Fixator yangaphandle

I-OcudURON

Ukulungiswa kwangaphandle kungasetshenziselwa ukufeza 'Ukulawulwa komonakalo okwenziwe kwasendaweni Ukutheleleka kwamathambo kuyinkomba enkulu yokusetshenziswa kokulungiswa kwangaphandle. Ukulungiswa kwangaphandle kungasetshenziselwa ukulungiswa kokukhubazeka kanye nokuphathwa kwamathambo.

2 .Kusebenzisa i Ukulungiswa kwangaphandle 

2.1 Izinzuzo zokulungiswa kwangaphandle

- Ukuphazamiseka okuncane kokugeleza kwegazi kuthambo.

- Umthelela ophansi ekuqothulweni kwezicubu ezithambile.

- Ingasetshenziswa ngokushesha ezimweni eziphuthumayo.

- Ukulungiswa kwama-fractures avulekile futhi angcolisiwe.

- Ivumela ukwabiwa kabusha futhi ukulungiswa okuzinzile kokuqhekeka ngaphandle kokuhlinzwa.

- Ukuba khona komzimba omncane wangaphandle uma kwenzeka kutheleleka.

- Idinga isipiliyoni esincane nekhono lokuhlinza kunokuncishiswa okujwayelekile kwesibonelelo kanye nokulungiswa kwangaphakathi (i-ORIF).

- Ukuphathwa kwamathambo kanye nokulungiswa kobuqili kungenziwa.

2.2 izinkomba zokulungiswa kwangaphandle

2.2.1 Ukuvulwa okuvulekile

Ukulungiswa kokulungiswa kwangaphandle kungenye yezindlela zokuvinjwa kwezikhashana noma ezichazayo zokulimala okuvulekile futhi kuboniswe ikakhulukazi phambi kokulimala kwezicubu ezithambile zezicubu ezithambile. Ama-braces angaphandle alungiselelwe asiza ekuqhekekeni okunobungozi obukhulu bokutheleleka, njengokubakhona kwabakhona emtholampilo kanye / noma ukungcoliswa kwenxeba. Ukulungiswa kwangaphandle sekuyisikhathi eside bekuyindlela ewusizo kakhulu yokulimala okunjalo futhi kusabhekwa njengezinga legolide.

2.2.2 Ama-fractures avaliwe

Izinkomba zokusetshenziswa kokulungiswa kwangaphandle kokuqhekeka okuvaliwe ukukhiqizwa kwesikhashana kweziguli ezine-polyrauma ezinzima, kanye nokulimala kwezicubu ezivuthiwe noma zokulimala kwezicubu zomzimba. Kulezi zimo, ukungasebenzi kahle kwesikhashana kusetshenziswa i-Finator yangaphandle kungenziwa kude nendawo yokulimala, mhlawumbe kude nendawo yokuhlinzwa okungenzeka, ukuphatha ukulimala kwezicubu ezithambile ngenkathi kugcinwa ukulungiswa kwezicubu.

2.2.3 Ukulimala okuningi

Inqubo yokulungiswa kwangaphandle kufanele ibhekwe lapho kwenziwa ukuhlinzwa kokulawulwa komonakalo ezigulini ezinokulimala okuningi. Izinzuzo eziphambili zokulungiswa kwangaphandle zishesha ukuqina okuhlobene nokuqhekeka, zisize ukudambisa izinhlungu, ukunciphisa ukopha, futhi kunciphise i-inflamving Realcunt Syndrome kalula ukunakekelwa.

2.2.4 Ukuqhekeka kwe-Intra-Aticular

Ukulungiswa kokulungiswa kwangaphandle kuvame ukuba yisilinganiso sesikhashana esivikela isembozo esithambile esithambile ekuqhekekeni okungazinzile noma ukuqhekeka okuyinkimbinkimbi kwe-intra-articular fractures; Futhi kuyindlela yokulungiswa okuhlangene noma ukulungiswa kwe-ligament lapho ukulungiswa kwangaphakathi kwesigaba esisodwa akunakwenzeka. Wonke amajoyinti amakhulu angavinjelwa ngale ndlela, kepha imvamisa kakhulu isihlakala, edolweni, kanye ne-ankle.

2.2.5 amathambo noma izicubu ezithambile

Ezigulini ezinezicubu ezithambile ezithambile kanye nokuphazamiseka kwamathambo, amafreyimu wokulungiswa kwangaphandle angasetshenziswa ukunciphisa umlenze esigabeni esisodwa bese ebuyisela ubude bemilenze ngokuphazamiseka kwe-osteogenesis esigabeni sesibili.

