Mitswe of humerus pamwe misha uye pasina kwaakarerekera

Maererano Statistical data, 7% pakati mitswe ari humerus nhoroondo. Similar kukuvadzwa simuka anonyanya nokuda mapopoma uye zvibhakera. Mitswe of humerus zvive zvakasiyana zvikamu kwaro achiperekedzwa Zviratidzo siyana uye dzimwe nguva zvinoda vakaparadzana kurapwa mharidzo.

The anatomical mamiriro

Humerus rakakamurwa zvitatu zveefa: muviri kana diaphysis - ndicho pakati chikamu, uye migumo anonzi epiphyses. Zvichienderana nzvimbo dzakakonzerwa anoratidza mitswe rokumusoro, pakati kana yakaderera humerus. Yokumusoro chikamu inonziwo proximal uye distal ezasi runhare. Diaphysis rakakamurwa muzvitatu: rokumusoro, pakati uye ezasi.

Uyewo epiphyses vane kunzwisisa mamiriro sezvo vari zvinosanganisirwa mapfundo chengeta netsandanyama. In yokumusoro chikamu humerus musoro uye semicircular anatomical mitsipa - nzvimbo pakarepo pasi musoro. Ivo articular pose chipande chikamu papfudzi rwakashodoka. tubercles maviri, izvo vashumire kuda kuti tsandanyama iri nechepazasi anatomic mutsipa. Dana navo zvikuru nezviduku tubercles. Zvimwe pfupa nhete, pova anonzi pamafudzi kuvhiya mutsipa. Lower humerus vakaparadzana anomiririrwa vaviri pamwe hukawanika: a nemwaranzi mapfupa honokono articulated musoro condyle ane woita chimiro, uye chinoita kuti ulnar chinogumbura humerus.

The Mhando chikuru mitswe

Kupatsanura pakati mitswe riri kuitwa nenzira dzakawanda. Kudivi rimwe, humerus mitswe dzikarongwa ne nzvimbo, kureva. E. By dhipatimendi. Saka, voga kutsemuka:

- in proximal (rokumusoro) chikamu;

- diaphysis (pakati chikamu);

- in distal (rezasi) chikamu.

Uyewo, makirasi aya mamwe rwakakamukana mhando. Kunze, mumwe kutsemuka anogona kuitika munzvimbo dzakasiyana mukati rimwe kadhi kana yakavakidzana.

Ukuwo, inogona kupatsanurwa kukuvara mitswe uye pasina zvaizopedza, uye govera ichiparara (comminuted) mitswe. A mutsauko kuri rakazaruka kunotevera (zvinokuvadza munyoro zvinyama uye ganda) uye Akanyatsovharwa. Panguva iyoyo upenyu hunodzorwa kare.

Specification pakati rudzi pakakuvara kubudikidza dhipatimendi

The kuchinja mune proximal chikamu inogona rakakamurwa intra-articular kana articular. With intraarticular (nadbugorkovom) musoro pachahwo kana anatomical mutsipa pfupa anogona sousingabatsiri. Articular kutsemuka rakakamurwa tubercle pamusoro humerus uye pakakuvara pakati kuvhiya mutsipa chaicho.

Kana zvaparadzwa diaphysis uyewo secrete akawanda subspecies: nokutyora yokumusoro wechitatu, nechepakati kana pasi. Zvakafanana rinokosha hunhu kutsemuka: a jeko, muchinjikwa, zononoka, comminuted.

Distal rinogonawo sei nenzira dzakasiyana-siyana. Tinogona kusiyanisa articular supracondylar nokutyora, uye mitswe pamusoro condyles uye zvidhinha kuti vari intra-articular. Hwakadzika kupatsanura chinosiyanisa flexor uye extensor supracondylar uye transcondylar, intercondyloid Y kana T-yakaumba yoga kutsemuka condyles.

Kupararira

Muupenyu hwezuva nezuva nokuda mapopoma uye akaridza ainyanya zvakakanganisa yokumusoro chikamu kuvhiya mutsipa, pakati rechitatu diaphysis kana epicondyles nechepazasi chikamu humerus. Closed mitswe vakawanda, asi vanogona kazhinji kuti zvaizopedza. Zvinofanira kucherechedzwa kuti panogona kubatanidzwa pane mhando mitswe chete nguva dzakawanda (kazhinji mukati chete dhipatimendi).

