Osteotomy - yintoni na le nto?

Osteotomy - etyandwa ejolise ukubuyisela imisebenzi weentshukumo ezilahlekileyo ngenxa asike ithambo ngumntu. Kwiimeko ezininzi, lisetyenziswa ukususa deformation ngethambo, nto leyo evumela ukuba ukubuyela ukukwazi yesigulane lokuzimela unakekelo ukuhamba.

imiba ngokubanzi

Operation osteotomy lwenziwa yi abanezakhono kakhulu trauma ugqirha. Xa uqala kubonakala nongenelelo ukuba inzima kwaye kufuna ixesha elininzi awachacha yesigulane, ke, ngokuthotyelwa kwezo ngcebiso kagqirha ndixhoxha umguli ngeenyawo zakhe ngokukhawuleza.

Osteotomy - utyando oluqhutywa ngokusebenzisa izixhobo ezikhethekileyo - osteotomes, iisarha Gigli, iisarha zombane kunye nezixhobo cuke. Banceda ukwenza imingxuma kungenelelwe wayityatya ithambo. Emva ukuqokelela iziqwenga bone kobutyobo ayinakutshintshwa kunye ngezikhonkwane, iinaliti, amacwecwe. Ngokungafaniyo iintanda random, ukutyabeka uphose sifakwa kunqabile, ukuze uphephe uphuhliso contractures kwamalunga kunokwenzeka.

ngezigaba

Kuxhomekeka kuhlobo ufikelelo zokusebenza ezi ntlobo osteotomy zilandelayo:

1. Vula - ifuna ufikelelo ithambo. Emva kokuba ulusu liqatywe, izicwili ongama kunye izihlunu apparatus, raspatory ezahlulwe periosteum, ithambo uze dissected. Lowo doti Iqinisekile kwindawo komzimba, top - cast.
2. Valiwe - olwenziwe ngokusebenzisa ukufikelela besentimitha ezimbalwa. Izihlunu Akukho ukusika kwaye sekhombuya ukuya ithambo. Ngokusebenzisa basike ezahlulwe sisithuba periosteum kunye izithonga ngesando eziliqela ithambo kumqheba baziqhaqhe. imithambo yegazi luvo bayacalulwa kwaye ezinzileyo kunye nezixhobo ezizodwa ukuze odalekayo kuwo. Kakhulu ngokufuthi esetyenziselwa osteotomy ezinqamlezayo.

Imilo eso basinqumla Ulandela zokungenelela:

• lateral;
• kuyiwa;
• elibhalwe ngokumileyo;
• nale;
• ukujikajika (ungqukuva, arcuate, nesinqumka-emile, angularly).

Kuxobekeka kwezo njongo, ahlinzwe iintlobo zilandelayo:

• osteotomy sokulungisa;
• derotation;
• ejoliswe ukutshintsha ubude mlenze;
• Ijolise ekuphuculeni umsebenzi inkxaso.

Ubungqina obubonakalayo buxela ukuba angenelele

Osteotomy - na amathambo, nto leyo yenzelwa kwezi meko zilandelayo ayikho efanele kuthomalaliso elondoloza:

• ukungaqheleki iziphene okanye lufundiwe kwaye deformation ithambo, iqondo elikhulu elide amathambo tubular (hip, igxalaba, ethangeni);
• ankylosis - ukungakwazi umsebenzi elidityanelweyo ngenxa yobukho azikhuli nokuqina izihlunu, intlala okanye lithambo nesimilo imiphezulu articular;
• hip azalwa dysplasia (dislocation);
• Ukophuka ukuba tho ngokuchanekileyo;
• osteomyelitis;
• phambi yamathumba okanye metastases;
• imiphumela yamathambo kwimbali;
• ebambe arthroplasty;
• ezinye izinto ezingaqhelekanga iziphene kwinkqubo musculoskeletal.

Olu tyando isetyenziswa endle izithambiso: osteotomy empumlo, elungisa yakhiwe yobuso, imisebenzi aphazamiseke imihlathi.

Izimo

Kukho eziliqela, ubukho apho utyando lilibaziseka:

• Izifo zemvelo ezosulelayo ngexesha xa osteotomy ithambo efunekayo okanye iiveki ezimbini phambi kokuba utyando;
• izifo zeenkqubo bokuphefumla sentliziyo decompensated;
• diabetes;
• ixesha lokumitha umntwana;
• lomonakalo kwezintso okanye hepatic;
• ubukho irhashalala ubovu okanye enye indalo kwindawo apho kuyimfuneko ukuze enze on-line ukufikelela.

Ubuhle nobubi

izinto ezintle yokungenelela ukuba ukwehla iintlungu (ukuba ikhona) kunye nokubuyiselwa umsebenzi motor. Umzekelo, osteotomy le amadolo aya kuziphelisa zonke iintlungu ngexesha intshukumo, aqalise flexor kunye extensor umsebenzi, susa azikhuli ngayo imiphezulu articular. Isifo eyeka inkqubela yayo.

Le Ububi obukhulu ithuba asymmetry olubonakalayo amalungu omzimba okanye amalungu. Ngaphezu koko, ukuba isigulane kuya kufuneka indawo arthroplasty joint, kuya kuba nzima kakhulu ukwenza emva osteotomy.

iingxaki kunokwenzeka

Osteotomy - umsebenzi apho iminyaka emininzi kwaphuculwa ukunciphisa ingozi kubunzima postoperative. Nangona kunjalo, naziphi na uphazamiseko ezinye izinto emzimbeni womntu ngumthombo ingozi, kuba ngaphandle elivumelekileyo specialist esebenzayo, sithetha iimpawu ngamnye yesigulana.

