Kuvunika kwa Clavicle ni kimwe mu bivunika byo hejuru bikunze kugaragara mu buvuzi, aho 82% by'imvune za clavicle ari imvune zo hagati mu gice cy'umubiri. Imvune nyinshi za clavicle zidahuye cyane zishobora kuvurwa mu buryo burambye hakoreshejwe ibipfuko bigera ku munani, mu gihe izifite ipfundo rikomeye, ingingo zoroshye zivanze, ibyago byo kwangirika kw'imitsi cyangwa ubwonko, cyangwa imikorere yazo ishobora gusaba ko zihuzwa imbere n'ibice. Igipimo cyo kudahuza nyuma yo guhuza imbere kw'imvune za clavicle ni gito, hafi 2.6%. Imvune zigaragaza ibimenyetso akenshi zisaba kubagwa, aho uburyo busanzwe ari uguteranya amagufwa hamwe no gufunga imbere. Ariko, gucunga imvune zisubiramo ku barwayi bamaze kuvugururwa ku buryo butari bwo ni ingorabahizi cyane kandi biracyari ikibazo ku baganga n'abarwayi.
Kugira ngo iki kibazo gikemuke, umwarimu wo mu bitaro bya Xi'an Croix-Rouge yakoresheje uburyo bushya bwo guteranya amagufwa ya autologous iliac hamwe na autologous cancellous igufwa grafting kugira ngo avure ibibazo byo kuvunika kw'amagufwa nyuma yo kubagwa nabi, bigatanga umusaruro mwiza. Ibisubizo by'ubushakashatsi byasohotse mu kinyamakuru "International Orthopaedics".
Uburyo bwo kubaga
Uburyo bwihariye bwo kubaga bushobora kugaragazwa muri make nk'uko bigaragara mu ishusho iri hepfo:
a: Kuraho clavicular fixation ya mbere, gukuraho sclerotic igufwa n'inkovu ya fibre ku mpera yavunitse;
b: Hakoreshejwe ibyuma byo gusana clavicle bya pulasitiki, hashyizwemo vis zo gufunga mu mpera z'imbere n'inyuma kugira ngo clavicle ikomeze kuguma neza muri rusange, kandi vis ntizashyizwe mu gace kagomba kuvurwa ku mpera ya clavicle yavunitse.
c: Nyuma yo gushyiraho isahani, banza ucukure imyobo ukoresheje urushinge rwa Kirschler ku mpera y'aho yavunitse ugana imbere n'inyuma kugeza aho umwobo uva amaraso (ikimenyetso cy'urusenda rutukura), bigaragaza ko amaraso y'amagufwa agenda neza hano;
d: Muri iki gihe, komeza gucukura 5mm imbere n'inyuma, kandi ucukure imyobo miremire inyuma, ibyo bikaba byiza kuri osteotomy itaha;
e: Nyuma yo kubagwa osteotomy ku mwobo wa mbere wo gucukura, shyira igice cyo hasi cy'igufwa hasi kugira ngo haveho umuyoboro w'amagufwa;
f: Igufwa rya Bicortical Iliac ryashyizwe mu mwobo w'amagufwa, hanyuma cortex yo hejuru, ikirenge cya Iliac n'igice cyo hasi by'amagufwa bishyirwaho imisumari; Igufwa rya Iliac cancellous ryashyizwe mu mwanya wo kuvunika.
Ibisanzwe
imanza:
▲ Uyu murwayi yari umugabo w'imyaka 42 ufite ikibazo cyo kuvunika hagati mu gice cy'ibumoso cyatewe n'ihungabana (a); Nyuma yo kubagwa (b); Yavunitse neza kandi amagufwa ntiyahuze mu mezi 8 nyuma yo kubagwa (c); Nyuma yo kuvugururwa bwa mbere (d); Yavunitse icyuma nyuma y'amezi 7 nyuma yo kuvugururwa no kudakira (e); Yavunitse neza (h, i) nyuma yo guterwa amagufwa (f, g) muri cortex ya Ilium.
Mu bushakashatsi bw'umwanditsi, harimo abantu 12 bose hamwe barwaye indwara yo kudahuza kw'amagufwa, bose bakaba barakize nyuma yo kubagwa, kandi abarwayi 2 bagize ibibazo, umwe muri bo yagize ikibazo cyo kuzura imitsi yo mu mitsi yo mu nda y'ikirenge n'undi umwe ufite ububabare bwo gukuraho amagufwa ya Iliac.
Gutera imitsi yo mu bwoko bwa refractory clavicular nonunion ni ikibazo kigoye cyane mu buvuzi, giteza umutwaro uremereye ku barwayi ndetse no ku baganga. Ubu buryo, hamwe no gutera amagufwa mu buryo bw'imiterere y'igufwa rya Ilium hamwe no gutera amagufwa ya cancellous, byageze ku musaruro mwiza wo gukira kw'amagufwa, kandi imikorere yayo ni myiza, ishobora gukoreshwa nk'icyitegererezo ku baganga.
Igihe cyo kohereza ubutumwa: Werurwe-23-2024
