Umdibaniso wangaphandle

1. Intshayelelo

Ukulungiswa kwangaphandle kunokusetyenziselwa ukufezekisa 'uLawulo loMonakalo waseKhaya ' kwi-physity enesisu esithambileyo somonakalo othambileyo kunye nonyango olucacileyo lwexhwisi ezininzi. Usulelo lwe-Bone luyimboniselo enkulu yokusetyenziswa kolungiso lwangaphandle. Ukulungiswa kwangaphandle kunokusetyenziselwa ukulungiswa kwesigaba kunye nokuphatha ithambo.

I-2 .ukuqinisekisa i Ukulungiswa kwangaphandle 

2.1 IINGXAKI ZOKUXELWA NGOKUGQIBELA

-Ukuphazamiseka kancinci kokuhamba kwegazi ukuya kwithambo.

-Impembelelo ephantsi kwi-tishu yesiqhelo.

-Ungasetyenziselwa ngokukhawuleza kwiimeko zongxamiseko.

-Ukulungiswa kwamanzi avulekileyo kunye nongcoliseko.

-Chulula ukusasazwa ngokutsha kunye nokulungiswa okuzinzileyo kwefratshi ngaphandle kotyando.

-Bukho umzimba ongaphandle kwelinye ilizwe kwimeko yosulelo.

-Ifuna amava amancinci kunye nobuchule botyando kunokunciphisa ukuncitshiswa okuqhelekileyo kunye nokulungiswa kwangaphakathi (i-Orif).

-Ukuhlonipha ithambo kunye nokulungiswa kokulahleka kunokwenziwa.

2.2 Izalathiso zezinto zangaphandle

2.2.1 I-Pract evulekileyo

Ukulungiswa kwangaphandle Brerating yenye yeendlela zendlela yethutyana okanye eqinisekileyo yokungaphulukiyo kwezinto ezivulekileyo kwaye iboniswe ngakumbi phambi kobukho bezinto ezithambileyo ze-tissue ezithambileyo. Iibratshi zangaphandle ziluncedo ekwenziweni komngcipheko omkhulu wokosuleleka, njengokulibaziseka ukubakho kwikliniki kunye / okanye inxeba. Ukulungiswa kwangaphandle kudala kuyindlela eluncedo kakhulu yokulimala kwaye isathathwa ngumgangatho wegolide.

2.2.2 I-quations evaliweyo

Iimpawu zokusetyenziswa kokulungiswa kwangaphandle kwi-quations ezivaliweyo kukuthathwa kwethutyana kwezigulana ezine-polytrauma enkulu, kunye nokuvalwa kwezicubu ezithambileyo okanye ukulimala okuthambileyo. Kwezi meko, ukungasebenzi okwethutyana kusetyenziswa i-fall engaphandle kunokwenziwa kude kwindawo yokwenzakala, kukhethwa kude nendawo yotyando, ukunyanga ukulimala okuthambileyo ngelixa ugcina ulungelelwaniso lwe-tissi.

2.2.3 Ukulimala okuninzi

Inkqubo yenkqubo yokwakhiwa kwangaphandle kufuneka ithathelwe ingqalelo xa usenza umonakalo wolawulo kwizigulana ezinesifo sokulimala ezininzi. Ezona zibonelelo ziphambili zokulungiswa kwangaphandle zilungiswa ngokukhawuleza kwesahlulo, nceda ukukhulula iintlungu, kwaye unciphise ukopha, kwaye unciphise i-syndrome ye-infrandme yokulungiselela ukhathalelo.

2.2.4 I-Intra-Arctilary Fratures

Ukulungiswa kwangaphandle Bings kuhlala kungumlinganiso wethutyana okhusela i-tishu yesixhobo esithambileyo se-tussies kwi-quisture engazinzanga okanye i-intraticula yentsokotha; Ikwayinketho yokuNgenisa ngokudibeneyo okanye ukulungiswa kwe-ligament apho kulungiswa ixesha elingaphandle inqanaba lokulungiswa kwenqanaba lokuchazwa. Onke amalungu ahlanganisiweyo anokuvalwa ngale ndlela, kodwa eyona ixhaphakileyo, idolo kunye ne-ankle.

2.2.5 ithambo okanye iziphene ezithambileyo

Kwizigulana ezinezicubu ezithambileyo kunye neziphene zethambo, izakhelo zokulungisa zangaphandle zinokusetyenziselwa ukunciphisa umlenze kwinqanaba elinye kwaye emva koko zibuyisele ubude be-I-I-Light osteogenesis kwinqanaba lesibini.

