Ukukhiya Imikhawulo Yezinsiza Zokusebenza Nemikhawulo

Ukusetshenziswa kwe Ukukhiya amapuleti kukhuliswe kakhulu ubukhulu bokusetshenziswa kokulungiswa kwangaphakathi kwama-fractures. Kodwa-ke, ukusetshenziswa kwazo kumele kuqondiswe futhi kwenziwe kahle ngenxa yezingibe nezingqinamba ezingaba khona. Kulesi sihloko, sizobheka ukucatshangelwa kohlelo lokusebenza, izinselelo zokususa, kanye nokulinganiselwa, izici ezi-3 zohlelo lokusebenza lokukhiya ipuleti.

01.Kungaphawulwa izici ezikhethekile nobunzima yini ekusebenziseni amapuleti okukhiya?

Izinyathelo nezinselelo ekwehliseni ukuphuna kwamapuleti okukhiya

Izinyathelo zokusetha kabusha ukwaphuka zilinganiswa. Ukukhiya amapuleti awasetha kabusha ama-fractures. 

Lapho sekwebekwe engxenyeni yamathambo, engeza izikulufo eziningi ngeke zikuhambise. Uma ipuleti lokukhiya elamukela kuphela izinzipho ezivaliwe, 

Lokhu kusho ukuthi ipuleti lingakhiywa kuphela ngemuva kokuthi ukuqhekeka sekusethiwe.

Njengoba ukukhiya amapuleti kuvumela ukuphulukiswa kwamathambo ngaphandle kokulahleka kokuphindisela kokuqala, 

Imbangela eyinhloko ye-malonion yamapuleti okukhiya ayilungile ukuyiphindaphinda. 

Futhi, ukubuyiselwa okumpofu ngenxa yemishini enganele kungaholela ekuphulukeni okungalungile njenge-bone Plate ngenxa yokuphulukiswa okubambezelekile noma ukungathembeki.

Ukuphindisela ngaphandle kokusebenzisa amapuleti okukhiya kunzima ikakhulukazi lapho wenza ngokuhlasela okuncane

 Izinqubo ngoba ukubonakaliswa kwamathambo kukhawulelwe kakhulu. Kudinga izinqubo ezahlukahlukene zokuphonsa (amatafula okuphonsa, ama-retractors),

 Amandla ahlukahlukene okuphindisela okuhlotshisayo, kanye nezikhonkwane ze-kirschner ukukhwabanisa izingcezwana zamathambo nokulungiswa kwesikhashana. 

Ngaphambi kokusetshenziswa kwamapuleti okukhiya kanye nokukhiya izipikili, kubalulekile ukubheka ukusetha kabusha nge-fluoroscopy.

Ngakolunye uhlangothi, lapho usebenzisa ipuleti lokukhiya futhi elinezimbobo ezijwayelekile zesikulufa, 

Isikulufa esijwayelekile sokuhamba singafakwa kwizimbobo ezijwayelekile zokuphakamisa kuqala epuletini.

 Izicucu zamathambo zibekwa epuletini. Uma ipuleti livumelana ne-anatomy, lingasetshenziswa njengesiqondisi se-Reset. 

Ukuvala izinzipho kuqinisekisa imiphumela ezinzile ngaphandle kokushintsha ukusetha kabusha kokuqala. Le oda lokufakwa (izikulufa ezijwayelekile, bese uvala izikulufo) kubalulekile (Umdwebo 4).

Umdwebo 4 Okokuqala faka izikulufa ezijwayelekile bese uziqinisa.

Ukuntuleka kwempendulo ye-tactile lapho kuqinisa izikhonkwane zokukhiya

Ayikho impendulo enobuhlakani lapho iqinisa izikulufo ezikhiyiwe zekhanda. Empeleni, 

Ukuqiniswa kwezipikili ezikhiya kwenzeka ngasikhathi sinye ethanjeni le-cortical noma elikhanyiselwe kanye nensimbi yepuleti lokukhiya. Ngokwalesi sizathu,

 Kulula ukuthi udokotela acabange ngephutha ukuthi isikhonkwane sokukhiya sibambe kahle ethango le-cortical noma elikhansulayo (Umdwebo 3).

