Imirongo ya metacarpal ni ukongera kuvunika mu ntoki, ibaruramari ku ya 1/4 cy'abarwayi b'ihungabana. Kubera imiterere yoroheje kandi igoye yintoki nigikorwa cyiza cyo kugenda, akamaro nubuhanga bwo kuvura intoki biragoye kuruta kuvura amagufwa maremare. Kwemeza umutekano wivururwa nyuma yo kugabanya ni urufunguzo rwo kwivuza neza kuri melantal folantaal folalantal. Kugirango tugarure imikorere yukuboko, kuvunika akenshi bisaba gukosorwa bikwiye. Mubihe byashize, plaster yo hanze cyangwa Kirschner Wire imbere yakoreshwaga, ariko akenshi ntabwo ifasha mumahugurwa yo gusubiza mu buzima busanzwe cyangwa igihe cyo gukosora gukosorwa, kiba gifite ingaruka zikomeye kugarura imikorere yintoki kandi izana ingorane zimwe na zimwe mu gukuraho ikiganza. Uburyo bwo kuvura bugezweho buragenda bukoresha gukosora imbere, nkisahani ya plaque yashushanyije.
I.Ni ayahe mahame yo kuvura?
Amahame yo kuvura ukuboko kw'intoki n'inzara: kugabanya anatomique, kugabanya urumuri no gukosora, ibikorwa byambere n'imikorere mige. Amahame yo kuvura mu nyenzi na peri-arti-arti-articular ameze nkizindi mvururu, nayo kandi yo kugarura anatomy yubuso hamwe nibikorwa byambere. Iyo ufashe ukuboko kwa metacarpal na falantaal, imbaraga zigomba gushyirwaho kugabanya anatoodical, no kuzunguruka, kurakara, cyangwa kungurana ibitekerezo bya> 10 ° kugeza ku iduka rya palm ntigomba kubaho. Niba kuvuza impera ya metacarpal phalange cyangwa inguni yimurera kumurongo, bizahindura inzira nyabagendwa no kwimuka cyangwa kugwa hamwe nurutoki rwegeranye mugihe cyoroshye cyintoki; Kandi iyo inguni yimukira mubice bya dorsal ni> 10 °, ubuso bworoshye hagati yamagufwa na Tendon burasenyuka, byongera imyigaragambyo no kwagura ingendo, hamwe no kwagura ingendo za mandon.
II.Ni ibihe bikoresho bishobora gutoranywa kuri metacarpal kuvugurura?
Hariho ibikoresho byinshi byo gukosora byimbere kumiterere ya metacarpal, nka Kirchner Wire, imigozi, ibyapa hamwe nibiporizo byo hanze, muri ibyo bicecchner insinga na microplant nibikoreshwa cyane. Kuri metacarpal kuvunika, Microplate Imbere yimbere ifite ibyiza hejuru ya Kirscner Wire kandi irashobora gukoreshwa mbere; Kubwububiko bwa phalanx, mikoroplete muri rusange iruta, ariko mugihe bigoye gushyiramo imigozi kuri prolanx ya Phalanx kure ya Phareal Kirscner Wires igomba gukoreshwa mbere yo kuvura prolanx yo hagati.
- Kerschner Wire:Kirschner Wire imbere yimbere yakoreshejwe mumyitozo myinshi mumyaka irenga 70 kandi yamye ari ibintu bikunze gukoreshwa imbere muburyo bwo gukosorwa imbere kuri metacarpal na falantaal. Biroroshye gukora, ubukungu kandi bufatika, kandi nuburyo bwo gukosora imbere. Nkibintu bikunze gukoreshwa imbere kugirango bivura ibiganza, biracyakoreshwa cyane. Ibyiza bya Kirchner Wire imbere: ① Biroroshye gukora no guhinduka cyane kugirango ukoreshe; ② tissue nkeya yoroheje yica, ingaruka nke kurimaraso yo kuvunika iherezo ryamavuza, ihahamuka rito ryo kubaga, kandi rifasha gukiza gukira; Byoroshye gukuramo urushinge ku nshuro ya kabiri; ④ Igiciro gito kandi gisanzwe cyo gusaba, kibereye kuvunika amaboko menshi (nko kuvunika ibihangano, kuvunika gukabije hamwe na farashi ya falantaal).
2.Tatemecakorol mikorobe: Gukosora imbere gukosora intoki nishingirwaho mumahugurwa yimikorere hakiri kare hamwe nuburyo bukenewe bwo kugarura imikorere yintoki. Ikoranabuhanga ryo gukosora imbere risaba ko kuvunika impera byasubiwemo neza hakurikijwe imiterere ya anatomicake kandi ko kumeneka birangiye munsi yimikorere, bizwi ko bikosowe, kugirango twemererwe cyane. Ao ashimangira kandi ibikorwa bike byo kubaga bitera, hamwe no kwibanda ku kurinda amaraso. Microplate ikosora imbere yo kuvura intoki birashobora kugera ku bisubizo bishimishije mubijyanye n'imbaraga, guturika byo kuvunika birangira, kandi igitutu hagati yo kuvunika birangirira. Mu rwego rwo gukira nyuma yo gukira, kuvunika gukira, no kunduza, bizera ko imikorere ya microtitanium nziza cyane kurenza iyo ya kirsclener. Byongeye kandi, kuva kuvunika igihe cyo gukosorwa ibyapa byaciriritse bigufi cyane kuruta uw'ubundi buryo bwo gukosora, ni byiza kubarwayi gusubukura ubuzima busanzwe hakiri kare.