2.2.6 Uhlaka lwangaphandle olusetshenziswe njengethuluzi lokusetha kabusha okungaqondile

Ngemuva kokuncishiswa kwe-fracture, lapho kufakwa ipuleti yangaphakathi noma i-intramenduundary nail, isikhundla sokuqhekeka singagcinwa ngokuvala i-Finator yangaphandle. Kwesinye isikhathi i-Finator yangaphandle ingagcinwa isikhathi esithile ukuhlinzeka ngokulungiswa okwengeziwe lapho ukulungiswa kwangaphakathi kungaqinile ngokwanele. Ama-Finators angaphandle noma iziphazamiso zabesifazane zikhonjiswe ukuba neqhaza elibalulekile ngesikhathi sokubekwa kwezipikili kwe-tibialntramentary. I-Pin ye-Schnee ihluthwe ohlangothini lwe-dorsal lwe-proximal tibial tibial invaltial nail yokungena isipikili futhi ungene ethanjeni lesithende, elinamathiselwe ngenduku ende. Lokhu kuhlinzeka nge-traction elinganiselayo esendaweni futhi futhi kuguqula ubude, ukujikeleza, kanye ne-axis yokuqhekeka ngaphambi kokufakwa kwesipikili se-intramedullary esimweni esiguquguqukayo noma esinwetshiwe.

I-Tibial intramentary neiil ukubekwa ngokubuyiselwa kwamabhasikisi kwangaphandle kwe-bracket

I-3.prinCringles yohlelo lokuhlelwa kwangaphandle lwe-Finetation Brace

3.1 izici ze-biomechanical

Beka okungenani izikhonkwane ezi-2 ngebhulokhi enkulu ye-Fracture nge-anatomic Safety Zone, ngezikhonkwane ezihlukaniswe kabanzi ngangokunokwenzeka. Uma izimo zezicubu ezithambile zivuma, izikhonkwane zokulungisa kufanele zibekwe eduze nasekupheleni kokuphela ngangokunokwenzeka, kepha akufanele zingene ekuqhekekeni ekugcineni kwe-hematoma noma endaweni ye-denigation yesikhumba. Uma kuhlelwa ukulungiswa kwangaphakathi kwangaphakathi, izikhonkwane zokulungiswa kufanele zigweme ukungezwani okuhlinzayo kanye nokufinyelela okuhlinzayo (indawo yokuhlinzwa). Izinduku zokuxhuma kufanele zibekwe eduze kwethambo ngangokunokwenzeka ukwandisa ukuqina. Ukuqina kokulungiswa kwangaphandle kuncike kulezi zinto ezilandelayo.

- Ibanga lezikhonkwane zokulungiswa kusuka ekugcineni kokuqhekeka: ukusondela kakhulu.

- Isikhala sezikhonkwane zokulungiswa ebhlokeni ngalinye le-fracture: okubanda kakhulu.

- Ibanga lezinduku zokuxhuma ezihamba phambili ezivela ethanjeni: okusondele kakhulu.

- Inani lezinduku zokuxhuma: ezimbili zinamandla kunoyedwa.

- Ukucushwa kohlaka lwangaphandle olunguhlaka (kusuka phezulu kuya emandleni aphezulu kakhulu): Indiza eyodwa / i-A-HAME / BILASE.

- Ukulungiswa kwangaphandle okuhlanganiswe nokulungiswa kwangaphakathi okulinganiselwe (izikulufo ezilinganiselwe): Akuvamile ukusetshenziswa ngoba ukuhlanganiswa kokunwebeka nokuqina okuqinile kungokwesikhashana kuphela.

- Ububanzi bezikulufo ze-schanz noma izikhonkwane ze-schnee: 6mm amandla aphindwe kabili angu-5mm.

a. Uhlaka olulodwa lwe-single-plane single-single-luxam-luxam Ibanga le-PIN kusuka ekugcineni kwe-fracture (x).

Ukusondela, okuzinzile. Ibanga lezikhonkwane ezahlukene kusuka ku-Main Fracture Block (y): Ukuqhubeka kude kakhulu.

Ukude, kuzinzile kakhulu. Ibanga le-Longitudinal exhuma izinduku ezivela ethanjeni (Z): eduze kwezinzindla.

b. I-Unilateral, i-Uniplar, i-3-Rood Combinator yangaphandle yangaphandle iyindlela ewusizo yokwakhiwa kwezicelo ezahlukahlukene, kufaka phakathi ukubuyisela kabusha.

