanz screw ndeye trocar-yakaumbwa njanji (Fig. 3.3.3-3a) uye kazhinji inoda pre-yekudhirowa.

Mufananidzo 3.3.3-3 Schanz screws.

A Standard Socket Pin-Yakavezwa Tip.

B inozvida-inodhira.

Kuzvifambisa uye kuzvibata-kuzvidza mapini vane mukana wakapinza uyo unokwanisa kugeda uye kucheka tambo panguva imwe chete kana yakacheneswa mukati. Izvo zvakagadzirirwa kushandiswa mune metaphysis (Fig. 333-3B).

SChanz screure inowanikwa musimbe, Titanium kana hydroxyapatite yakachekwa. Hydroxyapatite yakachekwa mapini inogona kuwana yakanaka kubata mune pfupa, kubvumira bhonzo repakutanga rinopenya uye kudzivisa kusunungura. Rudzi urwu rwepini rwakakodzera kune varwere vane vatambi vekunze munzvimbo kwenguva yakareba.

4.1.2 Steiner Pins

Steiner Pins anowanzo shandiswa segadziriro yekugadzirisa iyo inopinda mapfupa. Matipi avo ari muchimiro chekudonhedza sleeves uye kudiwa kuve pre-yakadhirowa muzvikwata zvekoreti usati waisa.

4.1.3 Tubes / tsvimbo

Zvichienderana nezviri kutaurwa kwemabhuru / tsvimbo, kune mana mhando dzakasiyana:

• Yakakura: 11 mm tube / tsvimbo, SChanz screws ndeye 4 ~ 6 mm.

• Medium: 8 mm tube / tsvimbo, schanz screws ndeye 3 ~ 6 mm.

• Diki: 4 mm tube / tsvimbo, SChanz screws 1.8 kusvika 4 mm.

• Mini: 2 mm maitiro eminwe, dhizaini yekugadzira, ine akawanda-pin-pin clamp yekugadzirisa k-waya uye 2 mm tsvimbo.

Ma module eiyi system anowedzerwa neyekutanga-yakaumbwa, yakakomberedzwa carbon fiber tsvimbo. Kune zvakaoma gadziriro nzvimbo dzakadai sechiuno, t-log modules zviripowo.

4.1.4 Clamp

Iyo Clamps inoshandiswa kubatanidza iyo tube / tsvimbo uye iyo yekugadzirisa mapini. Iyo tubes / tsvimbo dzinogona zvakare kubatana kune mumwe nemumwe neakakodzera clinamp (tube-tube).

Mufananidzo 3.3.3-5 Clamp

Chidimbu chekuzvikwereta chekubatanidza schanz screws uye machubhu / tsvimbo.

B kusanganisa clamp yekubatanidza matanda maviri kana machubhu.

c Universal Multi-Pin Clamp.

d Tube-tube clamp yekubatanidza machubhu maviri.

4.2 Unilateral yekunze yekugadzirisa maitiro maitiro

Iyo yakavharika block inogona kudzorwa neakapetwa-zvakapetwa kaviri clamp kana yakatarwa clinks. Chikamu chepakati chakarukwa chinogona kunge chakabatanidzwa nekuda kwekukanganiswa kana kumanikidzwa kweBone kureba uye / kana pfupa rekufambisa.

Unilateral yekunze gadziriso system yekufambisa yepafupa

4.3 zvakasanganiswa zvekunze kugadzirisa

Yakasanganiswa yekugadziriswa kwekunze inoshandiswa kune mapundu padhuze neyakajaira uye inoda kuyamwiswa Kiresi Kired Pini yekugadziriswa kweRING uye yakajairika SCArew yeDiaphyis. Mhete ye3 / 4. inoenderera ichingoshandiswa. Inosanganisa mhete emafirita anoshandiswa zvakanyanya kune iyo proximal uye distal tibia.

