I-Clavicle Fractures: Ukuxilongwa, Ukuhlelwa, Ukwelashwa kanye Nokubuyisela

Okuthathwayo Okubalulekile

• Ingxenye yesithathu emaphakathi, noma i-shaft, iyindawo evame kakhulu yokuphuka kwe-clavicle.

• Izimpawu ezijwayelekile zihlanganisa ubuhlungu, ukuvuvukala, imihuzuko, ububele, nobunzima bokunyakazisa ingalo.

• I-X-ray engenalutho iwukuhlolwa okuyinhloko kwezithombe; I-CT ingase isetshenziselwe izimo eziyinkimbinkimbi, ezimaphakathi, noma zangaphambi kokuhlinzwa.

• Iningi lezindawo eziphukile kancane ziphathwa ngesihlilingi, ukuthwebula isithombe esilandelayo, kanye nokuvuselelwa okuqhubekayo.

• Ukuphuka okuvulekile, isikhumba esisongelwa, ukulimala kwe-neurovascular, ibhande lehlombe elingazinzile, nokuphuka okukhethiwe okususiwe noma okungazinzile kungase kudinge ukuhlinzwa.

• Ukulungiswa kwepuleti kanye nokulungiswa kwe-intramedullary kokubili kunganikeza imiphumela emihle ekuqhekekeni kwe-shaft yabantu abadala ekhethiwe, kodwa ngayinye inezinzuzo nezingozi ezahlukene.

• Ukululama kuyahlukahluka ngeminyaka, iphethini yokuphuka, indlela yokwelapha, isimo sokubhema, nobufakazi bokuphulukiswa kwamathambo.

Iyini I-Clavicle Fracture?

I-clavicle iyithambo elimise okwe-S elixhuma i-sternum enkabeni yesifuba ne-scapula ehlombe. Isebenza njengesixhumanisi sesakhiwo phakathi kwesiqu kanye nengalo engenhla kuyilapho isiza ukuvikela imizwa nemithambo yegazi edlula ngaphansi kwayo.

Ukuphuka kwe-clavicle kwenzeka lapho amandla edlula amandla ethambo. Izinqubo ezivamile zihlanganisa ukuwa ngokuqondile ehlombe, ukuwa engalweni eyeluliwe, ukushayisana phakathi nemidlalo yokuxhumana, kanye nebhayisikili elinamandla amakhulu noma ukuhlukumezeka kwemoto. Ezigulini ezincane, lokhu kulimala kuvame ukulandela izingozi zezemidlalo noma zomgwaqo. Kubantu abadala asebekhulile, ukuwa kwamandla aphansi kungase kwanele, ikakhulukazi uma ikhwalithi yamathambo iyancipha.

I-Clavicle fracture ihlanganisa cishe u-3% kuya ku-5% wabantu abadala abaphuka. Ukusatshalaliswa kuvame ukuchazwa njenge-bimodal, ngenani eliphakeme phakathi kwentsha kanye nabantu abadala kanye nelinye phakathi kwabantu abadala.

Izimpawu Zokuphuka Kwe-Clavicle

Izimpawu zincike endaweni kanye nobukhulu bokulimala, kodwa ngokuvamile zihlanganisa:

• Ubuhlungu obusheshayo phezu kwe-collarbone ngemva kokulimala

• Ukuvuvukala, imihuzuko, nobumnene obusendaweni

• Ubuhlungu lapho uphakamisa noma uhambisa ingalo ethintekile

• Iqhubu elibonakalayo, isinyathelo, noma ushintsho ku-contour yehlombe

• Umuzwa wokugaya noma ukunyakaza endaweni yokuphuka

• Ukuthambekela kokusekela ingalo elimele ngesandla esiphambene

Izimpawu Eziyisixwayiso Ezidinga Ukuhlolwa Okuphuthumayo

Ukuhlolwa okuphuthumayo kwezokwelapha kubalulekile lapho isikhumba siphukile noma siboshwe ngokuqinile phezu kwesiqephu esibukhali; isandla noma ingalo iyaphaphatheka, igodole, ibe buthakathaka, noma ibe ndikindiki; ukuphefumula kunzima; ubuhlungu besifuba bukhona; noma ukulimala kulandele ukuhlukumezeka kwamandla aphezulu. Lokhu okutholakele kungabonisa ukuphuka okuvulekile noma ukulimala okuhlobene okubandakanya amaphaphu, udonga lwesifuba, imizwa, noma imithambo yegazi.

