Ukophuka ihumerus kunye ukubana kungekho namkhethe

Ngokutsho kwedatha yeenkcukacha-manani, 7% yazo kwamathambo-akhawunti ihumerus for. umonakalo efanayo kuvela ngenxa ngokuyintloko yokuwa kunye izithonga. Ukophuka ihumerus inokuba kwiindawo ezahlukeneyo kuyo, nto leyo ekhatshwa iimpawu ezahlukeneyo kwaye ngamanye amaxesha ufuna iindlela zonyango ezahlukeneyo.

Isakhiwo yokwakheka

Ihumerus wahlulwe ezintathu amalungu: omzimba okanye diaphysis - oko yile ndawo iphakathi, kunye iziphelo ebizwa epiphyses. Kuxhomekeka indawo umonakalo kubonisa Ukophuka ihumerus eliphezulu, eliphakathi okanye olusezansti. Icandelo eliphezulu ukwabizwa ngokuba proximal kunye umnxeba esezantsi distal. Diaphysis yahlulwe esithathwini: lelingaphezulu, phakathi nolusezantsi.

Ngenxa yoko, le epiphyses kufuneka isakhiwo ezintsonkothileyo, ukusukela ukuba ziyabandakanywa ekuhlanganeni ugcine izihlunu. Kwinxalenye engentla intloko ihumerus kwaye intamo omise yokwakheka - ummandla nangoko phantsi kwentloko. Bona articular kobuso ibe likhaba yinxalenye kwegxalaba. tubercles ezimbini, ezisetyenziswa kuthinjwe izihlunu ibekwe ngezantsi entanyeni zomzimba. Ukubabiza tubercles ezinkulu nezincinane. Sekunjalo ithambo ngakumbi uncipha, wakha ebizwa ngokuba yi-igxalaba entanyeni yotyando. ihumerus Lower ezahlulwe zimelwe iindawo ezimbini joint: a ithambo radiation ngesa- ezikhankanyiweyo intloko condyle ukanti imilo ajikelezayo, nezikhokelela ulnar block ihumerus.

Eyona eziphambili ze Ukophuka

Ukuhlelwa ophuka lwenziwa ngeendlela ezininzi. Kwelinye icala, yamophula ihumerus ndawonye ngama indawo, okt. E. liSebe. Ngenxa yoko, ukwa ekwanti:

- kule proximal (phezulu) kwicandelo;

- diaphysis (ongaphakathi);

- kwi distal kwicandelo (ngaphantsi).

Kwelinye icala, ezi klasi zahlulwe zibe esiXhoseni. Ngapha koko, a ngokwaphulwa kungenziwa kwiindawo eziliqela ngaphakathi ikhadi esinye okanye ezikufuphi.

Kwelinye icala, nabanako ukwahlulelana umonakalo Ukophuka ngaphandle ukulinganisa, kwaye inike beziko (comminuted) waphuka. A umahluko kwakhona umothuko evulekileyo (ukwenzakala kunye inyama ithambile nesikhumba) kunye ezivaliweyo. Ngelo xesha ubomi elilawulwa yi elidlulileyo.

Ingcaciso uhlobo zaphuka lisebe

Ingongoma esitsha kwicandelo proximal lungohlulwa lube intra-articular okanye articular. Kunye (nadbugorkovom) intloko intraarticular ngokwayo okanye entanyeni yokwakheka wethambo ukuze yonakele. ukwa Articular wohlulwe tubercle le ihumerus kunye ukwaphuka intamo zoqhaqho ebangela.

Ukuba diaphysis umonakalo kwakhona cell zenyathi ezininzi: lesithathu eliphezulu ngokwaphulwa, oluphakathi okanye ezantsi. Enye into ebalulekileyo uhlobo ngokwaphulwa: a scythe, umnqamlezo, ephotheneyo, comminuted.

Distal kwakhona bahlukunyezwe ngeendlela ezahlukeneyo. Sinako ukwahlula articular supracondylar ngokwaphulwa, kunye Ukophuka condyles kunye neebhloko ukuba intra-articular. Ukuhlelwa Kunzulu umahluko flexor kunye extensor supracondylar kunye transcondylar, intercondyloid Y okanye T-okwe kunye ekwanti condyles zaphuka.

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Kubomi bemihla ngemihla ngenxa yokuwa kwaye izithonga ikakhulu abachaphazelekayo inxalenye engentla entanyeni ngotyando, owesithathu phakathi diaphysis okanye epicondyles inxalenye esezantsi ye ihumerus. iintanda ezivaliweyo ngabona, kodwa kusoloko neyalo. Kufuneka kuqatshelwe ukuba kukho inokudityaniswa ngexesha iintlobo ezininzi elifanayo Ukophuka (ngokufuthi ngaphakathi kwisebe enye).

