tuta

"Gyara karyewar shaft na humeral ta amfani da dabarar osteosynthesis na farantin ciki na medial (MIPPO)."

Sharuɗɗan da aka yarda da su don warkar da karyewar shaft ɗin humeral sune kusurwar gaba da baya na ƙasa da 20°, kusurwar gefe na ƙasa da 30°, juyawa ƙasa da 15°, da kuma gajarta ƙasa da 3cm. A cikin 'yan shekarun nan, tare da ƙaruwar buƙatun aikin gaɓoɓin sama da murmurewa da wuri a rayuwar yau da kullun, maganin tiyata na karyewar shaft ɗin humeral ya zama ruwan dare. Hanyoyin da aka saba amfani da su sun haɗa da plating na gaba, anterolateral, ko na baya don gyarawa na ciki, da kuma farce na intramedullary. Nazarin ya nuna cewa ƙimar rashin haɗin kai don rage buɗewa gyarawa na ciki na karyewar shaft ɗin humeral kusan 4-13% ne, tare da raunin jijiya na radial na iatrogenic yana faruwa a kusan 7% na lokuta.

Domin gujewa raunin jijiyoyi na iatrogenic radial da kuma rage yawan raguwar budewa, masana a kasar Sin sun rungumi hanyar medial, ta amfani da dabarar MIPPO don gyara karyewar shaft na humeral, kuma sun cimma sakamako mai kyau.

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Hanyoyin tiyata

Mataki na ɗaya: Matsayi. Majinyacin yana kwance a kwance, tare da an ɗage hannun da abin ya shafa a kusurwar digiri 90 sannan a sanya shi a kan teburin tiyata a gefe.

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Mataki na biyu: Yankewar tiyata. A cikin gyaran faranti na tsakiya na yau da kullun (Kanghui) ga marasa lafiya, ana yin yanka biyu na tsayi kusan 3cm kowannensu kusa da ƙarshen kusanci da na nesa. Yankewar gaba tana aiki a matsayin hanyar shiga ɓangaren deltoid da pectoralis babban hanya, yayin da yankewar ta nesa tana sama da tsakiyar epicondyle na humerus, tsakanin biceps brachii da triceps brachii.

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▲ Zane mai tsari na yankewar kusa.

①: An yi tiyata; ②: Jijiyoyin Cephalic; ③: Babban Pectoralis; ④: Tsokar Deltoid.

▲ Zane mai tsari na yankewar nesa.

①: Jijiya ta tsakiya; ②: Jijiya ta Ulnar; ③: Tsokar Brachialis; ④: An yi wa tiyata.

Mataki na uku: Shigar da faranti da kuma gyarawa. Ana saka faranti ta hanyar yankewa kusa, a manne da saman ƙashi, yana wucewa ƙarƙashin tsokar brachialis. Da farko ana manne faranti a ƙarshen kusa na karyewar shaft na humeral. Daga baya, tare da jan hankali a kan babban gaɓoɓin, ana rufe karyewar kuma a daidaita ta. Bayan an rage ta sosai a ƙarƙashin fluoroscopy, ana saka sukurori na yau da kullun ta hanyar yankewar nesa don ɗaure faranti a saman ƙashi. Sannan ana matse sukurori mai kullewa, yana kammala gyaran faranti.

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▲ Zane-zanen tsarin ramin farantin sama.

①: Tsokar Brachialis; ②: Tsokar Brachii ta Biceps; ③: Jijiyoyin tsakiya da jijiyoyi; ④: Babban Pectoralis.

▲ Zane-zanen tsarin ramin farantin nesa.

①: Tsokar Brachialis; ②: Tsokar Tsakiyar Jijiya; ③: Tsokar Ulnar.


Lokacin Saƙo: Nuwamba-10-2023