He whara tino onge te whati o te kōiwi papatahi me te kokiritanga o te acromioclavicular ipsilateral i roto i te mahi haumanu. Whai muri i te whara, he nekeneke noa te wāhanga distal o te kōiwi papatahi, ā, kāore pea te kokiritanga o te acromioclavicular e whakaatu i te nekehanga mārama, ka ngāwari ai te tātaritanga hē.
Mō tēnei momo whara, he maha ngā huarahi pokanga e wātea ana, tae atu ki te pereti matau roa, te huinga o te pereti clavicle me te pereti matau, me te pereti clavicle me te whakapiri tīwiri ki te tukanga coracoid. Heoi, he poto noa te roa o ngā pereti matau, ka kore e pai te whakapiri ki te pito proximal. Mā te huinga o te pereti clavicle me te pereti matau ka nui ake te ahotea i te hononga, ka piki ake te mōrearea o te whati.
Te whati o te kōiwi maui me te nekehanga o te hononga acromioclavicular ipsilateral, i whakauhia mā te whakamahi i te huinga o te pereti matau me te pereti kōiwi.
Hei whakautu i tēnei, kua whakaarohia e ētahi tohunga he tikanga hei whakamahi i te huinga o te pereti clavicle me ngā tīwiri punga hei whakapiri. Kei te whakaahua e whai ake nei tētahi tauira, e whakaatu ana i tētahi tūroro he whati clavicle midshaft me te nekehanga o te hononga acromioclavicular momo IV ipsilateral:
Tuatahi, ka whakamahia he pereti anatomical clavicular hei whakatika i te whati clavicle. Whai muri i te whakaiti i te hononga acromioclavicular kua motuhia, ka whakauruhia ngā tīwiri punga whakarewa e rua ki roto i te tukanga coracoid. Kātahi ka mirohia ngā tuitui e piri ana ki ngā tīwiri punga mā roto i ngā kōhao tīwiri o te pereti clavicle, ā, ka herea ngā pona hei whakau i a rātou ki mua me muri o te clavicle. Hei whakamutunga, ka tuitui tikahia ngā hononga acromioclavicular me te coracoclavicular mā te whakamahi i ngā tuitui.
He tino noa ngā whara i roto i te mahi haumanu, arā, ko ngā whati clavicle takitahi, ko ngā kokiritanga acromioclavicular takitahi. Ko ngā whati clavicle e 2.6%-4% o ngā whati katoa, ko ngā kokiritanga acromioclavicular e 12%-35% o ngā whara scapula. Heoi, he onge te whakakotahitanga o ngā whara e rua. Ko te nuinga o ngā tuhinga o nāianei he pūrongo take. He huarahi hou pea te whakamahi i te pūnaha TightRope me te whakapiri i te pereti clavicle, engari ko te whakatakotoranga o te pereti clavicle ka taea te whakararuraru i te whakatakotoranga o te TightRope graft, ka waiho hei wero me aro atu.
Hei tāpiri atu, mēnā kāore e taea te aromatawai i ngā whara kua honoa i mua i te pokanga, he mea pai kia aromatawaihia te pumau o te hononga acromioclavicular i te wā e aromatawaihia ana ngā whati o te clavicle. Mā tēnei huarahi ka ārai i te wareware i ngā whara nekehanga o te wheua.
Wā tuku: 17 o Ākuhata-2023
