Nailing - kuyini? ekuhleleni kabusha Steel of izinsalela usebenzisa izakhiwo ahlukahlukene kokungathembeki

Compound lamathambo ngobugebengu usebenzisa operation ngeke ukusheshisa le nqubo zokuphulukisa, kanye nokuvuselelwa iziguli waphuka kuyinkimbinkimbi. Ngokokuqala ngqá nenqubo efana nenkanuko edlulele lamathambo, aphethwe ekhulwini le-19, kodwa ngenxa ukuvela eziyingozi kakhulu odokotela ubovu saphoqeleka ukuba sime nikwenza. Umzamo Emisha emva isingeniso practice ukwelashwa aseptic kanye isinqandakuvunda.

Kuyini nenkanuko edlulele?

Iningi leziguli ezine-waphuka eziyinkimbinkimbi odokotela ukunikela ukubamba osteosynthesis. Kuyini lokhu? Lokhu kwakwakhe izinsalela esebenzisa msebenzi. Ngokuvamile ebekiwe kuye ekwelapheni amalunga omzimba eziyinkimbinkimbi, tho kahle noma fresh waphuka non-united. Ukusebenzisa osteosynthesis nenkanuko edlulele kwenzeka izingcezwana ifaniswe. Lokhu kudala izimo ekahle Fusion zabo, kanye nokubuyiselwa ubuqotho esinye sezitho zomzimba wakho.

Kukhona izinhlobonhlobo emibili eyinhloko osteosynthesis:

• ukucwiliswa (extramedullary, intramedullary, transosseous);
• yangaphandle (extrafocal).

Kwenzeka osteosynthesis kakhudlwana futhi ultrasonic. Kuyini lokhu? Kuyinto ekhuthaza amathambo izicucu.

Imisebenzi eyenziwa usebenzisa fixatives ezahlukene. Ukuze ukucwiliswa intraosseous osteosynthesis izikhonkwane nezinzipho esetshenziselwa plate - ipuleti nge ngezikulufo, ngoba transosseous - spokes nezikulufi. Lezi amathebhu zenziwa elinama amakhemikhali, ngokomzimba futhi eziphila hlangothi. Yandise esetshenziswa metal takhiwo vitalliya, insimbi engagqwali, titanium, ingasaphathwa - kusukela plastic inert bone. Spacers ezenziwe metal ngemva ukwa srastetsja ngokuvamile isusiwe. Ilizarov apharathasi emlenzeni esetshenziselwa osteosynthesis zangaphandle. Siyabonga kuye, izingcezwana ithambo emva Ngokuqhathanisa egxilile. Iziguli zingenza ukuhamba evamile uma ithwele umthwalo omningi.

ubufakazi

Ukusebenza osteosynthesis olukhonjiswa njengedifolthi yokutakula eyinhloko su uma:

• Lokhu ukwa, okuyinto akakhulelanga ndawonye ngaphandle kosizo ukuhlukumezeka;
• umonakalo Amathuba perforation kwesikhumba (lapho ukwa avaliwe uyakwazi ukuya umphakathi);
• ukwa nzima ngokulimala Umthambo ezinkulu.

Izimo

kokungenela Steel akunconyelwe kwale mibandela elandelayo:

• uma isiguli ezizwa engaphilile;
• kukhona umonakalo evulekile ebanzi;
• phezu ukutheleleka wesayithi ethintekile;
• Uma kukhona isisho zokugula ka kabi noma isiphi isitho yangaphakathi;
• ku Ukudlondlobala kwalesi sifo letindzala ithambo;
• isiguli isitho somzimba esingamahlalakhona emithambo yegazi.

izinhlobo amapuleti

Lezi zingqimba ezisetshenziswa ngesikhathi ukuhlinzwa, esenziwe ngezinto ezihlukahlukene. The best waqaphela titanium amapuleti, njengoba le nto ine isici esithakazelisayo: Kumiswa ifilimu umoya kuyo ngokushesha, okuyinto neze ngeke uxhumana ezicutshini zomzimba. Kulokhu, akukho ukwesaba metallosis. Yingakho eziningi zalezi zingqimba akakhishwanga futhi ishiywa ukuphila.

Ngwenya osteosynthesis intraosseous

Enye igama ukusebenza - osteosynthesis intramedullary. He is ovulekile futhi ivaliwe. Esimweni sokuqala, indawo ukwa echayeke whereupon ngokuqhathanisa izingcezwana futhi umsele medullary wethambo ezilimele injected induku lokukhanda. nenkanuko edlulele Outdoor akudingi ukusetshenziswa imishini ekhethekile ukuxhuma izingcezwana, le ndlela kuyinto lula futhi kufinyeleleke ukusebenza ngamasizini athile. Nokho, kulesi simo-ke kwandisa ingozi ezithambile izicubu izifo.