2.2.6 Isakhelo sokuCwangciswa kwangaphandle Isetyenziswe njengesixhobo sokuseta kwakhona

Emva kokuncitshiswa kwe-phlity, xa ipleyiti yangaphakathi okanye i-Inramellary yabekwa, isikhundla sokuqhekeka sinokugcinwa ngokutshixa i-fandetor yangaphandle. Ngamanye amaxesha umlo wangaphandle unokugcinwa kangangexesha elithile ukubonelela ngokulungiswa ongezelelweyo xa ulungiso lwangaphakathi alunamandla ngokwaneleyo. Abalungisi bangaphandle okanye oophawu lokuphazamiseka babonakalisiwe ukuba nendima ebalulekileyo ngexesha lokubekwa kwe-gammelilimerland. IPIN ye-SCHneee i-scred kwicala le-dorsal ye-proximal ye-proxital ye-tibilimel kunye nethambo le-heel, eliqhotyoshelweyo. Oku kubonelela ngendlela elungeleleneyo yasekhaya kwaye ikwaguqula ubude, ukujikeleza, kunye ne-axis yefrafti ngaphambi kokufakelwa kwesikhonkwane se-intramellary okanye isikhundla esandisiweyo.

Ukubekwa kwe-tibility ye-tibial

3.Izicelo zangaphandle ze-brace

3.1 Izinto zebhayoloji

Beka ubuncinci iipins ezi-2 kwibhloko enkulu ye-friemority kwindawo yokhuseleko ye-anatomic, enezikhonkwane ngokubanzi kangangoko kunokwenzeka. Ukuba iimeko ze-tishu ezithambile, i-pins yokulungisa kufuneka ibekwe kufutshane nokuphela kokuphela, kodwa akufuneki ingene kwi-famatoma yokuphela kwe-hematoma okanye kwindawo yendawo yolusu. Ukuba ulungiso lwangaphakathi lucwangcisiwe, izikhonkwane zokulungisa kufuneka zikuphephe izithuba ezinokubakho kunye nokufikelela kwi-subgical (indawo yotyando). Iintonga zokudibanisa kufuneka zibekwe kufutshane nethambo kangangoko kunokwenzeka ukonyusa uzinzo. Uzinzo lolandelelwano lwangaphandle luxhomekeke kwezi zinto zilandelayo.

-Umgama wezikhonkwane zokulungisa kwisiphelo sokuqhekeka: Ukusondelela ngakumbi.

-Isithuba sezixhobo zokulungisa kwibhloko nganye yokuqhekeka: elona likhulu.

-Umgama weentonga eziqhagamshela zexesha elide ukusuka kwithambo: Ukusondelelana ngakumbi.

-Inani leentonga zokudibanisa: Zimbini zomelele kunenye.

-Ukuququzelelwa kwesakhelo sokulungisa sangaphandle (ukusuka ezantsi kumandla aphezulu): Inqwelomoya enye / i-biplane.

-Isakhelo sokulungiswa ngaphandle kwesakhelo esidityaniswe kunye nokulungiswa kwangaphakathi (isikrelemnqa)): kunqabile ukuba isetyenziswe kuba umxube we-elastic kunye nokulungiswa okuqinileyo okwethutyana.

I-Diameter ye-Schanz Screws okanye izikhonkwane zeSchnee: 6mm inamandla amabini eguqukayo e-5mm.

a. Isakhelo se-UNILXALL se-UNILTION Umgama wePIN kwi-phraction isiphelo (x).

Ukusondela, izinzile ngakumbi. Umgama wezikhonkwane ezahlukeneyo ezivela kwibhloko ephambili (Y): Ukuqhubeka nokuzinza ngakumbi.

Kude, kokukhona izinzile ngakumbi. Umgama weentonga zokudibanisa amaxesha elide ukusuka kwithambo (z): Ukusondelela ngakumbi ngakumbi.

b. I-Unilateliplel, i-UNIPLAANAR, i-3-rogration ye-3-ronetor yangaphandle iluncedo lokwakha uluhlu olubanzi lwezicelo, kubandakanya ukwakhiwa kwakhona.

Imodeli yoluhlu olubanzi lwezicelo, kubandakanya iindlela zokuseta kwakhona.

c. Isakhelo se-UNIlaneral singene kwi-UNICONIT SITENCE YOKUGQIBELA.

d. Ukucwangciswa kwe-biplane biplane (▲ Ukucwangciswa).

e. Ulungiselelo lweeBilatateral nge-Pins yokulungisa. Ngoku kunqabile ukuba isetyenziswe.