Kutsemuka of humeral musoro, anatomical uye kuvhiya mutsipa ndivo vakwegura kakawanda. Rezasi Chikamu zvinowanzooneka kudziviswa muvana pashure vakapunzika zvakaipa: intercondylar mitswe uye transcondylar havasi zvechienzi. muviri mapfupa (diaphysis) kubatwa mitswe kazhinji zvakakwana. Ivo simuka pa ekushandiswa pamafudzi, uyewo mapopoma ari kugokora kana anombotwasanudza ruoko.

Mitswe of proximal chikamu

For intra-articular kutsemuka anosanganisira humeral musoro uye rakamiswa chete shure kwake anatomical mutsipa. Muchiitiko chokutanga anogona comminuted kutsemuka kana dislocation anowedzera kuchengetwa. Kana yechipiri inogona rinoitei kutsemuka kana otlomok anatomical mutsipa chakaunzwa musoro uye kunogona kunyange uiparadze. Zvakananga-basa kukuvara otlomok zvinogonawo akatsemura, asi pasina chinokosha zvaizopedza.

Uyewo, kuvadza proximal chikamu pakakuvara zvinosanganisira mukuru tuberosity pamusoro humerus nemiduku: chrezbugorkovye mapoka uye anorovera. vanogona kuva kuwa pafudzi rake, asi kana yakawandisa kungoerekana tsandanyama marwadzo kwete chete. Kutsemuka of tubercle of humerus zvinogona pamwe chinokosha kusabatana pasina misha nezvimedu kana nokuita nayo pasi akromedialny muitiro kana pasi uye outwards. kukuvara kwakadaro kunogona kuitika kana zvakananga kukuvara kana dislocation pamusoro pamafudzi.

Rakajairika ndiyo pakakuvara ari kuvhiya pamitsipa pamapfudzi. The chikonzero kazhinji anova donhwe. Kana ruoko panguva yokukuvara akanzi kana kupiwa, ipapo tara adduktsionny kutapa kana pfupa kutsemuka, rinoitei nokuvhunika chingaitika neavhareji wokupedzisira nzvimbo kana distal Fragment chakaunzwa hwepamusoro chikamu.

Pakakuvara inogona panguva imwe chete munzvimbo dzinoverengeka. Bone ipapo huviri mana zvidimbu. Somuenzaniso, mashoko anatomical pamutsipa kutsemuka angaperekedzwa kuparadzana mumwe kana vaviri tubercles Kutyoka kuvhiya mutsipa kutsemuka kuzadzikiswa musoro uye t. D.

Zviratidzo mumwe pakakuvara chokumusoro papfudzi chikamu

Intra-articular pakakuvara wedhipatimendi pamwe edema kana ropa kupinda pejoinhi. Nemaziso pamafudzi kunowedzera vhoriyamu. Chinhu chinorwadza kumanikidzwa mumusoro. mutsipa humerus kutsemuka kunopa kurwadziwa pamwe dzeraundi anodudzira uye kunzwa. Kana rinoitei pakakuvara ari kuvhiya mutsipa inofamba iri pamapfudzi vadyi haigoni chibharo. Kana paine misha, zvinogona kushandura akabatana ari richiripo. Munzvimbo pejoinhi kunobvira ropa, kuzvimba, kana bundu. Kana anozviratidza pamusoro pemvura pamafudzi perednenaruzhnoy mamirire mhou prominences vanogona kutaura adduktsionnom dzoro, uye kana kwakaonekwa yokururamisa, izvozvo zvinopupurira kutapa.

Uyewo kuvhiya pakakuvara ari humerus kunogona kukonzera pathological mufambo. Mitswe ane guru misha kana kusabatana anogona kuvhara basa racho, uye kunyange chiduku mutoro pamusoro ekisero uye pusa kufamba vanokonzera marwadzo. Chinonyanya ngozi ndiyo musimboti iyo pamitsipa humerus kutsemuka kunoitika zvimwe kukuvara, jamming, kudzvanya pamusoro neurovascular masumbu. Kudzvinya danda ichi chinokonzera edema, kuderera nehanya, venous stasis uye kunyange rutivi rwomuviri uye paresis ruoko.

