Achiuroverera - chii? Kuvhiya repositioning repfupa zvimedu vachishandisa siyana kutara hurongwa

Remubatanidzwa dzakaparadzana mapfupa kushandisa mashandiro achange mhanyisa apore, uye kunaya varwere akaoma mitswe. Kokutanga muitiro akadai Kuda kutamba mapfupa, yakaitirwa remakore rechi19, asi nokuda chidzoke zvokuva chaizvo yematambudziko vanachiremba purulent dzakamanikidzwa kurega kuzviita. Kutsva kuedza pashure pakusuma mune tsika aseptic uye akambozvishandisa kuuraya utachiona kurapwa.

Chii Kuda kutamba?

Varwere vakawanda kunzwisisa mitswe navanachiremba kupa kubata osteosynthesis. Chii? Izvi remubatanidzwa mapfupa zvimedu achishandisa kushanda. Yemanyorero ushandiswe kwaari kurapwa mapfundo akaoma, zvakanaka fused kana yakanaka non-vakabatana mitswe. Kushandisa osteosynthesis Kuda kutamba kunoitika vachiwirirana zvimedu. Izvi zvinoita yakanaka ezvinhu nokuda Fusion yavo, uyewo kudzorerwa kutendeseka rimwe gumbo.

Pane huru akasiyana maviri osteosynthesis:

• kunyudza (extramedullary, intramedullary, transosseous);
• yokunze (extrafocal).

Zvinoitika zvakawanda uye ultrasonic osteosynthesis. Chii? Zviri remubatanidzwa zviduku mapfupa zvimedu.

Operations yaitwa kushandisa fixatives siyana. Kunyudza intraosseous osteosynthesis nembambo nezvipikiri kushandiswa nokuti ndiro - ndiro chete screws nokuti transosseous - spokes uye screws. Tabs aya wakaitwa mishonga, panyama uye pakugadzira kwazvakarerekera zvinhu. Yaiwanzoshandiswa Zvivako simbi kuti vitalliya, Stainless simbi, titanium, shoma zvikuru - kubva inert epurasitiki uye mapfupa. Spacers dzakagadzirwa nesimbi pashure kutsemuka srastetsja kazhinji kubviswa. Ilizarov midziyo pamusoro gumbo yaishandiswa kwokunze osteosynthesis. Pamusana kwaari, pfupa zvimedu pashure kuenzanisa zvakasimba wakaiswa. Varwere vanogona kufamba kuine zvakazara mutoro.

umboo

Operation osteosynthesis kuratidzwa sezvo chikuru kupora unyanzvi kana:

• kutsemuka ichi, izvo hazvina kukura pamwe pasina rubatsiro pfungwa;
• kukuvara ndingangokuvara perforation ganda (kana namahwindo kutsemuka anokwanisa kupinda pachena);
• kutsemuka kuoma ne kukuvadzwa chikuru tsinga.

Contraindications

Kuvhiya kupindira haina pachii zvinotevera ezvinhu:

• kana murwere ari kurwara;
• pane yakazaruka dzinokuvadza;
• pamusoro hweHIV njodzi nzvimbo;
• Kana pane chiratidzo zvokurwara chero zvemukati nhego;
• ari kufambira mberi systemic chirwere repfupa;
• murwere ane gumbo venous insufficiency.

marudzi kwamahwendefa

Mahwendefa zvinoshandiswa panguva oparesheni, chakagadzirwa nesimbi dzakasiyana. Akanakisisa kuzivikanwa titanium ndiro, sezvo mashoko aya ane inonakidza chinowanikwa: mhepo firimu achiumbwa pamusoro payo pakarepo, izvo hakuna nzira haangavi kushamwaridzana munyama muviri. Muchiitiko chino, hapana kutya metallosis. Ndokusaka vakawanda mahwendefa aya hadzina kubviswa uye asiyiwa kuti upenyu.

Submersible intraosseous osteosynthesis

Chimwe zita nokuti oparesheni - intramedullary osteosynthesis. Iye rakazaruka uye yakavharwa. Muchiitiko chokutanga, imwe kutsemuka mapazi ari pachena, pakwakanga tikaenzanisa nezvimedu uye medullary Canal of dzaparadzwa mapfupa jekiseni zvokuimba tsvimbo. Outdoor Kuda kutamba hakurevi kushandisa chaiyo midziyo kubatanidza nezvimedu, unyanzvi iri nyore zvikuru uye nyore Akanyatsovharwa oparesheni. Zvisinei, muchiitiko ichi nayo kunowedzera ngozi yokubatwa nyoro tishu zvirwere.