Ukulungiswa okungazinzanga ngaphandle kokulibaziseka kwenkqubo yokuphilisa, kodwa kunjalo nesakhelo sokuqina kwangaphandle.

Kuyimfuneko ngamanye amaxesha ukuyonyusa ukulungiswa okuzinzileyo kwaye kwandise umthwalo ngokuthi uthabathe okanye ugcwalise ubunzima kunye / okanye ukutshintsha ubumbeko lwesakhelo sengqikelelo yangaphandle.

3.2 Iindlela zokubeka inaliti

- Ziqhelanise ne-anatomy ukuthintela ukwenzakala kwimithambo, imithambo yegazi kunye neetekisi.

-Ungavumeli izikhonkwane zokulungisa okanye isikhafu sokungena kwiNtlawulo.

- Kulumkele ukuqhekeza iziphelo kunye ne-hematotos.

- Kulumkele iindawo zokugcina ulusu okanye impikiswano.

-Ukugqitha i-bone cortex ukuphepha ukonakala kwe-thermal (okhokelela ekrinta i-necrosis).

-Imipu yokulungisa kufuneka ibe nobude obufanelekileyo yokwakha isakhelo esifanelekileyo.

3.2.1 Indawo yokuhlala

I-rive ibukhali okanye iPIN yokulungisa, ubushushu obuncinci buya kuveliswa. Ukukhawulezisa isikroba, ukuphakama kwamaqondo obushushu aphezulu kuya kunyuka. Umonakalo we-thermal ukuya kwithambo lenkxalabo enzulu njengoko le inokukhokelela ekusekweni kwethambo le-ring elifekisiweyo, elinokubangela ukukhululeka kunye / okanye usulelo. I-Pins yokulungisa ngokuchanekileyo kufuneka ibambe kakuhle kumacandelo amabini, ngelixa iqhekeza akufuneki lingene kakhulu.

3.2.2 i-diaphysis

Kwi-epiphysis, imveliso yobushushu ayisiyongxaki. Isenokuba kukhuselekile ukusebenzisa izikrelem ezithambileyo kule nqanaba, njengoko kulula ukuphosa imingxunya ethambileyo xa isikhuhla isikhuselo kwizikrelem. Ukulungiswa kwe-pin ukungena kwi-dibang kumdibaniso kufuneka kuthintelwe njengoko kukho umngcipheko wefomathe yokufumana imbewu yembewu kwihlazo.

3.2.3 Imimandla yokhuseleko

Ukuthintela ukwenzakala kwimithambo-nkqubo, imithambo yegazi, iitekisi, umsipha kufuneka uqhelene ne-anatomy yelungu onke kwaye usebenzise indawo yokhuseleko ukuze ubekwe kwizikhonkwane zokulungiswa.

Umzobo 3.3.3-2 Indawo ekhuselekileyo yokubekwa kwePIN yePIN yangaphandle.

i-femur.

Umzobo 3.3.3-2 (iyaqhubeka)

B Tibia.

Umzobo 3.3.3-2 (iyaqhubeka)

C humerus, umbono ongasesikweni.

Xa isetyenziswa kwindiza enye, akukho mfuneko yokuqhuba i-scanz screw kwi-tibial tibial crest. I-tibial tibial crest inamathambo amathuko kunye nokuqhuba kuya kuvelisa ubushushu obugqithisileyo, onokubangela i-osteonegrasi yesibini. E-Drial Tibia, kukho umngcipheko wokulimaza i-tendon ye-tibilis ye-tibilis kunye ne-digithior yedijitha.

4. Inxalenye

4.1 Inkqubo ye-tube-rod

4.1.1 I-SCHNZ SCRUS 

Izikrelemnqa ze-SCAHZS zizinto eziqinisekisiweyo ze-SCHIC. Ziyafumaneka kwiidayamitha ezahlukeneyo, ubude (ubude bentonga, ubude bentambo) kunye neengcebiso ezahlukeneyo. Inqaku le-SCHNZS SCHNZ SCHWY yi-Trocar-i-Trocar-i-Trocar-i-Trocar. 3.3.3-3A) kwaye idla ngokufuna ukuqhuba kwangaphambili.

Umzobo 3.3.3-3 isikroksi

I-pic esemgangathweni ye-pin ye-pin.

