Nailing - ke eng? Ho buoa repositioning la likhechana lesapo sebelisa mehaho e fapa-fapaneng ho lokisa sepeiti

Komponeng la masapo a robehileng sebedisa tshebetso tla potlakisa tshebetso ho folisa, le ya tlhabollong ya bakuli ba fractures rarahaneng. Ka lekhetlo la pele mokgwa wa kang fixation la masapo, e neng e tšoaretsoe lekholong la bo19 la lilemo, empa ka lebaka la ho ho hlaha ha mathata a tebileng haholo purulent lingaka ba ile ba tlameha ho khaotsa ho se etsa. Nchafatsoa leka mora selelekela ka mokhoa oa kalafo aseptic le sebolaya dikokwana-hloko.

fixation ke eng?

Bakuli ba bangata ba nang le rarahaneng fractures lingaka fana ka ho tšoara osteosynthesis. ha e le eng? Sena lobed likhechana lesapo ka tshebetso. Ka tloaelo ho laetsoeng ho eena ea ho phekola manonyello rarahaneng, hantle fused kapa foreshe fractures bao e seng kopaneng. Sebelisa osteosynthesis fixation le hlaha likhechana matched. Sena se etsa maemo a loketseng bakeng sa ho logan bona, hammoho le ho tsosolosoa ha botšepehi ba leoto le.

Ho na le mefuta e sa tsoaneng tse peli tsa sehlooho tsa osteosynthesis:

• ho qoelisoa (extramedullary, intramedullary, transosseous);
• ka ntle (extrafocal).

Hoa etsahala ho feta le galena osteosynthesis. ha e le eng? Ho e motsoako ea likhechana tse nyenyane masapo.

Tshebetso ba atlehe ho sebelisa fixatives fapaneng. Bakeng sa ho qoelisoa intraosseous osteosynthesis Pinów le manala sebediswa bakeng sa ya poleiti - poleiti le woman stage, bakeng sa transosseous - spokes le woman stage. ditab tsena li entsoe ka ho lintho tse bonahalang ka lik'hemik'hale, 'meleng le biologically nke lehlakore. E atisa ho sebelisoa tšepe dibopeho tsa vitalliya, celik, thaethaniamo, haholo ka tlaase ho moo - ho tloha polasetiki inert le masapo. Spacers entsoe ka tšepe ka mor'a fracture srastetsja hangata tlosoa. Ilizarov sethusathuto ka leoto sebediswa bakeng sa osteosynthesis kantle. Thanks ho eena, mangeta lesapo mora bapisa ananela. Bakuli ba ka tsamaea ka tsela e tloaelehileng le mojaro e tletseng.

ya litatoli na

Opereishene osteosynthesis bontša ka ho hlaphoheloa mathomo mokhoa ha:

• fracture ena, eo ba ne ba sa hōla hammoho ntle le thuso ea ho sithabela;
• tshenyo kgonego ya perforation tsa letlalo (ha koetsoeng fracture o khona ho kena ka setjhaba);
• fracture thatafatsoa ke tshenyo mothapo e kgolo.

Contraindications

Ho buoa kenella e sa kgothaletswa bakeng sa maemo a latelang:

• haeba mokuli a se monate;
• ho na le bulehileng tšenyo e khōlō;
• holim 'a tshwaetso ya site ena ba anngoeng le;
• Haeba ho na le ke e le pontšo ea bolwetse ea lekala efe kapa efe ka hare;
• ka letotong la systemic lefu la lesapo;
• mokuli o leoto venous insufficiency.

Mefuta ea lipoleiti

Lipoleiti tse sebelisoa nakong ea sebetsa, e entsoe ka tšepe fapaneng. Molemo ka ho fetisisa a hlokomela thaethaniamo lipoleiti, ka boitsebiso boo e na le tšobotsi e thahasellisang: moea filimi Ho thehoa ka e hang-hang, eo ho hang ha e ke ke kopana le lisele tse 'meleng. Tabeng ena, ho na le se ke la tšaba ba metallosis. Ke ka lebaka leo ba bangata ba lipoleiti tsena ha ba tlosoa 'me se setseng bakeng sa bophelo.

Submersible intraosseous osteosynthesis

lebitso le leng la buuoa - intramedullary osteosynthesis. O bulehileng le koaloa. Tabeng ea pele, ka libaka fracture e pepesa bacha, eaba e bapisa likhechana le ka kanale medullary tsa lesapo senyehile tshelwa molamu phetha molao feela. Outdoor fixation ha a hloke ho sebelisa thepa e khethehileng ho hokahanya lingoathoana e, mokhoa ona ke pete e ngata le ho feta ho fihlella koetsoeng tshebetso. Leha ho le joalo, tabeng ena e eketsa kotsi ea tšoaetso ea dinama tse nyenyane tse le bonolo.