Imodeli yezinhlobonhlobo zezicelo, kufaka phakathi amasu wokusetha kabusha.

c. I-unilateral engazimele ye-tilanarar exhumanisa nangaphandle.

d. Ukucushwa kwe-Unilateral Billne (▲ Ukucushwa).

e. Ukucushwa kwe-BIlitateral ngezikhonkwane ezingena ngaphakathi. Manje akuvamile ukusetshenziswa.

Ukulungiswa kwangaphandle okungazinzile kubambezeleka inqubo yokuphulukisa ye-Fracture, kepha kanjalo nohlaka oluqinile lwangaphandle.

Kwesinye isikhathi kuyadingeka ukwenza kwashukumisa ukulungiswa okuzinzile futhi kwandise umthwalo ngokuthwala ngokwengxenye noma okuphelele kwesisindo kanye / noma ukuguqula ukucushwa kohlaka lwangaphandle.

3.2 Amasu wokubekwa wenaliti olungiselelwe

- Zijwayeze nge-anatomy ukugwema ukulimala ezinhlwini, imithambo yegazi kanye nama-tendon.

- Ungavumeli izikhonkwane ezilungiselelwe noma izikulufo ukufaka okuhlanganisiwe.

- Gwema ama-Fracture Ends kanye neHematomas.

- Gwema izindawo zokuphikisana noma ukungqubuzana kwesikhumba.

- Pre-Drill the bone cortex ukugwema ukulimala okushisayo (okuholela ku-ring necrosis).

- Izikhonkwane zokulungiswa kufanele zibe nobude obufanele ukwakha uhlaka olufanele.

3.2.1 Umsinga wangemuva

I-Sharper i-drill noma i-PIN yokulungisa, ukushisa okuncane kuzokhiqizwa. Ngokushesha isikulufa, izinga lokushisa lizovuka. Ukulimala okushisayo ku-bone kuyinto ebaluleke kakhulu njengoba lokhu kungaholela ekwakhekeni kwethambo elifile elibekiwe, elingadala ukukhululeka kwangaphambi kwesikhathi kanye / noma ukutheleleka. Izikhonkwane ezifakwe kahle zibekwe kahle kufanele zibambe kahle kuwo womabili ama-cortices, ngenkathi ithiphu kungafanele ingene kude kakhulu.

3.2.2 Diaphysis

Ku-epiphysis, ukukhiqizwa kokushisa akuyona inkinga. Kungaba iphephe ukusebenzisa izikulufo ezizidakayo njengamanje, ngoba kulula ukuphuthelwa izimbobo ezivuthwe ngaphambi kwesikhathi lapho zisika izikulufa. Ukungeniswa kwe-PIN kokuhlelwa kokuhlanganiswa kufanele kugwenywe njengoba kunengozi yenalivu yenaliti yokutheleleka ngegciwane ekuhlanganiseni.

3.2.3 Izindawo Zokuphepha

Ukugwema ukulimala ezinhlizweni, imithambo yegazi, ama-tendon, nemisipha, udokotela ohlinzayo kufanele ajwayele i-anatomy ye-limb kuzo zonke izigaba zesiphambano futhi asebenzise indawo yokuphepha yokubekwa kwezikhonkwane.

Umdwebo 3.3.3-2-2 Indawo ephephile yokubekwa kwe-PIN yangaphandle.

i-femur.

Umdwebo 3.3.3-2 (Iyaqhubeka)

B Tibia.

Umdwebo 3.3.3-2 (Iyaqhubeka)

C Humerus, umbono wangemuva.

Lapho isetshenziswa endizeni eyodwa, akudingekile ukushayela isikulufa se-schanz ku-anterior tibial crest. I-anterior tibial crest inethambo eliqinile le-cortical kanye nokushayela kuzokhiqiza ukushisa ngokweqile, okungadala i-osteonecrosis yesibili. E-Distal Tibia, kunengozi yokulimaza i-anterior Tibialis tendon kanye nemisipha ye-digitorum esolile.

4. Izakhi

I-4.1 tube-rod system

4.1.1 Izikulufo zeSchanz 

Izikulufo zeSchanz ziyingxenye ye-Finetation Pins. Zitholakala kumadayimane ahlukene, ubude (ubude bendabuko, ubude bentambo) namathiphu ahlukile. Ithiphu ye-Standard Schanz Screw iyithiphu enziwe nge-trocrar (Fig. 3.3.3-3A) futhi imvamisa idinga ukumba kwangaphambili.

Umdwebo 3.3.3-3-3 Schanz ngezikulufo.

Ithiphu elijwayelekile le-PIN enomumo.

B Ukuzibamba Ithiphu.

Izikhonkwane zokuzishayela nokuzishaya zinethiphu elikhethekile elibukhali elingashayela futhi linqume imicu ngasikhathi sinye lapho siklwebelwe. Zenzelwe ukusetshenziswa ku-Metaphysis (Fig. 333-3b).

