Osteotomy - he aha te mea tenei?

Osteotomy - he tukanga hāparapara e whāinga ana ki te whakahoki i te mahi toitoi ngaro i roto i tuaki wheua tāwhaiwhai. I roto i te nuinga o te wā, kei te whakamahia te reira ki te tango i te deformation e alangá, e taea ai e koe te hoki kaha o te manawanui ki te whaiaro tiaki-a nekeneke.

ariā General

whakamana Operation osteotomy e taote whētuki tino mohio. I mawhiti tuatahi te mea te reira e ko matatini te wawaotanga me te titau te rota o te wā i ora o te manawanui, Heoi, tautukunga ki ngā taunakitanga a te taote, e whakaara te manawanui ki ona waewae hohoro.

Osteotomy - he mahi kawea nei i roto i na tikanga o taputapu motuhake - osteotomes, kani Gigli, kani hiko me ngā pūrere ultrasonic. te āwhina ratou ki te hanga i te rua i roto i te wahi wawaotanga, me te tapahia te wheua. I muri kohikohi otaota wheua whatiwhatinga e whakaritea ki te tīwiri, ngira, mau api. Rerekē piere matapōkere, tono maka te raima te uaua, i roto i te tikanga ki te karo te whanaketanga taea o contractures i te hononga.

whakarōpū

Tei runga i te āhua o te whai wāhi whakahaere i te osteotomy momo e whai ake nei:

1. Open - me whai manauru ki te wheua. I muri i te kokoti kiri, kiko subcutaneous me te uaua taputapu, wehea raspatory kiriuhi wheua, wheua, me te ka dissected. whakaritea te otaota i roto i te tūranga whaiaroaro, runga - maka.
2. Kua katia - whakahaeretia i roto i te whai wāhi ki te torutoru henimita. E kore e nga uaua tapahia, ka papanga ki te tiki ki te wheua. Mā te whakamahi i toki wehea kiriuhi wheua, me te maha o nga whiu hama i runga i te wheua kakau tuaki. E panaia a whakaritea ki taputapu motuhake ki te karo i hoko ratou oko toto me raru. Nuinga o ngā wā e whakamahia ana mō te osteotomy hake.

Ko te āhua o te tarai e whai ake nei wawaotanga:

• lateral;
• arapiki;
• hōtiu;
• kōpekapeka;
• nōhanga (porohita, arcuate, poro-āhua, angularly).

Tei runga i te whāinga, pokanga ko te momo e whai ake nei:

• osteotomy fakatonutonu;
• derotation;
• hāngai ana i te huri i te roa o te e alangá;
• E whai ana ki te whakapai ake i te mahi tautoko.

Tuhinga mō te wawaotanga

Osteotomy - he pokanga orthopedic, whakamana nei i roto i te wā e whai ake nei e kore e Nireaha ki te therapy momo:

• abnormalities congenital riro ranei me wheua deformation, he tohu nui o te roa wheua tubular (huha, pokohiwi, huha);
• ankylosis - eita o mahi tahi e tika ana ki te aroaro o adhesions tūhonohono kikokiko, wheua ngohe wheua ranei huru o te papa articular;
• dysplasia hip congenital (raruraru);
• piere e tauta tika;
• te tapû-;
• aroaro o te pukupuku metastases ranei;
• nga pānga o kōiwi i hītori;
• pupuri arthroplasty;
• te tahi atu abnormalities congenital o te pūnaha musculoskeletal.

whakamahia te mahi i roto i te mara Paku: osteotomy o te ihu, te faatitiaifaroraa i takiwa kanohi, nga mahi ohorere o te kauae.

contraindications

He he maha o ngā āhuatanga, te aroaro o nei roa pokanga te:

• mate o te natura hopuhopu i te wa, ka te wheua osteotomy hiahiatia e rua wiki i mua i tafa ranei;
• mate o te pūnaha romahā me te Cardiovascular decompensated;
• mate huka;
• wā o te hapūtanga o te tamaiti;
• waimaero tākihi ate ranei;
• te aroaro o rashes purulent atu āhua i roto i te wahi i reira ko reira e tika ana ranei ki te kawe i roto i runga i-aho uru.

Huapai me ngā huakore

Kei te uhi āhuatanga takatika o te wawaotanga mamae (ki te tetahi), me te whakahokinga mai o te nekeneke mahi. Hei tauira, ka faaore osteotomy o te turi mamae i roto i te kaupapa, anō flexor me extensor mahi, tango nga adhesions o nga papa articular. mutu te mate tona haereraa.

Ko te ngoikoretanga Ko te taea o te karawhiti ataata o wahi hononga ranei. Ano, ki te e hiahia te manawanui he arthroplasty whakakapinga tahi, e mea fifi atu ki te kawe i muri i te osteotomy.

pōauautanga taea

Osteotomy - he mahi e hoki nga tau maha ake ki te whakaiti i te tūponotanga o pōauautanga postoperative. Heoi, i tetahi whakararu o ētahi atu āhuatanga i roto i te tinana tangata, ko te puna o te ati, no te mea i roto i te tua ki te nehenehe atu mātanga mahi, e korero tatou e pā ana ki te āhuatanga takitahi o te manawanui.

