Osteotomy - chii ichi?

Osteotomy - a kuvhiya kuti ndehwokuti kudzorera vakarasika locomotor mashandiro kuburikidza kubata mapfupa kwetsinga. Kazhinji, rinoshandiswa kubvisa muzvidimbu deformation, izvo zvinoita kuti kudzokera murwere anogona kuzvidzora-care uye kufamba.

General pfungwa

Operation osteotomy rinoitwa nevanhu zvikuru unyanzvi kunotevera chiremba. Pakutanga zvinoita sokuti kupindira yakaoma uye kunoda nguva murwere apore, zvisinei, zvaidiwa chiremba kunenge vachasimudza murwere netsoka dzake nokukurumidza.

Osteotomy - kuvhiyiwa iyo rinoitwa pachishandiswa anokosha zvishandiso - osteotomes, Gigli masaha, dzemagetsi namajeko uye ultrasonic namano. Vanobatsira kuita mumakomba panzvimbo kupindira akaguranya mafupa. Pashure nekunhonga marara mapfupa zvimedu vari wakaiswa pamwe screws, tsono, ndiro. Kusiyana anongoitika mitswe, varinamire chakakandirwa rinoshandiswa kashoma, kuitira kuti tidzivise kukura contractures majoini.

kupatsanura

Zvichienderana ari operative kuwana marudzi anotevera osteotomy:

1. Open - Zvinoda kuwana mafupa. Mushure ganda incision, subcutaneous zvinyama uye tsandanyama midziyo, raspatory akaparadzanisa periosteum, mapfupa uye ipapo dissected. Ngwanda ndee pane vasiri chinzvimbo, pamusoro - akakandwa.
2. Closed - vakaperekedza kuburikidza kuwana masendimita mashomanana. Tsandanyama hadzina kucheka uye layered kuenda mafupa. Nokushandisa mbezo vakaparadzana periosteum uye vakawanda nenyundo inovhuvhuta ari mubato dissect mafupa. tsinga uye tsinga vari kusundwa uye wakaiswa chaizvo nematurusi tisakuvara navo. Most inowanzoshandiswa nokuda transverse osteotomy.

Maumbirwe chekawo vari kutevera kupindira:

• lateral;
• manera;
• oblique;
• kunzvenganzvenga;
• swivel (idenderedzwa, arcuate, achikanganisa serin'i, angularly).

Zvichienderana chinangwa, kuvhiya ndiyo zvinotevera kwemarudzi:

• kwokururamisa osteotomy;
• derotation;
• zvainanga kuchinja Kureba gumbo;
• It rinotarisira kuwedzera rutsigiro ishande.

Zvairatidza kuti kupindira

Osteotomy - iri vachibatsira kuvhiyiwa, riri kuitwa zvinotevera nyaya havasi amenable kuti kuchinja kurapa:

• vachiberekwa kana vawana abnormalities uye mapfupa deformation, mukuru dhigirii refu mapfupa tubular (hudyu, mafudzi, nehudyu);
• ankylosis - hazvibviri kwemajoini mashandiro nokuda pamberi adhesions connective zvinyama, shwashwa kana pfupa hunhu articular hukawanika;
• vachiberekwa hudyu dysplasia (dislocation);
• mitswe kuti nemazvo fused;
• osteomyelitis;
• Kuvapo namamota kana metastases;
• migumisiro kusimba munhau;
• vakabata arthroplasty;
• vamwe vachiberekwa abnormalities ari zvetsandanyama nemapfupa hurongwa.

The oparesheni rinoshandiswa zvizorwa mumunda: osteotomy mhino, achiruramisa chiso contours, huchaita mashandiro ari shaya.

Contraindications

Pane zvinhu zvinoverengeka, kuvapo iyo Kuvhiya riri kunonoka:

• zvirwere zvinotapuriranwa hunhu panguva runodiwa osteotomy pfupa kana mavhiki maviri pamberi kuvhiya;
• zvirwere kufema uye zvemwoyo nehurongwa decompensated;
• chirwere cheshuga;
• Nguva gestation mwana;
• renal kana hepatic vanotaura;
• kuvapo purulent rashes kana zvimwe zvisikwa panzvimbo zvakakodzera kuita paInternet kuwana.

Zvakanakira nekuipira

Positive zvinobatanidzwa kupindira vari easing marwadzo (kana) uye kudzorerwa motokari chaitika. Somuenzaniso, osteotomy pamusoro ibvi ichabvisa marwadzo panguva kufamba, kutangazve flexor uye extensor basa, bvisai adhesions ari articular hukawanika. The chirwere Anodzivisawo kunoita kwayo.

Zvakaipira zvingangoguma kutarisana asymmetry nhengo dzake kana majoini. Uyezve, kana murwere achada Joint yokutsiva arthroplasty, zvichava zvakaoma kuita mushure osteotomy.

zvinogoneka yematambudziko

Osteotomy - kuvhiyiwa izvo kwemakore akawanda nani kuti yekuzvidzivirira postoperative yematambudziko. Zvisinei, chero chipingaidzo zvimwe zvinhu mumuviri womunhu itsime ngozi, nokuti kunze uzokwanisa kushanda nyanzvi, tiri kutaura pamusoro nomumwe zvechadenga murwere.

