N'ịkụgide - ihe ọ bụ? Ịwa repositioning nke ọkpụkpụ iberibe eji dị iche iche nsogbu owuwu

Onyinye nke ọkpụkpụ gbajiri agbaji iji ọrụ ga mee ngwangwa ndị na-agwọ ọrịa usoro, na ghara ịgbanwe nke ọrịa na mgbagwoju anya fractures. N'ihi na oge mbụ a usoro dị ka fixation nke ọkpụkpụ, ẹkenịmde ke narị afọ nke 19, ma n'ihi ntoputa nke dị nnọọ oké njọ nsogbu purulent dọkịta na-amanye ka ha kwụsị eme ya. Ọhụrụ anwa mgbe iwebata na omume nke aseptic na antiseptik ọgwụgwọ.

Gịnị bụ fixation?

Ọtụtụ ndị ọrịa na mgbagwoju fractures dọkịta na-enye jide osteosynthesis. Gịnị ka ọ bụ? Nke a compound ọkpụkpụ iberibe site ọrụ. A kenyere ya na ọgwụgwọ nke mgbagwoju nkwonkwo, n'ụzọ kwesịrị ekwesị gwakọtara ma ọ bụ ọhụrụ na-abụghị n'otu fractures. Iji osteosynthesis fixation emee ekwekọghị iberibe. Nke a na-emepụta ezigbo ọnọdụ ha anọ na, nakwa dị ka mweghachi nke ike n'ezi ihe nke a N'ịdị.

E nwere isi ihe abụọ iche osteosynthesis:

• imikpu (extramedullary, intramedullary, transosseous);
• elu (extrafocal).

Ọ na-eme ihe na ultrasonic osteosynthesis. Gịnị ka ọ bụ? Ọ bụ a compound nke obere ọkpụkpụ iberibe.

Operations na-rụrụ iji dị iche iche fixatives. N'ihi na nmikpu intraosseous osteosynthesis mkpọ ma mbọ na-eji maka nke efere - efere na kposara, maka transosseous - spokes na kposara. Ndị a na taabụ na-mere nke a na ya, n'ụzọ anụ ahụ na biologically anọpụ iche ihe onwunwe. Ejikarị metal owuwu nke vitalliya, igwe anaghị agba nchara, titanium, ọtụtụ obere - si inert plastic na ọkpụkpụ. Spacers mere nke metal mgbe mgbaji ọkpụkpụ srastetsja emekarị ewepụ. Ilizarov ngwa na ụkwụ na-eji maka mpụga osteosynthesis. N'ihi ya, ọkpụkpụ iberibe mgbe atụnyere ike ofu. Ọrịa nwere ike na-eje ije na-ejikarị na a zuru ibu.

na-agba akaebe

Operation osteosynthesis gosiri dị ka isi mgbake Usoro mgbe:

• Nke a mgbaji ọkpụkpụ, nke mere na-eto eto ọnụ na-enweghị enyemaka nke trauma;
• mmebi nke puru nke perforation nke anụ (mgbe mechiri emechi mgbaji ọkpụkpụ bụ ike na-aga n'ime ọha);
• mgbaji ọkpụkpụ mgbagwoju anya site mmebi a isi akwara.

contraindications

Ịwa ahụ aka na-adịghị na-atụ aro maka ndị na-esonụ ọnọdụ:

• ma ọ bụrụ na onye ọrịa bụ adịchaghị;
• e na-emeghe ọtụtụ mmebi;
• n'elu ọrịa nke emetụtara saịtị;
• Ọ bụrụ na e nwere onye na ngosipụta nke daa ọrịa nke ọ bụla esịtidem ngwa;
• na progression nke ọrịa nke ọkpụkpụ;
• onye ọrịa nwere N'ịdị venous insufficiency.

ụdị efere

The efere nke ndị na-eji n'oge ọrụ, ka nke ọla na ígwè kpụọ. The kacha mma ghọtara titanium efere, dị ka a na ihe onwunwe nwere ihe na-akpali atụmatụ: ikuku film a kpụrụ na ya ozugbo, nke ọ dịghị ụzọ agaghị emekọ ahu arọ. Na nke a, e nweghị egwu metallosis. Ọ bụ ya mere ọtụtụ n'ime ndị a efere na-adịghị wepụrụ na a na-ekpe maka ndụ.

Submersible intraosseous osteosynthesis

Aha ọzọ maka ọrụ - intramedullary osteosynthesis. Ọ bụ na-emeghe ma na-emechi. Ke akpa idaha, a mgbaji ọkpụkpụ mpaghara n'anwụ, whereupon a tụnyere nke iberibe na na medullary kanaal nke mebiri emebi okpukpu agbara n'ibu mkpara. N'èzí fixation adịghị achọ na ojiji nke pụrụ iche ngwá ijikọ rifọrọ, a Usoro bụ nnọọ mfe na ndị ọzọ inweta mechiri emechi ọrụ. Otú ọ dị, na nke a na ọ na-enwekwu ihe ize ndụ nke adụ anụ ahụ na-efe efe.

