I-humerus ephazamisa ukulimala ukulimala okuvamile kuhlombe. Ejwayelekile ikakhulukazi kubantu asebekhulile ngenxa ye- osteoporosis , i-humerus ephazamisayo i-fractures iphakathi kwamathambo aphukile kakhulu ehlombe . Eqinisweni, ezigulini ezineminyaka engaphezu kwengu-65, i-humerus i-properimal fractures yi-third bone ephukile kakhulu (emva kwe-hip fractures kanye ne- crystal fractures ).
Ukuphuka kwe-humerus okuphambene nakho kwenzeka lapho ibhola, elihlangene nehlombe le-ehlombe, liphukile. I-fracture empeleni ingaphezulu kwethambo lesandla (i-humerus). Iningi lama-humerus ama-proximal alifani ne-non-displaced (hhayi ngaphandle kwesimo), kepha cishe ama-15-20% kulawa maqabunga aphelelwe phansi, futhi lokhu kungadinga ukwelashwa okungaphezulu okunamandla.
Inkinga ebaluleke kunazo zonke nge-proximal humer fractures yilapho ukwelashwa kunciphisa kakhulu, futhi imiphumela ngokuvamile ivame noma iyimpofu. Iziguli eziningi ezisekela lokhu kulimala ngeke ziphinde zithole amandla noma ukuhamba kwehlombe, ngisho nokuphathwa ngendlela efanele.
I-Humerus Fractures e-Proximal Proximal
Uma ithambo lingekho ukulungiswa okulungile, ukuphuka kubizwa ngokuthi i-displaced. E-humerus elandelwayo ihlukana, ubukhulu buvame ukuchazwa ukuthi zingaki izingxenye ezinkulu ze-humerus eziphazamisekile eziqhekekile zithinteka. Kunezinxenye ezine "zezingxenye" ze-humerus esondelene nayo, ngakho ukuhlukana okushiywe phansi kungaba ingxenye engama-2, ingxenye engu-3, noma ingxenye engama-4 (ukuphulwa okungezona ukufuduka kwempahla, ngencazelo, ingxenye eyodwa).
Ngokuvamile, izingxenye ezithuthukile kakhulu, zibi kakhulu.
Izingxenye ze-humerus ezihamba phambili zibizwa ngokuthi yi-tuberosities (isifo sofuba esikhulu nakakhulu), ikhanda elihlabayo (ibhola lehlombe), kanye ne-shaft shaft. I-tuberosity ibhekene nebhola futhi yizinamathiselo zezingxube ezibalulekile ze- rotator cuff muscle .
Ukuze uthole ingxenye okumele ithathwe njengokuthi ichithekile, kufanele ukuthi ihlukaniswe nesimo sayo esivamile ngamasentimitha angaphezu kwengu-centimeter noma ijikeleze amazinga angaphezu kuka-45.
Ukwelapha
Amaphesenti angaba ngu-80% ama-humerus aphethwe yi-non-displaced (angaphandle kwesikhundla), futhi lokhu cishe kungaphelelwa njalo ku-sling. Ukwelashwa okuvamile ukuphumula ihlombe emasontweni amabili amasonto amabili, bese uqala ukuzivocavoca ngobumnene bokuhamba . Njengoba ukuphulukisa kuqhubeka, umzimba oqine kakhulu wezinhlanzi wokuqinisa ihlombe ungaqala futhi ukuphulukiswa okugcwele kuthatha cishe izinyanga ezintathu.
Uma kwenzeka ukulimala kakhudlwana lapho ithambo lisuswa khona (ngaphandle kwesimo), kungase kudingekile ukulungisa noma ukubuyisela ithambo elonakalisiwe. Ukunquma ukwelashwa okungcono kuncike ezintweni eziningi ezifaka:
- Ubudala besiguli
- Ukubusa kwesandla
- Izinga lomsebenzi wesiguli
- I-Degree yokuhamba kwe-fracture
Izinketho zokuhlinza zihlanganisa ukuguqula izingcezu zamathambo futhi uzibeke esikhundleni ngesimiso sezinto zensimbi, noma inqubo yokufaka esikhundleni sehlombe yenziwa. Uma izingcezu zethambo zingagcinwa, noma izikhonkwane, izikrini, izintambo, ama- sutures amakhulu, noma ipuleti kuzosetshenziselwa ukubamba amathambo endaweni. Amapuleti nezikuluvu, njengoba kuboniswe ngenhla, sekuye kwavame kakhulu njengoba ubuchwepheshe be-plating buye buphuthuka.
Uma kukhona ukukhathazeka mayelana nokulungisa ithambo, kungenziwa kunqunywe ukwenza uhlobo oluthile lwe- shoulder shoulder . Uma kunconywa inqubo yokufaka esikhundleni, izinketho zibandakanya ukugujwa okujwayelekile kwehlombe, i- hemiarthroplasty , noma ukushintshwa kwehlombe ehlane . Isiphakamiso esithile sokuthi yiluhlobo luni lokuhlinzwa oluhle kuncike ezintweni eziningi ezibandakanya uhlobo lokuphumula nesiguli esithile. Isibonelo, ukuguqulwa kwamahlombe okuphindaphindiwe kungaba yizokwelapha ezinhle kakhulu kepha kugcinwe iziguli ezindala, ezingasebenzi.
Izinkinga
Ngeshwa, i-humerus ephazamisekile i-fractures ivame ukulimala kakhulu, ikakhulu lapho ukulungiswa kwethambo kuye kwashintsha kakhulu.
Ukuhlaselwa emsebenzini kuhlombe akuvamile, futhi abantu abahlala belimala kaningi abaphululi amandla abo okugcwele noma ukuhamba kokujoyina. Ngenxa yokuhlukunyezwa kuya ekuhlanganyeleni kwehlombe, ukuthuthukiswa kwe-arthritis zakudala kuyinkinga evamile yalezi zingozi.
Ezinye zezinkinga ezihlobene ngokuqondile nokuhlinzwa ukwelashwa kwama-humerus ama-proximal fractures zihlanganisa ukutheleleka, izinkinga zokuphulukisa, ukulimala kwenzwa, nokungabi nokuphulukiswa kwethambo. Okokugcina kwalokhu, okubizwa ngokuthi ukungaboni ngaso sonke isikhathi , kwenzeka lapho amathambo ehluleka ukubumbana, futhi ukwehlukana kuyahlukana futhi. I-hardware yensimbi esetshenziselwa ukulungisa ithambo ephukile ayihloselwe ukuba yisisombululo esingunaphakade, kunalokho ithatha ithambo endaweni lapho ukuphulukiswa kwenzeka. Uma ithambo lingaphululi ngokuphelele, khona-ke izimila zensimbi zizophela, futhi ngokuvamile, ukuphinda ukuhlinzwa kudingeka kudatshangelwe.
Imithombo:
Nho SJ, et al. "Ukuvuselelwa kokuphathwa kwe-Humerus Fractures e-Displaced Proximal Proximal" J Am Acad Orthop Surg January 2007 15 no. 1 12-26