B Ingcebiso yokuziqhelanisa.

Izikhonkwane zokuziqhelanisa nokuzingca zinencam ekhethekileyo enokuqhuba kwaye zinqumle imisonto ngexesha elinye xa ikhutshiwe ingena kwiMetaphysis (Fig. 333-3b).

I-SCIMZ CHWS ifumaneka kwintsimbi, i-titanium okanye i-hydroxyatititite edityanisiweyo. I-HYDROXYCAPATIT I-HINS edityanisiweyo inokufezekisa ibambe kakuhle kwithambo, ivumela ithambo lakuqala kwaye liphephe ukukhulula. Olu hlobo lwePIN lulungele izigulana ezinabameli bangaphandle endaweni yexesha elide.

4.1.2 Izikhonkwane zeSteiner

Izikhonkwane ze-Steiner zihlala zisetyenziswa njengezikhonkwane zokulungisa ezingena. Iingcebiso zabo zikwimo yemikhono yokuqhuba kwaye kufuneka ifakwe ngaphambili kwithambo le-cortive ngaphambi kokufakwa.

4.1.3 Iityhubhu / ii-rods

Kuxhomekeka kwinkcazo yeetyhubhu / iintonga, kukho iimodeli ezi-4 ezahlukeneyo:

• Inkulu: I-11 mm tube / i-rod, isikrweqe se-SCAHNZ yi-4 ~ 6 mm.

I-Medium: i-8 mm tube / i-rod, isikrweqe se-SCAHNZ yi-3 ~ 6 mm.

• I-4 mm tube / i-rod, isikrweqe sika-Schanz 1.8 ukuya kwi-4 mm.

• I-Mini: 2 I-2 mm yenkqubo yeminwe, uyilo oluqhelekileyo, lusebenzisa i-thuphu ye-kires yokulungisa ii-k-nimes kunye ne-2 mm rods.

Iimodyuli zale nkqubo zixhaswa nge-carched fiber rods. Kwiindawo eziluncedo ezinzima ezinjengeemodyuli zesandla, iimodyuli ezidibeneyo ze-T-Jikelele ziyafumaneka.

4.1.4 I-Clampps

I-clamps isetyenziselwa ukudibanisa ityhubhu / yentonga kunye nezikhonkwane zokulungisa. Iityhubhu / iintonga zinokuqhagamshelwa kunye nomnye nomnye ngenkqwitha efanelekileyo (ityhubhu).

Umzobo 3.3.3-5 clamps

Inkqutyana yokuzidibanisa ukudibanisa isikrweqe kunye neetyhubhu / iintonga.

B Ukudibana kwe-clomp yokudibanisa iintonga ezimbini okanye iityhubhu.

c i-superal pini-pin.

D Tube-Tube Clamp yokudibanisa iityhubhu ezimbini.

4.2 Inkqubo yokufaka isakhelo sangaphandle sokulungisa

Ibhloko ye-phrad inokuthi ilawulwe nge-clamps ephindwe kabini okanye i-clamps eyenziwe ngokwezifiso. Icandelo eliphambili elinamagqabi linokuqhotyoshelwa yokuphazamiseka okanye ukunyanzelwa kwethambo lokwahlulwa kwethambo kunye / okanye kwithambo.

Inkqubo yokulungisa engaphandle yethambo

4.3 Ukudityaniswa kokulungiswa kwangaphandle

Ukulungelelaniswa kwangaphandle kusetyenziselwa ukuqhekeza kufutshane nokudityaniswa kwaye kufuna i-pinchner pin ye-kirschner ye-kirschner ye-kirschner yokukhala kunye ne-Schanz Scalz Screw ye-diaphysis. I-3/3 iringi ye-3 /4 yeringi ihlala isetyenziswa. I-Conding Taits isetyenziswa ikakhulu kwi-proximal kunye ne-dibia.

I-race yokulungisa yangaphandle ye-tibial plates. Ingasetyenziselwa ukwaphuka kwe-picia ye-dibia. Isakhiwo se-V-esomileyo sibonelela ngozinzo olufanelekileyo

4.4 I-race yokulungisa yangaphandle

Inzuzo yenkqubo yangaphandle yolwaphulo-mthetho yangaphandle yeyokuba i-axis yokuthwala kunye ne-Axis ye-Orthodic idlula embindini wenkqubo yangaphandle yolwaphulo-mthetho yangaphandle kunye ne-axicunidinal ye-axis yethambo. Inkqubo yolwaluko yangaphandle inokusetyenziselwa ukwandisa ithambo, ukuphatha ithambo, kunye nokunyanga ukwaphuka kwamanzi alula kunye nobunzima.