Iingxaki naluphi osteotomy uhlobo ingaba:

• usulelo inxeba ngotyando - kufuna ukuqashwa amathamo Njengokungeniswa unyango isibulala-zintsholongwane;
• offset kobutyobo kunye bone amaqhekeza - lwenziwa misa olunye nitrogen;
• fusion olucothayo iinkuni - izakhiwo amisiweyo anikezela ngezakhi ukuba iqanjwa izinto eziyimfuneko zokulanda umkhondo (calcium, phosphorus, nemagnesium, zinc);
• yakheka sustava- lobuxoki kufuna ungenelelo olongezelelweyo;
• parestezii- Uvakalelo ukungathobeli ulusu endaweni operation ngenxa ekudibaneni kwe amasebe-luvo (kufuna unyango ezongezelelweyo, ezivuselela);
• yokulahla nokufakelwa - athile omzimba kuyimfuneko.

osteotomy yokulungisa

kusetyenziswa ukwenza le nkqubo kwi accrete ukwaphulwa ephosakeleyo, iziphene ithambo enaso, uphuhliso ankylosis okanye pseudoarthrosis, sengozini iinkuni unyawo umsebenzi motor kakuhle, ukuze kupheliswe iziphene izithambiso olubonakalayo.

Phambi kokuba longenelelo wenziwe uvavanyo X-reyi yesifuba, ikuvumela ukuba ukhankanye indawo ithambo, beka ikamva asike, impilo ithambo iyonke. Ukuba kuyimfuneko, ikhompyutha, okanye MRIs. Ezinye saveyi ababelwe ngabanye traumatologist.

Olu tyando lwenziwa esibhedlele ezikhethekileyo. Ixesha sokungenelela - malunga 3-4 iiyure, kuxhomekeke kubungakanani iinkqubo eziyimfuneko. Emva asike imvuthuluka bone ayinakutshintshwa yi Ilizarov (utyando kwi yesiqephu) okanye izixhobo ebuntsimbi ezizodwa lesitofu ngqo ithambo (unyawo osteotomy).

Ilizarov izixhobo sisigqeba ekhethekileyo asetyenziswe traumatology kunye amathambo ngenxa kwamanani, ucinezelo okanye kukunaba ngamaqhekeza lithambo kwi indawo efunekayo kwithuba elide.

Emva kokuba umsebenzi wenziwe ulawulo x-reyi, uvumela ukuchaza entengo echanekileyo.

Ukungaphili osteotomy yokulungisa

iingxaki ezinokuba emva nokulungisa iimeko zophendlo lwezifo ziquka:

• buhlungu kakhulu, hayi isikiwe analgesics eqhelekileyo;
• ukungaphumeleli iinxalenye engaphandle umatshini okanye izakhiwo yesinyithi;
• uphuhliso ukopha;
• hematoma kwenkumbulo;
• ukubana wethambo ngamaqhekeza kuthelekiswa enye kwenye nayiphi na iinqwelo-moya;
• ezinye iingxaki jikelele.

Osteotomy endle bamazinyo kunye notyando maxillofacial

Endle zamazinyo osteotomy eyenziwa kwemihlathi, nto leyo asebenze umsebenzi ozimeleyo okanye ube liqonga etyandwa. Offset okanye kwizaphuko, ukulungisa malocclusion. Ukusikwa zenziwa kubude imihlathi kwemihlathi.

Emva nitrogen in emhlathini kwindawo komzimba enyanzeliswa umhlabelo compressive, ukulungisa nemihlathi kunye indawo chin. Ngoko nangoko i-zintsholongwane ukuze uphephe uphuhliso suppuration kunye nokusekwa kwe osteomyelitis. Phakathi amazinyo ukubeka ezinye gum kuba indawo leyo liyasetyenziswa specialist mihla le. Izitishi zisuswa emva kweeveki-2, kunye ngezikhonkwane abayibambe umhlathi ngenyanga ukugqiba isigaba unyango kulandele unyango amazinyo.

Endle kotyando yomlomo kunye maxillofacial isetyenziswa osteotomy ngeempumlo, nto leyo eyinxalenye rhinoplasty. Oko kubonisa ukuba:

• ubugqwetha ebonakalayo kwebhulorho ngeempumlo;
• Isisombululo eliphezulu amathambo;
• imfuneko ukufuduka ithambo ngokunxulumene ekudibaneni ngeempumlo.

Ekwenzeni le impumlo osteotomy ugqirha ukuba axoke iingxaki zobugcisa: evalayo nokususwa elisemqolo ngeempumlo igumbi nokolula ugobile le backrest, licuthe iindonga ecaleni. Yingcali kufuneka luthathele ingqalelo ukuba asike esiqwini ithambo kungachaphazela patency ye ngokuma eliphezulu, ke ngoko, ngexesha lokusebenza kuthinjwa iimpawu yokwakheka kunye nokomzimba lomguli ethile.

Iindidi osteotomy ngeempumlo:

• lateral (edge), kuthwalelwa phandle umntu perforation okanye umgca basis;
• medial (Centre);
• phezulu;
• eliphakathi.

Uhlobo longenelelo ngoncedo kusetyenziswa ikhethiwe ngamnye, kuthathelwa ingqalelo ingxaki yesigulane, injongo yalo msebenzi, imeko inwebu ithambo, umthamo eyimfuneko unyango ngotyando.

Nawuphi osteotomy kufuneka lwenziwe kuphela emva ukuphakamisa umgangatho sifo. Kuya kusebenza njengenyathelo lokuthintela yophuhliso iingxaki kunye nokudala iimeko ngenxa Fusion elungileyo nelifanelekileyo ithambo.