Fifi o tetahi osteotomy ahua e taea e:

• mate o te patunga hāparapara - titau te whakarite o pota hikitia o therapy paturopi;
• wāhikē otaota me te wheua whatiwhatinga - kua kawea i roto i ki atu warea mai anō te;
• hononga puhoi o nga wheua - whakaritea complexes multivitamin e kua tito o ngā huānga faufaa wahi (konupūmā, ūkuikui, konupora, konutea);
• hanga sustava- teka titau wawaotanga atu;
• parestezii- tūtohutanga takahi kiri i roto i te mahi wahi e tika ana ki te pūtahitanga o te manga karere (kore e rapu maimoatanga atu, hanga iho);
• he tika whakakapinga tahi - makanga o implants.

osteotomy fakatonutonu

A amo ana i roto i te hātepe taua whakamahia te i roto i te whatinga accrete he, melé wheua congenital, te whanaketanga o te ankylosis pseudoarthrosis ranei, deformities o nga wheua waewae ki waimaero mahi nekeneke, ki te whakakore hē Paku ataata.

I mua i kawea te wawaotanga i roto X-ray whakamātautau, e taea ana ki te tautuhi i te wāhi o te wheua, tuu i te heke mai o te tuaki, te hauora wheua whānui. Ki te tika, he rorohiko, ranei MRIs. Ko te toenga o te rangahau e faataahia takitahi traumatologist.

whakamana te mahi i roto i te hōhipera motuhake. Ko te roanga o te wawaotanga - e pā ana ki 3-4 haora, i runga i te rōrahi o te ngā tukanga e tika ana rānei. I muri i tuaki o wheua whatiwhatinga e whakaritea e Ilizarov (mahi whakamana i runga i nga topito) ranei whakaaro konganuku motuhake e kua patia tika ki te wheua (osteotomy waewae).

Ilizarov taputapu Ko te hanganga motuhake e whakamahia ana i roto i te traumatology, me orthopedics mo whakatika, kōpeketanga totoro wheua whatiwhatinga i roto i te tūranga e hiahiatia ana i runga i o te wā, he wā roa ranei.

I muri kawea te mahi i roto i te mana x-ray, tuku ki te tautuhi i te whakatika tika.

Fifi osteotomy fakatonutonu

Pea pōauautanga i muri i te ako o ngā āhuatanga pathological ngā:

• mamae kaha, e kore Katohia Pë tikanga;
• kore o nga wahi o waho o te mīhini o ngā hanganga whakarewa ranei;
• whanaketanga o te toto;
• kanokanototo hanganga;
• mōtete whanaunga ki tetahi ki tetahi i roto i tetahi o nga rererangi displacement o te wheua;
• atu pōauautanga whānui.

Osteotomy i te mara o te niho, me te pokanga maxillofacial

I roto i te mara niho i mahi osteotomy kauae, e taea mahi hei mahi motuhake rite te wā o te tukanga hāparapara ranei. Whakamahia i roto i wāhikē ranei piere, ki te whakatika i malocclusion. E hanga vahi haere te roa o te molars kauae.

I muri i warea o roto i te tūranga kauae whaiaroaro superimposed takai shock, whakatika nga paparinga, me te wāhi kauae. whakaritea tonu te rongoā paturopi i roto i te tikanga ki te karo te whanaketanga o te suppuration me hanganga o te tapû. I waenganui i nga niho tangohia etahi kapia mo te tauwāhi kitea nei te mātanga ia. E nekehia atu tuinga i muri i te 2 wiki, me nga pokekore e mau te kauae i roto i te marama ki te whakaoti i te wāhanga maimoatanga aru e te therapy orthodontic.

I roto i te mara o te pokanga-waha, me te maxillofacial whakamahia te osteotomy nasal, i te mea wahi o te rhinoplasty. Ko te tohu hoki:

• distortion nui o te piriti nasal;
• taumira teitei o wheua;
• te hiahia mō te displacement wheua i roto i te pā ana ki te pakitara wehewehe nasal.

I roto i te whakahaere i te osteotomy ihu te taote ki te takoto raruraru rerehua: kati nasal kikorangi, tango koropuku me te faaafaro i te curvature o te backrest, te whāiti o te taiepa taha. Me tango te mātanga ki pūkete e kia pā i te tuakitanga o wheua kikokiko te patency o te airway runga, reira, i roto i te mahi riro āhuatanga kikokiko, me te whaiaroaro o te manawanui ngā.

Momo osteotomy nasal:

• lateral (mata), kawea atu i te perforation aho ranei pūtake;
• medial (Center);
• runga;
• takawaenga.

tīpakohia Momo o te wawaotanga whakamahia te takitahi, tango ki pūkete raruraru o te manawanui, te whakaaro o te mahi, te āhua o te kiko wheua, te rōrahi tika o te maimoatanga hāparapara.

kia kawea tetahi osteotomy i muri te whakatairanga i te taumata o te wātea i te mate. Ka mahi te reira i rite te mehua ārai mo te whanaketanga o pōauautanga, me te hanga tikanga mo te hononga wheua pai, me te tika.