Ukwaphuka intloko humeral, intamo yokwakheka kwaye ngotyando ngabantu abadala kaninzi. Eli candelo esezantsi kudla kuphazanyiswa abantwana emva kokuwa embi: Ukophuka intercondylar kunye transcondylar bona ingaqhelekanga. yomzimba (diaphysis) basengozini Ukophuka rhoqo ngokwaneleyo. e iimpembelelo emagxeni, kwakunye kuwela kwi engqinibeni okanye ingalo ayinakolulwa ukuba kuvuka.

Ukophuka inxalenye proximal

Kuba intra-articular ngokwaphulwa ziquka intloko humeral kwaye sime nje emva entanyeni yalo yokwakheka. Kwimeko yokuqala ngayo ukuze comminuted ukwaphulwa okanye dislocation ngaphezu waphawula. Kwimeko yesibini ukuze ibe nefuthe ngokwaphulwa xa entanyeni otlomok yokwakheka yaziswa entloko yaye nokuba ulonakalise. In ngqo-umsebenzi kukwenzakala otlomok kwakhona yahlukana, kodwa ngaphandle ebalulekileyo neyalo.

Kwakhona, umonakalo inxalenye proximal ye ezinjengokwaphuka ziquka tuberosity ngakumbi ihumerus amancinci: chrezbugorkovye ngezigaba kunye amaqhuma. zinokuba ukuwa emagxeni akhe, kodwa xa kakhulu ngesiquphe izihlunu ucutheko kuphela. Ukwaphuka le tubercle le ihumerus nga sikhatshwe yiyantlukwano ebonakalayo ngaphandle ukubana amaqhekeza okanye ngokushukumisa phantsi akromedialny inkqubo okanye phantsi ngaphandle. loo monakalo kungenzeka xa ukwenzakala ngqo okanye dislocation ye emagxeni.

Avamise kakhulu ukwaphuka intamo zoqhaqho emagxeni. Isizathu amaninzi iba ukuhla. Ukuba isandla ngexesha lokwenzakala babelwa okanye anikwa, uze uphawule adduktsionny nokuxhwilwa okanye ithambo ngokwaphulwa, ngokwaphulwa nefuthe ingenzeka umndilili kwindawo yokugqibela xa isiqwenga distal yaziswa ingxenye eliphezulu.

Ezinjengokwaphuka ingaba ngaxeshanye kwiindawo ezininzi. Bone hlulwa ibe ziziqwenga ezibini ukuya kwezine. Hi xikombiso, intamo ukwaphuka yokwakheka ukuba sikhatshwe esekungcoleni elinye okanye zombini tubercles, ukwaphuka entanyeni ukwaphuka ngotyando intw 'intloko kunye t. D.

Iimpawu ukwaphulwa kwicandelo egxalabeni eliphezulu

Intra-articular ukwaphuka isebe kunye nokudumba okanye ukopha ukuya entlanganweni. ukunyuka igxalaba ngokubona umthamo. It is a xi kabuhlungu entloko. entanyeni ihumerus ngokwaphulwa unika ntlungu kwiziphakamiso setyhula kunye nemvakalelo. Xa negalelo ayikwazi anyhashwe ukwaphuka intamo zoqhaqho sindululo kwi kwegxalaba. Ukuba kukho ukubana, loo nto ingatshintsha ukuba ezimanyeneyo mlenze. Kule ndawo welungu na ukopha kunokwenzeka, ukudumba, okanye intlama iphela. Xa kuvela phezu komhlaba emagxeni perednenaruzhnoy prominences nokudleka uphawu uyakwazi ukuthetha adduktsionnom ekujikeni, yaye xa kwabonakala isimangalo, oko sibonisa ukuba nemithathu.

Kwakhona ukwa zoqhaqho le ihumerus kunokubangela ukushukumiseka yezifo. Kwamathambo kunye nokususwa elikhulu okanye noqhekeko unakho ukuvala intshukumo esebenzayo, kwaye nkqu umthwalo encinane kwi asi neentshukumo zezenzi kubangela intlungu ezibukhali. Eyona eyingozi lwalo apho intamo ezinjengokwaphuka ihumerus kwenzeka kunye umonakalo, jamming, ukuphehla le neurovascular bundle. Ukucudisa le umqadi kubangela nokudumba, ukuncipha uvakalelo, stasis lwemithambo kunye ukushwabana kunye paresis ngesandla.

