Nyuma yo kuvunika, amagufwa na tissules bikikije byangiritse, kandi hariho amahame nuburyo butandukanye ukurikije urwego rwimvune. Mbere yo kuvura ibivunitse byose, ni ngombwa kumenya urugero rwimvune.
Gukomeretsa TISSUSE
I.Classification
Kuvunika
Ibikomere byoroshye bya tissue byatanzwe uhereye kubito byoroheje kugeza bikomeye, mubisanzwe ukoresheje uburyo bwa tccurne (Ishusho 1)
Gukomeretsa0: Gukomeretsa Byoroheje
Gukomeretsa1: Ibisobanuro birenze urugero cyangwa kwiyumvisha ingirangingo yoroshye ikubiyemo urubuga
Gukomeretsa2: Imitsi ikomeye cyangwa ihumanya uruhu cyangwa byombi
Gukomeretsa3: Gukomeretsa gukabije kw'ibice bikabije hamwe no kwimurwa gukabije, guhonyora, syndrome y'urugo, cyangwa imvune nyinshi
Igishushanyo
Gufungura
Kuberako kuvunika ari nyuma yisi yo hanze, urwego rwangiza tissue yoroheje rufitanye isano ningufu zatewe nigihombo mugihe cy'ihungabana, kandi gahunda ya Gustilo isanzwe ikoreshwa (Ishusho 2)
Igishushanyo2: Gustiloclassification
Andika I: Uburebure busukuye <cm 1, ibyangiritse mumitsi
Ubwoko bwa III: Urwego rwibikomere, imitsi, periosteum, namagufa, hamwe nihungabana ryinshi, harimo nubwoko bwihariye bwibikomere byamasasu hamwe nibikomere byubuhinzi
Ubwoko IIIA: Kwanduza kwanduza na / cyangwa kuboneka cyane ibikomere byoroshye bya tissue, imyenda yoroshye hamwe nibisobanuro bihagije byamagufwa na neurovascular
Ubwoko III: Hamwe na progaramu nini yoroheje, metastase yimitsi izunguruka cyangwa yubusa irasabwa mugihe cyo kuvura kugirango ugere
Ubwoko bwa IIC: Gufungura ibintu hamwe nibikorwa byanduye bisabwa Gusana Gustilo Ibyiciro Gustilo bikunda kurushaho kuba bibi mugihe runaka, hamwe nimpinduka mubyiciro byacitse byagaragaye mugihe cyo gusanwa mugihe cyo gusana.
Ii.jury micuku
Gukira ibikomere bisaba ogisijeni, gukora uburyo bwa selile, kweza ibikomere bitanduye kandi bya necrotic. Hariho ibyiciro bine byingenzi byo gukira: coagulation (iminota); icyiciro cyo gutwika (amasaha); granulation tissue stage (iminsi ibarwa); Igihe cyo gushinga ibitanda (ibyumweru).
Gutegura kwivuza
Icyiciro gikomeye:Kuhira kwagura ibikomere, Debrudement, kwiyubaka kwamagufa, no kugarura urwego
(1) Suzuma urugero rwo gukomeretsa byoroshye no gukomeretsa neurovascular
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(5) Gutakambirwa kubuntu hasubijwe mu gikomere; Gitoya yahagaritswe Cortex yakuweho kugirango asuzume kandi isukure igufwa ryamagufwa
Kwiyubaka:Guhangana na seque yihungabana (gutinda, nonnion, ubumuga, kwandura)
Convalescence:Imitekerereze, Imibereho, hamwe nakazi byumurwayi
Ubwoko bwo gufunga ibikomere no gukwirakwiza
Gufunga ibikomere byambere cyangwa gukwirakwiza (3 ~ 5) birashobora kugera kubisubizo bishimishije: (1) gufunga byibanze
(2) Gufunga gufunga
(3) Gufunga kabiri
(4) guhinduranya-imbohe
(5) flap kubushake (kuruhande rwa digitale)
(6) imiyoboro ya pedicle flap (gastrocnemius flap)
(7) flap yubusa (Ishusho 3)
Igishushanyo3: Ibice byigice byimurikagurisha kubuntu bikunze gutangwa
Amagufwa
Ndangije umurongo
Transvers.umutwara Igikoresho cyo kuvunika giterwa no guhagarika umutima
Kugabanuka: Uburyo bwo gupakira igitutu kubera kuvunika diagonal
Spiral: Igikoresho cyo gushinga imirongo ya torsional kubera kuvunika
II.Fatire
Gutondekanya ukurikije kuvunika, ubwoko buvunika, nibindi (Ishusho 4)
Kuvunika byashyizweho nibice bifite amagufwa 3 cyangwa menshi bazima, mubisanzwe biva mubikomere byingufu nyinshi.