Itholakala Kanjani I-Clavicle Fracture?

Ukuxilongwa kuqala ngomlando wokulimala kanye nokuhlolwa komzimba. Udokotela uhlola indawo yesisa, ukukhubazeka okubonakalayo, isimo sesikhumba, ukunyakaza kwamahlombe, kanye nokujikeleza nokusebenza kwezinzwa zengalo ethintekile. Ekulimaleni kwamandla aphezulu, isifuba, intamo, i-scapula, nezinye izingxenye zebhande lehlombe nazo zidinga ukuhlolwa ngokucophelela.

I-X-Ray

Ama-radiographs angenalutho ayisivivinyo somugqa wokuqala ojwayelekile. Baqinisekisa indawo yokuphuka futhi basize ukukhombisa ukugudluka, i-angulation, ukufinyeza, kanye nokuhamba. Ama-radiographs aqondile angabonisa ukufuduka okuningi kunezithombe ezithathwe isiguli silele, ikakhulukazi lapho kuqhekeka i-clavicle ephakathi nendawo.

I-CT nokunye Ukufanekisa

I-Computed tomography ingase ibe usizo lapho ukuphuka kuhilela i-clavicle emaphakathi noma i-sternoclavicular joint, lapho iphethini yokuphuka iyinkimbinkimbi, lapho kusolwa ukulimala okuhambisanayo kwebhande lamahlombe, noma lapho ukuhlelwa okuningiliziwe kwangaphambi kokuhlinzwa kuyadingeka. Ukuthwebula izithombe okwengeziwe kukhethwa ngokuya ngokusolwa kokulimala okuhlobene kunokuba kusetshenziswe njalo kukho konke ukuphuka kwe-clavicle.

Izinhlobo Nezigaba Zokuhlukana Kwe-Clavicle

Isinyathelo sokuqala esiwusizo kakhulu ukuhlukanisa ukuphuka kwe-clavicle ngendawo:

Amasistimu Okuhlukanisa Okujwayelekile

Isistimu ye-Allman ihlanganisa ukuphuka kwe-clavicle kube ukulimala okumaphakathi-kwesithathu, i-distal-third, kanye nokulimala kwe-medial-third. Amasistimu anemininingwane eminingi ahlanganisa ukuhlukaniswa kwe-Neer kokuphuka kwe-distal clavicle, ukuhlukaniswa kwe-Robinson noma i-Edinburgh, kanye nesigaba se-AO/OTA. Lezi zinhlelo zichaza izinto ezifana nendawo, ukugudluzwa, ukuhamba, ukubandakanyeka kwe-articular, nokuzinza kwemisipha.

Igama lokuhlukanisa lilodwa alinqumi ukwelashwa. Udokotela kufanele futhi acabangele isikhumba nezicubu ezithambile, isimo se-neurovascular, ukulimala okuhlobene, iminyaka yesiguli, isimo sezokwelapha, umsebenzi, izinga lomsebenzi, kanye nezinketho zokwelashwa.

Ukwelashwa Okungasebenzi Kwama-Clavicle Fractures

Iningi le-clavicle fracture ehlukanisiwe lilawulwa ngaphandle kokuhlinzwa, ikakhulukazi lapho ukuqondanisa kwamukelekile futhi ukuphuka kulindeleke ukuthi kuhlale kuzinzile. I-sling yengalo elula ngokuvamile ikhethwa ngaphezu kwe-brace yesibalo-yesishiyagalombili ngoba kulula ukuyisebenzisa futhi ivamise ukukhululeka.

Ukunakekelwa okungasebenzi kungabandakanya:

• I-sling immobilization ukuze uthole induduzo nokuvikelwa

• Ukuphathwa kwezinhlungu kuqondiswa uchwepheshe wezempilo

• Ukulandelela okujwayelekile komtholampilo kanye ne-radiographic

• Ukunyakaza kusenesikhathi kwendololwane, isihlakala, nesandla

• Ukunyakaza kwehlombe okuqhubekayo lapho ubuhlungu nokuzinza kwe-fracture kuvumela

• Ukuqinisa ngemva kwezibonakaliso zemitholampilo neze-radiographic zokuphulukisa

Izinzuzo zokwelashwa okungasebenzi zibandakanya ukugwema ukusika, izinzwa, ingozi yokutheleleka, nezinkinga ezihlobene nokufakelwa. Ububi obungase bube buhlanganisa ukukhubazeka okuqhubekayo, inyunyana ebambezelekile, ukungenzi inyunyana, i-malunion, kanye nokubuya kancane kancane emsebenzini onzima noma ezemidlalo ezindaweni ezikhethiwe zokuphuka.