Kuvaliwe nenkanuko edlulele intramedullary libhekene iqiniso ukuthi ukukhiqiza Ukuqhathanisa izingcezwana, bese wenze imbobo encane kude indawo ukwa. Ngaphansi-X-ray isilawuli ngokusebenzisa le imbobo usebenzisa ama-apharathasi eyisipesheli busuka umsele medullary ka ezilimele ithambo umqhubi metallic kunalokho eside induku ozwakala ubukhulu ezifanele. Ngemva kwalokho, umqhubi kuyinto ekhishiwe kanye Isilonda sutured.

osteosynthesis ngwenya

Kuyini lokhu? Le ndlela izinsalela kwakwakhe kusetshenziswa khona waphuka ehlukahlukene (comminuted, Helical, periarticular, etshekile, lateral, intraarticular), kungakhathaliseki eguqa futhi ukuma komsele medullary. Izibopho, ezisetshenziswa for imisebenzi enjalo ziboniswa ifomu izingqimba ukujiya ezahlukene kanye shape, yokuxhuma ithambo usebenzisa ngezikulufo. amapuleti eminingi yanamuhla Uletha ndawonye idivayisi ekhethekile, kuhlanganise esikhiphekayo futhi okungezona esikhiphekayo. Ukulandela inqubo, ngokuvamile abeke ngisho ukhonkolo usimende.

Lapho Helical etshekile waphuka futhi osteosynthesis ngokuvamile kwenziwa esebenzisa yensimbi kanye wire, kanye amasongo akhethekile insimbi engagqwali isigamu-izindandatho. Le ngxube indlela ithambo, ikakhulukazi i-wire, kuyaqabukela esetshenziswa njengoba ezimele ngenxa nenkanuko edlulele akuyona eliqinile futhi ngokuvamile ukhonza ibhekwa njengengxenye ezinye izinhlobo osteosynthesis njengoba.

Lo msebenzi kakhulu kuyaqabukela esetshenziswa ezithambile suture (usilika, catgut, dacron), ngoba sesigcilikisha ezinjalo azibona bakwazi ukumelana traction kwemisipha ne ukufuduka imvuthuluka.

Ngwenya transosseus osteosynthesis

ekuhleleni kabusha okunjalo kuhlinzwa esebenzisa imishudo, ngezikulufo, spokes, futhi lezi izibopho wenziwa kosopoperechnom noma transversely ogangeni bone ku isayithi yokulimala. A uhlobo olukhethekile osteosynthesis chreskostnogo ilunga ithambo - lena lapho izingcezwana kuthiwa yamba iziteshi futhi ngabo ukuchitha ligatures (catgut, usilika, wire), okuyinto ke qinisa futhi tie. Isetshenziselwa lapho imigqa ephezulu nephansi ahlangene olecranon noma patella. osteosynthesis Transosseous sihlinzekela ukunqunywa ukhonkolo.

nenkanuko edlulele Outdoor

Lokhu ekuhleleni kabusha kwenziwa esebenzisa amadivayisi ezikhethekile (Ilizarov apharathasi, Volkova - Oganessian). Lokhu kuvumela Ukuqhathanisa izingcezwana ngaphandle ukuchayeka isayithi ukwa futhi uzilungise ngokuqinile. Le nqubo ibizwa eyenziwa ngaphandle ukunqunywa Gypsum, kanye Ilizarov apharathasi ngezinyawo ikuvumela ukuhamba isiguli uma ithwele umthwalo omningi.

yezinkinga

Ngemva kokuhlinzwa kungabangela eziyingozi. Le miphumela:

• ayilungile Ukukhetha amasu nenkanuko edlulele of izinsalela;
• Ukungazinzi ithambo ifaniswe doti;
• ukuphathwa luhlaza kwezicubu ezithambile;
• ngokungalungile bekhethe Ilokhi;
• non-ukuhambisana aseptic kanye isinqandakuvunda.

Lezi zinkinga neqhaza ayilungile ukwa sokuphulukiswa, ke ukuba yakhele noma nonunion ephelele.

Kusukela osteosynthesis ngwenya esetshenziswa eside amapuleti omkhulu futhi adalule ithambo salokhu ngoba ibanga elide, it is kwakuvame ukugeleza kwegazi, okuholela ukubambezela ukuphulukiswa kahle. Ngemva kokususa ngezikulufo kukhona izimbobo eziningana, ezinganikwa ezinye buthaka ithambo.

isiphetho

Ngakho, saxoxa amasu ezifana osteosynthesis. Kuyini lokhu? Kuyinto indlela yesimanje kunazo ukuxhuma izingcezwana ithambo emva ukwa. Siyabonga kuye, inqubo ngelashwa kweziguli yashesha kakhulu. osteosynthesis eziqhutshwa yilo Mnyango usebenzisa fixatives ezahlukene. It kubhekwa isikhathi eside kakhulu titanium amapuleti, okungakwazi ngisho ukudubula.