Yakasanganiswa yekugadzirisa kwekunze brace ye tiial plateau mapundu. Inogona zvakare kushandiswa kune perticular zvikamu zveiyo distal tibia. Iyo v-yakagadzirirwa chimiro inopa yakanaka yakagadzikana ectics

4.4 Dzidziso Yekunze Kunze Kugadziriswa Brace

Iko mukana wekudzikisira zvizere kugadzirisa system ndeyekuti axis yekuremerwa uye erthopedic axis inopfuura nepakati pekunze kwekugadzirisa system pamwe neiyo refuitudinal axis yepfupa. Iyo yekudzikiswa kwekunze fixator system inogona kushandiswa kune bone kureba, pfupa kubata, uye kurapwa kweakareruka uye kuomarara.

Tibial mhete ekunze yekugadzirisa brace

Clinical Photo yeTibial Rira Kunze Kugadziriswa system

Kushandiswa kweiyi nzira inobvumidza kutumira kwehuremu hwehuremu. Zvekufungidzira zvitsva, isu tinoda iyo yakapfava isina unilateral yekunze yekugadzirisa chimiro chekurapwa. Pfupa rinobata uye nekuwedzera rinogona kunge riinewo nehurongwa hwekunze hwekunze, asi zvinogona kuve zvakaoma kuita zvakaoma, zvakaringana, migariro yekuremara kugadzirisa, iyo gadziriso yekunze yekunze inokurudzirwa. Kana ichishandiswa seyakagadziriswa yekunze, iyo yekunze ekunze yekugadzirisa inopa kugadzikana kwehukama. Kana tsono yapfuura neye dzakasiyana ndege dzePliplanar Fixation, ichi chimiro chinopa huwandu hwakanyanya hwekugadzikana. Simba rezvimiro zvinosiyana zvichienderana nekugadziriswa kwekugadziriswa, huwandu hwemhete dzinoshandiswa, uye mhando yemapini anoshandiswa, senge kirschner mapini kana schanz screws. Zvichienderana nekereke, kupwanya kunogona kudzoserwa kana kumanikidzwa, uye kuremara kunogona zvakare kurangwa. Mhete yekunze inogadzirisa inowanzoshandiswa pakukanganiswa kweOsteogeneis kugadzirisa kururamisa pfupa, kupfupisa uye kushomeka uye kuremara.

4.5 Hinged External gadziriso Brace

Yakashandiswa kuchengetedza kudzoreredza majoini akaziviswa kana kupwanya disculocations uye kubvumira zvimwe (kudzorwa) kujoina kufamba kwekudzivirira kusimba. Izvo zvinonyanya kushandiswa kune iyo elbow Joint.

5 Kuvaka

5.1 Zvino namenclature yezvirairo

Pane nzira dzakasiyana dzekukamura zvimiro zvimiro, kunyanya zvichibva pane:

- basa.

- Dhizaini dhizaini.

- ndege yekushandisa.

- chimiro.

5.1.1 Unilateral frames

Iyo Unilateral Frame ndiyo inowanzo shandiswa kunze kwekunze fixator modelity yekurapa kweiyo nyowani digrayseal fractures. Chimiro chinoiswa mundege imwe, semuenzaniso antevialial kana medial kune tibia uye anteerolateral kana gare gare kune femur. Mafuta ekugadzirisa anoiswa kuburikidza neganda kune rimwe divi uye apinda zvakapetwa kaviri cortex. Iyo pini inofanira kuiswa kure kubva kujoinhi, kunze kwechikamu chakasarudzika chejoini capsule, kudzivirira kubatana sepsis. Matombo maviri aya akaiswa mune imwe ndege kana mune maviri akasiyana ndege uye ipapo vakabatanidzwa pamwechete.

5.1.2 Bilateral Frames

Iyo SZCECECIN PIN inopfuura nepakati peganda kune rimwe divi, inopinda bilaminar cortex, uye ipapo yakapfuura neganda kune rimwe divi rakatarisana. Bilates mapuranga haakurudzirwe kurapwa kwakadzikama kweakakora, asi kunogona kushandiswa kwekugadziriswa kwechinguvana.

5.1.3 Yambuka yekunze yekugadzirisa mafiramu

Inoshandiswa mukukuvara kudzora maitiro kune nzvimbo dzekupaza nezvakanyanya zvinyoro nyoro kukuvara kana kuomarara intra-articular fractures uye kupwanya disculoji.