I-Fig. 3 ubude bokusebenza kwezikulufo ezikhiyayo ezisuselwa kuhlobo lwamathambo nenombolo yama-cortices.

Izikulufo Zokukhiya Ukuzikhipha

Ukusetshenziswa kwezikulufo zokukhiya ngokuzithandela kusho ukuthi akukho mpendulo enobuhlakani ngesikhathi sokumba noma ukuqina njengoba kwenzeka ngasikhathi sinye.

Izakhiwo zazo zemishini zifana nalezo zesikulufo esikhiyiwe esisodwa se-cortex ngesikhathi se-cortex. Uma zinde kakhulu, 

Bazoxhumana ne-cortex yesibili engahlukaniswanga, okuholela ekumisweni okungalungile kwesipikili sokukhiya epuletini lokukhiya.

Ngezinhlelo zokusebenza ze-bicortical, zingahle zibe mfushane kakhulu, zibenze zilinganise ngomshini nezinzipho ezikhiyiwe ze-single-cortical. 

Uma zinde kakhulu, zizokwanda ngaphesheya kwe-cortex futhi zingalimaza izakhiwo ezibucayi ngakolunye uhlangothi lwepuleti.

Ubude bezipikili abakhethiweyo bakwazi ukutholakala kuphela ngokulinganisa ubude obufunayo ngemuva kokumba noma ukuqinisekisa nge-fluoroscopy.

Izici zezikulufo ezikhiyiwe ezi-Uniaxial

Ububi obukhulu bezipikili zokukhiya ezi-Uniaxial ukuthi ukuqondiswa kwazo kunqunywe kusengaphambili. 

Bangaba nesinye isiqu esifakiwe noma esifakayo esendleleni yabo, okwenza ukufakwa kungenzeki noma bakuvikele ekuhlelweni okungafani.

Amapuleti okukhiya anatomical asetshenziswe emaphethelweni anezipikili ezikhiyiwe ezi-UniXial ezinomoya ohleliwe, 

Kwenzelwe izizathu ze-anatomical ne-biomechanical, kunengozi yokubekwa kwezipikili kwe-intra-arvicular ukukhiya. 

Isibonelo esijwayelekile ukwaphuka kwe-distal radius. Le ngozi ikhulu ngokwengeziwe lapho ipuleti lokukhiya lisondele kakhulu ekuhlanganiseni noma lapho i-anatomy ingenasisekelo. 

Ukungabikho kokuqhekeka kwe-Intra-articular kumele kuqinisekiswe yi-fluoroscopy.

I-MIPO Technologies

Isu elihlaselayo le-percutaneous osteosynthesis (MiPo) libandakanya i-Subcutaneous kanye / noma ngaphansi 

kanye nokufakwa kwangaphandle kwepuleti yethambo ngokuvula okuncane ungene ethanjeni ngemuva kokuslayida, ngaphandle kokudalula

 isayithi lokuphuka. Lokhu kuvumela ukungezwani okuncane, ukuhlinza okusayithi okuvinjelwe okuncane, futhi kwenza inqubo ibe khona 'biologic '

 Ngoba asikho isidingo sokudalula isiqephu sethambo ngalinye futhi akukho ukuphazamiseka kwezicubu ezithambile, i-periosteal vasculalization, noma i-flacture hematoma.

Kungafezwa ngepuleti lokukhiya kanye nensimbi eyenzelwe ngokukhethekile evumela ipuleti 

Ukukhokhwa futhi kudlule esikhunjeni ukuze uthole kalula izimbobo zezipikili ezikhiyiwe epuletini. 