Izikulufo zeSchanz zitholakala ngensimbi, i-titanium noma i-hydroxyapapatite ehlanganisiwe. Izikhonkwane ezihlanganisiwe ze-Hydroxyapapatite zingafinyelela ukubamba okuhle ethanjeni, zivumele i-Ingrowth yamathambo okuqala futhi zigweme ukukhulula. Lolu hlobo lwe-PIN lulungele iziguli ezinokulungiswa kwangaphandle zisendaweni isikhathi eside.

4.1.2 Izikhonkwane zeSteiner

Izikhonkwane ze-Steiner zivame ukusetshenziswa njengezikhonkwane zokulungiswa ezingena emathanjeni. Izeluleko zabo zisesimweni semikhono yokumba futhi zidinga ukudonswa kwangaphambili ethanjeni le-cortical ngaphambi kokufakwa.

4.1.3 Amashubhu / izinduku

Kuya ngokucaciswa kwamashubhu / izinduku, kunamamodeli ama-4 ahlukene:

• Okukhulu: I-11 mm tube / induku, ama-schanz screws angu-4 ~ 6 mm.

• Iphakathi: 8 mm tube / induku, ama-schanz screws yi-3 ~ 6 mm.

• Okuncane: 4 mm ishubhu / induku, schanz screws 1.8 kuye ku-4 mm.

• I-Mini: 2 MM uhlelo lweminwe, umklamo ojwayelekile, nge-clamp ye-multi-pin yokulungisa izintambo ze-K-MM.

Amamojula alolu hlelo anezelwa ngezinduku ezakhiwe ngaphambili, ezigobile zekhabhoni. Ukuze uthole izingosi ezinzima zokulungiswa njengezihlangothini, amamojula we-T-Joint ayatholakala.

4.1.4 Ama-Clamps

Ama-Clamps asetshenziselwa ukuxhuma ishubhu / induku kanye nezikhonkwane zokulungiswa. Amashubhu / izinduku angaxhunywa futhi komunye nomunye ngesigaxa esifanele (ishubhu le-tube).

Umdwebo 3.3.3-5 ama-Clamps

Isigaxa esizikhiyiwe sokuxhuma izikulufa zeSchanz namashubhu / izinduku.

b inhlanganisela ye-clamp yokuxhuma izinduku ezimbili noma amashubhu.

C I-Universal Mult-Pin Clamp.

D I-Cube-Tube Clamp yokuxhuma amashubhu amabili.

4.2 Izinhlelo zokulungiswa kwangaphandle zangaphandle

I-Fracture Block ingalawulwa ngama-clamp aphiniwe kabili noma ama-clamp enziwe ngokwezifiso. Ingxenye ephakathi nendawo enganamathiselwa ekuphazamisekeni noma ekucindezelweni ukuze ithole amathambo kanye / noma ukuthuthwa kwamathambo.

Uhlelo lokulungiswa kwangaphandle olungapheli lwangaphandle lokuhamba kwamathambo

4.3 Kuhlanganiswe ukulungiswa kwangaphandle kwangaphandle

Ukulungiswa kwangaphandle okuhlanganisiwe kusetshenziselwa ukuqhekeka okusondelene nokuhlangana futhi kudinga i-KIRSchner Pin ye-Kirschner yokulungiswa kwendandatho kanye nesikulufa esijwayelekile se-schanz yedayi. Indandatho eyi-3/4 esondelanayo ivame ukusetshenziswa. Izindandatho zendandatho yokuhlanganiswa zisetshenziselwa ikakhulukazi i-proximal ne-distal tibia.

Kuhlanganiswe i-brace yangaphandle yokulungiswa kwangaphandle yeTibial Plateau fractures. Ingase futhi isetshenziselwe ukuphahlakala kwe-periaraarticular kwe-dibia distal. Isakhiwo esakhiwe nge-V sinikeza ama-Edics aqinile wokuqina

4.4 I-Brace Engalingani Yangaphandle Yokulungiswa Kwangaphandle

Inzuzo yohlelo lokuguqulwa kwangaphandle okuphelele ukuthi i-axis ye-axis yokuthwala umthwalo kanye ne-axis yama-orthopedic idlula enkabeni yohlelo lokulungiswa lwangaphandle kanye ne-eksisi ende yethambo. Uhlelo lwe-Diactal Finator lwangaphandle lungasetshenziselwa ukwandisa ithambo, ukuphatha amathambo, kanye nokwelashwa kweziqhekezi ezilula neziyinkimbinkimbi.