Pakakuvara chikuru tuberosity pamusoro humerus kunopa marwadzo mafudzi, kunyanya kana iwe ruoko rwako mukati. Movement of fudzi muhudyu hwakavhunika, kuva kunorwadza.

Zviratidzo diaphyseal kutsemuka

Mitswe zviri humerus iri diaphyseal nharaunda chaizvo nevakawanda. Pane kuzvimba, marwadzo, uye uncharacteristic kufamba panguva lesion nzvimbo. Zvidimbu kungaita kwakasiyana-siyana. Hand kufamba vari kutyora. Possible ropa. Mitswe ane simba kuchinja zvinogona kuonekwa kunyange akashama ziso uri pamapfudzi epfungwa. Kana TOUR tsinga wakaremara, hazvibviri kutwasanudza mumakwenzi uye minwe. Zvisinei, kudzidza hunhu zvaparadzwa vanofanira kuva X-ray.

Mitswe of distal vavo zviratidzo

Mitswe of distal rakakamurwa mamwe-articular (supracondylar extensor kana flexor) uye intra-articular (condylar, transcondylar, mitswe capitate pakukwirira kana humerus nechigumbuso). Mhirizhonga munyika dhipatimendi ichi kukonzera deformation yacho kugokora rwakashodoka. Uyewo, pane kurwadziwa uye kuzvimba, uye kufamba kushoma uye kurwadza.

Supracondylar flexion kuitika pashure kuwa pamusoro hwakakungwa ruoko, zvichitungamirira mumatenhere nzvimbo kukuvara, marwadzo uye waioneka chinoabatsira dzikawedzerwa yacho honokono. Extensor kuoneka apo pererazognutosti ruoko mu kuwa nemaziso kuatapudza honokono uyewo aine marwadzo uye kuzvimba. mitswe kwakadaro rinogonawo nezvaaiitawo mawa dislocation ari muhudyu.

External condyle mitswe kazhinji nemumwe donhwe rimwe furati rwakatambanudzwa ruoko kana yakananga kunotevera, uye mudzimba kumbozorora kana akadonha pasi kugokora ake. Pane ari kuzvimba mu kugokora nharaunda, marwadzo, uye dzimwe nguva minyato kana ropa ari muhudyu pacharo. Movement panguva kugokora havabvumirwi, kunyanya nokuti ropa.

Capitate Ukuru kutsemuka kunogona kuitika kana kuwira pasi yakananga ruoko. Also zvakawanda kufamba ari pamwe uye zvinorwadza. Kazhinji, izvi ndizvo namahwindo pakakuvara ari humerus.

rubatsiro First uye Diagnostics

Kana uchifungidzira munhu kutsemuka gumbo anofanira zvakanaka ngadzirambe kudzivisa Kushatiswa zvinhu. Unogonawo kushandisa analgesics kuti kurwadziwa. Zvadaro, nekukurumidza vanofanira kuuya wacho kuchipatara kuongororwa zvakarurama uye rubatsiro rwavanachiremba.

Diagnosing anogona kutsemuka pamusoro apa zviratidzo, asi kuguma nemigumisiro chete pashure radiography. Kazhinji akaita mifananidzo maberere siyana, kujekesa mufananidzo zvizere. Mitswe of humerus dzimwe nguva zvakakwana vakaratidza zvavo ipapo zvakaoma kusiyanisa kubva sprains, utachiona uye namavanga, izvo zvinoda zvakasiyana.

Mabatirwo zviduku mitswe

Pakakuvara humerus pasina misha inoda immobilization kuti gumbo varinamire kana kutiza bhazi. Matambudziko vari apo neapo. Kana paine zvishoma kutsvetera, zvinonzi akaita kuti reposition haizopereri immobilization. Mune zvimwe zviitiko, kugadzwa munhu bvisika chitsamhura yakakwana, mune dzimwe kurekodha kwakakwana kunodiwa.

mitswe Minor yose proximal chikamu kubvumira mazuva matatu gare gare kuita UHF uye rinobva kurapa, uye shure kwamazuva 7-10 kutanga kukura kugokora uye chiningoningo majoini, electrophoresis, UFO, masaja uye Ultrasound chokupfeka. Pashure pevhiki 3-4 kubva nesuko Longuet kana chinokosha okusungisa kutsiva mucheka, kuramba mumuviri kurapa uye maitirwe ezvinhu.