Izithombe ze-Fluoroscopic kumele zithathwe esinyathelweni ngasinye ukuze ziqinisekise inqubekela phambili. Isinyathelo ngasinye sale ndlela siyinselelo. Inselelo yokuqala ukusetha kabusha ukwaphuka ngaphambi kokulungiswa.

 Ipuleti lokukhiya kufanele ligxile kahle kanye nobude bethambo, ngaphandle kwalokho ukuhambisana kwepuleti lokukhiya kuzoba yi-asymmetric (Umdwebo 5). Ngaphezu kwalokho, 

Ipuleti lokukhiya kumele lifane ngokuphelele ku-cortex yethambo lenzelwe ukulandela futhi eduze kwethambo njengoba 

kungenzeka ngaphandle kokunciphisa kakhulu ukuqina kwesakhiwo. Ngesikhathi sesinyathelo sokugcina sokukhiya, kunzima ukuqinisekisa lokho

 I-secreits of izikulufo ihambelana kahle epuletini lokukhiya nokuthi izipikili ezikhiyayo zibandakanyeke kahle ngesikhathi sokuqina.

Umdwebo 5 Ukuma kwe-eccentric kwepuleti lokukhiya kanye nokuntuleka kwempendulo ye-haptic ngesikhathi sokuqina kwesikhashana.

Ukulimala kwesikhumba okungenzeka lapho usebenzisa amapuleti okukhiya ama-ankle angaphandle

Ukusetshenziswa kwamapuleti okukhiya ukulungisa ama-ankle wangaphandle ahlanganiswe namanani aphezulu angajwayelekile we-necrosis yesikhumba. 

Ubukhulu balawa mapuleti okukhiya okufingqiwe bubeka ingcindezi esikhunjeni futhi baphazamise ukusabalalisa kwalo kwemithambo nokuphulukiswa. 

Kwenzeka into efanayo lapho kukhiya amapuleti okukhiya ama-hawksbill ukuphazamiseka.

Ingozi ye-Osteoporosis kanye nokukhishwa kwesikulufa

Ethanjeni le-osteoporotic, izinzipho ezikhiya izinzipho zisiza ukunciphisa ubungozi bokudonsa noma ukuhoxiswa. 

Ukwakhiwa akukuhle ngokwanele ngenxa ye-cortex yethambo elincanyana kanye nobude obuncishisiwe be-trabeculae.

Kulokhu, ukukhiya ukulungiswa kwepuleti kuhlala kunamandla futhi kuhlolwe kangcono lapho usebenzisa i-evanescent noma ukuguqulwa kwe-monolithic commolithic (Umdwebo 3).

Isifinyezo:

1

2. Ukuphuka kufanele kusethwe kabusha ngaphambi kokungeza isikulufa sokukhiya.

3 Indlela ye-MIPO ifuna kakhulu.

02. Izinselelo zokususa amapuleti okukhiya

Ukususa ipuleti lokukhiya uma ukwaphuka kuphulukise kuyinselele futhi kungalindeleki, 

Kepha isimo singaxazululwa. Inselelo enkulu kunazo zonke ikhulula isikulufa sokukhiya.

Kwezinye izimo, imicu ekhanda lesipikili elivaliwe ilimele ngesikhathi sokufakwa 

(Ukuqiniseka okuningi nokukhulula, iphethini yesikulufa isolisiwe futhi hhayi ngokuphelele i-hexagonal, ukufakwa kwesikulufa kwenziwa nge-drill yamandla), 

okusho ukuthi akunakugwenywa. Ngakho-ke, kungcono ukuvikela le nkinga ngokuthatha indawo ngokushesha noma yisiphi isikulufa nge 

Iphethini yenhloko elonakalisiwe ngesikhathi sokufakwa, usebenzisa i-screwdriver ephelele futhi uqinisa ngokuphelele isikulufa ngesandla (hhayi nge-drill kagesi).