Koetsoeng intramedullary fixation e tšoauoa ka taba ea hore ba hlahisa papiso ea likhechana ho, 'me joale etsa incision nyane tloha fracture saeteng. Tlas'a X-ray taolo ka incision ena sebelisa sethusathuto khethehileng e hlahiswa ka kanale medullary a senyehile lesapo mokhanni ena telele metallic sekoti molamu oa bophara loketseng. Ka mor'a moo, mokhanni ke tlositse le leqeba e sutured.

Submersible osteosynthesis

ha e le eng? Sena mokhoa likhechana lesapo komponeng e sebelisoa ka fractures tse fapa-fapaneng (comminuted, helical, periarticular, oblique, lateral, intraarticular), ho sa tsotellehe hore ba kobang le sebopeho sa kanale medullary. Lintho tse kopanyang, tse sebediswa bakeng sa tshebetso e kang ena e bontša ka mokgwa wa etsa lipoleiti tsa botenya fapaneng le sebopeho, o tlohang ho lesapo la sebelisa woman stage. lipoleiti tse ngata tsa kajeno li tlisa hammoho le sesebediswa khethehileng, ho akarelletsa le ka ntshuwang ho le bao e seng ntshuwang. Mokgwa ona, hangata lefisa esita le liheloe samente.

Ha helical fractures oblique le osteosynthesis hangata li entse ka hlobolisa tšepe le terata, hammoho le masale a khethehileng le celik halofo mehele. Sena lobed mokhoa lesapo, haholo-holo ka terata, ke ka seoelo e sebelisoa e le e ikemetseng e loketseng ho fixation hase matla haholo 'me hangata o sebeletsa e le tlatsetsa ho mefuta e meng ea osteosynthesis.

tshebetso ena ke ka seoelo haholo sebediswa bonolo suture (silika, catgut, dacron), hobane linaleli joalo ke sa khone ho hanela traction mesifa le displacement la likhechana.

Submersible transosseus osteosynthesis

Joalo repositioning buoa ka tsekema, woman stage, spokes, 'me lintho tse kopanyang tsena o etsoang ho tsoa e kosopoperechnom kapa transversely ka leboteng lesapo ka site ea bobe. A mofuta o khethehileng oa osteosynthesis chreskostnogo lesapo kopanetsoeng - ena ke ha likhechana li e ile ea fata metjha e le ka ba ba qeta ligatures (catgut, silika, terata), e leng ka nako tighten le thae. E e sebediswa ha lesapo kopanetsoeng fracture tsa olecranon kapa patella. Transosseous osteosynthesis lokisetsa ho kenngwa ha lahletseng ka.

Outdoor fixation

repositioning sena se etsoa ka tsela ya disebediswa tsa ho khethehileng (Ilizarov sethusathuto, Volkova - Oganessian). Sena se nolofalletsa ho bapisa lingoathoana e ntle le ho pepesehela tsa fracture saeteng le lokisa bona ka tieo. Lewa lena e etsoa ntle ho kenngwa ha gypsum, le Ilizarov sethusathuto ka maoto lumella u ho tsamaea ho ba le mamello le mojaro e tletseng.

mathata

Ka mor'a opereishene ka baka mathata a tebileng. Tsena results:

• fosahetseng khetha mokhoa fixation la likhechana lesapo;
• tsitse matched lesapo maloanlahla;
• mekhoa e metle kalafo ya dinama tse nyenyane tse bonolo;
• hampe nka loko;
• bao e seng ho latelwa le aseptic le sebolaya dikokwana-hloko.

mathata ana kenya letsoho hore ho fosahetse fracture ho folisa, e fester kapa nonunion feletseng.

Ho tloha osteosynthesis submersible sebelisoa lipoleiti telele e meholohali le e pepesa lesapo ena bakeng sa hōle, hangata tšoenngoa phallo ea mali, e leng e etsa hore a liehe ke pholiso hantle. Ka mor'a ho tlosa woman stage ke mekoti e mengata, e leng se fokolisa masapo.

bofello

Ho joalo, re ile ra buisana ka mokhoa o kang osteosynthesis. ha e le eng? Ke tsela ea kajeno ho fetisisa ho hokahanya mangeta lesapo mora fracture ka. Thanks ho eena, tshebetso ya ho kalafo le tsosoloso ea bakuli ba potlakisa haholo. Kenngwa tshebetsong osteosynthesis sebelisa fixatives fapaneng. Ho nkoa lipoleiti thaethaniamo fetisisa tsoarellang, le ke keng esita thunya.