E 2.6% o ngā whatinga katoa o ngā pakeke e pā ana ki ngā whatinga o te angaanga, ā, tae atu ki te 80% e puta ana i te rohe o waenganui o te angaanga. Mai i te tīmatanga o te tekau tau atu i 1990, kua roa te whakaaro ko te tikanga whakahaere ā-pūmau i whakatakotoria e Neer te maimoatanga tuatahi mō ngā whatinga o te angaanga. Heoi anō, he maha ngā rangahau kua whakamanahia he maha ngā wā kāore e taea e te maimoatanga kore-pokanga te pupuri i te whakaiti i ngā whatinga o te angaanga o waenganui o te angaanga kua nekehia, kua pakaru rānei, ka hua ake he nekehanga haere tonu me te whakapoto haere, ka nui ake te tūponotanga o te malunion me te nonunion tohumate. I tua atu, kua whakaatuhia e ngā pūrongo he iti te kaha o te pakihiwi o ngā tūroro e whakahaeretia ana me te kore pokanga. Nō reira, kua piki ake te hiahia o te pokanga ki ngā tūroro he whatinga angaanga i ngā tau tata nei, ā, i roto i ēnei ko te whakaiti tuwhera me te whakapiri ā-roto (ORIF) me te whakapiri pereti e whakamahia whānuitia ana.

Mō ēnei whati uaua, i arotahi te tākuta ki tētahi tikanga whakapiripiri me te whakamahi i ngā pereti iti. He rite te mahi a ēnei pereti ki ngā tīwiri whakaroa engari he māmā ake te tono. I whakaatuhia hoki e ngā tirohanga i te wā o te pokanga he pumau pakari, ā, kua tutuki ngā hua haumanu pai me te whakamahinga i roto i ngā whati patellar kua pakaru. I runga i ngā rangahau e whakaū ana ka tukuna e te whakapiri pereti-rua te pumau ā-mīhini, i whakamahia e te tākutaorongoā-ā-rotomtēneiptōmurihei whakau i ngā kongakonga whati iti ki te wāhanga wheua matua, kia angitu ai te huri i ngā tauira whati uaua ki ngā whirihoranga māmā ake. I whai ake ko te whakaiti i ngā mata whati i whakahaeretia, ā, i muri mai ko te whakatakotoranga o tētahi mea pai akepereti kōpeketanga maukati(LCP). Hei whakaiti i te whara o te periosteal, i mahia noa ngā tapahi iti rawa te whakaekenga hei whakaatu i ngā wāhi i whakaurua ai te tīwiri, kia tutuki ai te whakapiringa e rite ana ki ngā mātāpono o te iti rawa te whakaekenga o te osteosynthesis pereti (MIPO).

Take Hauora

I mua i te pokanga, i whakahaerehia te aromatawai i te āhua o te whati mā te whakamahi i ngā kiriata hihi-X me ngā karapa CT hanga-3D. I kitea he whati o te clavicular o te pou matau o tētahi tūroro tāne 22 tau te pakeke i puta i ngā mahi hākinakina. I whakamanahia e te x-ray clavicular anteroposterior (a) me te x-ray apical oblique (b) nō te momo whakarōpūtanga AO/OTA 15.2C (whawhati maha-whatuwhatu pakaru) te whati. I whakaatuhia e ngā whakaahua CT hanga-toru-ahu o te tūroro he tirohanga stereoscopic o te whirihoranga whati ā-wāhi, e whakarato ana i ngā taunakitanga anatomical mārama mō te whakamahere i mua i te pokanga.

I whakanohoia te tūroro ki te tūru-tātahi i raro i te rongoā whakamoe whānui, me te upoko me te kaki e anga atu ana i te taha pokanga. Whai muri i te patu huakita auau me te hipoki parakore, i tohua te āhua katoa o te angaanga me te wāhi whati ki te tohu pokanga i raro i te arataki fluoroscopic mā te ringa-C. I tapahia he tapahi whakawhiti tata ki te 5 cm te roa (e rite ana ki te roa o te rohe whati) i te rārangi whati angaanga. KotahiPereti Tūmau Titanium(2.0 mm te kiatoPereti Tūmau Orthopedic) i whakamahia hei āwhina i te whakaiti i te whati.

Pereti wheuai whakamahia hei hono me te whakapiri i ngā kongakonga wheua āhua poro, pakaru rānei ki ngā wāhanga whati matua. I muri i te hurihanga o te whati uaua ki tētahi whirihoranga ngāwari ā-mīhini, ka whakapirihia ki tētahi mea pai akepereti raka hauorai mahia. I whakatakotoria he clavicular LCP (pūnaha clavicular LCP superior 3.5 mm) ki te mata cortical superior o te clavicle, ā, i whakatōkia mā te tikanga minimally invasive plate osteosynthesis (MIPO).

I mau te tūroro i tētahi whitiki mō ngā rā tuatahi e whitu i muri i te pokanga hei whakamama i te mamae, ā, i muri mai ka tīmatahia ngā mahi whakakori tinana. I te 8 wiki i muri i te pokanga, ka tīmatahia te whakangungu whakapakari uaua i muri i te whakaūnga o ngā whakaahua X-ray i te hononga o ngā wheua, ā, i kitea he mamae ngawari i roto i te aromatawai haumanu. I whiwhihia ngā whakamātautau X-ray (tirohanga clavicular anteroposterior me te tiro clavicular apical oblique) i muri tonu i te pokanga, me ia haerenga whai muri mai i waho o te hōhipera.

Ki te hiahia koe ki te ako atu mō ngāPereti Maukati Tūmau Orthopedicmōhiotanga, tēnā koa whakapā maiwhakapā mai; mā tā mātou tīma koe e whakarato ki te tautoko ngaio me ngā whakautu.