 Kusetshenziswa izikulufa ezenziwe ngezinto ezinamandla zingasiza ukunciphisa le nkinga.

Ezimweni eziningi, kukhona ukukhiya okwenziwe ngomshini noma okuhlangene phakathi kwemicu yezipikili yokukhiya kanye nomgodi ofakwe intambo epuletini lokukhiya. 

Lokhu kuvame ukubonwa kakhulu nge-3.5mm ububanzi be-titanium hex iphethini eyodwa yokukhiya shaft. Ayikho indlela eyodwa

 ukuphazamiseka. Izikulufa zivame ukuqiniswa ngokweqile ngenxa yokwehluleka ukusebenzisa i-torque wrench enikezwe ekhingweni yensimbi, 

Okungaguqula imicu esikhonkwaneni sokukhiya kanye nepuleti lokukhiya. Kwezinye izimo, 

Ukwehluleka ukusebenzisa noma ukusetshenziswa komhlahlandlela ongalungile we-Drill kuholele ekutheni izikulufo ezingahambelani lapho ziqiniswa, 

okwadala izikulufo zibe ujamu. Ukuze unciphise ubungozi bokuhlangana ngesikhathi senqubo yokuqala yokulungisa,

 Kubalulekile ukusebenzisa zonke izinsimbi ezikhona: imihlahlandlela yokushayela kanye nezisekelo, ama-torque wrenches kwimodi ephelele yokuthembeka lapho uqinisa izipikili ezikhiyiwe.

Indlela ye-MIPO ithwala ubungozi obukhulu bokubekwa okungalungile komhlahlandlela wokuqondanisa, 

njengoba kungekho umbono oqondile wepuleti lokukhiya. Ukuqondaniswa okungalungile komhlahlandlela we-Drill kusho ukuthi umgodi obiziwe 

Isipikili sokukhiya nokufakwa kwesipikili sokukhiya nakho kuzolunga. Kukhona nengozi yokulimaza iphethini yekhanda ye

 Ukukhiya izipikili lapho i-screwdriver ingazibandakanyi kahle isikulufa.

Ngalezi zizathu, ngaphambi kokususa ipuleti lokukhiya, udokotela ohlinzayo kufanele azi ukuthi kungenzeka 

kungenzeka ukukhulula isipikili sokukhiya, ngaleyo ndlela kudinga ukusetshenziswa kwe-hexagonal screwdriver ephezulu kanye ne-appyn appleation.

Lapho izipikili ezikhiya zingathukululwa, noma iphethini lekhanda lilimele, 

Isinyathelo sokuqala ukubeka i-screw extractor yesikulufa (i-tapered screwdriver enezintambo ezihlanekezelwe) ekhanda lesikulufa;

 Lokhu kungenzeka kwanele ukukhulula isikulufa. Enye inketho ukusika ipuleti lokukhiya ngapha nangapha kwesipikili sokukhiya nokusetshenziswa

 njenge-screwdriver ukukhulula lonke isakhiwo. Uma isikulufa namanje asikwazi ukukhululwa, ipuleti lokukhiya lingathululwa ngu 

Ukuyifaka nge-drill, kubhubhise ikhanda lesipikili sokukhiya, noma ngokusika uzungeze ipuleti ukuze ukhulule isipikili sokukhiya. Ngemva kwalokho, 

I-Vise ingasetshenziselwa ukususa izigxobo zezikhonkwane zokukhiya. Uma kungakakhululwa (ngoba kuhlanganiswe kuthambo noma kungavimbi ngokwanele), 

Ingasuswa nge-ring drill (Fig. 6).

Umdwebo o-6 wezeluleko namathiphu wokususa izikulufa zokukhiya ezinamathele ebhodini.

Zonke lezi zinkinga zingakwandisa ukuhlinzwa, kungadala ukuthi izicubu ezithambile zibangelwa izingcezwana zensimbi, futhi ziphathe ingozi yokutheleleka. 

