Mātauranga me te maimoatanga o te nonunion

tahi teka - ko te ahua o te takahi o te tonu o te wheua, āhuatanga nei i te nekeneke rerekē, rerekē tenei tari. I roto i te mahi hauora mō tenei kāwanatanga whakamahi i te wā motuhake - "pseudarthrosis". I reira, tenei mate tino pai tukinotia, a taea maimoatanga hei rua whakahaere, me te momo. I tua atu, maimoatanga i roto i te nuinga o te wā kei te pai hua me te tangata ka hoki ki noa. Tenei tuhinga tātari i roto i te taipitopito nga take mo te hanganga o te hononga teka. Na te aufauraa i whakarongo ki te tātaritanga me te maimoatanga.

ICD: pseudoarthrosis, momo

tahi teka - he takahi o te tapatahi o te wheua cortical, haere tahi i te nekeneke rerekē. E ai ki te International Whakarōpū o Diseases waehere e kua he tahi teka - ICD 10. Kei roto te reira: whati kore-uniana, arā psevdoartoroz me tahi teka i roto i te hononga papamuri arthrodesis ranei.

I runga i te wahi o tauira pathological me te tikanga maimoatanga o hononga teka e wehea ki kaiota te, me te pono. Ko te tuatahi ko te wā takawaenga i waenganui i te puhoi me te whakatōpū o te pseudarthrosis pono. Ratou pikitia haumanu ko te āputa iti i waenganui i te whatiwhatinga ki tonu i te kiko kaiota, papa paraharaha, wheua i pito e taupoki ana i te awa medullary.

I roto i wā onge te pseudarthrosis synovial kaiota i hanga i roto i i hipoki nga pito o nga wheua e na roto i te wheua ngohe me te wheua whatiwhatinga kei roto i te capsule tūhonohono taketake. I waenganui whakaemi ratou inu synovial, Ka taea e whatiwhatinga katoa sclerosis.

nearthroses Whakarōpū

kia congenital riro ranei Pseudoarthrosis. Ko te tino onge congenital tahi teka, me te he kore neke atu i te 0.5% o te māuiuitanga. Ko te pūtake o tona hanganga he takahi wheua intrauterine kiko hanganga, hua i roto i te hanganga wheua iho i roto i te rohe motuhake. A, i muri i te whanautanga, i 2-3 tau, te tapatahi o te wheua he pakaru. Ko te tikanga congenital tahi teka ko te tibia, i te iti rawa - o te āhei, pūkaka me pūkaka.

Ko te pseudarthrosis riro ko e pā ana ki 3% o mate āhua orthopedic. I roto i te nuinga o te wā i te reira ko te hopearaa o te whati, ka reira ko te hē, me te oti hononga o te wheua whatiwhatinga. wehea ki atrophic pseudoarthrosis riro, me normotroficheskie hypertrophic.

take Local o mate

take Local o te hanganga o te tahi teka, i tahuri, kua wehea ki ngā rōpū e toru. rōpū Tuatahi - take e kua e pā ana ki ngā hapa me hē i roto i te maimoatanga o: juxtaposition wāhanga o whatiwhatinga o te wheua, ki te kore te whakakore interposition o te kopa ngohengohe, immobilization rerekē, e tika ana ki nei te nekeneke rongoa o whatiwhatinga, ka maka te huringa auau wawe ranei, te whakamahi o te mingimingi tano ore, kaupapa kaha rawa, me te korikori tinana , sklerotirovanie whānui.

Ko te rōpū tuarua ngā take e pā ana ki te tohu o te pakeke o te whara, me pōauautanga pou-ngaukino: piere, mate o te wahi nui o te wheua, uaua kuru whara mo te tawhiti nui, te rongo o te suppuration wheua kikokiko, te tapû, kino ki raru me oko toto, me te tauwhatinga i roto i to ratou supply.

Na rawa, te toru o nga rōpū o ngā āhuatanga e pā te hanganga o te tahi teka, e pā ana ki ngā āhuatanga kikokiko, me te whaiaroaro o te toto supply ki te wheua i te pae whati, me te localization.

take arataukai

Mai i te arataukai taimaha ai te hanganga o te pseudoarthrosis matua ko: mate, hei tauira, pakewakewa, malaria, mate whakapeka; mate pūkoro a ngā pākia konupūmā-ūkuikui i roto i te kopa; mate huka; beriberi; iti hoki iaia i muri wharanga innervation o oko toto; nui irradiation X-ray, e te mea e taea ki te tautāwhi i te tukanga o te wheua hanganga; disorders arataukai i te pae whati.

pikitia haumanu

He ona ake āhuatanga te pikitia haumanu o te hanganga o te hononga teka. I roto i te wahi o te whati kitea nekeneke, uaua atrophy, puku, tini o te kiko tūhonohono, nawe hanganga. I te X-ray e taea kitea he āputa nui i waenganui i nga whatiwhatinga, sclerosis wheua te kūmuri, hononga o te awa medullary.

tātaritanga o te pseudarthrosis

I te tātaritanga, i roto i te tua ki raraunga haumanu, utua whakarongo te ki te rā kati, i te mea faufaa no te he hononga oti o te whati. A, no te pau tenei wā, tautuhia te mana o te whatinga te rite te accrete āta ranei asymphytous, a i muri i te wā e rua rawa te täkupu hanganga whakapae o te tahi teka.