I-tibilia iriiling yokulungisa i-race

Ifoto yeklinikhi yenkqubo ye-tifi

Ukusetyenziswa kwale ndlela ivumela ubunzima bomzimba obutsha. Kwiziqwengana ezintsha, sikhetha isakhelo sokulungiswa esilula sonyango sonyango. Ukuphathwa kweqhina kunye nokwandiswa kunokuphathwa ngenkqubo yangaphandle yokulungisa engasenziyo, kodwa kunokuba nzima ukwenza izilungiso ezintsonkothileyo, ezinzileyo, ezikhutshelweyo ze-Multiclanar, apho kucetyiswa khona i-fator yangaphandle. Xa isetyenziswa njengolungiso lwangaphandle, i-fatotor yangaphandle inika uzinzo lwesihlobo. Xa inaliti idluliselwa kwiinqwelomoya ezahlukeneyo zokulungiswa kwe-Multiplanar, olu lwakhiwo lubonelela ngenqanaba eliphezulu lozinzo. Amandla endalo ahluka kuxhomekeka kulungiso lolungiso, inani lamakhonkco asetyenzisiweyo, kunye nohlobo lweekhonkwane ezisetyenzisiweyo, ezinjenge-kirschner pins okanye isikrelemnqa. Kuxhomekeka kwiNdibano, iqhekeza lingarhoxiswa okanye icinezelwe, kwaye ukugculelwa kunokulungiswa. I-ICTIOPIP engaphandle zihlala zisetyenziselwa ukuphazamiseka kwe-osteogenesis ukulungisa iziphene, ukunqunyulwa kunye neziphenyane.

I-4.5 ye-hinged i-race yokulungisa ngaphandle

Isetyenziselwa ukugcina kwakhona ukuhlangana kwamalungu afumileyo okanye ukuqhekeka okuqhelekileyo kunye nokuvumela abanye (okulawulwayo) ngokudibeneyo ukhusela ukungabi nalukhuni. Ihlala isetyenziselwa ukudityaniswa kwe-elbow.

5 Ukwakhiwa kwesakhelo se-braces yangaphandle

5.1 Akukho ngqiqweni kwezixhobo zefreyimu

Kukho iindlela ezahlukeneyo zokugcwala kwamacandelo, ikakhulu ngokusekwe:

Umsebenzi.

- Isakhelo sezakhelo.

- Iplani yesicelo.

- uphawu.

5.1.1 Iifreyimu ze-UNcialporal

Isakhelo esingaqhelekanga sesona sisetyenziselwa ukusetyenziswa kwangaphandle kwendlela yokufumana unyango lokuphathwa kweedrafutha ezintsha. Isakhelo sifakwe kwindiza enye, umzekelo, i-antermial okanye i-medial kwi-tibia kunye ne-anterollal okanye i-feral kwi-femur. Izikhonkwane zokulungisa zifakwe kulusu kwelinye icala kwaye lingene kwi-cortex ephindwe kabini. I-PIN kufuneka ibekwe kude kwi-dibane, ngaphandle kwenxalenye ebiweyo ye-capsule edibeneyo, ukunqanda i-sepsis ye-gepsis. Iintonga ezimbini zifakwe kwindiza enye okanye kwiindiza ezimbini ezahlukeneyo emva koko zidityaniswe kunye.

5.1.2 izakhelo ezibini

IPIN ye-SZCCZINC idluliselwa kulusu kwelinye icala, lingena kwi-bilaminar ye-bilaminar, kwaye emva koko idluliselwe esikhumbeni kwelinye icala. Iifreyiti ze-Bilateral azicetyiswanga kunyango oluchazayo lwezinto zokuqhekezwa, kodwa zinokusetyenziselwa ukulungiswa okwethutyana.

5.1.3 Lawela ifreyimu zangaphandle

Isetyenziswe kwiinkqubo zolawulo lomonakalo kwiindawo zokulimala ezithambileyo ze-tissue ezithambileyo okanye i-intratical yentsokothi ye-Intra ye-Intra kunye ne-Fratures.

▲ I-Pelvic Fractures, i-proximal fectures, kunye ne-proximal tibia ityhefu isebenzisa i-braces yethutyana yangaphandle engaphaya kwamalungu edolo kunye ne-ankle.