Ukusetshenziswa kwe-Ring Drill kukhulisa ubungozi bokuqhekeka kwe-perioperative.

Isifinyezo:

1. Inselelo yokususa izinzipho ezikhiyayo kwenzeka ngokuyinhloko nge-3.5mm hex ikhanda elikhiya amakhanda titanium screws.

2.Indlela engcono kakhulu yokugwema le nkinga ukusebenzisa wonke amathuluzi anikeziwe lapho ufaka isikulufa. Ubunzima bungaxazululwa ngokusebenzisa amathuluzi afanele.

03. Uyini umkhawulo wohlelo lokusebenza lwepuleti lokukhiya?

I-Clavicle Plate Fracture kanye ne-Osseous nosnonion

Ngokuqinisekisa ukuthi isakhiwo asiqili ngokweqile ngenxa yobude obungenele bokusebenza kwepuleti lokukhiya noma inani elishibhile lokukhiya izipikili (umkhiphelo wepuleti lokukhiya (ubungozi bokhiye be-screen Breaking ngaphansi kwezimbobo zesikulufa noma ngesikulufa / i-bone Plate Junction ingancishiswa.

Umdwebo 7 Ukuphulukiswa kwamathambo kufinyelelwe ngemuva kwezinsuku ezingama-60 ngokuhluka ngenombolo kanye nesikhundla sokukhiya izikulufo nokwandisa ukuqina kwezakhiwo eziqinile ngokweqile.

Ukuxilongwa kwethambo lethambo kuvame ukuqinisekiswa ukuqhekeka kwepuleti. 

Ukuqhekeka sekwephuzile kwepuleti lokukhiya noma isipikili sokukhiya sifike ngesikhathi njengoba kwenzeke microshow

Ekuqhekekeni okulula okudinga ukucindezela, okuncike ohlotsheni lokuqhekeka hhayi ithambo elibandakanyekile, 

Isakhiwo esiqinile lapho izingcezwana ezimbili zingathinti zingaholela ekuhlulekeni okungaphuluki nokukhathala kwepuleti. 

Inhlanganisela ye-slid splint + ukukhiya isikhonkwane + troction endaweni ye-Fracture kuphumela ethanjeni.

Ukwehluka kwalokhu ukuqhekeka kanyekanye kwesipikili sokuvala izipikili ngaphansi kokunamathiselwe kwayo epuletini, 

okubuye kube ngesakhiwo esiqinile ngokweqile. Lokhu kubangela ukuphela kwepuleti ukuze kukhishwe 'esiqeshini esisodwa ' nokuphulukisa akutholakali (Umdwebo 8).

Umdwebo 8 ukwehluleka kwesibili kwesakhiwo esiqine futhi esingalinganiseli: Izikulufo eziningi zokukhiya kakhulu zazisetshenziswa kude futhi ipuleti le-plaxilal splice alizange libe lide ngokwanele.

Ngakho-ke, ukulungiswa kokuqhekeka kwe-intracapsure kwe-hip ngamapuleti okukhiya kungaholela ethanjeni le-bone ngoba ukwakheka kuqinile kakhulu ku-Implinge kusayithi lokuphuka. 

Ngaphandle kwe-microcotion edingekayo ekwakheni, wonke umthwalo uthathwe ngokufakelwa futhi ekugcineni wehluleka.

izicubu zokupholisa ze-asymmetric

I-Periosteal Bone Scabs ingaba yi-asymmetric, 

Ikakhulu ekuqhekekeni kwe-distal 1/3 ye-femur. I-Microcotion ngenxa ye-elasticity ivumela 

Ukuthuthukiswa komfaniswano kwezicubu zokuphulukisa ze-Fracture ezenzeka kuphela ezindaweni ezihambisanayo zepuleti / ye-nail yokwakha.