I-tibial ring yangaphandle fixeration brace

Izithombe Zomtholampilo Zohlelo Lokulungiswa Kwangaphandle Kwangaphandle Kwe-Tibial

Ukusetshenziswa kwale ndlela kuvumela ukuthwala isisindo kusenesikhathi. Okwenziwa okusha, sikhetha ifreyimu elula yokulungiswa yangaphandle yokwelashwa. Ukuphathwa kwamathambo nokunwebeka kungaphathwa ngokufanayo ngohlelo lokulungiswa kwangaphandle olungaphandle, kepha kungaba nzima ukwenza ukulungiswa okuyinkimbinkimbi, okuqinile, okuhlukahlukene, okunconywayo okujikelezayo kwangaphandle. Lapho isetshenziswa njengokulungiswa kwangaphandle, i-diactal yangaphandle ye-Accitcerial inikeza ukuqina okuhlobene. Lapho inaliti idluliswa ngezindiza ezahlukahlukene zokulungiswa kwe-multiplanar, lesi sakhiwo sinikeza ngezinga eliphakeme lokuqina. Amandla wesakhiwo ayahlukahluka ngokuya ngokucushwa kokulungiswa, inani lezindandatho ezisetshenzisiwe, kanye nohlobo lwezikhonkwane ezisetshenzisiwe, njengezikhonkwane ze-kirschner noma izikulufa ze-schanz. Ngokuya ngomhlangano, ukwaphuka kungatholwa noma kucindezelwe, futhi ubuthi bungalungiswa. Ama-Finators angaphandle endandatho ajwayele ukusetshenziselwa ukuphazamiseka kwe-osteogeneis ukuze alungise amaphutha amathambo, ukufinyeza kanye nokukhubazeka.

4.5 Hinged Foxtation Brace yangaphandle

Kusetshenziselwa ukulondolozwa kokuphindwaphindwa kwamalunga ahlukaniswe noma ukwakhiwa kwamahlaya nokuvumela ukunyakaza okuthile (okulawulwayo) ukunyakaza okuhlangene ukuvimbela ukuqina okuhlanganyelwe. Isetshenziswa kakhulu ngokuhlanganiswa kwe-elbow.

Ukwakhiwa kwezinhlaka ezi-5 ze-Precival Finetation braces

5.1 i-nomenclature yezinhlaka zozimele

Kunezindlela ezahlukahlukene zokuhlukanisa izakhiwo zozimele, ngokusekelwe ikakhulu ku:

- Umsebenzi.

- Idizayini yohlaka.

- Indiza yesicelo.

- Inhlanganisela.

5.1.1 ozimele abangavumi

Uhlaka lwe-Unilateral luyindlela esetshenziswa kakhulu yeFuda Frame Frame yezokwelapha ama-diaphyseal fractures amasha. Uhlaka lusetshenziswa endizeni eyodwa, isib. I-anteremedial noma i-medial kuya eTibia kanye ne-anterolantal noma i-anderal to femur. Izikhonkwane zokulungiswa zifakwa esikhunjeni ohlangothini olulodwa futhi zingena kwi-cortex ephindwe kabili. I-PIN kufanele ibekwe kude nokuhlanganiswa, ngaphandle kwengxenye ekhethiwe ye-capsule ehlanganisiwe, ukugwema i-Sepsis ehlanganyelwe. Izinduku ezimbili zifakwa endizeni efanayo noma ngezindiza ezimbili ezahlukene bese zihlanganiswa.

5.1.2 ozimele be-BIlateral

I-Szczecin Pin idluliswa esikhunjeni ngakolunye uhlangothi, ingena kwi-bilaminar cortex, bese idluliswa esikhunjeni ngakolunye uhlangothi. Amafreyimu e-BIlateral awanconywa ekwelashweni okuchazayo kokuqhekeka, kepha kungahle kusetshenziselwe ukulungiswa kwesikhashana.

I-5.1.3 yeqa amafreyimu wokulungiswa kwangaphandle

Kusetshenziswe ezinkulwini zokulawula ukulimala ezindaweni ezihamba ngezindawo ezinokulimala kwezicubu ezithambile noma ukuqhekeka okuyinkimbinkimbi kwe-intra-articular fractures kanye nokukhishwa kwe-fracture.

▲ Fractures Fractures, Ama-Proximal Femur Fractures, kanye ne-Proximal Tibia Fractures ayengasebenzi kusetshenziswa izikejana zokulungisa zangaphandle zangaphandle kulo lonke amalunga amadolo nama-ankle.