I-sling yengalo elula ijwayele ukusetshenziselwa ukunethezeka nokuvikela phakathi nokunakekelwa kwangaphambi kwesikhathi okungasebenzi.

I-Clavicle Fracture Idinga Nini Ukuhlinzwa?

Ukuhlinzwa akudingekile kukho konke ukuphuka kwe-clavicle, futhi asikho isikali esisodwa okufanele sisetshenziswe sodwa. Ukwelashwa kufanele kube komuntu ngamunye ngokuthatha izinqumo okwabelwana ngazo phakathi kwesiguli nodokotela ohlinzayo owelaphayo.

Ukwelashwa kokuhlinzwa kungase kunconywe noma kucatshangelwe ngokuqinile uma kukhona:

• Ukuphuka okuvulekile

• Ukonakala kwesikhumba noma ukunamathela okunzima phezu kwengcezu yokuphuka

• Ukulimala okuhambisana nemithambo yegazi noma izinzwa

• Ibhande lehlombe elingazinzile noma iphethini ekhethiwe yokuhlukumezeka okuningi

• Ukususwa okumakiwe, ukufinyezwa, noma ukwenziwa kabusha ekuqhekekeni kwe-midshaft yabantu abadala

• Ukuphuka kwe-distal clavicle engazinzile nokuphazamiseka kwe-coracoclavicular ligament complex

• I-symptomatic nonunion noma malunion

• Isidingo sokubuyisela ukuqondana nokuzinza ngemva kokucabangela umsebenzi, ezemidlalo, impilo evamile, nokuthandwa yisiguli

Kubantu abadala abanezimo eziphukile ze-midshaft, ukwelashwa ngokuhlinza kuhlotshaniswa namazinga aphezulu enyunyana kanye nemiphumela engcono embikwe isiguli kusenesikhathi kunokunakekelwa okungasebenzi. Imiphumela yesikhathi eside nokwaneliseka, nokho, kungafana nanoma iyiphi indlela. Ibhalansi iyahluka entsheni, amandla ayo okuphulukisa makhulu futhi okuhlinza okuvamile lapho kuphuka i-midshaft ehlukanisiwe kungase kunikeze inzuzo ecacile yokusebenza kwayo.

Ukunakekelwa Okungasebenzi vs. Kokulungiswa Kokuhlinzwa

Izinketho Zokwelashwa Kokuhlinzwa

Ukulungiswa Kwepuleti kanye Nesikulufu

Ukunciphisa okuvulekile kanye nokulungiswa kwangaphakathi ngepuleti kuyindlela evamile yokuhlinzwa ye-clavicle fractures. Udokotela ohlinzayo ubuyisela ukuqondanisa futhi avikele ukuphuka ngepuleti nezikulufu. Okwesimanje amasistimu wepuleti lokukhiya amathambo ahlinzeka ngezinketho ze-engeli engaguquki kumaphethini okuphuka akhethiwe. Ukulungiswa kwepuleti kungaba usizo ikakhulukazi lapho ukuphuka kwehliswa noma lapho ukugcinwa ubude nokujikeleza kubalulekile.

Izimila ezenziwe ngaphambilini njenge- Ipuleti lokukhiya i-clavicle emise okwe-S yakhelwe ukulandela ukugoba kwe-clavicle, nakuba ukukhethwa kokugcina kokufakelwa kanye ne-contouring kuncike ku-anatomy ngayinye kanye nokucushwa kokuphuka. Okubi okungase kube khona kufaka phakathi ukuba ndikindiki nxazonke zokusikwa, ukugqama kokufakelwa, ukucasuka kwezicubu ezithambile, ukutheleleka, kanye nokwenzeka kwenqubo yakamuva yokususa izingxenyekazi zekhompuyutha ezinezimpawu. Ukususwa kwe-implant akudingekile ngokuzenzakalelayo ngemva kokuphuka konke okupholisiwe.