 Ukulawula lobu bungozi, ubude bokusebenza kwepuleti lokukhiya kufanele bukhuphuke, kungaba ngokusebenzisa amapuleti ama-titanium aguquguqukayo noma ngokusebenzisa imiklamo emisha yokukhiya izipikili. 

Ngakolunye uhlangothi, ukwakhiwa okuguquguqukayo ngokweqile kungaholela ethanjeni le-hypertrophic.

Ukuguqulwa kwepulasitiki kwamapuleti ensimbi

Ukubeka ipuleti eduze kwe-cortex ngangokunokwenzeka kwehlisa ubungozi bokuguqulwa kwepulasitiki phakathi kwepuleti;

 Lapho ibanga phakathi kwepuleti ne-cortex lidlula i-5 mm,

 Amandla wesakhiwo ancishiswe kakhulu futhi ubungozi bokuguqulwa kwepulasitiki kwepuleti nokwehluleka kwe-titanium plate kuphakeme.

Ukuqhekeka sekwephuzile kwedayiso noma i-metaphysis ekugcineni kwepuleti lokukhiya

Ingozi yokuqhekeka sekwedlule isikhathi ekugcineni kwesimo sokukhiya ipuleti noma metaphysis, 

Ikakhulu ethanjeni le-osteoporotic, lingancishiswa ngokufaka isipikili esisodwa sokukhiya i-cortical noma isikulufa esijwayelekile se-bicortical ekugcineni kwepuleti ukuze linciphise izingcindezi kulesi sifunda.

Ukwehluleka okwenziwe ngomshini

Lezi zimo ezilandelayo zandisa ingozi yokwehluleka kwemishini yepuleti lokukhiya:

1. Ukulungiswa kokuqhekeka kwedayiso lokuthosa kudinga ukusetshenziswa kwezipikili ezine ezikhiyiwe nhlangothi zombili zesayithi lokuqhekeka ukuze umelane ne-torrion futhi wandise ukwehluleka kwemishini; futhi

2. Ukulungiswa kwama-epiphyseal fractures kunzima ngoba kuvame ukungazinzi, 

Ikakhulu ngoba isayithi lokuphuka alikwazi ukucindezelwa yizipikili ezivaliwe futhi ithambo yi-osteoporotic;

3. I-ortixed intra-arvicular kanye ne-acticular fractures fractures of epiphysis ayizinzile

 (isib.

4. Ukudluliselwa kwempilo kwe-metaphyeeal fractures kubhebhethekisa ukususa ukuguqula (isib

 Ukukhiya amapuleti afakwe esicini se-sateral se-bone kunikezela ngesakhiwo esiqinile esivame ukwanele 

Ukuqinisa lokhu kuqhekeka ngaphandle kwesidingo sokungeza amapuleti wohlobo lweConsole ngokuqinile noma ukwengeza ithambo ngenkathi kugcinwa imvelo ye-biologic fracture. 

Ukuqina kuncike kuphela ku-Lock Plate / Lock Living Nail Interface, 

Okugcizelelwa kakhulu ngemuva kokusetha kabusha lapho i-epiphysis ihlala iveziwe noma lapho ikhonsoli ye-medial ingakhiwa kabusha. Ipuleti lokukhiya lingase sehluleke okwesibili ukukhathala.

Ngakho-ke, ukulungiswa kwe-Bicondylar Tibial Plateau Fractures usebenzisa ukukhiya amapuleti kuphela ohlangothini lwamuva kufanele kubhekwe ngokuya ngohlobo.

 Okwe-Proximal Humerus fractures, inani lamabhulokhi we-fracture, ukulahleka kokusekelwa kwezindlela,

 kanye nokungenisa kwe-epiphysis yokulungiswa kwaziwa izici eziziwa yingozi. Ukunciphisa ubungozi bokwehluleka ukwakha, 

Amanye izipikili ezivalekile azokwesekwa ngokusebenza ukuze anxephezele ukungabikho kokuxhaswa kwendalo ekunciphisweni kwangaphandle kwamahlaya ahunyushwe ngaphandle

Ukwehluleka kwemvelo kwamapuleti okukhiya

Izindlela zokuhluleka kwezinto eziphilayo zamapuleti ezikhiye zisikiwe isikulufa nokuqhekeka noma ukuhlukaniswa kwesipikili sokukhiya. 