Ukwaphuka le tuberosity ngakumbi ihumerus ibonelela intlungu igxalaba, ingakumbi xa uvula isandla sakho ngaphakathi. uwaphule Movement kwegxalaba, baba buhlungu.

Iimpawu diaphyseal zaphuka

Ukophuka ihumerus kummandla diaphyseal ngendlela eqhelekileyo. Kukho ukudumba, iintlungu, kunye uncharacteristic of ukuhamba kwindawo sisilonda. Amaqhekeza aseleyo, ukuze sihambe ngeendlela ezahlukeneyo. movement isandla engahlonitshwa. yokopha kunokwenzeka. Kwamathambo kunye utshintsho owomeleleyo kungabonwa nkqu ngeliso lenyama kwi uhlobo emagxeni. Ukuba luvo iphiramidi ebonisa yonakele, akunakwenzeka ukuba ukuqondisa brush neminwe. Noko ke, ukuze bafunde uhlobo umonakalo kufuneka i-X-ray.

Ukophuka distal kunye neempawu zazo

Ukophuka distal yahlulwe extra-articular (extensor supracondylar okanye flexor) kunye intra-articular (condylar, transcondylar, yamophula ukuphakama capitate okanye ihumerus block). Ukuphazamiseka kweli sebe kungakhokelela deformation le joint ingqiniba. Kwakhona, kukho intlungu ukudumba, kunye nentshukumo nambalwa kwaye ibuhlungu.

flexion Supracondylar kwenzeka emva kokuwa kwi ingalo kruthu, ekhokelela ekweneni site umdlali olimeleyo, intlungu alibonakali abaze iliso kungoluka zengalo. Extensor kuvela xa isandla pererazognutosti ekwindla, abangaboniyo yayinqamlela ziyenza njani kwaye ekhatshwa iintlungu kunye ukudumba. Ukophuka enjalo zidityaniswe kunye dislocation ngaxeshanye entlanganweni.

Ukophuka condyle lwangaphandle asoloko ehamba ukuhla kwi isandla tyaba esolukileyo okanye umothuko ngqo, uwaphule basekhaya xa lehla kwi ingqiniba yakhe. Kukho ukudumba kwindawo engqinibeni, iintlungu, kwaye maxa wambi ukukhubazeka okanye ukopha entlanganweni ngokwayo. Movement kwi engqinibeni anqongophele, ingakumbi ngenxa yokopha.

Capitate ingqongqo ukwa nga kwenzeke xa esiwa kwi ingalo ngqo. Kwakhona kuphela intshukumo intlungu ngokudibeneyo kwaye ibangela. Ngokuqhelekileyo, oku ukwaphuka okuvala ezi ihumerus.

uncedo lokuqala kunye uxilongo

Ukuba ukrokrela lomzimba ngokwaphulwa kufuneka ngokufanelekileyo esisigxina ukuthintela ukugxagxiseka le meko. Uyakwazi ukusebenzisa analgesics ukuba ntlungu. Emva koko, ngokukhawuleza kangangoko kunokwenzeka kufuneka eze ixhoba esibhedlele ukuxilongwa kunye uncedo lobungcali.

Uxilongo uyakwazi zaphuka phezu mpawu zingasentla, kodwa iziphumo zokugqibela zifumaneka kuphela emva ray. Ngokuqhelekileyo wenza imifanekiso uqikelelo ezahlukeneyo, ukucacisa umfanekiso ngokupheleleyo. Ukophuka ihumerus maxa wambi ngokukweka wavakalisa ngoko wabo onzima ukwahlula evela komsipha, neentlobo nemivumbo, nto leyo ifuna unyango eyahlukileyo.

Unyango lwe waphuka ezingephi

Ukwaphuka ihumerus ngaphandle ukubana kufuna immobilization lomzimba udaka okanye ibhasi esindayo. Iingxaki zinqabile kakhulu. Ukuba kukho icala kancinane, nto yenzelwa misa immobilization olulandelayo. Kwezinye iimeko, ukufakelwa umhlabelo elisusekayo kwanele, ngamanye ukurekhodwa ngokupheleleyo iyafuneka.

