Education a me ka lapaʻau o nonunion

Wahahee ke ami hoi - mea heʻano o ka 'aʻe' ana i ka ka hoʻomauʻana o ka iwi, a ua wehewehe aku ma'āno'ē ka hoʻoneʻe, hana keia oihana. I ka 'inikua hana maʻamau no kēia moku'āina hoʻohana i ka kūikawā kau - "pseudarthrosis". I keia manawa, i kēia maʻi loa anaʻia, a me nā'āpana hana e hiki e nā hana ana a me ka makeʻe kulana. Eia hou kekahi, hana maikaʻiʻole i loko o ka hapanui o na hihia o ka maikaʻi hoʻokūkū, a me ka mea hoʻi i ka maʻamau. He 'atikala kālailai i au mamuli o ka kumu no ka ho okumu ana o ke ami wahahee. A me ka manaʻo o Kāʻeokūlani i kaʻike, a me ka ohe..

ICD: pseudoarthrosis,ʻano

Wahahee ke ami hoi - he 'aʻe' ana i ka pono o ka cortical iwi, pu ma'āno'ē ka hoʻoneʻe. E like me ka Mea Maluna o ka Maʻi kuhi i loaʻa ka wahaheʻe ami International - ICD 10. kekahi mau mea like: ole-hoao ana fracture, oa psevdoartoroz a me ka wahahee ke ami hoi i loko o ke kāʻei kua kuʻi nukeliu paha arthrodesis.

Ma ka hapa o pathological lauana a me ka lapaʻau ano o ami wahahee e māheleʻia i loko o fibrous a me ka oiaio. Ka mea mua o ka palapala ke kahua ma waena o ka lohi a me ka ka hoʻohuiʻana o ka pseudarthrosis oiaio. Lākou lapaʻau kiʻi mea he uuku nahā i waena o nā hakina piha me fibrous'aʻaʻa, iwi papa i welau e uhi i ka medullary Canal.

Ma pohihihi keia hihia i ka hana fibrous synovial pseudarthrosis ma i nā wēlau o nā iwi i uhi ma ka cartilage a me ka iwi koena ai i loko o ka palapala connective mea hōʻikeʻikeʻuʻuku. Ma waena o ia loaa synovial loli, hiki i nā hakina sclerosis.

Mea Maluna nearthroses

Pseudoarthrosis i e congenital a loaa. Congenital wahahee ke ami hoi ka loa pohihihi a me ka mea i oi aku 0.5% o ka pathology. Ke kumu o kona ho okumu ka 'aʻe' intrauterine iwi'aʻaʻa ho okumu, kūpono ai i loko o ka emi iwi 'ole i loko o ka ho'ākāka' ia wahi. A ma hope o ka hanau ana, ma 2-3 makahiki, ka mea i haki ka pono o ka iwi. IeAUPIIe, IAa IO congenital wahahee ke ami hoi o ka tibia, ma ka liʻiliʻi loa - o ka clavicle, ulna a me femur.

Na lilo pseudarthrosis mea ma kahi o 3% o ka maʻi orthopedic ano. Ma ka hapanui o na hihia ia mea heʻilihune o ka fracture, ka wā ma laila mea i pololei ole, a kāpili kuʻi nukeliu o ka iwi koena ai. Lilo pseudoarthrosis maheleia i atrophic, a me hypertrophic normotroficheskie.

Local kumu o ka maʻi

Local kumu o ke kahua o ke ami wahahee, ma ka huli, e māheleʻia i loko oʻekolu pūʻulu. First pūʻulu - kumu i i pili i ka wahaheʻe a me ka wā i loko o ka iapaau ana o: hapa juxtaposition ke koena o ka iwi, ole e hoʻopau interposition o ka pahee nā'aʻaʻa,'āno'ē immobilization, ma muli o ia i ka waiho waho ka hoʻoneʻe i ke koena ai, pinepine 'ole i kakahiaka nui loli i mahiki aku, hoʻohana a kūpono fastener, hoiʻeleu ka hele a me ka physical aayoaeuiinoe , nui sklerotirovanie.

