Ko ngā whati o te angaanga tetahi o ngā whati tino noa o te peka o runga i roto i te mahi haumanu, ā, 82% o ngā whati o te angaanga he whati o waenganui o te angaanga. Ko te nuinga o ngā whati o te angaanga kāore he nekehanga nui ka taea te rongoā mā te whakamahi i ngā takai ahua-o-te-waru, ko ngā whati he nekehanga nui, he kiko ngohengohe kei waenganui, he mōrearea o te ngoikore o te toto, o te pūnaha io rānei, he nui rānei ngā mahi e hiahiatia ana kia whakapirihia ā-roto ki ngā pereti. He iti noa te auau kore-hononga i muri i te whakapiringa ā-roto o ngā whati o te angaanga, tata ki te 2.6%. Ko ngā kore-hononga tohumate e hiahia ana kia pokanga whakatikatika, ko te huarahi matua ko te whakapiri wheua kore-hononga me te whakapiri ā-roto. Heoi, he tino uaua te whakahaere i ngā kore-hononga atrophic e hoki mai ana i roto i ngā tūroro kua oti kē te whakatikatika kore-hononga, ā, he raruraru tonu mō ngā tākuta me ngā tūroro.
Hei whakatika i tēnei take, i whakamahia e tētahi ahorangi i te Hōhipera o te Ripeka Whero o Xi'an te hononga hanganga wheua iliac autologous me te hononga wheua cancellous autologous hei rongoā i ngā hononga kore-hononga uaua o ngā whati clavicle whai muri i te korenga o te pokanga whakatikatika, ā, i tutuki ai ngā hua pai. I whakaputaina ngā hua rangahau ki te puka "International Orthopedics".
Te tikanga pokanga
Ka taea te whakarāpopoto i ngā tikanga pokanga motuhake penei i te pikitia i raro nei:
a: Tangohia te whakapiringa clavicular taketake, tangohia te wheua sclerotic me te koha muka i te pito whati o te whati;
b: I whakamahia ngā pereti hanga-anō wheua kirihou, i whakaurua ngā tīwiri raka ki ngā pito o roto, o waho hoki hei pupuri i te pumau whānui o te wheua, ā, kāore i whakaukia ngā tīwiri ki te wāhi hei rongoā i te pito whati o te wheua.
c: Whai muri i te whakapiringa o te pereti, pokaia he kōhao ki te ngira Kirschler i te pito whati o te whati ki roto, ki waho hoki kia puta mai he toto i te kōhao (tohu pepa whero), e tohu ana i te pai o te kawe toto wheua ki konei;
d: I tēnei wā, me keri tonu te 5mm ki roto, ki waho hoki, ka keri i ngā kōhao roa ki te tuara, he mea pai mō te osteotomy e whai ake nei;
e: Whai muri i te tango wheua i te taha o te kōhao keri taketake, nekehia te kiri wheua o raro ki raro kia waiho he awa wheua;
f: I whakatōkia te wheua iliac bicortical ki roto i te awaawa wheua, kātahi ka whakapūmauhia te cortex o runga, te crest iliac me te cortex o raro ki ngā tīwiri; I whakaurua te wheua cancellous iliac ki roto i te wāhi whati.
Noa
ngā kēhi:
▲ He tāne 42-tau te pakeke o te tūroro, he whati waenga-wāhanga o te anga maui i puta mai i te whara (a); I muri i te pokanga (b); He whati kua whakatikatikaina me te kore-hononga o te wheua i roto i ngā marama 8 i muri i te pokanga (c); I muri i te whakahoutanga tuatahi (d); He whati o te pereti maitai 7 marama i muri i te whakahoutanga me te kore-ora (e); I ora te whati (h, i) i muri i te honohono wheua hanganga (f, g) o te ilium cortex.
I roto i te rangahau a te kaituhi, e 12 ngā kēhi katoa o te kore-huinga o te wheua uaua i whakaurua, ā, i ora katoa ēnei wheua i muri i te pokanga, ā, e 2 ngā tūroro i pāngia e ngā raruraru, 1 te kēhi o te totohu uaua i waenganui i te kuao kau, me te 1 te kēhi o te mamae tango wheua iliac.
He raruraru tino uaua te kore-hononga o te clavicular refractory i roto i te mahi haumanu, he taumaha te taumahatanga hinengaro ki ngā tūroro me ngā tākuta. Nā tēnei tikanga, i honoa ki te honohono wheua hanganga o te wheua cortical o te ilium me te honohono wheua cancellous, kua tutuki he hua pai mō te whakaora wheua, ā, he tika te whai huatanga, ka taea te whakamahi hei tohutoro mā ngā tākuta.
Wā tuku: Maehe-23-2024