Ukulungiswa kwepuleti kubuyisela ukuqondanisa futhi kuzinzisa i-clavicle ngenkathi ukuphuka kuphola.

Ukulungiswa kwe-Intramedullary

Imishini ye-Intramedullary ifakwe ngaphakathi komsele we-clavicle ukuze kuzinziswe ukuphuka kwe-shaft ekhethiwe. Uma kuqhathaniswa nokucwenga, le nqubo ingase isebenzise ukusika okuncane futhi inciphise ukuchayeka kwezicubu ezithambile. Kodwa-ke, akuwona wonke ukuphuka okulungele ukulungiswa kwe-intramedullary, ikakhulukazi uma ukuhlanganiswa kwenza ubude noma ukulawula okujikelezayo kube nzima. Kokubili amapuleti nezinzipho kwakha ingxenye yobubanzi uhlelo lwe-orthopedic trauma fixation.

Ngokuphuka kwe-shaft ye-clavicle yabantu abadala, ukubethelwa kwe-intramedullary kanye nokulungiswa kwepuleti elilodwa kungaveza imiphumela efanayo yesikhathi eside yomtholampilo kanye namazinga ezinkinga. Ukulungiswa kwepuleti kungase kunikeze inzuzo phambi komhlangano.

I-Minimal Invasive Plate Osteosynthesis

I-plate osteosynthesis ye-invasive kancane isebenzisa ukusika okuncane nokuchayeka okulinganiselwe kuyilapho iqinisa ukuphuka ngepuleti. Le nqubo ihlose ukulondoloza izicubu ezithambile kanye ne-fracture biology, kodwa ukunciphisa okunembile nokuvikelwa kwemizwa ye-supraclavicular kusabalulekile.

I-Distal Clavicle Fixation

I-Distal clavicle fractures idinga ukuhlolwa kwendawo yokuphuka, usayizi wesiqephu, ukubandakanyeka kwe-articular, nobuqotho be-coracoclavicular ligament complex. Izinketho zingabandakanya a ipuleti lokukhiya i-distal clavicle , ukuqina kwe-coracoclavicular, noma amanye amasu okulungisa akhethelwe iphethini ethile. Ubufakazi abusekeli inqubo eyodwa kukho konke ukuphuka kwe-distal.

I-Medil Clavicle Fractures

Iningi lokuqhekeka kwe-clavicle ephakathi nendawo elifuduka kancane lingaphathwa ngaphandle kokuhlinzwa. I-CT ivamise ukuba wusizo lapho kunzima ukukuchaza ukufuduka noma uma kusolwa ukufuduka kwangemuva. Ngenxa yokuthi umgudu woqhoqhoqho, umphimbo, imikhumbi emikhulu, nezinye izakhiwo ze-mediastinal ziseduze, ukulimala kwaphakathi kwangemuva kokufuduka kudinga ukuhlolwa okuphuthumayo kochwepheshe.

Ukubuyiselwa Nokuvuselelwa Kwe-Clavicle Fracture

Alukho uhlelo lwezikhathi lokutakula olulodwa kukho konke ukuphuka kwe-clavicle. Iminyaka yobudala, indawo yokuphuka, ukufuduka, indlela yokwelapha, isimo sokubhema, ukulimala okuhlobene, nokuphulukiswa kwe-radiographic konke kuthinta ukuqhubeka. Iziguli eziningi zithola kabusha ukusebenza okuwusizo phakathi kwamaviki angu-6 kuya kwangu-12, kodwa ukuphulukiswa okuphelele kwamathambo, ukululama kwamandla, nokubuyela emsebenzini odingeka kakhulu kungase kuthathe isikhathi eside.

1. Isigaba sokuvikela: Isihlilingi sisetshenziselwa ukunethezeka nokuvikela. Ukunyakaza kwesandla, isihlakala, nendololwane kuvame ukukhuthazwa ngaphandle uma kuvinjwa omunye ukulimala.

2. Isigaba sokuqala sokunyakaza: Ukuzivocavoca kwehlombe okumnene kungase kuqale lapho ubuhlungu buyancipha futhi umtholampilo olapha uqinisekisa ukuthi ukunyakaza kufanelekile.

3. Isigaba esiqinisayo: Izivivinyo zokumelana nazo zethulwa ngemva kokwelashwa okwanele komtholampilo kanye ne-radiographic.

