Imfundo kunye nonyango nonunion

joint False - luhlobo waphula ngokuqhubeka ithambo, nto leyo luphawulwa ukuhamba okungaqhelekanga, okungaqhelekanga eli sebe. Xa practice zonyango ngenxa yale meko ukusebenzisa igama elikhethekileyo - "pseudarthrosis". Okwangoku, esi sifo kakubi kakhulu ngempumelelo, kwaye unyango ibe zombini zokusebenza ngendeb '. Ukongeza, unyango kwiimeko ezininzi na isiphumo esihle umntu ubuyela eqhelekileyo. Eli nqaku uhlaziye iinkcukacha izizathu zokusekwa kwe sentlanganisela lobuxoki. Nokuhlawula ingqalelo isifo kunye nonyango.

ICD: pseudoarthrosis, ezahlukeneyo

joint False - ukugxojwa ukuthembakala ithambo cortical, ekhatshwa ukuhamba engaqhelekanga. Ngokutsho kwe International Classification yezifo ikhowudi ukuba unalo sentlanganisela lobuxoki - ICD 10. Oku kuquka: ukwaphulwa non-union, okt psevdoartoroz kunye namalunga lobuxoki ezo ngasemva okanye arthrodesis.

Ngomhla inxalenye iipatheni zophendlo lwezifo kunye nendlela unyango amalungu ababuxoki zahlulwe zibe ezinezikhondo, ayinyaniso. Eyokuqala i nqanaba oluphakathi phakathi kwe kade kunye nokudityaniswa a pseudarthrosis lokwenyaniso. umfanekiso wabo yinto umsantsa encinane phakathi amaqhekeza ezaliswe izihlunu ezinezikhondo, iipleyiti ithambo iziphelo egubungela lomsele medullary.

Kwiimeko ezinqabe kakhulu le pseudarthrosis ezinezikhondo kwakhiwa lwamalunga apho iziphelo amathambo lulungiselelwe intlala nethambo ineminyaka kwi philisi yokuqala nokuqina. Phakathi kwabo angemi fluid lwamalunga, unako Liziziqendwana sclerosis.

nearthroses Classification

Pseudoarthrosis abe naso okanye lufundiwe. joint lobuxoki bekhubazekile inqabile kakhulu yaye ayikho ngaphezu kwe-0.5% leengxaki. Isiseko lasungulwa ukuhlukumeza ithambo intrauterine izihlunu ekwakhiweni, okutsho ukuba amathambo enasilela kwindawo ethile. Kwaye emva kokuzalwa, eneminyaka 2-3, isidima ithambo yaphulwe. Ngokuqhelekileyo joint lobuxoki iziphene ke lesiquluba, ubuncinane - le clavicle, ulna kunye yifemur.

Le pseudarthrosis ababeyizuzile malunga ne-3% lwezifo uhlobo wamathambo. Kwiimeko ezininzi oku ngenxa ezinjengokwaphuka, xa kukho fusion engachanekanga kwaye azigqibeleli amaqhekeza ithambo. pseudoarthrosis Acquired yahlulwe atrophic, kunye normotroficheskie hypertrophic.

ezibangela Local zezifo

ezibangela Local ye ukuyilwa sentlanganisela lobuxoki, bona, yahlulwe ngokwamaqela amathathu. iqela lokuqala - izizathu athe anxulunyaniswa iimpazamo kunye ezisilelayo kunyango: yokubeka ecaleni kwenxenye ngamaqhekeza ngethambo, ukusilela ukuphelisa interposition izicwili ezithambileyo, immobilization okungaqhelekanga, ngenxa apho ukuhamba egcinwe amaqhekeza aseleyo, utshintsho rhoqo okanye ekuqaleni ukhupha, ukusetyenziswa lokuvala ngokungafanelekanga, intshukumo esebenzayo kakhulu kwaye eyahlukahlukeneyo , sklerotirovanie omkhulu.

Iqela lesibini liquka izizathu enxulumene iqondo ubungqongqo yokwenzakala, kunye nezigulo post-traumatic: kwizaphuko, ukulahlekelwa inxalenye enkulu ngethambo, izihlunu iyasilwa na ukwenzakala kumgama elide, ukungakhuseleki suppuration esiqwini ithambo, osteomyelitis, umonakalo luvo kunye imithambo yegazi, kwakunye na ukuphazamiseka konikezelo zabo.

Ke ekugqibeleni, iqela lesithathu yeemeko ezichaphazela ukuyilwa sentlanganisela lobuxoki, ezinxulumene ezineempawu yokwakheka kunye nokomzimba wegazi ubonelelo ithambo kwisiza ukwaphuka zalapha.

izizathu trophic

Ukususela trophic ubunzima ebangela ukuyilwa pseudoarthrosis eziphambili zezi: usuleleko, umz, negcushuwa, imalariya, usuleleko oyingozi; isifo pathways, kwaye ingakumbi calcium-phosphorus yokucolwa zomzimba; diabetes; beriberi; insufficiency semithambo emva kokonzakala innervation kwemithambo yegazi; ebalulekileyo zokukhanya X-reyi yesifuba, onako zinqanda inkqubo ukubunjwa amathambo; nokuphazamiseka trophic kwindawo zaphuka.

picture clinical

Lo mfanekiso kwezonyango ukuyilwa sentlanganisela lobuxoki uneempawu zawo. Endaweni ezinjengokwaphuka waphawula ukuhamba, izihlunu yoma, ukudumba, nonyebeleziso kwizicwili, amabala ukwakhiwa. Kwi-X-ray uyakwazi ukubona umsantsa omkhulu phakathi amaqhekeza, ithambo sclerosis emsileni, ngxubevange emjelweni medullary.

isifo pseudarthrosis

Xa kufunyaniswa isifo, ukongeza iinkcukacha zonyango, ingqalelo ihlawulwe osikiweyo, nto kubalulekile ukuba Fusion epheleleyo ezinjengokwaphuka. Xa eli xesha liphela, ubume ezinjengokwaphuka luchazwa ngokucothayo accrete okanye asymphytous, yaye emva kwexesha kabini esingadlulanga norm ukuyilwa ekucingelwa sentlanganisela lobuxoki.