Ukuqina okunikezwe yifreyimu yokulungiswa kwangaphandle kuvumela ukululama kwezicubu ezithambile kanye nokuskena kwe-CT kanye nokuhlelwa kwabasebenzi. Amafreyimu e-Unilateral asetshenziswa kakhulu, futhi izikhonkwane zokulungisa kufanele zibekwe ngaphandle kwendawo yokulimala kanye nokusebenza okuzayo kokuhlinzwa okuchazayo.

5.1.4 ozimele ezengeziwe

I-Iliving yethula le ndlela ngohlaka lokulungiswa kwangaphandle olungaphandle. Amafreyimu wokulungiswa kwangaphandle kwe-tubular kanye namafreyimu wokulungiswa kwangaphandle angaphandle angasetshenziswa ukufaka lesi simiso sokutholwa kancane, nobubi bokuhlungwa kwazo zombili lezi zinto eziguqukayo akunakwenziwa ngasikhathi sinye ngaphandle kokuthi kwandiswe kwenziwa nge-intrametullary

5.2 Amasu wokuphakamisa amaphethini

Ithuba lefreyimu yokulungiswa kwangaphandle ehlanganisiwe ukuthi ivumela ukuncishiswa, ukubopha kanye nokulungiswa kwawo wonke amathambo amade, izindawo eziseduze nokuhlangana, kanye nokuhlangana uqobo (iTransarticular).

Ukubekwa kwezikulufo ze-Schanz kungaba yinkululeko, ukuvumela ukukhetha kwendawo efanelekile yokulungiswa kwe-anatomic ngezikulufo ze-schanz noma indawo efanelekile yokulungiswa ngokuya ngohlobo lokuqhekeka nokulimala kwezicubu ezithambile. Ukuncishiswa kwezingcezu ezinkulu ze-fracture kungenziwa ngamasu okunciphisa kanye nokuncishiswa okungaqondile, ngenkathi kulondolozwa igazi ligeleza ligelezele amathambo nezicubu ezithambile. Ukusetshenziswa kwale ndlela kuvumela ukulungiswa kokuncishiswa kokuqhekeka nganoma yisiphi isikhathi.

Inqubo ehlanganisiwe yokunciphisa.

uhlobo lwe-b tbial stem fracture.

b kwibhlokhi ngayinye enkulu ye-Fracture, izikhonkwane ezi-2 zokulungisa zikhonjisiwe ngaphandle kwendawo yokulimala.

Izikhonkwane zokulungiswa kwe-C zivikelekile kwizinduku zokuxhuma ezinama-reffals ama-reffal

D Ngemuva kokukhishwa kwe-Fracture, i-3 Connecting Rood enamathiselwe kwizinduku zokuqala ezi-2 zokuxhuma nge-clampion yeshubhu.

▲ Ukuboniswa kwe-brace yokulungiswa yangaphandle ehlanganisiwe. i-tibia. b femur. c i-trans-knee.

Izicelo ezi-6 ezikhethekile

6.1 Ukuhlanganiswa okuhlangene

Ukusetshenziswa okukhethekile kokulungiswa kwangaphandle kuyinto ehlanganisiwe yamalunga ngokucindezela ngama-filateral angaphandle Filators. Lesi simiso kwesinye isikhathi sisetshenziselwa ukuhlanganiswa kwe-ankle, edolweni, kanye namalunga akwa-elbow, ikakhulukazi phambi kokutheleleka.

6.2 Ukutheleleka

Ukulungiswa kwangaphandle ukwelashwa okuphezulu kokutheleleka ngokweqile noma ukungenwa yileli gciwane lokuqhekeka, njengoba izikhonkwane zokulungiswa zivame ukubekwa kude nendawo yokutheleleka.

6.3 Ukulungiswa kwe-Osteotomy

Ama-Osteotomies okulungiswa kwezimo lapho izimo ezithambile zezicubu ezithambile zimpofu noma zikhubazekile futhi ubungozi bokusebenzisa ukulungiswa kwangaphakathi buphezulu, lapho kubakaki bendawo yangaphandle kungasetshenziselwa ukulungiswa. Okunye okukhonjiswa yi-osteotomy ngokuphathwa kwamathambo ngasikhathi sinye. Lokhu kuvame ukudinga ukulungiswa ngohlaka lokulungiswa kwangaphandle olukuyo.