Gukuramo patralogique kuvunika umurongo bibaho mukarere kaguka amagufwa yabanjirije amagufwa, harimo: ibibyimba by'ibanze amagufwa, amagufwa, osteastase, indwara ya ostebolesise, n'ibindi
Kuvunika bituzuye ntabwo bivunika mubice bitandukanye byamagufwa
Kuvunika gutandukanya hamwe na kure, hagati, no gukandanya ibice. Igice cyo hagati kigira ingaruka ku maraso, ubusanzwe biturutse ku gukomeretsa imbaraga nyinshi, hamwe no guhagarika imirongo yoroshye mu magufa, bigatera ibibazo byo gukiza amagufwa.
Kuvunika hamwe na bone ishyano, kuvunika hamwe nibice byamagufwa, cyangwa imivuruke idakora ihantu hagomba gusobanurwa, cyangwa kuvunika gukabije bivamo indyu.
Kuvunika hamwe nibice byamagufwa bisa nibirangagurika mugihe badashyiramo ibice byose byamagufwa kandi mubisanzwe nibisubizo byo kunama ihohoterwa.
Guhungabana biterwa no kwishoramo inshuro nyinshi kandi akenshi bibaho muri Calcaneus na Tibia.
Kuvunika guhinga bitera kuvunika amagufwa kwinjiza amagufwa mugihe mandon cyangwa ligament irambuye.
Kuvunika no kuvunika aho ibice by'amagufwa byashizwemo, mubisanzwe ukoresheje imitwaro ya axial.
Igishushanyo 4: Gutondekanya imiterere
III
Ibinyabuzima bifatika: Imyaka, indwara zamagufwa, indwara zikorwa, urwego rwimirire, imiti ihamye, imiti ihamye Imiterere, imiterere ya anatoma, urwego rwingufu zibabaje, urwego rwamagufwa.
IV. Uburyo bwo kuvura
Ubuvuzi budasanzwe bwerekanwa kubarwayi bafite imbaraga zingufu zingufu cyangwa badashoboka kubera uburyo bwa sisitemu cyangwa ahantu.
Kugabanya: gukurura kumurongo muremure wigihome, gutandukana.
Brace Gukosora ku mpande zombi zo kuvunika amakuru: Gukosora amagufwa yagabanijwe binyuze mu gukosora hanze, harimo tekinike yo gukosora ingingo eshatu.
Ububiko bwa TUBular bukomeza kubirangira tekinike yo kurangiza tekinike: uburyo bwo kugabanya, harimo gukurura uruhu, gukoma amagufwa.
Kwivuza
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Igishushanyo 5: Uburyo bwo gukosora hanze
(2) Gukosora imbere birakoreshwa mubundi bwoko bwimiterere kandi ikurikira ihame rya Ao (Imbonerahamwe 1)
Imbonerahamwe 1: Ubwihindurize bwa Ao mu buvuzi bwo kuvunika
Ibice bifitanye isano no gusoza ibicuruzwa, harimo compression (compression spression imisumari (intera idasanzwe (kunyerera hagati yikintu cyimbere namagufwa (no gukosora ibikoresho (ibikoresho byimbere bimara aho byashyizweho)
(4) kugabanya inzira zitaziguye:
Ikoranabuhanga rya traction rishyirwa mu bikorwa mu gace kakozwe mu rwego rwo kugabanya igice binyuze mu mpagarara zinyuranye, kandi imbaraga zo gukurura zikomoka ku gikoresho cyo gukwirakwiza igitsina, igikoresho cyo hanze, igikoresho cya Lamina cyangwa Lamina.