Hei whakaū i te whakapae, mahi he X-ray i roto i rua haurangi tahi hāngai, me i roto i ētahi wā - me haurangi matahao. Signs o te aroaro o te nonunion whakaaro te pikitia e whai ake nei i runga i te X-ray: te ngaro o te callus, i te mea te wahi honotanga o te whatiwhatinga wheua; pito o te whatiwhatinga i te āhua porotaka koeko ranei maheni; kōhao tupuria i nga pito o te whatiwhatinga, a hanga e te pereti kati. A, no te mutunga te tahi teka i roto i tetahi ranei e rua o nga whatiwhatinga wheua te mea he āhua hemispherical me i ahua rite te matenga tahi. pea te atu kongakonga he kōhao glenoid. I roto i tenei take, ko mārama kitea te wāhi tahi.

Hei whakatau i te whānuitanga o te ako radionuclide tukanga kaha whakaritea.

te mau parau tumu maimoatanga hāparapara

Ahakoa te täoro tikanga momo o te maimoatanga (whakahaere o taero, hiko, autō, me pera i runga i. D.), he whakahaere te tikanga matua o te te rongoā pseudarthrosis. nohoia te wahi ārahi e kōpeketanga osteosynthesis. Me pēhea te ki te hamani i te pseudoarthrosis? Me kawea te mahi i roto i roto i 8-12 marama i muri i oti whakaora o patunga i roto i te piere matatini. Ki te mea i reira he tohu e kua soldered ki te wheua, me kia motuhia ratou, ka whai tafa kirihou ki te whakatika i te koha.

He nui wāhi i roto i te mahi kei tika rite o wheua whatiwhatinga i, me te whakahauora o ratou pito, excision o nawe kiko me te whakahokinga mai o patency o te medullary awa.

maimoatanga pvsedoartroza i te taputapu Ilizarov

hanga i tēnei tikanga e taea ki te kawe tahi nga whatiwhatinga, me whakahaere to ratou hononga tere o kahore tafa tonu. Ko te aha i huaina tenei tikanga ko osteosynthesis extrafocal.

Hei timata, tono te manawanui nga titi o te pūrere orthopedic e nei e whakaritea wheua whatiwhatinga. Na, e pā ana ki te wiki pumau te tukanga whakaora i muri i te tono o te pūrere i roto i nei te wahi, te wahi i nga tuara, te whakaora me te haamata i te tukanga o te wheua hononga. Bone kongakonga āta whakatata tahi i te tahi, whakangaro kōrero e hiahiatia, me te pēpēhinga tahi teka.

Atu i reira he he warea, e ko, te hanganga o kotia me te tukanga o te ossification. Ko te roa tenei wā, engari he reira haumaru, me te kore e rapua e mehua motuhake. kia tango i te manawanui huaora, kai tika me te hoatu ake mau peu kino.

I te pae hopea, i reira ko te wā whakamutunga o te whakanohonoho, i roto i nei ki nga tohutohu katoa e tika ana te ū ki te tākuta, me te hanga i te huinga o mahi motuhake. Ideal i taua wa whakaaro ki te hei e haere ana, kaukau.

Te pütahitanga me osteosynthesis extramedullary

He tikanga whai hua o te maimoatanga he kōtuitanga intramedullary hāparapara. I mua e mau ana i roto i tona tākuta tango nga kopa ngohengohe pakaru, e kore e nei i te kiriuhi wheua, me te toto clots. I muri e te whatiwhatinga hononga wheua te whakamahi i te titi motuhake. Ko te patunga i muri i te pokanga sutured i roto i ngā papa, i roto i tona wahi kia noho i te nawe iti.

I roto i osteosynthesis extramedullary o whatiwhatinga wheua raka Supraspinous titia. Kei te aki te reira ki te wheua pakaru, a i muri i te miia a e nekehia atu whatiwhatinga paraharaha mā te tapahi.

Na, kōrero te tuhinga i roto i te taipitopito pseudarthrosis. Roto i te whakamutunga, kia tuhia te reira e mahi nga āhuatanga mōrearea mō te hanganga o te tahi teka he momo o te endocrine mate, peu kino (paowa, tūkino waipiro), te mōmona, kai rawakore, me te kore o te mahi tinana. Na reira, te whakaū i te āhua hauora ka whakaiti i te mōrea o tenei mate.