Ukophuka Minor zenxalenye proximal ukuvumela kwiintsuku ezintathu kamva ukwenza UHF kunye nonyango Imagnethi, yaye emva kweentsuku 7-10 ukuqalisa uphuhliso ngengqiniba kunye kwisihlahla amalunga, electrophoresis, UFO, yokuthanjiswa ultrasound exposure. Emva kweeveki 3-4 of ukutyabeka Longuet okanye yamasango ezizodwa indawo umhlabelo, baqhubeke unyango kunye neenkqubo.

iziqwenga lokubuyisa abafudukayo ngaphandle utyando

ukulimala kakhulu ezifana ezinjengokwaphuka okanye steel intamo ukwaphuka le ihumerus kunye ukubana ifuna Ukumiswa, ukutyabeka umhlabelo kunye rhoqo x-reyi esibhedlele. Ukutyabeka kufakwe isicelo kwiiveki 6-8. Kuyimfuneko ukuba yisa izandla neminwe ukususela kusuku olulandelayo emva kweeveki ezi-4, unako ukwenza iintshukumo nje kwegxalaba, isandla sakhe olungileyo, ngoko hamba uye intshukumo esebenzayo. kwimo yangaphambili ngakumbi kuquka unyango umzimba, ngemiyalezo, mechanotherapy.

Kwimfuneko yokungenelela ngoncedo kuhlinzwa

Kwezinye iimeko, Ukumiswa akunakwenzeka ngenxa ukuqhekeka eyomeleleyo okanye nje ayiniki iziphumo ezinqwenelekayo. Ukuba kukho ukwaphuka le ihumerus liphathwa uqhaqho ezilindekileyo ukufezekisa esi indibanisela amaqhekeza aseleyo. imbaxa Strong, yahlukana okanye aliphelelanga, isiza ngokwaphulwa ezingazinzanga zingafuna ukuba ukubeka nje kunye osteosynthesis kunye - ukulungisa kwitekisi iinaliti, izikrufu, amacwecwe. Umzekelo, ukwaphuka entanyeni ihumerus kunye usasazeko epheleleyo ngamaqhekeza kufuna kwamanani ipleyiti Kaplan-isemoyeni, iinaliti, okanye umqadi Vorontcova Klimov, phina okanye ngentonga, ngaloo ndlela sikuphephe kukuvela ukubana emboxo yi omhlophe. Yohambo ukugcina ngezikhonkwane fusion okanye Ilizarov. I tape skeletal ibambelele sisetyenziselwa Ukophuka ezinye ngokwahluka kwekhadi asezantsi, emva koko waseTire lwenziwe kwaye kubanjwe ukuyifundisa.

Kwamathambo epicondyle ngaphandle ukubana lifune unxibe udaka iqhiya ngexesha kwiiveki ezi-3. Offset angafuna ungenelelo yotyando. Condylar (intercondylar kunye transcondylar) Ukophuka soloko ilandelwa lutshintsho lwemithetho ukubana amaqhekeza bone kunye eziqhutshwa. Nokumisa kule meko yenziwe evulekileyo ukuqinisekisa nokubuyiselwa kwindawo echanekileyo kwezi imiphezulu articular kwaye wenze osteosynthesis. isicelo Okulandelayo unyango bembuyekezo kwi entsonkothileyo.

Unyango lwe zaphuka nzima

Ukwaphuka le ihumerus kunye ukubana, kunye umonakalo luvo iphiramidi, kufuna uthelekiso amaqhekeza bone kunye nonyango endala ye-luvo. Ukwa akasakwazi Isibalo kweziyobisi unyango ukuya luvo nga ukuntshula ngokwayo. Kamva ukudibanisa unyango ngokwasemzimbeni impilo yomzimba. Kodwa ukuba usebenziso luvo lo kwakhona kwiinyanga ezimbalwa, ngoko uqhaqho olwenziweyo.

Kumatyala amaninzi kakhulu, xa mathambo kakhulu kakhulu aliphelelanga, amaqhekeza asuswe, emva koko kufuneka le ngengqondo. Nomlenze sokwenziwa joint iyasetyenziswa endaweni entloko. Ukuba umonakalo ngokugqithiseleyo izihlunu elisemqolo kungenziwa sutured ngqo ihumerus.

Unyango nawuphi na ukwaphulwa kufuna ukuthotyelwa zonke izindululo ziingcali, kwakunye indlela kakhulu ukuba kwimeko yesiqhelo. Ekugqibeleni Immobilization kunye yokuphumla olupheleleyo umphezulu umonakalo indawo umthwalo ethile. Iikhosi ukuyifundisa, impilo yomzimba, yokuthanjiswa kunye neenkqubo ezifana linokwenziwa ngaphezu kwakanye, ezinye iziphazamiso de bachache ngokupheleleyo. Kubalulekile kwakhona ukuzalisekisa ngesazela zonke iimfuneko kwisimo ekhaya kwaye unakekele kwakhona kukwenzakala-.