▲ Plvic Fractures, Proximal Femur Fractures, uye Proximal Tibia Fractures yakavezwa ichishandisa nguva pfupi yekugadzirisa yekugadzirisa brace pamabvi uye majoini.

Kugadzikana kwakapihwa neyekunze gadziriso chimiro chinobvumira kune zvinyoro nyoro kudzoreredza pamwe neCT kuongorora uye kuronga kunoronga. Mapuranga asina usiku anowanzo shandiswa, uye maPini ekugadzirisa anofanirwa kuiswa kunze kwenzvimbo yekukuvara uye kuita kwemangwana rekuvhiya kuri pachena.

5.1.4 Overnsion Frames

Ilizarov yakaunza iyi nzira neicho kwekutenderera kwekunze kwekugadzirisa chimiro. Tubular Ekunze Kugadziriswa Mafuta uye Unilateral Ekunze Mafuremu anogona kushandiswa kushandisa iyi nheyo yekudzoreredza, nehurongwa hwekutenderera hwakaitwa neyakaitwa panguva imwe chete kunze kwekunge kureba kunoitwa nekukwira nemukati.

5.2 Yakatemerwa kudzokorora maitiro

Kubatsira kweiyo yakasanganiswa yekugadzirisa chimiro ndechekuti inobvumidza kuderedzwa, kudzimudzirwa, uye kugadziriswa kwemapfupa ese akareba, nzvimbo dziri padyo neyakajaira, uye yakabatanidzwa

Kuiswa kweSchanz Screw kunogona kuve kusarudzwa kweiyo yakasarudzwa yeAnatomic Fixation chinzvimbo cheSchanz screws kana nzvimbo yakakwana yekugadziriswa zvichienderana nemhando yekukuvara uye yakapfava. Kuderedza kwezvidimbu zvakakura zvinoitika kunogona kuitwa nekuwedzera uye nzira dzakasarudzika dzekudzora, uku uchichengetedza kuyerera kweropa kune pfupa uye zvakapfava matishu. Kushandiswa kwehunyanzvi uhu kunobvumira kugadziridzwa kwekudzikiswa kwekudzikiswa chero nguva.

Yakasanganiswa kuderedza maitiro.

mhando b tibial stem kupwanya.

B kune yega yega yakakura bracture block, 2 maPini ekugadzirisa anokwenenzverwa kunze kwenzvimbo yekukuvara.

C gadziriso mapini anochengetedzwa kune iyo inobatanidza matanda ane Universal clamps, ichivaita kuti mafambi maviri ekudzora zvisina kufanira.

D mushure mekupwanya kwapera, iyo ye3 yekubatanidza tsvimbo yakabatanidzwa kune yekutanga 2 yekubatanidza tsvimbo ne tube-tube clamp.

▲ Kuratidzira kweiyo yakasanganiswa yekugadzirisa yekugadzirisa brace. tibia. b femur. c trans-ibvi.

6 ZVINOKOSHA ZVINOGONESA

6.1 Joint Fusion

Kushandiswa kwakakosha kwekunze kwekunze ndiko kupararira kwemajoini nekumanikidza ne bilateral kunze kwekunze. Iyi nheyo inoshandiswa dzimwe nguva inoshandiswa pakufutiswa kwengwe, ibvi, uye majoini ejoini, kunyanya pamberi pehutachiona.

6.1 Shanduko

Kugadziriswa kwekunze ndiko kurapa kwekupedzisira kwehutachiona hwehutachiona kana hutachiona hwehungwaru hwekupwanya, sezvo maPini ekugadzirisa anogona kuiswa kure neyekutapukirwa kwehutachiona.

6.3 kururamisa osteotomy

Osteotomies yekururamisa erformities kana yakapfava yemamiriro ezvinhu asina kunaka kana kuremara uye njodzi yekushandisa yemukati yakakwira, mune iyo mamiriro ekunze ekugadzirisa mabhureki anogona kushandiswa kugadziriswa. Chimwe chiratidzo chiri pane imweTeotomy neiyo imwe pfupa pfupa. Izvi zvinowanzoda kururamisa nekudzokorora kwekunze kwekugadzirisa chimiro.

