Ko te whati o te angaanga he momo whati noa, e 2% ki te 5% pea o ngā whati katoa o te tinana tangata. E taunakihia ana te pokanga mō ngā tūroro he nui te nekehanga, he kore pumau, he raruraru e pā ana, he nui rānei ngā mahi e hiahiatia ana, ko te whāinga he whakaiti i te tūponotanga o te kore hononga me te whakaora i te mahi a te hononga pakihiwi. Mō ngā whati he kitea te nekehanga, te kore pumau rānei, ka whakamahia e ngā tākuta te pokanga whakapiri ā-roto o te pereti hei whakatairanga i te whakaora whati. Heoi, he iti noa ngā tūroro (tata ki te 1% ki te 3%) ka pāngia e te whati o te pereti i muri i te pokanga, e kore e whakararu noa i te whakaora engari me mahi anō hoki he pokanga tuarua (e whakaaturia ana i te pikitia i raro nei).
Ka whakamāramahia e tēnei tuhinga ngā take me ngā tikanga rongoā mō te whati o te pereti, me te whakarato hoki i ngā rautaki urupare pūtaiao.
Te Take mō te Pakaru o te Pereti
1. Ngā Take Koiora-ā-Mīhini
He āhua-S te angaanga o te wheua, ā, ko te tuatoru o waenganui te wāhi e tino pāngia ana e te whati, me te wāhi hoki e tino pāngia ana e te ahotea ā-mīhini. Ka pāngia ngā pereti o tēnei rohe e te ahotea piko me te ahotea hurihuri; ki te whakaroa te whakaora whati, ka pakaru pea te pereti nā te ngenge roa.
Kukū ahotea: Ki te kore e ranea te roa o te pereti (hei tauira, ko te kapi i ngā kōhao tīwiri e 2-3 anake i te pito whati) ka pakaru pea ngā pito e rua o te pereti, ka wetekina rānei te tīwiri nā te kukū ahotea.
Hei tāpiritanga, mā te nui rawa o te whakapiri i ngā tīwiri, te here rānei i te waea rino ki ngā wāhi whati pakaru ka nui rawa te kukū o te ahotea me te pakaru o te pereti (e whakaaturia ana i te pikitia i raro nei).
Kua whakaatuhia e ngā whakamātautau koiora-mīhini ko te koretake o te whānui o te pereti me te koretake o te whakapiri i ngā tīwiri ngā tino take ā-mīhini e pakaru ai te pereti.
2. Ngā Take Hangarau Pokanga
I roto i te haumanu, he nui ake te tere whakaora o te maimoatanga ā-pūmau i tērā o te maimoatanga pokanga, engari ko te maimoatanga ā-pūmau te mea nui e pā ana ki te mōrearea o te malunion. Mō te maimoatanga pokanga, ko te whiriwhiri i te huarahi pokanga ka pā tika ki te pumau o te pereti, koia te take he paku teitei ake te auau o te kore-union whati pokanga i tērā o te maimoatanga ā-pūmau. Kia whiriwhiria te pokanga, he mea tino nui te tikanga pokanga.
Te kōwhiringa pereti hē:
Ina whakamahia ngā pereti kore-raka (ngā pereti tikanga), ka ngāwari te wetewete o ngā tīwiri, ka pakaru pea te pereti. Kāore i te tino whakamahia ēnei pereti i ēnei rā, ā, he maha ngā wā ka kitea i ngā wā i pakaru ai i mua.
Kāore pea e ranea te matotoru o te pereti (hei tauira, ngā pereti 2.7 mm e whakamahia ana mō ngā tūroro uaua, momona rānei) e tautoko tika ai.
Te kore e ranea te whakapiri i ngā tīwiri: Kāore i te ranea te maha o ngā tīwiri (kia 6 ngā tīwiri e taunakihia ana), ā, me whakanoho ngā tīwiri e 6 katoa ki te whakapiri bicortical—ko taua kaha pupuri anake ka taea te ātete i te kaha hurihuri me te taumaha o te pito o runga. Mō ngā take motuhake, pērā i ngā tūroro he ngoikore te piri, he osteoporosis kino rānei, me whakapiri bicortical (me wero ngā tīwiri i te wheua cortical o mua me muri o te clavicle hei whakapai ake i te pumau) i ētahi wā.
3. Ngā Take e Pā Ana ki te Tūroro
Ko te tino take o te pakaru o te pereti ko ngā pito whati kāore anō kia ora, te roa rānei o te hononga o te wheua (nonunion). Mēnā ka puta te nonunion o te whati, me nui ake te taumahatanga o te pereti hei utu mō te wheua, ā, ka mutu, ka ngenge te whati o te pereti i roto i te wā. I roto i ngā āhuatanga e pā ana ki te nonunion, he mea nui ngā āhuatanga e pā ana ki te tūroro, tae atu ki te momi hikareti (ka ārai te nikotīni i te whakaora o te wheua), te mate huka, te kore kai pai (te korenga o te huaora D, te konupūmā rānei) me te osteoporosis (te kounga ngoikore o te wheua ka ngāwari te wetewete o te tīwiri). I ētahi wā, ka taea hoki e te mate patunga te take o te nonunion: ka hua pea i te mate i muri i te pokanga te mimiti o te wheua, ka ngaro te tautoko o te pereti, ā, ka pakaru i te mutunga.
Ngā Tikanga Maimoatanga mō te Pakaru o te Pereti
1. Pokanga Whakahou (Maimoatanga Raina Tuatahi)
Ngā tohu: Te whati kāore anō kia ora, me te whati o te pereti me te ngoikore o te mahi. Ngā whāinga pokanga: Whakahokia te roa o te clavicular, te whakatutuki i te pumau me te whakatairanga i te whakaora o te whati koiora.
2. Ngā Maimoatanga Rerekē
Te whakapiri i ngā whao intramedullary: He pai mō ngā tūroro he ngoikore te kounga o te wheua, engari he ngoikore te kaha ārai-hurihuri.
Te rongoā ngaru ohorere o waho o te tinana (ESWT): E tika ana mō te kore-union ngawari, ka taea te whakaoho i te whakaora wheua.
Te orooro pāorooro iti-kaha (LIPUS): Ka whakatairanga i te whakaora whati, engari he puhoi te pānga rongoā.
Whakamutunga
He raruraru pea te pakaru o te pereti i muri i te pokanga whati angaanga, engari ka taea te whakaiti i tōna mōrearea mā roto i ngā tikanga pokanga kua whakapaitia, te whakahaere tika i muri i te pokanga, me te whakaora tika. Mena ka pakaru te pereti, ko te pokanga whakahou me te tāpiri wheua te tikanga maimoatanga tino whai hua i tēnei wā. Nō reira, e taunakihia ana kia tino whai ngā tūroro i ngā tohutohu hauora, ā, kia kaua e whakakorikori wawe i muri i te pokanga.
Wā tuku: Hanuere-21-2026