Mechiri emechi intramedullary fixation e ji eziokwu na ha na-emepụta a tụnyere nke ha rifọrọ, na-eme ka ahụ a obere mbepụ efep mgbaji ọkpụkpụ na saịtị. N'okpuru X-ray akara site na nke a mbepụ eji a pụrụ iche ngwa na ẹkenam n'ime medullary kanaal nke a mebiri emebi okpukpu eduzi kama ogologo dara oghere mkpanaka nke kwesịrị ekwesị dayameta. Mgbe ahụ, onye na-eduzi bụ wepụrụ na ọnya na-sutured.

Submersible osteosynthesis

Gịnị ka ọ bụ? Nke a na usoro ọkpụkpụ iberibe compound na-etinyere na dị iche iche fractures (comminuted, helical, periarticular, oblique, mpụta, intraarticular), n'agbanyeghị nke ekwe na udi nke medullary kanaal. Clamps, nke na-eji dị otú ahụ arụmọrụ na-egosi na ụdị nke efere dị iche iche ọkpụrụkpụ na udi, ejikọta ọkpụkpụ iji kposara. Ọtụtụ oge a na efere na-eweta ọnụ a pụrụ iche ngwaọrụ, gụnyere mbughari na-abụghị nke mbughari. Ịgbaso usoro, mgbe mgbe, wetara ọbụna a nkedo.

Mgbe helical oblique fractures na osteosynthesis a na-emekarị mere site n'aka metal ibe na waya, nakwa dị ka ihe pụrụ iche yiri mgbaaka na igwe anaghị agba nchara ọkara yiri mgbaaka. Nke a na usoro ọkpụkpụ compound, karịsịa a waya, na-adịkarịghị eji dị ka otu nọọrọ onwe ha ruru fixation adịghị kwa ike ma na-eje ozi dị ka a emeju ọzọ di iche iche nke osteosynthesis.

Nke a na ime ihe na-nnọọ adịkarịghị eji soft agịga (silk, catgut, dacron), n'ihi na ndị dị otú ahụ filaments agaghị enwe ike iguzogide muscular traction na displacement nke akwụkwọ ya.

Submersible transosseus osteosynthesis

Ndị dị otú ahụ nke ogwugwo repositioning site bolts, kposara, spokes, na ndị a clamps a rụrụ kosopoperechnom ma ọ bụ transversely site ọkpụkpụ mgbidi n'ime saịtị nke mmerụ. A pụrụ iche ụdị osteosynthesis chreskostnogo a ọkpụkpụ nkwonkwo - nke a bụ mgbe ndị iberibe na-gbapuru ọwa na site na ha na-eji ligatures (catgut, silk, waya), nke ahụ ikesiike na tie. Ọ na-eji mgbe ọkpụkpụ nkwonkwo mgbaji ọkpụkpụ nke olecranon ma ọ bụ patella. Transosseous osteosynthesis enye maka imposition nke nkedo.

n'èzí fixation

Nke a repositioning na-mere site n'aka pụrụ iche ngwaọrụ (Ilizarov ngwa, Volkova - Oganessian). Nke a na-enye ohere a tụnyere nke iberibe enweghị ikpughe nke mgbaji ọkpụkpụ saịtị na idozi ha ike. Nke a na Usoro a rụrụ na-enweghị imposition nke gypsum, na Ilizarov ngwa ụkwụ-enye gị ohere na-eje ije ka onye ọrịa na a zuru ibu.

nsogbu

Mgbe ime ihe nwere ike ime ka oké njọ nsogbu. A pụta:

• ekwesịghị ịdị nhọrọ Usoro fixation nke ọkpụkpụ rifọrọ;
• akwusighi ekwekọghị ọkpụkpụ irighiri;
• akparị ọgwụgwọ nke adụ anụ ahụ;
• ọhụma ẹmende mkpọchi;
• ndị na-abụghị nnabata ya aseptic na antiseptik.

A nsogbu na-eme ka na-ekwesịghị ịdị mgbaji ọkpụkpụ na-agwọ ọrịa, ọ akawanye njọ ma ọ bụ na-ezu nonunion.

Ebe ọ bụ na submersible osteosynthesis eji ogologo oke efere na-ekpughe ndị ọkpụkpụ a maka a anya, ọ na-emekarị nsogbu ọbara, nke na-eduga ná nwayọọ na-agwọ ọrịa nke ọma. Ke ama okodorode ndị kposara nwere ọtụtụ oghere, nke imebi ọkpụkpụ.

ọgwụgwụ

Ya mere, anyị tụlere a Usoro dị ka osteosynthesis. Gịnị ka ọ bụ? Ọ bụ ndị kasị oge a ụzọ jikọọ ọkpụkpụ iberibe mgbe a mgbaji ọkpụkpụ. N'ihi ya, usoro ọgwụgwọ na-agwọ nke ọrịa na ngwa ngwa na budata. Emejuputa osteosynthesis iji dị iche iche fixatives. Ọ na-atụle ihe ndị kasị inogide titanium efere, nke pụrụ ọbụna gbaa.