(1) Ni izihe nyungu za microplate gukosora imbere?
Ugereranije na kirscrene wire, microplate ibikoresho byashizwemo bifite ubumwe bwa tissue no gusubiza neza. Sisitemu yo gutunganya amasahani-yashushanyijeho isahani hamwe nigitutu cyo kuvunika burundu kugirango ikorwe na anatomical igabanuka rya anatomical, bikosora neza, kandi bifasha kuvunika gukira; Imyitozo ikora kare muri rusange yemerewe gukosora microplate gukosorwa, bifasha kugarura imikorere yintoki.
(2) Nubuhe buryo bwo kubaga bukomeye bwa mikoroppate?
Kubaga mubisanzwe bikorwa munsi ya anesitiya ya brachial ya brachialia, kandi umuyoboro wa pneumatike usabwa mubisanzwe. Guhagarika dorsal byafashwe, dorsal aponeurose yimibare yaciwe cyangwa imitsi ikonjeshijwe kugirango igaragaze amagufwa, kandi imivurungano iragabanuka itangwa neza. Ibyapa bigororotse birakwiriye kuvunika igice cyo hagati hamwe no kuvunika gukabije, T-Plate birakwiriye ko bikosora ibicuruzwa birebire kandi byashinzwe. Muri rusange isahani ishyirwa kuruhande rwamagufwa kugirango ibuze mandon kunyerera no kwambara igihe kirekire, bifasha amahugurwa ya mbere. Nibura imigozi ibiri igomba gukoreshwa mugukosora impera zombi zunguni, bitabaye ibyo, insinga zibi, kandi imigozi ikenewe hanze kugirango ifashe gukosorwa kugirango igere kuntego ikosorwa.
3.min: Imiyoboro ya mini ifite umutekano usa ku masahani yo kunyerera mu gukosora cyangwa kurambitseho imirongo yoroheje, ariko urutonde rwa tistue na persopteum ni ntoya yo kurinda amaraso, bifasha kurinda amaraso no kumurongo wibikorwa bidafite ishingiro. Nubwo hari t-ubwoko na plaque yisahani hafi-ibishushanyo mbonera, gukira imikorere ihuriweho nyuma yo gukurikiranya hakurikiraho gukurikiranwa nabi ni ikirangaga diapyseal. Imiyoboro ya mini nayo ifite ibyiza bimwe mugukosora intra-Arti-Peri-Arti-Arti-Articular. Imigozi yashizwe mu magufa ya cortique irashobora kwihanganira imitwaro minini yo guhangayika, bityo ikosora irarangiye, kandi gucika intege birashobora kumeneka cyane, gabanya gukiza kumeneka, nkuko bigaragara ku gishushanyo cya 4-18. Mini yashinze igenamiterere ry'imbere rikoreshwa cyane cyane ku buryo bwa oblique cyangwa ikabije rya diaphyseal na victhion ivura ivugurura ryamagufwa manini. Twabibutsa ko mugihe ukoresheje mini screw wenyine kugirango ukosore imiguru ya difrale yintoki, uburebure bwamagufwa yamaze kabiri, ubugari bwamagufwa agomba kuba byibuze inshuro 3 diameter.
4.microro yo hanze yo hanze:Ibicuruzwa byashyizweho na metacarpal rimwe na rimwe biragoye kugabanuka cyangwa bidashobora gukosorwa byimazeyo na nyuma yo kubaga biterwa no gusenya igufwa ryamagufwa. Gukosora hanze birashobora kugarura no kubungabunga uburebure bwimiterere yibyerekeranye gukurura, muganira ku ruhare rwo gukosora ugereranije. Ibisanzwe bitandukanye bya Phalantal byashyizwe mumwanya bitandukanye: Prolanges ya 1 na 2 na 2 na 2 MetacarPal ishyizwe kuruhande rwa dorsal, hamwe na Phalange ya 3 ya Dorsal ishyirwa kuruhande rwa dorsal cyangwa uruhande rwa Dorsal ukurikije uko ibintu bimeze. Witondere gushishikarizwa kwinjiza inshinge kugirango wirinde ibyangiritse. Gufunga birashobora kugabanuka munsi ya x-imirasire. Iyo igabanuka ridasobanutse, hashobora gukorwa ikito gito kugirango ufashe kugabanya.
Ni izihe nyungu zabenegihugu bato?
Igikorwa cyoroshye, gishobora guhindura imyanzuro itandukanye yo kuvunika irangira; ② irashobora kugabanya neza no gukosora ibishushanyo mbonera bya metacarpophilangeal amagufwa make atangiza ubuso, kandi bushobora kurangaza ihuriro rihuriweho kugirango twirinde kwamasezerano na ingwate; ③ Iyo kuvunika ibijyanye no kugabanuka, barashobora guhuzwa no gukosorwa imbere, kandi filime yo hanze irashobora kugabanya igice no kubungabunga umurongo; Emera imyitozo yo gukora hakiri kare urutoki rwibasiwe muburyo butagaragara kugirango wirinde gukomera hamwe na osteoporose; ⑤ Irashobora gukosora neza ibiganza bitabangamiye kuvura ibikomere ku kuboko kwatewe.
Igihe cyohereza: Ukuboza-21-2024