Matambudziko chero osteotomy mhando kunogona kuva:

• hweHIV of kuvhiya ronda - zvinoda kugadzwa kuvhunduka mishonga ose asingaurayiwi kurapa;
• zvaizopedza masarasara uye mapfupa zvimedu - rinoitwa mimwe reposition Kuda kutamba;
• kunonoka Fusion mapfupa - yakatarwa zvivako multivitamin kuti akaumbwa zvinokosha zvisaririra zvinhu (calcium, phosphorus, magnesium, zingi);
• vanoumba sustava- kwenhema kunoda mamwe kupindira;
• parestezii- kutyora ganda nehanya panzvimbo kushanda nokuda mharadzano pematanda etsinga (kwete zvinoda rumwe kurapwa, kugadziridza pacharo);
• kurambwa anodyara - kwemajoini yokutsiva kunokosha.

kwokururamisa osteotomy

Tichiita zvinhu zvakadaro rinoshandiswa isiri accrete nokutyora, vachiberekwa mapfupa kuremara, kukura ankylosis kana pseudoarthrosis, deformities norutsoka pamwe havachanyatsogoni gwenya basa mapfupa, kubvisa kutarisana zvizorwa kuremara.

Pamberi Kupindira rinoitwa X-ray ongororo, izvo anobvumira kuti kutaridzwa nzvimbo pfupa, isa remangwana kwetsinga, zvinonyatsorehwa mapfupa utano. Kana zvakakodzera, kombiyuta, kana mris. The vamwe kuongorora vanotumirwa nomumwe traumatologist.

The oparesheni rinoitwa mu chipatara unyanzvi. Nguva yose Kupindira - maawa anenge 3-4, zvichienderana Vhoriyamu zvakafanira nzira. Pashure kwetsinga repfupa zvimedu vari yakatarwa Ilizarov (oparesheni anoitwa pamakona) kana chinokosha esimbi namano kuti jekiseni zvakananga vakapinda pfupa (osteotomy rutsoka).

Ilizarov midziyo chinokosha marongerwo yakashandiswa traumatology uye orthopedics nokuda kutara, compression kana ndichinanavira mapfupa zvimedu iri kutsvakwa nzvimbo pamusoro yakareba nguva.

Pashure pokuvhiyiwa kuitwa kudzora X-ray, vachibvumira chidzore zvakarurama kutara.

Matambudziko kwokururamisa osteotomy

Possible yematambudziko pashure nokururamiswa pathological ezvinhu zvinosanganisira:

• marwadzo simba, kwete yakasvikawo kwakajairika analgesics;
• kukundikana kwokunze zvikamu mumuchina kana simbi hurongwa;
• Kugadzirwa ropa;
• hematoma inotungamirwa;
• misha yose pfupa nezvimedu hama kune mumwe ari pakati ndege;
• zvimwe zvayo matambudziko.

Osteotomy mumunda dentistry uye maxillofacial kuvhiyiwa

Ari mazino munda osteotomy akaita rushaya, izvo zvinogona kuita yakazvimirira kuvhiyiwa kana somunhu pavaipfuura munhu kuvhiya. Anoshandiswa zvaizopedza kana mitswe, kururamisa malocclusion. Cheka dzinoitwa pamwe nokureba shaya molars.

Pashure Kuda kutamba mu vasiri shaya nzvimbo seari compressive bhandeji, kugadzirira pamatama uye chirebvu nharaunda. Pakarepo akagadza mushonga unorwisa kuitira kudzivisa kukura suppuration uye paumbwe osteomyelitis. Pakati pameno kumanikidza vamwe chingamu nokuti nzvimbo iyo kuchengetwa nyanzvi nezuva. Stitches vanobviswa pashure 2 weeks, uye screws vanobatisisa rushaya ari mwedzi kupedza mishonga danho achiteverwa orthodontic kurapa.

Mumunda nomumukanwa uye maxillofacial kuvhiyiwa inoshandiswa nasal osteotomy, inova chikamu rhinoplasty. It kunoratidza kuti:

• zvinokosha kukanganisa pamusoro nasal zambuko;
• yakakwirira kupedza mapfupa;
• kudiwa mapfupa misha chokuita nasal septum.

Pakuita mhino osteotomy chiremba kuti nhema matambudziko aesthetic: kuvhara nasal rakatenderera ano kubviswa uye kuswatura curvature ari backrest, kuti aienda rutivi masvingo. Mazvikokota anofanira kufunga kuti kwetsinga repfupa rinenge kungaita patency rokumusoro yemweya, saka, panguva nokushanda akabatwa anatomical uye vasiri zvechadenga chaiyo murwere.

Types nasal osteotomy:

• lateral (unopinza), akaita perforation kana mutsetse hwaro;
• medial (Center);
• kumusoro;
• zvenguva.

Type kupindira inoshandiswa anosarudzwa nomumwe, kufungisisa dambudziko murwere, chinangwa oparesheni, mamiriro pfupa rinenge anodiwa Vhoriyamu kuvhiya kurapwa.

Chero osteotomy yaifanira Pashure pokukumutsirai padanho kutapata. Rive kuzvidzivirira nechiyero kuti kukura yematambudziko nokusika mamiriro ezvinhu akanaka uye zvakakodzera mapfupa Fusion.