Ko ngā paearu e whakaaetia ana mō te whakaora i ngā whati o te humerus he koki o mua-muri iho i te 20°, he koki taha iti iho i te 30°, he hurihuri iti iho i te 15°, me te whakapoto iho i te 3cm. I ngā tau tata nei, me te piki haere o ngā tono mō te mahi a ngā peka o runga me te whakaoranga wawe i roto i te oranga o ia rā, kua piki haere te whakamahinga o te pokanga mō ngā whati o te humerus. Ko ngā tikanga matua ko te whakakikorua o mua, o mua-taha, o muri rānei mō te whakapiringa ā-roto, me te whao intramedullary. E whakaatu ana ngā rangahau ko te auau kore-union mō te whakapiringa ā-roto tuwhera-whakaiti o ngā whati humerus he tata ki te 4-13%, me te whara io radial iatrogenic e puta ana i te 7% o ngā take.
Hei karo i te whara o te io radial iatrogenic me te whakaiti i te tere kore-union o te whakaiti tuwhera, kua whakamahia e ngā tohunga o te rohe o Haina te huarahi rongoā, mā te whakamahi i te tikanga MIPPO hei whakatika i ngā whati o te humerus shaft, ā, kua tutuki ngā hua pai.
Ngā tikanga pokanga
Hipanga tuatahi: Te whakanoho. Ka takoto takoto te tūroro, ka hikitia te peka e pāngia ana ki te 90 nekehanga, ka whakatakotoria ki runga i te tēpu pokanga taha.
Hipanga tuarua: Tapahi pokanga. I roto i te whakapūmau pereti-kotahi o te taha waenga (Kanghui) mō ngā tūroro, e rua ngā tapahanga roa, tata ki te 3cm te whānui, ka mahia i te taha o ngā pito proximal me te pito distal. Ko te tapahanga proximal te tomokanga mō te huarahi o te deltoid me te pectoralis major, ko te tapahanga distal kei runga ake i te epicondyle medial o te humerus, i waenganui i te biceps brachii me te triceps brachii.
▲ Kauwhata hoahoa o te tapahi tata.
①: Tapahi pokanga; ②: Uaua cephalic; ③: Pectoralis major; ④: Uaua deltoid.
▲ Kauwhata hoahoa o te tapahi tawhiti.
①: Io waenga; ②: Io ulnar; ③: Uaua brachialis; ④: Tapahi pokanga.
Hipanga tuatoru: Te whakaurunga pereti me te whakapiri. Ka whakaurua te pereti mā te tapahi tata, ka piri ki te mata o te wheua, ka haere i raro i te uaua brachialis. Ka mau tuatahi te pereti ki te pito tata o te whati humerus. Muri iho, me te kukume hurihuri i te peka o runga, ka katihia te whati, ka whakaritea. Whai muri i te whakaiti pai i raro i te fluoroscopy, ka whakaurua he tīwiri paerewa mā te tapahi tawhiti hei whakapiri i te pereti ki te mata o te wheua. Kātahi ka whakakīia te tīwiri raka, ka oti te whakapiri pereti.
▲ Kauwhata hoahoa o te kauhanga pereti o runga.
①: Uaua Brachialis; ②: Uaua Biceps brachii; ③: Ngā oko toto me ngā io o waenganui; ④: Pectoralis nui.
▲ Kauwhata hoahoa o te kauhanga pereti tawhiti.
①: Uaua Brachialis; ②: Io Median; ③: Io Ulnar.
Wā tuku: Whiringa-ā-rangi 10-2023