4. Isigaba sokubuyela emsebenzini: Ukuphakamisa kanzima, imidlalo yokuxhumana, nemisebenzi enengozi enkulu yokuwa kufanele ilinde kuze kube yilapho ukuphuka sekupholile futhi amandla nokunyakaza sekuphinde kwalulama.

Ukulandelela kubalulekile ngoba ukukhubazeka okwandayo, ubuhlungu obuqhubekayo, noma ukuntuleka kokuqhubeka kwe-radiographic kungase kubonise ukufuduka, ukubambezeleka kwenyunyana, noma ukungavumelani. Ukubhema kungaphazamisa ukuphulukiswa kokuphuka futhi kufanele kubhekwe njengengxenye yohlelo lokwelapha.

Izinkinga Ezingenzeka

Izinkinga Ngemva Kokwelashwa Okungasebenzi

• I-Nonunion: ukuphuka kwehluleka ukuphulukisa, okungabangela ubuhlungu obuqhubekayo noma ubuthakathaka.

• I-Malunion: i-fracture iphola endaweni efushane, e-angulated, noma esusiwe.

• Ukugqama okubonakalayo: iqhubu lingase lihlale phezu kokuphuka okupholisiwe.

• Ukuqina kwamahlombe noma ubuthakathaka: ukuvuselelwa kungase kudingeke ukuze kubuyiselwe ukusebenza.

• Izimpawu ze-Neurovascular: lezi azijwayelekile kodwa zidinga ukuhlolwa ngokushesha.

Izinkinga Ngemva Kokuhlinzwa

• Ukutheleleka ngenxeba

• Ukuba ndikindiki noma umuzwa oshintshile eduze nokusikeka

• Ukucasulwa kwezingxenyekazi zekhompuyutha noma ukuvelela

• Faka ukuxegisa, ukugoba, noma ukuphuka

• Inyunyana ebambezelekile, inyunyana, noma i-malunion

• I-refracture, kuhlanganise ngemva kokususwa kokufakelwa

• Isidingo sokunye ukuhlinzwa, ngokuvamile ngenxa yezingxenyekazi zekhompuyutha ezinezimpawu

Ingozi yezinkinga incike ekuqhekekeni kanye nesiguli. Izinga eliphakeme lenyunyana ye-radiographic alisho ukuthi ukuhlinzwa kuyisinqumo esingcono kakhulu sawo wonke umuntu, njengoba nje nokugwema ukuhlinzwa kungaqedi ithuba lokungenelela kamuva.

imibuzo ejwayelekile ukubuzwa

Ingabe i-clavicle fracture ingaphola ngaphandle kokuhlinzwa?

Yebo. Iningi le-clavicle fracture elihlukanisiwe lilashwa ngaphandle kokuhlinzwa futhi liphulukiswa ngokusekelwa kwe-sling, ukulandelela, nokuvuselelwa okuqhubekayo. Amathuba okunakekelwa okuphumelelayo okungasebenzi ancike ekuzinzeni kokuqhekeka, ukufuduka, ukuhamba, indawo, iminyaka yesiguli, nezinye izici zomtholampilo.

Kuthatha isikhathi esingakanani ukuphuka kwe-clavicle ukuze kuphole?

Iziguli eziningi zithola umsebenzi ojwayelekile noma oseduze nojwayelekile phakathi namasonto ayi-6 kuya kwayi-12, kodwa isikhathi sokuphulukiswa siyahluka. Abantu abadala, ababhemayo, abantu abanezimo eziphawulekayo zokufuduka noma abaphuka kakhulu, kanye neziguli ezinezinye izimo zezokwelapha zingase zidinge isikhathi eside. Ukubuyela emidlalweni yokuxhumana kudinga ukuphulukiswa okuqinisekisiwe kanye nemvume yokwelashwa.

Iluphi uhlobo oluvame kakhulu lokuphuka kwe-clavicle?

I-Midshaft clavicle fractures yizona ezivame kakhulu. Ukuphuka kwe-Distal akuvamile, futhi ukuphuka kwe-clavicle ephakathi akuvamile.

Ingabe iqhubu elibonakalayo ngemva kokuphuka kwe-clavicle livamile?

Ukuvelela okubonakalayo kuvamile ngesikhathi sokuphulukiswa futhi kungase kuhlale ngemva kokuba ithambo lihlangene. Ezinganeni nasentsha ingase ilungiswe kakhulu ngokuhamba kwesikhathi. Ukukhubazeka okukhulayo, isikhumba esisengozini, ubuhlungu obunzima, ukuba ndikindiki, noma ubuthakathaka kufanele kuhlolwe ngokushesha.

