I-Osteosynthesis - yintoni na? Ukutshintshwa kwendawo yokuphinda i-bone fragments ngoncedo lwezakhiwo ezahlukeneyo zokulungisa

Ukuqhagamshelana kwamathambo aphulekileyo ngoncedo lotyando lwavunyelwa ukukhawuleza inkqubo yokunyanga kunye nokuvuselelwa kwezigulane ezinokonakala eziqhekezayo. Ngethuba lokuqala inkqubo enjalo njenge-osteosynthesis yamathambo yaqhutyelwa ngekhulu le-19, kodwa ngenxa yobunzima beengxaki ezinzulu zogqirha, oogqirha banyanzelekile ukuba bayeke ukwenza. Ukuqalisa kwakhona iinzame emva kokuqaliswa kwonyango lwe-antiseptic kunye ne-aseptic.

Yintoni i-osteosynthesis?

Izigulane ezininzi ezinamaqabunga adibeneyo zenziwa ukuba zenze i-osteosynthesis. Yintoni na? Olu qhagamshelo lwamaqhekeza amathambo ngokusebenza. Ngokuqhelekileyo, umiselwe ukuba unyango lwamaqhina adibeneyo, ukuchithwa ngokungalunganga okanye iintambo ezingenakunqandwa. Ngoncedo lwe-osteosynthesis kukho ukulungiswa kweziqwenga ze-juxtaposed. Ngaloo ndlela, iimeko ezifanelekileyo zenziwe ngokubambelela kwabo, kunye nokubuyisela ukuthembeka kwelungu.

Kukho iintlobo ezimbini ezibalulekileyo ze-osteosynthesis:

• Ehlanjululwe (ithambo, intraosseous, transosseous);
• Ngaphandle (ukugxininisa okukodwa).

Kukho ne-ultrasonic osteosynthesis. Yintoni na? Olu dibane lweengcezu ezincinci zethambo.

Iinkqubo zenziwa ngokuncediswa kwezilungiso ezahlukeneyo. Ukubhoboza i-osteosynthesis ye-intraosseous, iiphonkwane kunye nezikhonkwane zisetyenziselwa, isitya seethambo kunye nezikriti, ngeenaliti kunye ne-screws. Ezi zilungiso zenziwa ngamachiza, ngokwezinto eziphilayo kunye nezempilo ezingathathi hlangothi. Eyona nto isetyenziswayo izakhiwo zetsimbi ezenziwe nge-essentiallium, insimbi engenasici, i-titanium, kaninzi kangako-ye-plastiki engenayo kunye namathambo. Izilungiso ezenziwe ngentsimbi, emva kokuqhaqhaqhaqhaqhalwa, zihlala zisuswa. Isixhobo se-Ilizarov emlenzeni sisetyenziselwa i-osteosynthesis yangaphandle. Ndiyabulela kuye, iinqununu zethambo zenziwe emva kokuthelekiswa. Izigulane ziqhele ukuhamba ngomthwalo opheleleyo.

Iinkcazo

Usebenziso lwe-osteosynthesis luboniswa njengendlela yokubuyisela eyona ndlela:

• Ukuphuka okunjalo okungakhuli kunye ndawonye ngaphandle koloncedo lwe-traumatologist;
• Ukulimala ngethuba lokuhlanjululwa kwesikhumba (xa i-fracture evaliweyo iyakwazi ukungena evulekile);
• Ukuqhekeka, okunzima ngumonakalo omkhulu kumzobo.

Ukungqinelana

Ukungenelela kokusebenza akukhuthazwa kule miqathango ilandelayo:

• Ukuba isiguli asiva kakuhle;
• Kukho umonakalo omkhulu ovulekile;
• Usulelo lwengingqi echaphazelekayo;
• Ukuba kukho izigulane ezinzima zaso naziphi na izitho zangaphakathi;
• Ngokuqhubela phambili kwesifo se-bone system;
• Isigulane sinokuphelelwa ngamandla kwesilungu.

Iindidi zamacwecwe

Iiplati, ezisetyenziswe ngexesha lokusebenza, zenziwe ngeensimbi ezahlukeneyo. Iipatatesti ezibalaseleyo ezibonakalayo, ngokuba le nto inomdla obalulekileyo: emoyeni kwangoko kwakha ifilimu, engayi kusebenzisana namancuba omzimba. Kule meko, awukwazi ukwesaba ukuphuhliswa kwe-metallosis. Kungenxa yoko amaninzi amaninzi afakelwe, kodwa ashiye ubomi.

Ikhupha i-osteosynthesis ye-intraosseous

Olunye igama lo msebenzi luyi-intramedullary osteosynthesis. Ivulekile kwaye ivaliwe. Kwiimeko zokuqala, indawo yezahlulo ibonakala, emva koko iifaki zithelekiswa, kwaye intonga yomatshini ifakwe kwingxowoma yethambo lomnxeba owonakele. Vula i-osteosynthesis ayifuni ukusetyenziswa kwezixhobo ezikhethekileyo zokudibanisa iziqhekeza, le ndlela ilula kwaye ifumaneke ngakumbi kunokuba kuvaliwe ukusebenza. Nangona kunjalo, kule meko, umngcipheko wokusuleleka kwezicubu ezincinci ukwanda.