Lezi zingozi zinkulu lapho amathambo amathambo ekhona emathanjeni, 

Okusho ukuthi ukuvuselelwa kusenesikhathi nokubuya ekuvuseleleni isisindo kufanele kwenziwe ngokucophelela ngaphambi kokuphulukiswa kwamathambo.

(1) Ukususwa kwezikulufo ezikhiyiwe

Ukukhishwa kwesikulufa kuhambelana ne- 'ephelele ' nokususwa ngasikhathi sinye kwezipikili zokukhiya kusuka ithambo endaweni eyodwa noma zombili zepuleti. Kwezinye izimo, 

Isipikili sokukhiya sikhishwa ngengxenye yethambo elizungeze.

Esifundeni se-epiphyseal, isakhiwo sepuleti elilodwa le-One-Plate livame ukuhlinzeka ngokokwazi okwanele ngenxa yokufakelwa okuhlakazekile noma okuguqukayo okukhiya izikhala, 

Futhi isakhiwo esinezinhlangothi ezintathu sandisa ukumelana nokukhishwa kwesikulufa kusuka ethanjeni elikhanyiselwe.

Esifundeni seDiafyeel, ukuguqulwa kwahlaselwa futhi kwahlakazeka izipikili zokukhiya nokwakha ngamapuleti amade okukhiya kunamandla okudonsa okungcono. 

Lolu hlobo lokwakha lufaneleke kakhulu ukuqhekeka kwe-periprosthetic. E-Osteoporotic Bone, 

Ukulungiswa kwesikulufu se-bicortical stem kuphakeme kakhulu ku-monocortical screw fidetion. Okwe-periprosthetic fractures, izikulufo zekhanda lekhanda le-anicortical zisiza ukugwema ukuxhumana nezimila ze-intrametullary.

Lokhu kwehluleka kokulungiswa kuhlotshaniswa nekhwalithi yamathambo ampofu, noma ngabe ukwakheka kuyinto eqinile.

(2) ukusika noma ukuncishiswa kwezikulufo ezikhiyiwe

Ukusikwa noma okuphazamisekile kwezipikili ezikhiyiwe ngokungena kwe-intra-articular kungenzeka kungenzeka kukhanyiselwe esifundeni se-epiphyseal.

Lokhu kudonswa kwalokukhishwa kwezingcezu ze-epiphyseal zethambo elisezingeni eliphansi elihanjiswe endaweni yokukhiya kokulungiswa kwezipikili.

 Lokhu kuphumela ekulahlekelweni kwe-Epiphyseal Fracture Deacture. Esimweni esihle kakhulu, i-epiphyseal Locking Nail ingena futhi

 ungene ethanjeni elikhanyiselwe. Esimweni esibi kakhulu, i-epiphyseal Locking Nail iphuma i-epiphysis futhi ihamba ibe ngokuhlanganiswa.

Lezi zingxabano ezimbili zenzeka kaningi kakhulu kwi-humerus ye-auterus kanye ne-distal radius fractures. 

Ukukhiya ukulungiswa kwepuleti ye-auterus fractures, kunconyelwa ukuthi ubude be 

I-Epiphyseal Locking Nail inomkhawulo ekunciphiseni ubungozi bokungena kwe-ingrowth kanye nasesikhundleni sokungena kwesibili.

Lokhu kwehluleka kokulungiswa kungenxa yekhwalithi yethambo elinganele nokuthuthwa okukhulu kokuqala kwezingcezwana zokuqhekeka ngaphambi kokuncishiswa, 

Noma ngabe isakhiwo sisebenza ngomshini.