Ingabe ukulungiswa kwepuleti kungcono kunokulungiswa kwe-intramedullary?

Ayikho indlela elungele sonke isiguli. Kokubili kunganikeza imiphumela emihle yesikhathi eside ekuqhekekeni kwe-shaft yabantu abadala. Ukulungiswa kwepuleti kungase kube kuhle kumaphethini ahlanganisiwe, kuyilapho ukulungiswa kwe-intramedullary kungase kunciphise usayizi wokusikeka ezindaweni ezifanele zokuphuka. Isinqumo sincike ku-fracture morphology, isipiliyoni sikadokotela ohlinzayo, izinto eziza kuqala esigulini, kanye nezingozi ezihlobene nokufakelwa.

Ingabe i-clavicle hardware ihlale idinga ukususwa?

Cha. Amapuleti, izikulufu, nezisetshenziswa ze-intramedullary azikhishwa njalo uma zingenayo izimpawu futhi ukuphuka sekupholile. Ukususwa kungase kucatshangelwe ukucasuka okungapheli, ukuvelela, ubuhlungu, izinkinga zokufakelwa, noma ezinye izizathu zomtholampilo ngemva kokuxoxa ngezingozi zokunye ukuhlinzwa.

Yiziphi izimpawu zokuthi i-clavicle fracture ingase ingapholi?

Ubuhlungu obuqhubekayo endaweni yokuphuka, ukunyakaza okuqhubekayo noma ububele, ukuthuthukiswa okulinganiselwe kokusebenza, nokuntuleka kokuqhubekela phambili ekucabangeni okulandelwayo kungase kuphakamise ukubambezeleka kwenyunyana noma ukungenzi lutho. Lokhu okutholakele kudinga ukuhlolwa ngudokotela owelaphayo.

Isiphetho

Ukwelashwa kokuphuka kwe-clavicle kuncike kokungaphezu kokubonakala kwe-X ray eyodwa. Ukuphuka okuningi okuzinzile noma okufuduka kancane kungaphathwa ngempumelelo ngaphandle kokuhlinzwa. Ukulimala okukhethiwe okususiwe, okufushanisiwe, okuncishisiwe, okuvulekile, noma okungazinzile kungase kuzuze ekulungiseni ukusebenza, ikakhulukazi kubantu abadala. Ukuhlolwa ngokucophelela kwephethini yokuphuka, isimo sesikhumba kanye nemithambo yegazi, ukulimala okuhlobene, iminyaka yesiguli, izimfuno zomsebenzi, kanye nemigomo yokwelashwa kubalulekile ekuthathweni kwezinqumo okwabelwana ngazo.

Izinsiza Ezihlobene Zomkhiqizo we-XC Medico

Izikhombo Zezokwelapha

1. I-American Academy of Orthopedic Surgeons. Ukwelashwa Kwama-Clavicle Fractures: Isiqondiso Semitholampilo Esisekelwe Ebufakazini. 2022.

2. I-American Academy of Orthopedic Surgeons. Ukwelashwa Kwama-Clavicle Fractures: Isifinyezo Solimi Olulula.

3. Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. Ijenali Yokuhlinzwa Kwehlombe Nendololwane. 2002;11(5):452-456.

4. Robinson CM. Ukuphuka kwe-clavicle kumuntu omdala: i-epidemiology kanye nokuhlukaniswa. I-Journal of Bone and Joint Surgery British Volume. 1998;80(3):476-484.

5. U-Ersen A, Atalar AC, Birisik F, et al. Ukuqhathaniswa kwe-sling yengalo elula ne-figure-of-eight clavicular bandage ye-midshaft clavicular fractures: isifundo esilawulwa ngokungahleliwe. I-Bone & Joint Journal. 2015;97-B(11):1562-1565.

6. Thurston D, Jordan RW, Thangarajah T, et al. Ingabe i-distal clavicle fractures esusiwe ehlobene nemiphumela yomtholampilo ephansi elandela ukuphathwa okungasebenzi? Ukubuyekeza okuhlelekile. Ijenali Yokuhlinzwa Kwehlombe Nendololwane. 2024;33(8):1847-1857.