Ibizava mu kwivuza biterwa no gusubiramo ibishushanyo mbonera, bikosorwa gukomeye kumeneka, kubungabunga imiti myiza yoroshye hamwe nimyitozo yo hambere.
Anatomy
TheHumal Humerusigabanijwemo inkingi yo hagati hamwe ninkingi yinkingi (Ishusho 1).
Igishushanyo 1 Umuyoboro wa kure igizwe ninkingi yo hagati kandi yinyuma
Inkingi yo hagati ikubiyemo igice cyo hagati cya epiphysis yubuhinzi, epicondyle ya Humerus hamwe na Humberlean Company harimo glide yubuhinzi.
Inkingi yikiruhuko zigizwe nigice cya epiphysis yubuhinzi, epicondyle yo hanze ya humerusi na comele yo hanze ya humerusi harimo na tumbersity.
Hagati yinkingi ebyiri zikiruhuko ni forsa yimbere ya cossa hamwe na festeri yimbere.
Mechanism
Kuvuka kwa supracondy yumusomeri akenshi biterwa no kugwa ahantu hirengeye.
Abarwayi bato bafite ibishishwa byingenzi cyane biterwa nibikomere byubugizi bwa nabi, ariko abarwayi bakuze barashobora kugira ibikomere byingufu ziva mubikomere byo hasi-imbaraga zingufu ziterwa na Osteoporose.
Kwandika
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Igishushanyo 2 Ao Kwandika
Ao Umuyoboro wo kwandika (Ishusho 2)
Andika A: kuvunika-bidasanzwe.
Andika B: Kuvunika birimo ubuso bwa Arcticular (kuvugurura-inkingi imwe).
Andika C: Gutandukanya Byuzuye Ubuso Bwimbuye bwa Humertus kuva ku rubavu rw'Abasoral (kuvunika bicolumnar).
Buri bwoko bugabanyijemo ibice 3 subtypes ukurikije urwego rwibihugu bivunika, (1 ~ 3 subtypes hamwe nurwego rwibihugu).
Igishusho3 Kwegera-Radin Kwandika
Rangeborough-Radin Kwandika Kuvunika Intercondy ya Humerus (Ubwoko bwose burimo igice cya supracondylar ya Humerus)
Andika I: Kuvunika nta kwimurwa hagati yinyenzi zubukorikori na Talus.
Ubwoko bwa II: Kuvunika Intercondylar ya Humerus hamwe no kwimura imitwe ya condle idafite ubumuga bwo ku isigano.
Ubwoko bwa III: Kuvunika Intercondylar ya Humerus hamwe no kwimura igice cyacitse ka cogley hamwe nubumuga bwo ku isi.
Andika IV: Kuvunika bikabije byumugaragaro ubuso bwa articular yindirimbo imwe cyangwa byombi (Ishusho 3).
Igishushanyo 4 Ubwoko I Guvuza umukoza
Igicapo Cumeral Tuberale
Kuvunika umusoro mwinshi: gukomere gukomeretsa humer
Andika I: Kuvunika kwa Tumbaral Tumbersity arimo kuruhande rwa Talus y'Ubutori (Flec-Ste-Steinthal Flecture) (Ishusho 4).
Ubwoko bwa II: Kuvunika amaguru ya karitsiye ya Articular ya Tumbersity ya Tumbersity (Kocher-Lorenz).
Andika III: Kuvunika byashyizweho na tuberal tumbersity (Ishusho 5).
Kuvura no kudakora
UBURYO BUKORESHEJWE KUBURYO BUKORESHEJWE BIDASANZWE bafite uruhare ruto. Intego yo kuvura kudakora ni: Urugendo ruhuriweho kugirango wirinde gukomera; Abarwayi bageze mu zabukuru, ahanini barwara indwara nyinshi z'imiryango, bagomba gufatwa n'uburyo bworoshye bwo guhagarika inkokora mu 60 ° guhindagurika ibyumweru 2-3, bikurikirwa nigikorwa cyoroheje.
Kwivuza
Intego yo kwivuza ni ukugarura imikorere yububabare bwimikorere yingingo (30 ° kwagura inkokora, 130 ° yinkokora, 50 ° yo kuzunguruka imbere no kuzunguruka); Gukosora kandi bihamye byimbere byimbere bituma intangiriro yinkokora ikora nyuma yo gukiza uruhu; Gukosora isahani ibiri yo gukosora humer itandukanijwe: Hagati na inyuma yinyuma yo kurangiza amasahani ebyiri, cyangwametaial na kuruhandeGukosora amasaha kabiri.
Uburyo bwo kubaga
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Kumenyekanisha no kurinda imitsi ya median na Radial inztrate.
Inkomoko yinyuma irashobora kwiyongera kubaga: Ulnar Hawk Osteotomy cyangwa Triceps Gusubira inyuma kugirango yerekane imivuruke yimbitse
Ulnar Hawkeye Osteotomy: Kugaragaza bihagije, cyane cyane kubijyanye no kuvunika hejuru yubuso bwa Articular. Ariko, kuvunika bitarimo ubumwe bikunze kubaho kurubuga rwa Osteotomy. Igipimo cyo kutavunika kitagabanijwe cyane na Ulnar Hawk Osteotomy (HerringBone Osteotomy) no gukosora band insinga cyangwa plaque.
