Yokhomerera - ndichiyani? Opaleshoni repositioning makombo fupa ntchito nyumba zosiyanasiyana chikukonzekera

Pawiri mafupa wosweka ntchito opareshoni adzakhala imathandizira lipole, ndipo kukhazikitsa kwa odwala ndi fractures zovuta. Kwa nthawi yoyamba ndondomeko monga fixation mafupa unachitika mu zaka za m'ma 19, koma chifukwa zikamera wa mavuto aakulu purulent madokotala anakakamizika kusiya kuchita izo. Alikukonzeka watsopano pofuna pambuyo oyamba mu mchitidwe wa mankhwala aseptic ndi antiseptic.

fixation ndi chiyani?

odwala ambiri ndi zovuta fractures madokotala kupereka kugwira osteosynthesis. Ndi chiyani icho? Izi pawiri zidutswa fupa mwa ntchito. Childs Kwalamulidwa kwa iye mankhwalawa mfundo zovuta bwino zinaphatikizidwa kapena mwatsopano fractures sanali ogwirizana. Kugwiritsa osteosynthesis fixation amapezeka zidutswa chikufanana. Izi amalenga abwino maphatikizidwe awo, komanso kubwezeretsa kukhulupirika kwa chiwalo.

Pali mitundu iwiri waukulu osteosynthesis:

• kumiza (extramedullary, intramedullary, transosseous);
• akunja (extrafocal).

Zimachitika ndi akupanga osteosynthesis. Ndi chiyani icho? Ndi pawiri makombo yaing'ono fupa.

Ntchito akutsatiridwa ntchito fixatives osiyana. Kumiza thupi intraosseous osteosynthesis zikhomo ndi misomali ntchito ya mbale - mbale ndi zomangira, chifukwa transosseous - masipoko ndi zomangira. totsegulira izi zopangidwa zakuthupi mankhwala, thupi ndi biologically ndale. Amagwiritsidwa ntchito zitsulo nyumba vitalliya, zosapanga dzimbiri, titaniyamu, makamakanso - kuchokera pulasitiki inert ndi fupa. Spacers amapangidwa ndi zitsulo pambuyo wovulala srastetsja zambiri kuchotsedwa. Ilizarov zida pa mwendo ntchito osteosynthesis kunja. Uyamiko kwa Iye, makombo fupa pambuyo kuyerekeza dwi. Odwala angayende bwinobwino ndi katundu zonse.

umboni

Opaleshoni osteosynthesis akuonetsedwa ngati kuchira yaikulu njira pamene:

• wovulala ichi, chimene sanakule pamodzi popanda thandizo la zoopsa;
• kuwonongeka Mwina perforation wa khungu (pamene chatsekedwa wovulala ndi kupita ku anthu);
• wovulala kobvuta ndi kuwonongeka kwa mtsempha wamagazi yaikulu.

contraindications

Opaleshoni alowererepo ali osavomerezeka chifukwa zinthu zotsatirazi:

• Ngati wodwala akudwala;
• pali lotseguka kuwonongeka kwakukulu;
• pa matenda a malo akhudzidwa;
• Ngati pali kumasonyeza kudwala ya chiwalo chilichonse mkati;
• mu kupitirira wa zokhudza zonse matenda a mafupa;
• wodwalayo nthambi venous insufficiency.

mitundu ya mbale

Mbale amene ntchito pa ntchito lili ndi zitsulo zosiyana siyana. The bwino anazindikira titaniyamu mbale, ngati nkhaniyi ali mbali chidwi: mpweya filimu aumbike pa nthawi yomweyo imene zosatheka sadzakhala kucheza ndi zimakhala thupi. Pankhaniyi, palibe kuopa metallosis. Ndichifukwa chake ambiri mbale izi si kuchotsedwa ndipo anasiya moyo.

Submersible intraosseous osteosynthesis

dzina lina opaleshoni - intramedullary osteosynthesis. Iye amakhala womasuka ndi kutsekedwa. Mbali yoyamba, woyendera nthambi wovulala poyera, inatuluka tikayerekezera makombo ndi mu ngalande medullary la fupa kuonongeka jekeseni ndodo makina. Panja fixation sikutanthauza ntchito zipangizo zina zapadera kulumikiza makombo, njira imeneyi wosalira zambiri ndipo mosavuta chatsekedwa ntchito. Komabe, mu nkhani iyi izi kumaonjezera ngozi ya matenda minofu zofewa.