Ukuze uqinisekise hypothesis, yenza i-X-ray in uqikelelo ezimbini macala nkqo, kwaye kwezinye iimeko - kunye noqikelelo elibhalwe ngokumileyo. Iimpawu lobukho nonunion ingqalelo lo mfanekiso zilandelayo kwi-X-ray: ukungabikho callus, yona inxalenye ukudibanisa amaqhekeza ithambo; iincam amaqhekeza ukuba imile kakuhle ajikelezayo okanye etsobhileyo; kwisisu yene e iziphelo amaqhekeza kunye nembasa lokuvala yenziwe. Xa joint nkohliso elinye okanye zombini amaqhekeza ithambo liphela ngokumila hemispherical kwaye imbonakalo kufana intloko ehlangeneyo. Enye Isiqwenga inokuba umngxuma glenoid. Kulo mzekelo, isithuba edibeneyo ibonakala ngokucacileyo.

Kufunyaniswe ngobungakanani kophononongo inkqubo engamandla echaziweyo radionuclide.

izimiso unyango ngotyando

Nangona iindlela yokugcina conservative yonyango (ulawulo iziyobisi, umbane, Imagnethi yomhlaba, njalo njalo. D.), Indlela eziphambili ukuphatha pseudarthrosis iyasebenza. Le ndawo phambili kuhlala ucinezelo osteosynthesis. Indlela yokuphatha i pseudoarthrosis? Lo msebenzi kufuneka wenziwe kweenyanga 8-12 emva ukuphiliswa ngokupheleleyo kwi evela kuziphuko zendalo ezintsonkothileyo nxeba. Ukuba kukho zixela ukuba soldered ukuya ithambo, kufuneka excised kwaye wenze utyando zeplastiki ukuba lilungise eso siphene.

Enye ingongoma ebalulekileyo apha usebenzo uthelekiso echanekileyo ngamaqhekeza ithambo, kwakunye ahlaziyayo iziphelo zabo, Ukusikwa kukuqulungana inyama kunye nokubuyiselwa patency lomsele medullary.

unyango pvsedoartroza kwi izixhobo Ilizarov

Le ndlela yenza kube lula ukuzisa ndawonye amaqhekeza kwaye iququzelela fusion zazo ngokukhawuleza of ngaphandle atyandwe ngokukhawuleza. Kungenxa yoko le ndlela kuthiwa osteosynthesis extrafocal.

Okokuqala, isigulane isicelo iiasi isixhobo wezamathambo apho iziqwenga ithambo ayinakutshintshwa. Emva koko, malunga ngeveki ihlala inkqubo ixesha ekuphulukenwe nalo emva kokuba isicelo kwefowuni apho ndawo, apho nezipeki, okuphilisa iqala inkqubo fusion ithambo. iziqwenga Bone ngokuthe ukusondela omnye komnye, etshabalalisa zonxibelelwano okungafunwayo ukucudisa joint lobuxoki.

Ngaphezu koko kukho nitrogen, oko kukuthi, ukuyilwa calluses kunye nenkqubo kwamathambo. Eli xesha elide, kodwa kukhuselekile kwaye ayifuni amanyathelo awodwa. Isigulana kufuneka sithathe iivithamini, nidle okulungileyo, ancame nemikhwa emibi.

Okokugqibela, kukho ixesha lokugqibela yesiqhelo, ngexesha apho yonke imiyalelo eziyimfuneko ukuthobela kugqirha kwaye benze ubuhlanti olulandelenayo ezizodwa. Ideal ngelo xesha ingqalelo ukuba ukuhamba, zokudada.

Obuvakalayo osteosynthesis extramedullary

Indlela eziluncedo unyango ngotyando intramedullary yokuqaphela. Ngaphambi kokwenza ugqirha wakhe lisusa ancedisana ethambileyo yonakele, apho la periosteum negazi egazi. Emva koko iziqwenga bone le eqwalasele kunye icingo. Isilonda emva kotyando sutured ngokwemaleko, endaweni yayo uhlale amabala encinane.

Ngexesha osteosynthesis extramedullary ngamaqhekeza bone zibambene lock Supraspinous. It licinezelwe nxamnye amathambo yonakele, kwaye emva kokuba Splice iziqwenga ipleyiti asuswe ngokusika.

Ngoko ke, eli nqaku ibixoxwa ngokunzulu pseudarthrosis. Xa ndiqukumbela, kufanele kuqatshelwe ukuba ubungozi ukuze kwakhiwe sentlanganisela lobuxoki bakhonza ezinye izifo yonyango, imikhwa emibi (ukutshaya, ukusebenzisa kakubi utywala), ukutyeba, ukutya kakuhle kunye nokunqongophala eyahlukahlukeneyo. Ngoko ke, ukulondoloza yokuphila esempilweni kuza kucutha umngcipheko kwesi sifo.