6.4 Pfupa rinobata - rinotsikiswa osteogeneis

Kukanganiswa kwepopi kunoenderana neIlizarov's nheyo yekuchengetedza iyo periever yepfupi inogona kudzorwa zvishoma nezvishoma (0.5-1 mm / d), uye pfupa idzva rakaumbwa mune iri gomba. Inononoka mwero yekukanganisa mhedzisiro yekuporesa pfupa, nepo inokurumidza huwandu hwekuvhiringidza iyo inodarika kushivirira kwetishu hakuzoguma nekuumbwa kwefuma. Kutakurwa kana kukanganiswa pfupa scabs, seiya yekukanganisa, endawo mumatanho ese ezvipfuyo zvakatsemuka kusvikira bony kupora kunoitika. Pane zviratidzo zvitatu zvekushandiswa kwehunyanzvi uhwu, uye dzimwe nguva izvi zvinoratidza zvinogona kugara:

- rimbudzi kureba.

- Segmental pfupa rinobata kubata pfupa kuremara.

- Kururamisa osteotomy.

Iyo yakakodzera mafuremu mapuranga nekuda kweichi chiitiko chekunze kwekunze gadziriso (ne kana pasina hafu-ekutenderera kunze kwekugadzirisa chimiro) uye iyo unilateral yekunze gadziriso.

6.5 Joint Kudzorera uye Kugadziriswa Kwekuchengetwa

A RINDET EXTETATE Fixator ndeyekuwedzera kwehuwandu hwehuwandu hwehuwandu hwakaoma kusagadzikana kwekukuvara, kusanganisira kusarongeka kana kusarongeka conlow Iyo yakarongedzwa yekunze fixator inochengetedza lEBOW reset ine inodzorwa moblization. Kuchengeta kudzoreredza ndiko kutanga kwekutanga. Kusagadzikana kwakanyanya kuoma kubata kupfuura kurasikirwa kwekufamba. Iyo axis inoda kuve yakanyatsoiswa pasi peFluoroscopy. Kutendeuka kudiki munzvimbo yehudyu kunogona kukanganisa zvakanyanya basa raro.

▲ Kuiswa kwehombodo yekunze yekunze fixator yeiyo elbow.

7 PostPeperative Kurapwa

7.1 pini turakiti yekutarisira

Pini turakiti reaction rinoenderana nechinzvimbo uye kugadzikana kweiyo gadziriso pini, kurapwa kwekutanga kweboka rekuyamwisa uye murwere. Iyo yakasanganiswa yekudzikiswa maitiro anobatsira nekuti inobvumira kusarudzwa kweiyo yakanakisa anatomical chinzvimbo cheiyo gadziriso pini maererano nerudzi rwepakungwa. Chipatara chinofanira kuve neyakajeka pini turakiti yekutarisira maitiro, uye vanamukoti vane ruzivo vanofanira kudzidzisa varwere kuti vaite pini turakiti rinotarisirwa. Nekudzivisa kukuvadzwa kwemunharaunda uye yemunharaunda hematoma kuumbwa panguva yekuisa PEPU, uye kushandisa doro dismence kuchenesa nzvimbo yekutevera, uye kusunungura pini kunogona kuderedzwa zvakanyanya.

7.2 PIN TENDA TENDA 

Pini turakiti yekutarisira inofanirwa kutanga kuve neiyo chaiyo pini yekuisa. Kuti uwane kujairika Screal screws, pre-drilling inowanzodikanwa uye iyo pini yakakwenenzverwa mukati kuti ideredze inopisa necrosis. Zvisina kukodzera zvinyoro nyoro tissiune kutenderedza pini inofanira kusunungurwa panguva yekuvhiya. Kuchengeta kwakakodzera kweTurakiti Kwakakosha kuti uderedze chiitiko chePIN TATURS Constles. Pini turakiti utachiona uye screw kusununguka kunogona kugadziriswa nekubvisa iyo pini yakasununguka uye kudzoreredza pini mune imwe nzvimbo.