Uzinzo olunikezwe yisakhelo sokulungiswa kwangaphandle Ivumela ukuvuselelwa kwezicubu ezithambileyo kunye ne-CT Scanning kunye nokucwangciswa kwezokhuseleko. Iifreyimu ezingasetyenziswanga zezona zisetyenziswayo, kwaye izikhonkwane zokulungisa kufuneka zibekwe ngaphandle kwendawo yokulimala kunye nokusebenza kwixesha elizayo kunyango oluchanekileyo.

5.1.4 izakhelo ezamileyo

ILIZISAROV Yazisa ngolu hlobo lwesakhelo sangaphandle. I-tubearle yangaphandle yokulungisa izakhelo kunye neefreyimu zokulungisa ezingasetyenziswanga zinokusetyenziselwa ukusebenzisa le migaqo yokubhalwa kancinci, kunye nokungancedisi ukuba ukulungiswa kokulungiswa kwe-Angland kunye nokujikeleza akunakwenziwa ngaxeshanye ngaphandle kokwandiswa kwe-intramellary.

5.2 Iindlela zokubuyisela kwimeko yesiqhelo

Inzuzo yesakhelo sokulungiswa esidityanisiweyo sekukuvumela ukuncitshiswa, ukugqobhoza, kunye nokulungiswa kwamathambo amade, iindawo ezikufuphi neNtlanganiso, kunye neNtlanganiso uqobo (iTranssericular).

Ukubekwa kwezikrweqe ze-SCHAHZ zinokuba yinkululeko, zivumela ukhetho lwe-anatomic ficeration ye-Anatomic Scours okanye indawo efanelekileyo yokulungisa ukulimala kunye nokulimala okuthambileyo. Ukuncitshiswa kweqhekeza eliphambili lokuqhekeka kunokwenziwa ngokunyusa kunye neendlela zokunciphisa ukuthembeka, ngelixa igcina ukuhamba kwegazi ukuya kwithambo kunye nezicubu ezithambileyo. Ukusetyenziswa kobu buchule kuvumela ukulungiswa kwenkqubo yokuqhekezwa kweflicare nangaliphi na ixesha.

Indlela yokuNika iMiselweyo.

Uhlobo lwe-b tibial tibial stem phrity.

b kwibhlokhi nganye ephambili, i-2 yokulungisa i-spins ikhutshiwe ngaphandle kwendawo yokwenzakala.

I-CION ZOKUGCINWA Kukhuselekile kwiintonga zokudibanisa kunye ne-clamps uperst, ebangela ukuba zibe neziphatho ezi-2 zokuncitshiswa okungathanga ngqo.

D Emva kokuba iqhekeza libekiwe, i-3 yokudibanisa i-3 yokudibanisa iqhotyoshelwe kwi-2 yeentolo zokuqala eziqhagamshela kunye ne-tube-tube.

▲ Umboniso we-brace yokulungisa yangaphandle edibeneyo. i-tibia. b femur. C Idon-dolo.

Izicelo ezi-6 ezizodwa

6.1 Ukudibana ngokudibeneyo

Ukusetyenziswa okhethekileyo kwezilungiso zangaphandle kukwenza i-cussion yamalungu ngoxinzelelo kunye nabalungisi bangaphandle. Lo mgaqo ngamanye amaxesha usetyenziselwa ukungcungcutheka kwe-ankle, idolo, kunye namalungu e-onbow, ngakumbi phambi kosulelo.

6.2 Usulelo

Ukulungiswa kwangaphandle lolona nyango lukhuselekileyo losulelo olunamandla okanye osulelekileyo lokuqhekeka, njengoko izikhonkwane zokulungisa zihlala zibekwe kude kwindawo yosulelo.

6.3 I-Osteotomy ye-osteotomy

I-Osteotomies yokulungiswa kwezinto zokuphulukana nezicubu xa iimeko ezithambileyo zihlwempuzekile okanye ziphazamiseka kwaye umngcipheko wokusebenzisa ulungiso lwangaphakathi luphezulu, apho amatyala angaphandle anokusetyenziselwa ukulungiswa. Enye into ebonisa i-osteotomy ephatheni ngaxeshanye yethambo ngaxeshanye. Oku kudla kufuna ukulungiswa ngento ephikayo yesakhelo sangaphandle.