Ukuvuselelwa Ngokuhlangene Nokuvuselelwa Ngokushesha Isisindo

Ukuvuselelwa kanye nokuvuselelwa kwesisindo kuvunyelwe kuphela ngemuva kokutholwa okuhleliwe okuphelele futhi kuqinisekiswe kuma-X-ray we-Ppopoperative.

Izifundo ze-biomechanical zikhombisile ukuthi kuthambo elijwayelekile, uma igebe phakathi kwezicucu lingaphansi kwe-1 mm, 

Ukuthwala isisindo kungenzeka ngaphandle kwengozi. Ngemuva kwemijikelezo eyizigidi eziyi-1, ukuqina kuyafana nalokho kwethambo elijwayelekile, elanele ukuphulukiswa okuzokwenzeka.

Lapho kuzwakala ngokuhlelekile, ukukhiya amapuleti kanye nezinzipho ezikhiyiwe ze-angle-angle zivumela ukubuyela kwangaphambi kwesikhathi 

Ukufaka isisindo ngoba umthwalo udluliswa ngokuqondile kusuka kwisipikili sokukhiya kwipuleti lokukhiya, ngaphandle kwengozi yokwehluleka kokulungiswa kwe-nail-plate Jewtion.

Kodwa-ke, lapho i-eksisi ye-multiaxiaxial ukukhiya i-perpendicular i-perpendicular epuleti lokukhiya, ukuthwala isisindo kusenesikhathi akuvunyelwe.

KwiMiPo, ukuhanjiswa kwesisindo kusenesikhathi kuvunyelwe ukuqhekeka okwengeziwe, okulula / / noma okulula. 

Izakhiwo ezinde kakhulu zivumelana nezimo ngokwanele ngokushintshana kwezipikili zokukhiya ze-bicortical

Isiphetho:

Izifundo ze-1.BiomeChanical zihlole izinhlobo ezahlukene zokwakha nezakhiwo zazo zemishini.

Izincwadi zisiza ukuqinisekisa amathemba ethiyori ahambisana nalolu hlobo lokulungiswa. 

Kodwa-ke, izincwadi ezisanda kwenzeka futhi ziqokomisa ubunzima bobuchwepheshe kanye nokwehluleka okuhambisana namapuleti okukhiya.

2.Isizathu esikhulu sokwehluleka ukuhlela okunganele kwendlela yokuhlinzwa, 

okufunwa kakhulu, ikakhulukazi lapho wenza izinqubo ezihlaselayo.

3.Ukuqhekeka kumele kusethwe kabusha kuqala, ngaphandle kokukhiya izikulufa epuletini,

Njengokuhlala kabusha kwepuleti ngokuvala izikulufo akunakwenzeka.

4.Ukwakhiwo kumele kube ngobude obufanele namandla, 

Okusho ukuthi udokotela ohlinzayo kufanele azazi nemigomo nemithetho eqondisa ukusetshenziswa kwalawa mapuleti. 

Isakhiwo kufanele sibe nokunwebeka, ngenombolo elilinganiselwe yezikulufo ezikhiyiwe ezivalekile njalo ezishintshana ngezimbobo ezingenalutho.

5.Phite ukuqina okungcono kokuqala kwamapuleti okukhiya, 

Ukulungiswa kwesakhiwo kukhawulelwe yinkimbinkimbi yokuqhekeka, ikhwalithi yokwehliswa, kanye nekhwalithi yemvelo yethambo.

6.Uma ukwakheka kuyinto eqinile, ikhwalithi yethambo yinhle futhi ukuqhekeka kuyinto eyengeziwe. 

Isiguli esinokuzimela esanele singavunyelwa ukuthwala isisindo emlenzeni ophukile. Ezimweni eziningi, ukukhiya ukulungiswa kwepuleti kuvumela ukuvuselelwa kusenesikhathi.