6.4 I-Bone Handleng - Iziphazamiso ze-Osteogenesis

Ukuphazamiseka kwamathambo kususelwa kunqubomgomo ka-Ikhodi ye-Periosteum yokulondolozwa kwe-periosteum ukuze ithambo elihlukaniswe ngokucophelela lingaphazanyiswa kancane (0.5-1 mm / d), nethambo elisha lakhiwa kuleli gebe. Amanani ahamba kancane okuphulukiswa kwamathambo, kanti amanani asheshayo okuphazamiseka adlula ukubekezelelana kwezicubu ngaphandle kokuthola ukwakheka kwamathambo. Kuphethe noma ukuphazamiseka kwamathambo amathambo, afana nalawo aqhekeki, nawo adlula kuzo zonke izigaba zokuvuthwa kwe-scab kuze kube yilapho ukuphulukiswa kwe-bony kwenzeka. Kunezimpawu ezi-3 zokusebenzisa le ndlela, futhi kwesinye isikhathi lezi zinkomba zingahle zihlangane:

- I-LEMB eyandisa.

- I-Segmental Bone Hearnge ukuphatha amathambo.

- Ukulungiswa kwe-OSTEOTOMY.

Amafreyimu wokulungiswa afanele kakhulu ngale njongo yihlaka lokulungiswa kwangaphandle okujikelezayo (nge noma ngaphandle kohlaka lokulungiswa kwangaphandle olungaphandle) nohlaka lwangaphandle olungaphandle.

6.5 Ukubuyiselwa okuhlanganyelwe kanye nokunyakaza okuqhubekayo

I-fixilator eyayinama-hinged yangaphandle iyindlela ebalulekile ekwakhiweni okuyinkimbinkimbi ukulimala okungazinzile okungazinzile, kufaka phakathi ukwakheka okungamahlalakhona noma okungaxazululiwe kulandela ukubuyiselwa kwe-incinas. Umuzwa wangaphandle onamawele ugcina ukusetha kabusha kwe-elbow ngokuhlanganisa okulawulwayo. Ukulondolozwa kokuphindisela kuyinto ebaluleke kakhulu kuqala. Ukungazinzi kunzima ukuphatha kakhulu kunokulahlekelwa ukunyakaza. I-axis idinga ukubekwa kahle ngaphansi kwe-fluoroscopy. Ukuphambuka okuncane esikhundleni se-hinge kungathinta kakhulu ukusebenza kwawo.

▲ Ukubekwa kokulungile kwangaphandle okuhlangenwe nakho kwe-elbow.

7 Ukwelashwa Ngezenzo 7

7.1 Pin tract traction

Ukusabela kwe-Pin Tract kuncike esimweni nasekuqineni kwe-PIN yokulungiswa, ukwelashwa okuphathelene neqembu labahlengikazi kanye nesiguli. Icebo lokunciphisa elihlanganisiwe linenzuzo enkulu ngoba livumela ukukhethwa kwesikhundla esihle kakhulu se-anatomical se-PIN yokulungiswa ngohlobo lokuqhekeka. Isibhedlela kufanele sibe nenqubo yokunakekelwa kwe-Pine Tract Tract, kanye nabahlengikazi abanolwazi kufanele bafundise iziguli ukuthi zenze ukunakekelwa kwe-PIN THE CONTERY yedwa. Ngokugwema ukulimala okushisayo kanye nokwakheka kwe-hematoma yendawo ngesikhathi sokufakwa kwe-pin, futhi kusetshenziswa ama-alcohol disinfectants ukuhlanza isiza se-PIN ngokucophelela okulandelayo, nokusebenzisa ukugqoka kwengcindezi evaliwe, ukutheleleka kanye nokukhuphuka kwe-PIN kungancishiswa kakhulu.

7.2 Ukutheleleka Okuphonyisiwe 

Ukunakekelwa kwe-Pin Tract kumele kuqala kube nokufakwa kwe-PIN olungile. Ngezikulufo ezijwayelekile ze-Schanz, ukumba kwangaphambili kuvame ukudingeka futhi i-PIN yenziwe ngesandla ukuze inciphise i-necrosis eshisayo. Ukungezwani kwezicubu ezithambile ezingafanele ezizungeze iPIN kufanele kukhishwe ngesikhathi sokuhlinzwa. Ukunakekelwa okufanele kwepheshana le-PIN kubalulekile ukunciphisa ukwehla kwengxabano ye-PIN Tract. Ukutheleleka kwe-pin tract kanye nesikulufu sokulunga kungaxazululwa ngokususa iPIN evulekile futhi kusheshise iphinikhodi kwenye indawo.

7.3 Ukuhlanganisa

Ngaphandle kwamacala akhethekile ambalwa (ukukhiqizwa kokubopha, ukusetshenziswa okuphuthumayo, ukulungiswa kwengxabano), ukuthwala kwesisindo okuyingxenye kuvunyelwe ekuqaleni kokulungiswa kwangaphandle. Njengoba ukuphulukiswa kuqhubeka, ukuthwala okugcwele kwesisindo kungakhuphuka kancane kancane. Asikho isidingo sokwengeza amadivaysi angeziwe ashukumisayo ku-Finator yangaphandle. Ukuthwala kwesisindo okuyingxenye noma okugcwele kuyindlela engcono kakhulu futhi ephumelela kakhulu yokushintshana.