Triceps yongeye guhura irashobora gukoreshwa muri Trifeld Trifel Crufral Clure hamwe ninguzanyo ihuriweho, kandi yagutse imurikagurisha ryimisoro irashobora gutema no gushyira ahagaragara Ulnar Hawk inama kuri cm 1.
Byagaragaye ko amasahani yombi ashobora gushyirwaho orthogonally cyangwa ugereranije, bitewe n'ubwoko bwo kuvunika aho plaque igomba gushyirwamo.
Kuvuka hejuru yubuso bugomba gusubizwa hejuru ya articular articular kandi bishyirwa mubiti byubukorikori.
Igishushanyo 6 nyuma yo gukora igenamiterere ryimbere ryinkonie
Gukosora by'agateganyo inkoko byakozwe hakoreshejwe a KI insinga ya KM, nyuma y'isahani y'amashanyarazi ya miliyoni 3.5 yatunganijwe n'inkingi ya kure ya Hurmer, bityo isahani yo kubaka iy'isahani ya kure ya humeli, kandi ku mpapuro nshya zidasanzwe zishobora koroshya inzira.) (Ishusho 6).
Witondere kudakosora ibishushanyo mbonera byimigozi hamwe na screw cortique zose hamwe nigitutu kiva kuri meta kumurima kuruhande.
Urubuga rwibihumbi-humerusi ni ngombwa kwirinda kutuvunika.
Gutanga amagufwa byuzuza ahabereye inenge, ushyiramo amagufwa ya iliac guhagarika amagufwa yo kuvuka: Inkingi ya ARTIAL, Gutegura Amagufwa Kumurongo Kuri Epiphysis.
Ibuka ingingo z'ingenzi zo gukosora.
Gukosora igice cyo gucika intege hamwe na benshiimigozibishoboka.
Gukosora Ibice byinshi byacitse nkibishoboka hamwe na scurews yambuka hagati kugirango bitangire.
Isahani y'icyuma igomba gushyirwa kumpande zo hagati kandi kuruhande rwa humer.
Amahitamo yo kuvura: Elbow ya Elbow Arthroplasy
Ku barwayi bafite ibicuruzwa bikabije cyangwa osteoporose, inkokora yose ya elbow irashobora kugarura icyerekezo cyerekana inkokora hamwe nintoki zintoki nyuma yabarwayi basaba; Ubuhanga bwo kubaga busa na arthroplasty rwose impinduka zidahwitse ryinkokora.
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(2) Incamake y'ibikorwa byo kubaga.
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Ibinyomoro bya Ulnar Herve.
Kwinjira mu mpande zombi za Triceps kugirango ukureho amagufwa (Ingingo y'ingenzi: Ntukagabanye ihagarara rya Triceps kurubuga rwa Ulnar Hawk).
Umuyoboro wose wa kure harimo na Hawk Fossa urashobora kuvaho kandi prostrasi yashyizwemo, itazasiga sequelae ikomeye niba inyongera i kuri cm 2 yakuweho
Guhindura amakimbirane yimbere ya triceps imitsi mugihe gikwiye prosthos yuburyo nyuma yo kwemezwa kwurubuga.
Excrans yisonga ryibihe bya UlImisance ya Proximient kugirango yemere uburyo bwiza bwo kubona no gushiraho ulnar prostrasi ibice (Ishusho 7).
Igicapo 7 Elbow Arthroplasty
Kwitaho nyuma yo kwitabwaho
Nyuma yinyuma yinyuma yinyuma yinkokora igomba kuvaho ibikomere byuruhu byumurwayi bikiza, hamwe nuburyo bukora bukora bugomba gutangira; Inkomoko igomba gukosorwa mugihe kirekire gihagije nyuma yo gusimbuza hamwe kugirango utegure ibikomere byuruhu (inkokora irashobora gukosorwa mubyumweru 2 nyuma yo kubagwa kugirango bifashe imikorere myiza); Guhinduka kwawe gukosowe ubu bikunze gukoreshwa mubuvuzi kugirango byoroherezwe uburyo bwimyitozo yo gutembera mugihe ishobora gukurwaho kenshi kugirango bakure neza intandaro yibasiwe; Imyitozo ikora ikora isanzwe itangira ibyumweru 6-8 igikomere cyuruhu rwakize rwose.
Kwitaho nyuma yo kwitabwaho
Nyuma yinyuma yinyuma yinyuma yinkokora igomba kuvaho ibikomere byuruhu byumurwayi bikiza, hamwe nuburyo bukora bukora bugomba gutangira; Inkomoko igomba gukosorwa mugihe kirekire gihagije nyuma yo gusimbuza hamwe kugirango utegure ibikomere byuruhu (inkokora irashobora gukosorwa mubyumweru 2 nyuma yo kubagwa kugirango bifashe imikorere myiza); Guhinduka kwawe gukosowe ubu bikunze gukoreshwa mubuvuzi kugirango byoroherezwe uburyo bwimyitozo yo gutembera mugihe ishobora gukurwaho kenshi kugirango bakure neza intandaro yibasiwe; Imyitozo ikora ikora isanzwe itangira ibyumweru 6-8 igikomere cyuruhu rwakize rwose.
Igihe cyohereza: Ukuboza-03-2022
