Sakamakon jiyya ya dogara ne akan sake buɗe abubuwan toshewar ƙwayar cuta, haɓaka ƙarfi na karaya, adana kyawawan nama mai laushi da farkon aiki.
Ilmin jikin mutum
DaDistal Humerusya kasu kashi a cikin shafi na tsakiya da kuma shafi na a gefe (Hoto 1).
Hoto 1 Distal Humerus ya ƙunshi lambar medial da na gefe
Tsarin lambar ta haɗa da yanki na tsummoki na Humeral Erephysis, da miji na HUMERY da kuma humeral conydle ciki har da haske mai haske.
Rundunar shafi na gefe da aka haɗa da rabo daga cikin Humeral Erephysis, na waje Epiceryle na Humerus da kuma Conyle Conyle na Humeral ciki har da matsanancin ƙwanƙwasa.
Tsakanin ginannun ginshiƙan biyun shine Fossa na mahaifa da kuma Fossa na bayan Fossa.
Rauni motsi
SupracondyLlar karar-hushir mafi sau da yawa lalacewa ta hanyar faduwa daga tuddai.
Marasa lafiya tare da karaya na ciki-articular ne mafi yawan lokuta sakamakon raunin da ya faru daga ƙananan raunin tashin hankali saboda osteoporosis.
Buga
(a) Akwai SupondyyLaryylar rauni, conylar rauni da kuma tatercondysrather.
(B) Barsonondyylar karar HUMERY: Sadar karaya tana saman fossa na Hawk.
(C) Karamin kaddara na ciki: Site ɗin karaya yana cikin Fossa ta Hawk.
(d) Intercondyyy backure na Humerus: Shafin karaya yana tsakanin karkara biyu na Userus na Humer.
Hoto na 2 AO Typing
Ao humeral karaya (adadi na 2)
Rubuta: karin-artacular.
Rubuta b: rauni da ya shafi fasahar articular (rarrabe cikin rarrabe).
Rubuta C: Cikakken rabuwa da sandararrun maƙaryaci na Distal humerus daga humeral «.
Kowane nau'in an ƙara raba kashi uku cikin subypes bisa ga matsayin roko na karaya, (1 ~ 3 subtypespes tare da kara digiri a wannan tsari).
Adadi
Radewa-Rading Rubutun Kariya na HUMERIR (Duk nau'ikan sun haɗa da Supondyn Supondyy of Humerus)
Rubuta i: karaya ba tare da fitarwa tsakanin ɗakunan huji da ƙuruciya da Talus ba.
Rubuta II: Intercondyyysacks na HUMERY da gudun hijira daga cikin rushewar conyle ba tare da nakasar rashin daidaito ba.
Type III: Intercondyyy Sackure na Humerus tare da hijira na rauni yanki na conyyle tare da nakasar m.
Rubuta IV: karfin karaya daga cikin sandararrun masarauta na daya ko duka condyles (Hoto na 3).
Hoto na 4 Nau'in i Humerority bracure
Hoto na 5 HUMERROR rashin karfin karaya
Karaya na huma
Rubuta i: karaya daga cikin jarumawa humeral tare da gefen gefen tal (Hahh-Steinthal karaya) (Hoto na 4).
Rubuta II: Subdgal karaya na zane mai articular na humermer korarci (kocher-lrenz karaya).
Type III: Compinuted facgure na huper
Lura da aikin sarrafawa
Hanyoyin aikin sarrafawa don karkatar da bugun jini mai narkewa suna da iyakantaccen rawar. Manufar rashin kulawa ita ce: motsi na haɗin gwiwa don guji taurin haɗin gwiwa; Manyan tsofaffi, waɗanda galibi suna fama da cututtukan fili da yawa, ya kamata a kula da shi da sauƙi don tsinkayen gwiwar hannu a cikin 60 ° na juyawa na makonni 2-3, yana biye da aikin haske.
Jiyya na Jiyya
Manufar magani ita ce mayar da kewayon aikin jin daɗin rayuwa na haɗin gwiwa (30 ° na gwiwar gwiwar gwiwar hannu, 130 ° na gwiwar gwiwar hannu, kashi 50 ° na gabar jiki); Kamfanin tsayayye da kafaffiyar ƙwayar cuta ta ba da damar fara aikin motsa jiki na gwiwar gwiwar bayan warkar da fata; Double farantin farantin dan wasan humerus ya hada da: Medial da na baya a gefe guda na farantin biyu, komedial da na kaikaiceninki biyu farantin.
Hanyar tiyata
(a) An sanya mara lafiya a cikin matsayi mai zuwa tare da layin da aka sanya a ƙarƙashin ƙafafun da aka shafa.
ganewa da kariya daga median da radial jijiyoyi da ba a sani ba.
Bayanan gwiwar hannu za a iya fadada hanyar tiyata: Ulnar Hawk ulnar
Ulnar Hawkeye ostteotomy: isasshen bayyanuwa, musamman don comfuled comculty na compuleted compuly na articular surface. Koyaya, rauni ba tare da-Union sau da yawa yakan faru a wurin osteotom. An rage yawan haɗin kai wanda ba a rage yawan ukun ulnar Hawk Osteotomy ba (herringbone osteotomy) da kalmar wucewa ta waya ko farantin waya.