8 Isikhathi sokulungiswa kwangaphandle

8.1 Ukushintshwa kokwelashwa

Kunezinketho ezi-3 eziyisisekelo zokwelashwa:

• Sebenzisa i-Finator yangaphandle njengokwelashwa okuchazayo kuze kube yilapho ukwaphuka kokwelapha.

• Ukuguqulwa kusenesikhathi ekuhlelweni kwangaphakathi.

• Shintshela ekuphumeni kokungapheli, njengodaka, orthosis, njll.

Uma ukuguqulwa kokuhlelwa kwangaphakathi kulindeleke, kufanele kwenziwe kusenesikhathi ngangokunokwenzeka (kungakapheli amasonto ama-2) ngoba izinga lezinkinga liphansi kakhulu kunaleso sokuguqulwa sekwedlule isikhathi.

Imithetho elandelayo kufanele ilandelwe lapho uhlela noma yikuphi ukuhlinzwa ngaphambi, ngesikhathi, noma ngemuva kokulungiswa kwesikhashana:

• Uma ukufakwa okusha kufakwa endaweni yokuqala yokulungiswa kwangaphandle, wonke amapheshana we-PIN kumele ahlanzeke. Kwesinye isikhathi inqubo yenziwa ngezigaba ezimbili, ngesigaba esisodwa sokuhlanza ipheshana lesibili lesibili kanye nesigaba sesibili ukwenza ukulungiswa okuchazayo.

• Noma iyiphi isayithi le-PIN TRACT CAINTER ngaphezu kwezinsuku eziyi-10 kuye kwezingu-14 libhekwa njengecolizwe futhi kufanele lihlanzwe futhi lihlanzeke ngaphambi kokulungiswa okuqondile.

• Uma kukhona ukungabaza mayelana nalezi zindawo ezingama-PIn tract noma ipheshana le-PIN selivele lithelelekile, okungenani izinsuku eziyi-10 ezidingekayo ngemuva kokufakwa okusha kwe-PIN ngaphambi kokufakwa okusha.

• Ama-antibiotics kumele asetshenziswe prophylactically nge-antimicrobial spectrum ehlanganisa amagciwane avela ekuthelelekeni kwamapheshana e-pin edlule.

• Vala ukulandela amasonto okuqala ayi-6 ngemuva kokubuyiselwa kokulungiswa kwangaphakathi.

Uma kunobufakazi benkinga ngepheshana le-PIN, kungcono ukukhomba izinhlobo zegciwane, faka ama-antibiotic, shintsha iphini bese uliguqula, bese uqhubeka nokwelashwa ngocingo lwangaphandle. Ukunakekelwa kwe-Pin Tract kufanele kuhilele isiguli ukuqinisekisa imiphumela efanele. Uma i-Finator yangaphandle kufanele ifakwe esikhundleni sokulungiswa kwangaphakathi esiteji sekwephuzile, kunconywa ukuthi kube nenkathi ye- 'PIN yokuphumula Ama-antibiotic angasetshenziswa ngendlela efanele ngalesi sikhathi.

8.2 Ukulungiswa kokugcina

Ukulungiswa kwangaphandle okuphuthumayo kungafinyelela ukuqina kwesikhashana kwe-limb futhi kuvume ukuvuselelwa kwezicubu ezithambile. Uma nje izimo ezithambile zezicubu eziqinile zizinzile, i-Finator yangaphandle ingashintshwa ngokulungiswa kwangaphakathi kokugcina. Ngokufanelekile, kufanele ithathelwe indawo ngokulungiswa kwangaphakathi kungakapheli izinsuku eziyi-10.

Uma ukulungiswa kwangaphandle kusezinzile futhi azikho izimpawu zezinkinga, ukulungiswa kwezimali akudingekile. Uma ukumbozwa kwesikhumba kumpofu, noma kukhona ukukhathazeka ngomonakalo omkhulu wezicubu ezithambile kanye nengozi yokutheleleka kusuka ekunciphiseni okuvulekile kuphezulu, i-fixilal yangaphandle ingagcinwa njengokwelashwa kokugcina kokuphuka.

Intuthuko yokwelapha kwe-fracture kumele ibonwe ngokucophelela, futhi uma kungekho nqubekela phambili, ezinye izindlela zokwelapha kufanele zibhekwe.