Closed intramedullary Kuda kutamba kunoratidzwa ne chokwadi kuti pave nokuenzanisa nezvimedu, uye ipapo ita chiduku incision kure kutsemuka yacho. Under X-ray kuzvidzora kuburikidza incision ichi uchishandisa chaiyo midziyo kutaurwa kupinda medullary Canal munhu wakakanganiswa pfupa kondakita nani refu esimbi mhango tsvimbo zvakakodzera dhayamita. Pashure paizvozvo, muitisi hwaputswa uye ronda sutured.

Submersible osteosynthesis

Chii? Izvi nzira mapfupa zvimedu remubatanidzwa rinoshandisirwa panguva dzakasiyana mitswe (comminuted, helical, periarticular, oblique, lateral, intraarticular), zvisinei vachikotama uye Maumbirwe medullary mugero. Okusungisa, izvo anoshandiswa kwacho vanoonekwa muchimiro mahwendefa zvakasiyana ukobvu uye chimiro, unobatanidza kune pfupa vachishandisa screws. Mahwendefa akawanda ano vari kuunganidzwa chaiyo mudziyo, kusanganisira bvisika uye non-bvisika. Zvichitevera nzira, kazhinji kusangomanikidzira kunyange purasita akakandwa.

Kana helical oblique mitswe uye osteosynthesis kunowanzoitwa pachishandiswa rinoparadza simbi waya, uyewo dzinokosha zvindori uye Stainless simbi hafu zvenzeve. Izvi nzira mapfupa remubatanidzwa kunyanya kuva waya, haawanzopiwi kushandiswa yakazvimirira nokuda Kuda kutamba haisi simba zvakare uye kazhinji ndipiyona kwokunwa dzimwe mhando osteosynthesis.

oparesheni iyi chaizvo kashoma kushandiswa nyoro suture (nesirika, catgut, dacron), nekuti filaments kwakadaro havasi kupikisa tsandanyama traction uye misha zvimedu.

Submersible transosseus osteosynthesis

Kwakadaro repositioning zvomusejari achishandisa kukurova, screws, spokes, uye okusungisa izvi rinoitwa mu kosopoperechnom kana transversely kuburikidza pfupa rusvingo kupinda nzvimbo zvinokuvadza. A rinokosha mhando osteosynthesis chreskostnogo pfupa vadyi - ndiwo kana nezvimedu vari akachera hova uye kuburikidza navo kupedza ligatures (catgut, sirika, waya), iyo zvino sungisa uye netayi. Rinoshandiswa kana pfupa pamwe pakakuvara ari olecranon kana patella. Transosseous osteosynthesis anopa nokuiswa chakakandirwa.

Outdoor Kuda kutamba

repositioning Izvi zvinoitwa pachishandiswa anokosha mano (Ilizarov midziyo, Volkova - Oganessian). Izvi zvinobvumira tikaenzanisa nezvimedu pasina nokufumura pakakuvara nzvimbo uye dzibve zvakasimba. nzira iyi rinoitwa kunze nokuiswa gypsum, uye Ilizarov midziyo netsoka unokubvumira kufamba murwere ane zvizere mutoro.

yematambudziko

Pashure pokuvhiyiwa kunogona kukonzera zvakakomba matambudziko. zvabuda izvi:

• sizvo vakasarudzwa chidobi Kuda kutamba repfupa zvimedu;
• Kusagadzikana vachiwirirana pfupa masarasara;
• unhu Mabatirwo nyoro tishu;
• zvisiri akabata zvechizarira;
• asiri zvaidiwa aseptic uye akambozvishandisa kuuraya utachiona.

yematambudziko izvi zvinoita kuti kururama kutsemuka zvokuporesa, izvozvo akaora kana nonunion zvakakwana.

Sezvo submersible osteosynthesis kushandiswa muhombe ndiro refu uye kuratidza pfupa kuti iri kure, kazhinji zviri anetseka aibuda ropa, iyo inotungamira kuderedza kuporeswa zvakanaka. Mushure kubvisa screws izhinji mumakomba, izvo kupedza mafupa.

mhedziso

Saka, takakurukura nzira yokutora akadai osteosynthesis. Chii? Ndicho inonyanya ano nzira kubatanidza pfupa zvimedu shure kutsemuka. Pamusana kwaari, muitiro kurapa uye kunaya varwere nokukurumidza yekudyidzana. Chinozoiswa osteosynthesis achishandisa fixatives siyana. It anonzi kupfuura rakasimba titanium mahwendefa, havanyatsooni kupfura.