I-osteosynthesis ye-intramedullary evalwe ibonakaliswe ngento yokuba baqhathanisa iziqhekeza, emva koko benza ukuchithwa okuncinci kude nesayithi yokuphuka. Ngaphansi kolawulo lwe-X-ray, intonga engapheliyo yentsimbi ye-diameter efanelekileyo ifakwe kwisicatshulwa esikhethekileyo kwisitya somnyoba wethambo lesithambo esonakalisiweyo kunye nomqhubi. Emva koko, umqhubi uyasuswa kwaye isilonda sutured.

Kwangenisa i-bone osteosynthesis

Yintoni na? Le ndlela yokudibanisa iziqhekeza zethambo isetyenziselwa iintlobo ezahlukileyo (eziguqulelwe, i-helical, i-circumarticular, oblique, i-transverse, intraarticular), kungakhathaliseki ukuba i-bend kunye nokubunjwa komsele we-medallary. Ukugcinwa kwezinto ezisetyenziselwa imisebenzi enjalo kuboniswa ngokwefomathi yamacwecwe ahlukeneyo kunye nemilo exhunyiwe kwithambo kunye nezikrini. Amacwecwe amaninzi anamhlanje afumana izixhobo ezikhethekileyo, ezibandakanya ukususwa kunye nokungenakususwa. Emva kwenkqubo, i-bandage ye-plaster isetyenziswa rhoqo.

Ngamaqabunga e-helical and oblique, i-osteosynthesis yamathambo ngokuqhelekileyo iqhutywe kusetyenziswa iintsimbi zensimbi kunye nentambo, kunye neendandatho ezikhethekileyo kunye neemimirings ezenziwe ngensimbi engenasici. Le ndlela yokudibanisa ithambo, ingakumbi i-wire, ayinakudla ngokusetyenziswa njengeendlela ezizimeleyo ngenxa yokulungiswa okunamandla kwaye ihlala ihambelana nezinye iintlobo ze-osteosynthesis.

Kulo msebenzi, izinto eziphathekayo zetyuty (i-silk, catgut, lavsan) ayinakudla ukusetyenziswa, kuba loo misonto ayinakukwazi ukumelana neengxube ze-muscular kunye nokufuduka kweziqhekeza.

I-osteosynthesis engapheliyo

Ukutshintshwa kweso sikhokelo kuqhutywe ngoncedo lweebhentshi, izikrini, izithethi, ezi zitshixo ziqhutyelwa kwinqanaba le-oblique okanye elijikelezayo ngokusebenzisa iindonga zethambo kwindawo yokulimala. Uhlobo oluthile lwe-osteosynthesis ye-transosse ye-bone suture-yilapho iinqanawa zidibene kwiinqununu kunye ne-ligatures (i-catgut, i-silk, i-wire) iqhutywe kuyo, leyo yomelelwa kwaye iboshwe. I-bone seam isetyenziselwa iziqhekeza zomgca okanye i-patella. I-osteosynthesis i-Transosseous iquka ukufakwa kwebhanti yokubeka.

Osteosynthesis yangaphandle

Ukuhlaziywa okunjalo kuqhutyelwa ngoncedo lwezixhobo ezikhethekileyo (izixhobo i-Ilizarov, iVolkov-Oganesyan). Oku kukuvumela ukuba uqhathanise iinqununu ngaphandle kokubonisa indawo yeqhekeza kwaye uzilungise ngokuqinile. Le ndlela iyenziwa ngaphandle kokusetyenziswa kwe-gypsum, kwaye idivayisi ye-Ilizarov emlenzeni ivumela isigulane ukuba sihambe ngomthwalo opheleleyo.

Iingxaki

Emva kokusebenza, iingxaki ezinzima zivela. Kubo iziphumo:

• Ukukhetha okungalunganga kwenkqubo yokulungisa iinqununu zethambo;
• Ukukhubazeka kweziqhekeza zethambo ezidibeneyo;
• Ukuphathwa kakubi kwezicubu ezithambileyo;
• Ugcino olukhethiweyo olungakhethiweyo;
• Ukungathobeli i-asepsis kunye ne-antiseptics.

Iingxaki ezinjalo zifaka isandla ekuhlanganiseni okungahambi kakuhle kwe-fracture, ukuxhaswa kwayo okanye ukugqiba okungagqithwanga.

Ekubeni iiplati ezide ezide zisetyenziselwa i-osteosynthesis yamathambo, kwaye ngenxa yeli bone ityhila ngokubanzi, igalelo layo legazi lisoloko likhubazekile, elikhokelela ekufuseni okucothayo. Emva kokususa iifreyi, kukho imingxuma emininzi eyenza ithathaka ithambo.

Isiphelo

Ngoko, sihlolisise indlela enjalo njenge-osteosynthesis. Yintoni na? Le ndlela yindlela yanamhlanje yokudibanisa amaqhekeza amathambo emva kokuphuka. Ndiyabulela kuye, inkqubo yokonyango kunye nokuvuselelwa kwezigulane zikhawuleza kakhulu. I-osteosynthesis yenziwa ngoncedo lwezixhobo ezahlukeneyo. Izona ziqineleyo zingama-titane, azinakususwa.