Ukuqhekeka kweClavicular kubangela i-2.6% yazo zonke iimfantu zabantu abadala, kunye ne-80% eyenzeka kwindawo ye-midshaft. Ukususela ekuqaleni kweminyaka yoo-1990, inkqubo yolawulo oluzinzileyo ecetywayo yiNeer ibisoloko ithathwa njengonyango lokuqala lwe-clavicular fractures. Nangona kunjalo, izifundo ezininzi ziqinisekisile ukuba unyango olungelulo utyando luhlala lungaphumeleli ukugcina ukuncipha kwemfantu ye-midshaft clavicular fractures eguqukileyo kakhulu okanye eguquliweyo, nto leyo ebangela ukufuduka okuqhubekayo kunye nokuncipha okugqithisileyo, okuphakamisa kakhulu umngcipheko we-malunion kunye ne-nonion. Ngaphezu koko, iingxelo zibonise ukuba izigulana eziphathwa ngaphandle kotyando zinobunzima obuphantsi bamagxa. Ngoko ke, utyando luye lwafumana ukuthandwa okwandayo kwizigulana ezineemfantu ze-clavicular fractures kwiminyaka yakutshanje, phakathi kwazo kwamkelwa kakhulu i-open reduction kunye ne-internal fixation (ORIF) ene-plate fixation.

Kwiziqhekezo ezintsonkothileyo, ugqirha ugxile kwindlela yokubopha eyongeziweyo ngee-mini-plates. Ezi plates zisebenza ngendlela efanayo nezikrufu ezilagiweyo kodwa zinika ukusetyenziswa okulula. Ukuhlolwa ngexesha lotyando kukwabonise uzinzo oluqinileyo, kwaye iziphumo ezilungileyo zeklinikhi ziye zafezekiswa ngokusetyenziswa kwazo kwiiqhekezo zepatellar ezixutyiweyo. Ngokusebenzisa uphando oluqinisekisa ukuba ukulungiswa kwee-dual-plate kunika uzinzo olwaneleyo loomatshini, ugqirha usebenziseoi-rhetopedicminipemva kwexeshaukubethelela iziqwenga ezincinci zokwaphuka kwicandelo eliphambili lethambo, ukuguqula ngempumelelo iipatheni zokwaphuka ezintsonkothileyo zibe ziindlela ezilula. Ukunciphisa okulandelayo kwemiphezulu yokwaphuka kwenziwe lula, kulandele ukubekwa kwe-superioripleyiti yokucinezela etshixwayo(LCP). Ukunciphisa ukwenzakala kwe-periosteal, kwenziwe imingxunya emincinci kuphela ukuze kubonakale iindawo zokufakwa kwezikrufu, nto leyo eyabangela ukuba kuqiniswe ngokuhambelana nemigaqo ye-minimally invasive plate osteosynthesis (MIPO).

Ityala lezonyango

Uvavanyo lwangaphambi kotyando lokwakheka kwezaphuko lwenziwe kusetyenziswa iifilimu ze-X ray kunye nee-CT scans ezilungisiweyo ze-3D. Isigulana esiyindoda esineminyaka engama-22 ubudala safunyaniswa ukuba saphuke i-clavicular midshaft ngexesha lemidlalo. I-anteroposterior clavicular radiograph (a) kunye ne-apical oblique radiograph (b) ziqinisekisile ukuba la phuko liluhlobo lwe-AO/OTA classification type 15.2C (comminuted multifragmentary fracture). Imifanekiso ye-CT eyakhiwe ngokutsha enemilinganiselo emithathu yesigulana ibonise umbono we-stereoscopic wokwakheka kwezaphuko zesithuba, inika ubungqina obucacileyo bokwakheka komzimba wokucwangcisa ngaphambi kotyando.

Isigulana sabekwa kwisitulo saselunxwemeni phantsi kwe-anesthesia eqhelekileyo, intloko nentamo zityekele kude necala lotyando. Emva kokucoca iintsholongwane rhoqo kunye nokufakelwa kwe-sterile draping, yonke i-contour ye-clavicle kunye nendawo yokuqhekeka yaphawulwa ngophawu lotyando phantsi kwesikhokelo se-fluoroscopic ngengalo ye-C. Ukusika okunqamlezileyo malunga ne-5 cm ubude (okufana nobude bendawo yokuqhekeka) kwenziwa kumgca wokuqhekeka kwe-clavicular.Ipleyiti yeTitanium Clavicle(2.0 mm encinciIpleyiti yeClavicle yamathambo) yasetyenziswa ukunceda ukunciphisa ukwaphuka kwamathambo.

Ipleyiti yeClaviclezisetyenziselwe ukuhlanganisa nokulungisa iziqwenga zamathambo ezimile okwesikwere okanye eziqhekekileyo kwiindawo eziphambili zokwaphuka. Emva kokuguqula ukwaphuka okuntsonkothileyo kube yindlela elula yokwenziwa, ukulungiswa ngesixhobo esingaphezuluipleyiti yokutshixa yezonyangoKwenziwe i-clavicular LCP (inkqubo ye-clavicular LCP eyi-3.5 mm ephezulu) yabekwa kumphezulu we-cortical ophezulu we-clavicle yaza yafakwa ngendlela ye-minimally invasive plate osteosynthesis (MIPO).

Isigulana sasinxibe isilingi kwiintsuku ezisi-7 zokuqala emva kotyando ukuze sithomalalise ukungakhululeki, kulandele ukuqaliswa koqeqesho lokuhamba ngeendlela ezahlukeneyo. Kwiiveki ezisi-8 emva kotyando, uqeqesho lokuqinisa izihlunu lwaqaliswa emva kokuba i-radiographs iqinisekisile ukuhlangana kwamathambo kwaye uvavanyo lweklinikhi lwabonisa intlungu encinci. Uvavanyo lwe-X-ray (umbono we-anteroposterior clavicular kunye nombono we-apical oblique clavicular) lufunyenwe kwangoko emva kotyando nakutyelelo ngalunye lokulandelela lwesigulane sangaphandle.

Ukuba ufuna ukufunda okungakumbi malunga ne-Iipleyiti zokutshixa zeClavicle zamathamboulwazi, nceda uzive ukhululekileQhagamshelana nathiIqela lethu liza kukunika inkxaso yobungcali kunye neempendulo.