Clavicle fractures yog ib qho ntawm cov pob txha sab sauv feem ntau hauv kev kho mob, nrog 82% ntawm cov pob txha clavicle yog midshaft fractures.Feem ntau cov pob txha clavicle yam tsis muaj kev hloov pauv loj tuaj yeem kho tau zoo nrog daim duab ntawm yim daim ntaub qhwv, thaum cov neeg uas muaj kev hloov pauv loj, cuam tshuam cov ntaub so ntswg, kev pheej hmoo ntawm vascular lossis neurological cuam tshuam, lossis xav tau kev ua haujlwm siab yuav xav tau kev kho sab hauv nrog daim hlau.Lub nonunion tus nqi tom qab kho sab hauv ntawm clavicle puas yog qhov tsawg, kwv yees li 2.6%.Cov tsos mob tsis zoo feem ntau xav tau kev phais kho dua tshiab, nrog rau txoj hauv kev tseem ceeb yog kev tshem tawm cov pob txha grafting ua ke nrog kev kho sab hauv.Txawm li cas los xij, kev tswj hwm cov neeg mob atrophic tsis zoo nyob rau hauv cov neeg mob uas twb tau hloov kho qhov tsis zoo yog qhov nyuaj heev thiab tseem muaj teeb meem rau ob tus kws kho mob thiab cov neeg mob.
Txhawm rau hais txog qhov teeb meem no, tus xibfwb ntawm Xi'an Red Cross Tsev Kho Mob tau tsim kho tshiab siv autologous iliac pob txha cov qauv grafting ua ke nrog autologous cancellous pob txha grafting los kho refractory nonunions ntawm clavicle fractures tom qab kev phais kho tsis tau, ua tiav cov txiaj ntsig zoo.Cov kev tshawb fawb tau luam tawm nyob rau hauv phau ntawv journal "International Orthopaedics".
Kev phais mob
Cov txheej txheem phais tshwj xeeb tuaj yeem sau tau raws li daim duab hauv qab no:
a: Tshem tawm qhov qub clavicular fixation, tshem tawm cov pob txha sclerotic thiab fiber ntau caws pliav ntawm qhov kawg ntawm qhov tawg;
b: Yas clavicle reconstruction daim hlau tau siv, locking screws tau muab tso rau hauv lub puab thiab sab kawg kawg los tswj lub zuag qhia tag nrho stability ntawm lub clavicle, thiab screws tsis tsau nyob rau hauv lub cheeb tsam yuav tsum tau kho nyob rau hauv lub tawg kawg ntawm lub clavicle.
c: Tom qab lub phaj fixation, laum qhov nrog Kirschler koob raws li qhov kawg ntawm cov pob txha tawg mus rau sab hauv thiab sab nraud kom txog rau thaum lub qhov oozed ntshav (liab kua txob kos npe), qhia tias zoo pob txha ntshav thauj ntawm no;
d: Lub sijhawm no, txuas ntxiv mus laum 5 hli sab hauv thiab sab nraud, thiab xyaum qhov ntev ntawm lub nraub qaum, uas yog qhov tsim nyog rau osteotomy tom ntej;
e: Tom qab osteotomy raws lub qhov tho qhov qub, txav cov pob txha cortex qis qis kom tawm ntawm cov pob txha;
f: Cov pob txha bicortical iliac tau cog rau hauv cov pob txha zawj, thiab tom qab ntawd lub cortex sab saud, lub iliac crest thiab qis cortex tau kho nrog cov ntsia hlau;Cov pob txha iliac cancellous tau muab tso rau hauv qhov chaw tawg
Hom
rooj plaub:
▲ Tus neeg mob yog ib tug txiv neej muaj hnub nyoog 42 xyoo uas muaj pob txha hauv nruab nrab ntawm sab laug clavicle tshwm sim los ntawm kev raug mob (a);Tom qab phais (b);Kho pob txha thiab pob txha tsis sib koom ua ke hauv 8 lub hlis tom qab kev phais (c);Tom qab thawj qhov kev kho dua tshiab (d);Kev tawg ntawm steel phaj 7 lub hlis tom qab kho dua tshiab thiab tsis kho (e);Cov pob txha kho (h, i) tom qab kev txhim kho pob txha (f, g) ntawm ilium cortex.
Nyob rau hauv tus sau txoj kev tshawb no, tag nrho ntawm 12 tus neeg mob ntawm cov pob txha refractory nonunion tau suav nrog, tag nrho cov uas ua tiav cov pob txha kho tom qab phais, thiab 2 tus neeg mob muaj teeb meem, 1 rooj plaub ntawm calf intermuscular vein thrombosis thiab 1 rooj plaub ntawm iliac pob txha tshem tawm mob.
Refractory clavicular nonunion yog ib qho teeb meem nyuaj heev hauv kev kho mob, uas ua rau lub cev hnyav rau cov neeg mob thiab kws kho mob.Txoj kev no, ua ke nrog cov txheej txheem ntawm cov pob txha grafting ntawm cortical pob txha ntawm ilium thiab cov pob txha tshem tawm, tau ua tiav cov txiaj ntsig zoo ntawm cov pob txha kho, thiab qhov ua tau zoo yog qhov tseeb, uas tuaj yeem siv los ua kev siv rau cov kws kho mob.
Post lub sij hawm: Mar-23-2024