V.Station yo kuvura
Ukurikije inzira y'ibinyabuzima yo gukiza, igabanijwemo ibyiciro bine (Imbonerahamwe 2). Muri icyo gihe, hamwe n'imikorere y'ibinyabuzima, kuvura kuvuka bigabanyijemo ibice bitatu, biteza imbere kurangiza inzira y'ibinyabuzima no gukiza kuvunika (Ishusho 6).
Imbonerahamwe 2: Imibereho Yubuzima Gukiza
Igishushanyo 6: Igishushanyo cya Schematic cyo gukiza imbeba
Icyiciro cya Infimatoto
Hetorroge kuva kurubuga no hejuru yimpapuro zoroshye ikora imperuka ya hematoma, fibrovascular ikora imperuka yavunitse, hamwe na osteblaslas na fibroblasts batangira kurundi.
Igihe
Igisubizo cya mbere cyimanuka kibaho mugihe cijoro, hamwe no gushinga skeleton ya karitsiye ikurikiwe no gushiraho callis binyuze mukwakira ubuso bwa enochondral, kandi uburyo bwose bwo gukiza bifitanye isano nuburyo bwo kuvura bufitanye isano nubuvuzi bwo kuvura.
Kubabara
Mugihe cyo gusana, igufwa ryakozwe ryakozwe ni igufwa rya lamellar, kandi umwobo wadullar wagaragaye kugirango ushire ikimenyetso cyo gusana.
Ingorane
Ubumwe bwatinze bugaragarira cyane cyane kumeneka ntabwo bukiza mugihe gikwiye, ariko bukaba bufite ibikorwa bimwe byatinze, kandi impamvu zo gutinda zatinze ziratandukanye, zifitanye isano nibintu bireba kuvunika gukira.
Nonunion yerekanwe nko kuvunika nta kimenyetso cyerekana amavuriro cyangwa gukira ku maradiyo, kandi habaye ibikorwa nyamukuru ni:
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. Indwara y'amagufwa osteomielitis ni indwara y'amagufwa n'amagufwa, ashobora kwandura ibikomere bikomeretsa ibikomere cyangwa indwara ya indwara yanduye, kandi ni ngombwa kumenya mikorobe n'imbaraga zanduye mbere yo kuvurwa.
Syndrome yo kubabara mu karere kigoye irangwa nububabare, hybresthesia, amazu ya allergie, amaraso yaho adasanzwe, ibyuya, na Edema, harimo bidasanzwe bya sisitemu yimbere. Mubisanzwe bibaho nyuma yihungabana no kubaga, kandi iramenyekana kandi ivurwa hakiri kare, hamwe na mbega imitsi yimpuhwe nibiba ngombwa.
• OSTROPTOCIQUE Ossific (HO) irasanzwe nyuma yo guhaguruka cyangwa kubaga, kandi iramenyerewe mu nkokora, ikibero, hamwe n'ibibero, hamwe n'ibibero, hamwe na bisphossonates byabuza amagufwa nyuma y'ibimenyetso.
• Umuvuduko mubice bya periophysal byiyongera kurwego runaka, kwinjiza farusion imbere.
• Imvune ya neurovascular ifite ibitera gukomeretsa neurovascular kubera ahantu hatandukanye.
• Necroses necroses ibaho mubice byamaraso adahagije, byumwihariko, reba ibikomere na anatatotike, nibindi, kandi ibyangiritse bidasubirwaho bibaho.
Igihe cyohereza: Ukuboza-31-2024