6.4 I-Bone eNikenti -Ukuphazamiseka kwe-Osteogenesis

Isiphazamiso sethambo sisekwe kumgaqo ka-Ilizarov wokugcina i-periosteum ukuze ithambo le-genered lingaphazamiseka kancinci (0.5-1 mm / d), kwaye ithambo elitsha lenziwa ngalo msantsa. Amanqanaba acothisayo ephazamisayo kukhokelela kwi-bone yokuphilisa, ngelixa amaxabiso ekhawulezayo esiphazamisayo egqitha ukunyamezelana kwe-tissin ye-tissue. Iqhutywa okanye iphazamiseka ithambo lethambo, njengezo zezaphulelo, zihamba kuwo onke amabakala omtshato we-scab kude kube kwenzeka ukuba kuphindwe. Kukho iimpawu ezi-3 zokusetyenziswa kolu hlobo, kwaye ngamanye amaxesha ezi zinto zibonisa ukuba zinokuthi zenze i-axist:

-Ukuzimasa ilungu.

-Ukunikezela ngesandla sethambo lokuphatha ithambo.

-Ulungisa i-osteotomy.

Olona candelo lifanelekileyo lokulungisa le njongo yisakhelo somhlaba wolwalukiso (kunye okanye ngaphandle kwesakhelo se-semi- wolwazelelo) kunye nesakhelo sokulungisa.

6.5 Ukubuyiselwa ngokudibeneyo kunye nokuhamba okuzinzileyo

Umnxeba wangaphandle oxhonyiweyo lungendo olubalulekileyo kwinani lokulimala okungafunekiyo, kubandakanya nokunganyangeki okunganyangekiyo okanye ukungasonjululwa ngokunganyangekiyo ngokulandela i-Equicumer Reupces. I-teator yangaphandle ye-Hinged igcina i-Elbow Setset kunye ne-plation ebiyelweyo. Ukugcina imeko iphambili kwindawo yokuqala. Ukungazinzi kunzima ngakumbi ukuphatha kunokuphulukana nokulahleka. I-Axis ifuna ukuba ibekwe ngqo phantsi kweFluoroscopy. Ukuphambuka kancinci kwisikhundla se-hinge kunokuyichaphazela kakhulu umsebenzi wayo.

▲ Ukubekwa kwe-fayiletor yangaphandle exhonyiweyo ye-elbow.

Unyango olu-7

I-7.1 ukhathalelo lwephecana

Impendulo yephecana ixhomekeke kwisikhundla kunye nokuzinza kwePIN yokulungisa, unyango lwe-Postoperation lweqela labahlengikazi kunye nesigulana. Indlela yokuncitshiswa edibeneyo iluncedo ngakumbi kuba ivumela ukhetho lweyona ndawo intle ye-anatomical yePIN ngokoluhlobo lokuqhekeka. Isibhedlele kufuneka sibe nenkqubo yokhathalelo lwePict yePipple, kwaye abongikazi abanamava kufuneka bafundise abaguli ukuba bakhathalele i-phecana le-phecana. Ngokuphepha ukulimala kwe-thermal kunye nokuqulunqwa kwe-hematoma yendawo ngexesha lokufakelwa kwePIN, kwaye kusetyenziswe iintsholongwane zotywala ukucoca indawo ejongene nepini, kwaye usebenzisa i-PITISTURE CORT, usulelo kunye nokukhululwa kwePIN kunokuncitshiswa kakhulu.

7.2 Usulelo lwephecana 

I-Pict Tect Tech kufuneka iqale ngokufakelwa iphini. Kwisikhuseli esiqhelekileyo saseSchanz, ukuqhuba kwangaphambili kuhlala kufuna kwaye iPIN ikhutshiwe ngesandla ukunciphisa i-necrosis ye-thermal. Ingqungquthela engalunganga ethambileyo ejikeleze iPIN kufuneka ikhululwe ngexesha lotyando. Ukhathalelo olufanelekileyo lwephecana elichanekileyo kubalulekile ukunciphisa ukucutha iingxaki ze-phecana. Isifo sephetshana lesiphelo kunye nokukhulula ukukhululwa kunokusonjululwa ngokususa isikhonkwane esikhululekileyo kunye nokuphinda-phinda iphini kwenye indawo.

7.3 Ukuhlanganisa

Ngaphandle kweemeko ezimbalwa ezikhethekileyo (ukulungiswa okubonakalayo, ukusetyenziswa kwexesha elingxamisekileyo, uhlengahlengiso lwengxamiseko), ukulungiswa kwengqwalaselo), ubunzima bomzimba buthathaka kuvunyelwe ekuqaleni komkhenkce wangaphandle. Njengoko ukuphiliswa, ukuthwala ubunzima ngokupheleleyo kunokwanda ngokuthe ngcembe. Akukho sidingo songeza izixhobo zongezelelweyo zokulinganisa kwi-falltor yangaphandle. Inxenye okanye isisindo esigcweleyo seyona ndlela ilungileyo neyona isebenzayo yokusebenza.