Za a iya amfani da bayyanar cututtukan retal don distal humal mai ban sha'awa toshe tare da shinge na Humeral, da kuma faɗaɗa bayyanar ɓarnar da zai iya yanke da bijirewa da ulnar shaho a kusan 1 cm.
An gano cewa faranti biyu za a iya sanya Orthoogonally ko a cikin layi daya, dangane da nau'in karfin da ya kamata a sanya fararen.
Ya kamata a mayar da karaya na articular zuwa wani lebur mai articular surface kuma gyarawa ga humeral kara.
Hoto 6 Bible ficewa na ciki
An yi gyara na wucin gadi na block na block na wire, bayan haka kuma an kashe farantin farantin kashin (sabon salo na farantin mutum (sabon salon gargajiya zai iya sauƙaƙe tsarin.) (Hoto 6).
Take care not to fix the articular surface fracture fragment with all-threaded cortical screws with pressure from the medial to the lateral side.
Shafin epiphysis-humerryis na Humrusis yana da mahimmanci don guje wa rashin karaya.
Bayar da graft mai yawa ciko a shafin na lahani na kashi, amfani da counter carcrit na ci gaba da counterculous kasusuwa, grafting concezth kashi da kuma counter counts a cikin epiphysis.
Ka tuna mahimman abubuwan gyara.
Gyaran yanki mai karkacewa tare da mutane da yawasukurorikamar yadda zai yiwu.
Gyara da yawa yanki guntu gutsutsure tare da sukurori ƙetare tsakiya zuwa gefe.
Ya kamata a sanya faranti karfe a kan midal da kuma ƙarshen gefuna na Distal Humer.
Zaɓuɓɓukan magani: Jimlar gwiwar hannu Arthoplasty
Don marasa lafiya tare da karaya mai tsananin ƙarfi ko osteoporosis, jimillar gwiwar hannu arthroplasty na iya dawo da motsi na gwiwar hannu da kuma aikin hannu bayan da ƙarancin masu haƙuri; A tricque na tiyata ya yi kama da temproplasty na arthroplasty don degelative canje-canje na hadin gwiwar gwiwar hannu.
(1) Aikace-aikacen mai dogon kara mai tsayi prosthesis don hana kara karaya.
(2) taƙaita na ayyukan tiyata.
(A) Hanyar da aka yi ta amfani da tsarin gwiwar gwiwar hannu, tare da matakai kama da wadanda aka yi amfani da su don karkatar da tsintsiyar karaya da gyaran ciki (Orif).
Yanayin cututtukan ulnar.
Samun damar shiga ɓangarorin biyu na kwararru don cire ƙashin kashi (maɓallin key: Kada a yanke tsayar da kwali a cikin shafin ulnar Hawk site).
Dukkanin distal humerus ciki har da Hawruser da aka cire kuma za a iya cire wani muhimmin sequelae idan an cire ƙarin m cm 2 cm
Daidaitawa na tashin hankali na ciki na tsoka mai tsoka yayin dacewa da humeral na pruneral prosedis bayan ya watsar da humeral condyle.
Bayyanar tip na ulnar ulnar don ba da izinin mafi kyawun damar amfani da haɗuwa da shigarwa na ulnar prosthesis (Hoto na 7).
Hoto na 7 Enbow Arthroplasty
Kula
Ya kamata a cire daskararren ɓangaren ɓangaren ɓangaren haɗin gwiwar hannu sau ɗaya a cikin raunin fata na mai haƙuri, da kuma aikin aiki mai aiki tare da taimako ya kamata a fara shi; Ya kamata a gyara gwiwar hannu ta dogon lokaci bayan samun sauyin hadin gwiwa don inganta warkar da fata na fata na makonni 2 bayan tiyata don taimakawa samun kyakkyawan aiki); An yi amfani da daskararru a asibiti don sauƙaƙe kewayon aikin motsi lokacin da za'a iya cire shi akai-akai don kare kare abin da abin ya shafa. Aiki mai amfani da aiki yawanci ana fara makonni 6-8 bayan raunin fata ya warkar da shi.
Kula
Ya kamata a cire daskararren ɓangaren ɓangaren ɓangaren haɗin gwiwar hannu sau ɗaya a cikin raunin fata na mai haƙuri, da kuma aikin aiki mai aiki tare da taimako ya kamata a fara shi; Ya kamata a gyara gwiwar hannu ta dogon lokaci bayan samun sauyin hadin gwiwa don inganta warkar da fata na fata na makonni 2 bayan tiyata don taimakawa samun kyakkyawan aiki); An yi amfani da daskararru a asibiti don sauƙaƙe kewayon aikin motsi lokacin da za'a iya cire shi akai-akai don kare kare abin da abin ya shafa. Aiki mai amfani da aiki yawanci ana fara makonni 6-8 bayan raunin fata ya warkar da shi.
Lokaci: Dec-03-2022