7.3 Mobilation

Kunze kweiyo mashoma akakosha kesi (gadziriso yekugadzirisa, kushandisa kwekukurumidza, kushushikana kwekushushikana), chidimbu chehuremu chinobvumidzwa pakutanga kweiyo yekunze fixator. Sezvo kupora kunoenderera mberi, kuremerwa kwakazara kunogona kuwedzera zvishoma nezvishoma. Iko hakuna kudikanwa kwekuwedzera mamwe midziyo yeDynamization kune ekunze fixator. Chidimbu kana kuzere uremu kutakura ndiyo nzira yakanyanya kunaka uye yakanyanya kunaka yekudzvinyirira.

8 nguva yekugadzirisa kwekunze

8.1 Shanduko yekurapa

Pane nzira nhatu dzekurapa dzekurapa:

• Shandisa kunze kwekunze ficha seyakajeka kurapwa kusvikira iyo inopwanya kupora.

• Kutendeuka kwekutanga kugadziriswa kwemukati.

• Chinjana kune zvisiri-zvekuvhiya kurapwa, senge plaster, orthosis, nezvimwe.

Kana kutendeuka kune kugadziriswa kwemukati kunotarisirwa, kunofanira kuitwa nekukurumidza sezvinobvira (mukati memavhiki maviri) nekuti huwandu hwenhandare hwakanyanya hwakadzika zvakanyanya pane zvekushandurwa kwekunonoka.

Mitemo inotevera inofanira kuteverwa kana uchironga chero kuvhiyiwa zvisati zvaitika, mukati, kana mushure mekugadziriswa kwenguva pfupi:

• Kana kutsva kutsva kuiswa kutenderedza iyo yekutanga yekugadzirisa nzvimbo yekugadzirisa, maturakiti ese anofanirwa kuve akachena. Dzimwe nguva maitiro anoitwa mumatanho maviri, nechimwe nhanho yekuchenesa iyo yekutanga PIN Turakiti uye yechipiri nhanho yekuita chaiyo gadziriso.

• Chero pini turakiti tarishi risati rasvika

• Kana paine kusava nechokwadi nezve shuwa yeiyi PIN turct Sites kana turakiti rekutanga ratotapukirwa, 'PIN nguva yegumi

• Antibiotic inofanirwa kushandiswa prophylactically neanarchrobial spectrum inofukidza mabhakitiriya kubva yapfuura pini turakiti turakiti.

• Vhara kutevera-kumusoro kwemavhiki matanhatu ekutanga mushure mekutsiva kweiyo yemukati fixator.

Kana paine humbowo hwechinetso ne turakiti rePIN, shandisa mishonga inorwisa mabhakitiriya, shandura pini, shandura iyo, uye ramba uchirapwa neyekunze ficha. Pini turakiti yekutarisira inofanira kusanganisira murwere kuti ave nechokwadi chekunyepedzera mibairo. Kana iyo yekunze fixator inofanira kutsiviwa nekugadziriswa kwemukati mune imwe nhanho yekunonoka Mishonga inorwisa mabhakitiriya inogona kushandiswa nenzira kwayo panguva ino.

8.2 yekupedzisira kugadziriswa

Emergency ekunze kugadziriswa kunogona kuzadzisa kugadzikana kwechinguvana kwegumbo uye bvumira zvakapfava kupora. Chero bedzi mamiriro akapfava emhando yakagadzikana, iyo yekunze fixator inogona kutsiviwa neyekupedzisira yemukati yekugadzirisa. Zvine musoro, inofanira kutsiviwa nekugadziriswa kwemukati mukati memazuva gumi.

Kana iyo yekunze gadziriso ichiri kugadzikana uye hapana zviratidzo zvekutenderera, kutsiva kutsiva hakudidiwi. Kana iyo yekuvhara kweganda iri murombo, kana kuti kune kunetseka pamusoro pekukuvara kwakapusa uye njodzi yekutapukirwa kubva mukuvhurika kuderedzwa kwakakwira, iyo yekunze ficha inogona kuchengetwa sekurapa kwekupedzisira kwekupwanya.

Kufambira mberi kwekupora kupora kunofanira kucherechedzwa, uye kana pasina kufambira mberi, mamwe marapirwo anofanirwa kutariswa.