Tatseka intramedullary fixation amakhala ndi chakuti iwo adzatulutsa poyerekeza ndi makombo, ndiyeno kupanga ang'ambe thupilo yaing'ono kutali ndi fupa lothyoka malo. Mu X-ray ulamuliro kudzera ang'ambe thupilo ichi ntchito zida wapadera umayamba mu ngalande medullary la kuonongeka fupa wochititsa m'malo yaitali zachitsulo dzenje ndodo awiri yoyenera. Pambuyo pake, kondakitala chikutha ndi chilonda ndi sutured.

Submersible osteosynthesis

Ndi chiyani icho? Izi njira zidutswa fupa pawiri umagwiritsidwa ntchito pa fractures zosiyanasiyana (comminuted, helical, periarticular, oblique, lateral, intraarticular), kaya kupinda ndi mawonekedwe a ngalande medullary. Clamps, amene Ntchito amenewa amaoneka mu mawonekedwe a zigawo makulidwe osiyana ndi mawonekedwe, kulumikiza kwa fupa ntchito zomangira. mbale ambiri masiku ano kubweretsa pamodzi ndi chipangizo wapadera, kuphatikizapo zochotseka ndipo sanali zochotseka. Potsatira ndondomeko, nthawi zambiri amalowerera ngakhale pulasitala.

Pamene helical fractures oblique ndi osteosynthesis nthawi anachita kudzera mwa n'kupanga zitsulo ndi waya, komanso mphete wapadera ndi zosapanga dzimbiri theka mphete. Izi pawiri njira fupa, makamaka waya, sikawirikawiri ntchito ngati woima chifukwa fixation si amphamvu kwambiri ndipo nthawi zambiri akutumikira monga enaake kuti mitundu ina osteosynthesis.

Opaleshoni imeneyi kawirikawiri ntchito zofewa suture (silika, catgut, dacron), chifukwa filaments ngati sangathe kukana samatha akulu ndi kusamutsidwa a zotsala.

Submersible transosseus osteosynthesis

Chotero repositioning opaleshoni mwa akapichi, zomangira, masipoko, ndi clamps izi ikuchitika kosopoperechnom kapena transversely khoma fupa mu malo kuvulazidwa. A mtundu wapadera wa osteosynthesis chreskostnogo fupa olowa - ndi pamene makombo ali mokhomerera TV ndipo mwa iwo amathera ligatures (catgut, silika, waya), kenako kumangitsa ndi tayi. Izo ntchito pamene fupa olowa wovulala ndi olecranon kapena patella. Transosseous osteosynthesis amapereka imposition a pulasitala lapansi.

panja fixation

repositioning Izi zachitika mwa zipangizo wapadera (Ilizarov zida, Volkova - Oganessian). Zimenezi zimathandiza tikayerekezera makombo popanda kukhudzana kwa fupa lothyoka malo ndi kukonza iwo mwamphamvu. Njira imeneyi ikuchitika popanda imposition wa gypsum, ndi Ilizarov zida wapansi amalola kuyenda kwa mtima ndi katundu zonse.

zosokonezeka

Pambuyo opaleshoni zingachititse mavuto aakulu. Zotsatira:

• pachithunzichi kusankha njira fixation makombo fupa;
• Kusakhazikika chikufanana fupa zinyalala;
• wamwano mankhwala a minofu zofewa;
• molakwa anatola loko;
• sanali kugwilizana ndi aseptic ndi antiseptic.

zosokonezeka izi zimathandiza kuti pachithunzichi wovulala machiritso, izo fester kapena nonunion wathunthu.

Popeza osteosynthesis submersible ntchito mbale yaitali yaikulu poyera fupa zimenezi kwa mtunda wautali, kawirikawiri kusokonezedwa ndi nthenda yotaya magazi, imbaenda m'mbuyo machiritso bwino. Pambuyo kuchotsa zomangira ndi mabowo ambiri amene kufooketsa fupa.

Pomaliza

Choncho, tinakambirana njira monga osteosynthesis. Ndi chiyani icho? Ndi njira zamakono kwambiri kulumikiza makombo fupa pambuyo wovulala a. Uyamiko kwa Iye, ndondomeko mankhwala ndi konzanso odwala ndi inapita patsogolo kwambiri. Zagwiridwa osteosynthesis ntchito fixatives osiyana. Amaona mbale titaniyamu kwambiri cholimba, omwe sangathe ngakhale kuwombera.