Ixesha le-8 lokulungiswa kwangaphandle

Ukutshintsha unyango

Kukho iindlela ezi-3 ezisisiseko zonyango:

Sebenzisa i-facitor yangaphandle njengonyango olucacileyo de kuphilise isaphulelo.

Ukuguqulwa kwangoko ukuya kulungiso lwangaphakathi.

• Tshintshela kunyango olungaphanga utyalo, njengodaka, i-orthosis, njl.

Ukuba ukuguqulwa kulungiso lwangaphakathi kulindeleke, kufuneka kwenziwe kwangoko (kwiiveki ezi-2) kuba ireyithi yokuqhutywa iphantsi kakhulu kunoko kuguqulwe kade.

Le mithetho ilandelayo kufuneka ilandelwe xa icwangcisa naluphi na utyando ngaphambili, ngexesha, okanye emva kokulungiswa okwethutyana:

• Ukuba i-pient entsha ibekwe kwindawo ejikeleze indawo yolungiselelo lwangaphandle, onke amaphecana kufuneka acoceke. Ngamanye amaxesha inkqubo yenziwa ngamanqanaba amabini, kunye nenqanaba elinye ukucoca iphecana lesikhonkwane lentsusa kunye nenqanaba lesibini ukwenza ulungiso oluchanekileyo.

• Nayiphi na indawo yeTript yeTript engaphezulu kwe-10 ukuya kwiintsuku ezili-14 ithathwa njengezichongisingwana kwaye kufuneka icocwe kwaye icoceke kwaye iphinde icoceke.

• Ukuba kukho amathandabuzo malunga nokugula kwezi phecana zePIN okanye i-PICT yePIN sele inosulelo, i- 'i-' i-Pick 'ubuncinci kwiintsuku ezili-10 ezifunwayo emva kokufakelwa kwe-pin.

• Iintsholongwane kufuneka zisetyenziswe prophylatic kunye ne-antimicrobial spectrum egubungela i-bacteria ukusuka kusulelo lwangaphambili.

• Ukulandela ukulandela iiveki ezi-6 zokuqala emva kokutshintshwa kwe-famitor yangaphakathi.

If there is evidence of a problem with the pin tract, it is best to identify the bacterial species, apply antibiotics, change the pin and reposition it, and continue treatment with an external fixator. I-Tech Tract Tract Carct kufuneka ibandakanye isigulana ukuqinisekisa iziphumo ezilungileyo. Ukuba i-facebotor yangaphandle kufuneka itshintshwe ngenkqubo yangaphakathi kwinqanaba lokugqibela, kuyacetyiswa ukuba i- i- i- 'ubuncinci ' ubuncinci kwiintsuku ezili-10, kwaye emva koko isuswe i-spling de icocwe i-Splint de ilungiswe utyando lwangaphakathi. Iintsholongwane zinokusetyenziswa ngokufanelekileyo ngeli xesha.

8.2 Ukulungiswa kokugqibela

Ukulungiswa kwangaphandle kwexesha kunokufezekisa uzinzo okwethutyana lwelungu kwaye uvumele ukubuyiswa kwezicubu ezithambileyo. Logama nje iimeko ze-tissies ezithambileyo zizinzile, i-facebotor yangaphandle inokutshintshwa ngokokulungiswa kwangaphakathi. Ngokufanelekileyo, kufuneka itshintshwe ngelungisa lwangaphakathi kwiintsuku ezili-10.

Ukuba ulungiso lwangaphandle lusazinza kwaye akukho zimpawu zobunzima, ukulungiswa kokutshintsha akuyimfuneko. Ukuba ukugubungela ulusu kuhlwempuzekile, okanye kukho inkxalabo malunga nomonakalo othambileyo wezicubu kunye nomngcipheko wokosuleleka ngokuncitshiswa okukhoyo, i-faceboto yangaphandle inokugcinwa njengonyango lokugqibela lokuqhekeka.

Inkqubela phambili yokuphiliswa komtshato kufuneka iqwalaselwe ngononophelo, kwaye ukuba akukho nkqubela phambili, abanye unyango kufuneka luqwalaselwe.