Recovery misha zvimedu pasina kuvhiyiwa

More vanotambura zvakakomba zvakadai kutsemuka kana kuvhiya mutsipa pakakuvara ari humerus pamwe misha zvinoda repositioning, varinamire bhandiji uye kugara X-ray muchipatara. Varinamire ingashandiswa kwevhiki 6-8. Zvakakodzera kufamba maoko uye minwe kubva rakatevera pashure 4 mavhiki, unogona kuita pusa fambisa pamafudzi muhudyu, kubatsira ruoko rwake yakanaka, ipapo kuenda basa racho. Uyezve vapore zvinosanganisira utano kurapa, kukwizwa, mechanotherapy.

Kudiwa kuvhiya kupindira

Mune zvimwe zviitiko, repositioning hazvibviri nokuti simba kusabatana kana kungoti Haapi unodikanwa zvabuda. Kana paine pakakuvara ari humerus kubatwa kuvhiyiwa kunodiwa kuti vabudirire wemishonga zvimedu. kutsvetera Strong, yakapatsanuka kana ichiparara, kusagadzikana kutsemuka nzvimbo kungada kwete kungoita reposition uye osteosynthesis uye - kugadzira ngwanda tsono, screws, ndiro. Somuenzaniso, pakakuvara pamitsipa humerus zvizere vakapararira nezvimedu kunoda kutara ndiro Kaplan-Antonov, tsono, kana danda Vorontcova Klimov, mbambo kana tsvimbo, saka kudzivisa panowanikwa chisina kutsetseka misha pedyo musono. Shards kuchengeta Fusion screws kana Ilizarov. The tepi uye skeletal traction rinoshandiswa mamwe ichiparara mitswe ari kadhi ezasi, pashure iyo Tire seari uye akabata physiotherapy.

Mitswe epicondyle pasina misha zvaanoitawo kupfeka varinamire bhandeji panguva 3 mavhiki. Kushaya kungada kuvhiya kupindira. Condylar (intercondylar uye transcondylar) mitswe kazhinji aine misha remafupa nezvimedu uye kuvhiyiwa. Reposition muchiitiko ichi chinoitwa yakazaruka nechokwadi kudzorerwa yakarurama nzvimbo articular hukawanika uye kuti osteosynthesis. Next shandisa rokudzorera kurapwa vari kunzwisisa.

Mabatirwo kuoma kutsemuka

Kutsemuka of humerus pamwe misha, achiperekedzwa kuvadza TOUR etsinga, zvinoda tikaenzanisa pfupa nezvimedu uye kuchinja mabatiro tsinga. Kutsemuka kuita chinhu mukwanisi zvinodhaka kurapa kune tsinga kunogona kuramba uchizviita. Gare gare batanidza mumuviri kurapa uye mumuviri kurapa. Asi kana etsinga functionality haina vakadzorerwa mukati mishomanana, ipapo kuvhiya rinoitwa.

In wakakura zvikuru kacho, kana mapfupa vari yakanyanya zvikuru ichiparara, zvimedu anogona kubviswa, pashure iyo prosthesis kunodiwa. Bandauko kwemajoini prosthesis rinoshandiswa pane musoro. Kana kunyanya kukuvara ano tsandanyama zvinogona sutured zvakananga humerus.

Kurapa kupi kutsemuka kunoda zvaidiwa zvose kunenge yose nyanzvi, uyewo chakakomba ainoita vapore. pakupedzisira Immobilization uye zororo rakakwana ukama pamusoro ne imwe mutoro. Mapoka physiotherapy, panyama kurapa, masaja uye zvakafanana kurapa anogona kupiwa kupfuura kamwe, vamwe zvinovhiringidza kusvikira kunaya zvakakwana. Zvinokoshawo kuti akatendeseka azadzise zvose zvinodiwa vapore pamba uye kutarisira apiwa kukuvara.