Kutsemuka kwetsinga dzemusana kunokonzera 2.6% yetsinga dzose dzemusana dzevanhu vakuru, uye 80% yacho iri munzvimbo yepakati petsinga. Kubva kuma1990 ekutanga, nzira yekutarisira yakakurudzirwa neNeer yagara ichionekwa senzira yekutanga yekurapa kutsemuka kwetsinga dzemusana. Kunyange zvakadaro, zvidzidzo zvakawanda zvakaratidza kuti kurapwa kusingashandiswi kunowanzo kundikana kuchengetedza kudzikira kwekutsemuka kwetsinga dzemusana dzemusana dzakabviswa zvakanyanya kana kuti dzakabviswa, zvichikonzera kutsemuka kunoramba kuchienderera mberi uye kupfupika kwakanyanya, izvo zvinowedzera njodzi dzezviratidzo zvemalunion uye kusabatana. Uyezve, mishumo yakaratidza kuti varwere vanorapwa vasina kuvhiyiwa vanotambura nekuderera kwesimba remafudzi. Saka, kuvhiyiwa kwave kuchinyanya kufarirwa nevarwere vane kutsemuka kwetsinga dzemusana mumakore achangopfuura, pakati pazvo kuderedzwa kwekudzikiswa kwetsinga dzemusana nedzemukati (ORIF) nekuisa plate fixation.

Pakutyoka kwakadaro kwakaoma, chiremba akatarisa pakushandisa nzira yekubatanidza mapfupa nezvidimbu zvidiki. Maplate aya anoshanda zvakafanana nemasikiruu asina kusimba asi ari nyore kushandisa. Kuongorora panguva yekuvhiyiwa kwakaratidzawo kugadzikana kwakasimba, uye mhedzisiro yakanaka yekiriniki yakawanikwa nekushandiswa kwawo mukutyoka kwemapfupa kwakachekwa. Vachishandisa tsvakiridzo yakaratidza kuti kusungirirwa kwemaplate maviri kunopa kugadzikana kwakakwana kwemuchina, chiremba akashandisaorhetopediaminipkunonokakuchengetedza zvidimbu zvidiki zvakatyoka kuchikamu chikuru chemapfupa, zvichibudirira kushandura maitiro akaomarara ekutyoka kuita magadzirirwo ari nyore. Kuderedzwa kwakatevera kwenzvimbo dzakatyoka kwakaitwa nyore, zvichiteverwa nekuiswa kwenzvimbo yepamusoro.ndiro yekumanikidza inokiya(LCP). Kuti kuderedze kukuvara kweperiosteal, kucheka kushoma kwakaitwa kuti nzvimbo dzekuisa sikuruu dzionekwe, zvichiita kuti kugadzika kuenderane nemisimboti ye minimally invasive plate osteosynthesis (MIPO).

Nyaya yekiriniki

Kuongororwa kwechimiro chekutyoka kwemutsipa kwakaitwa vasati vavhiyiwa vachishandisa mafirimu eX-ray uye 3D reconstructed CT scans. Murwere wechirume ane makore makumi maviri nemaviri ekuberekwa akaonekwa aine kutyoka kweclavicular midshaft right shaft kwakaitika panguva yemitambo. Anteroposterior clavicular radiograph (a) uye apical oblique radiograph (b) zvakaratidza kuti kutyoka kwacho kwaive kwerudzi rweAO/OTA classification type 15.2C (comminuted multifragmentary fracture). Mifananidzo yeCT yakagadzirwazve yemurwere ine mativi matatu yakaratidza mufananidzo we stereoscopic we spatial fracture configuration, zvichipa humbowo hwemuviri hwekuronga kuvhiyiwa.

Murwere akaiswa pachigaro chegungwa achibatsirwa neanesthesia, musoro nemutsipa zvakarerekera kure nedivi rekuvhiyiwa. Mushure mekuvhiyiwa nguva dzose uye kuputirwa nejira risina utachiona, chimiro chose checlavicle nenzvimbo yakatyoka chakaiswa chiratidzo chekuvhiya pasi pekutungamirirwa nefluoroscopic neC-arm. Kuchekwa kwakachinjika kweanenge 5 cm pakureba (kunoenderana nehurefu hwenzvimbo yakatyoka) kwakaitwa pamwe chete nemutsara wekutyoka kweclavicle.Titanium Clavicle Plate(2.0 mm dikiPlate yeClavicle yeMasapfupa) yakashandiswa kubatsira kuderedza kutyoka kweganda.

Ndiro yeClavicleZvakashandiswa kubatanidza nekubatanidza zvidimbu zvemapfupa zvakaita sechimedu kana zvakachekwa kuzvikamu zvikuru zvakatyoka. Mushure mekushandura kutyoka kwakaoma kuita chimiro chakareruka, kugadzirisa ne superiorndiro yekukiya yekurapayakaitwa. Clavicular LCP (3.5 mm superior clavicular LCP system) yakaiswa pamusoro pepamusoro pe clavicle ndokuisirwa kuburikidza ne minimally invasive plate osteosynthesis (MIPO) technique.

Murwere akapfeka chirauro kwemazuva manomwe ekutanga mushure mekuvhiyiwa kuti aderedze marwadzo, zvichiteverwa nekutanga maekisesaizi ekufamba-famba. Pamasvondo masere mushure mekuvhiyiwa, kudzidziswa kusimbisa tsandanyama kwakatanga kana radiographs yaratidza kubatana kwemapfupa uye kuongororwa kwekiriniki kwakaratidza kurwadziwa kudiki. Kuongororwa kweX-ray (anteroposterior clavicular view uye apical oblique clavicular view) kwaiitwa pakarepo mushure mekuvhiyiwa uye pakushanya kwega kwega kwekutevera kwemurwere wekunze.

Kana uchida kudzidza zvakawanda nezveMapureti Ekuvhara Emabvi Emapfuparuzivo, ndapota inzwa wakasununguka kutaura nesu; timu yedu ichakupa rutsigiro rwehunyanzvi nemhinduro.