Ka lua o ka pūʻulu nā kumu e pili ana i ke degere o ka oolea o ka poino, a me ka lāʻau kū-traumatic complications: fractures, make o kekahi hapa nui o ka iwi, Muscle ino e hoea no kahi loihi, waiū o ka iwi'aʻaʻa suppuration, osteomyelitis, poino i nä olonä a me nā ipu koko, e like me ka pono me ka hoʻohuikau 'i loko o kā lākou mau lako hou.

A eia ka mea hope, o ka kolu o ka pae ana o kumumea i aloha ia i ke kahua o kekahi mau wahahee, pili me ka anatomical a me ka physiological ano o ke koko na lako i ka iwi i ka fracture paena a me ka IIeEeAIEUAA.

trophic kumu

Mai ke kaumaha trophic kumu i ke kahua o ka papa kuhikuhiE pseudoarthrosis i: maʻiʻaʻai, e laʻa me, syphilis, malaria, huʻi maʻiʻaʻai; metabolic maʻi a oi loa kalipuna-phosphorus pūnao i loko o nā'aʻaʻa; mimikō; beriberi; vascular insufficiency ma hope hewa innervation ana o na moku i ke koko; nui X-Ray irradiation, i mea hiki ke inhibit i ke kaʻina hana o ka iwi ho okumu; trophic kāna hana ma ka fracture paena.

lapaʻau kiʻi

Ka lapaʻau kiʻi o ke kahua o ke ami wahahee i kona mau ano. I wahi o ka fracture nānāʻana aku i ka hoʻoneʻe, Muscle atrophy, nani, ka hoʻonuiʻana o connective'aʻaʻa, me ka makaʻu no ho okumu. Ma ka X-Ray ke huai ae i ka nui nahā i waena o ka hakina, iwi sclerosis a hāʻule pahū, kuʻi nukeliu o ka medullary Canal.

ʻike, o ka pseudarthrosis

Iʻike, ma ka hou i ka lapaʻau ikepili, ua uku ia ka palena pau, i mea nui no ka piha kuʻi nukeliu o ka fracture noonoo. Ka wā o kēia wā make, ua ho'ākāka 'ia ke kūlana o ka fracture like me ka lohi accrete a asymphytous, a ma hope o ka manawa,ʻelua hahauʻana e oi aku i ke kūmau kēia kahua o ke ami wahahee.

E hoʻokūpaʻa i ke kuhiakau, hana i ka X-Ray i loko o nā hana kuikahi ÷ haku nā wānana waiwai, a ma kekahi mau hihia - a me kēlā nā wānana waiwai. Na hoailona o ke alo o ke nonunion noʻonoʻo i nā kēia mau kiʻi ma ka X-Ray: i ka wa e kaawale aku o ka callus, i mea no ka ai pili aku kekahi hapa o ka iwi hakina; welau o na hakina i ke ala apuupuu ua hoʻokōʻia paha conical shape; ulu lua ma nā wēlau o ka hakina, a me ka panina papa ua hana. A i kekahi mau wahaheʻe i loko o hoʻokahi a 'elua o ka iwi koena ai a pau ia i ka hemispherical shape, a me ka nānā aku kohu ka ami poo. ʻO kekahi apana nahaha paha ia he glenoid lua. Ma kēia hihia, na ami hookahi mea maopopo i nanaia.

E hoʻoholo i ka nui o ke kaʻina hana pinepine 'i hoakaka ia radionuclide mahele.

ʻoki lāʻau lapaʻau lapaʻau nā loina

ʻOiai he arsenal makeʻe kulana ano o ka hana (hooponopono o ka ai ', uila,ʻume mākenēki, a no laila, ma luna o. D.), ka papa kuhikuhiE iaoiaeii o ka hana maikaʻi pseudarthrosis ka hana ana. Ke alakai wahi ua noho ma ka mīkini'opihia osteosynthesis. Pehea e hana i ka pseudoarthrosis? Ka hana pono e lawe mai ma 8-12 mahina ma hope o piha ka hoola ana ma ka wahi luna 'fractures. Inā he mau scars mea i soldered i ka iwi, ka mea pono e excised a i eaʻoki kino, e hooponopono i ka kina.

An nui wahi i loko o ka hana ka pololei e like me ka iwi koena ai, e like me ka pono iʻoluʻoluʻo o ko lākou mau welau, excision o ka me ka makaʻu no'aʻaʻa a me ka hoihoi hou ia ana o ka patency o ka medullary Canal.

pvsedoartroza lapaau ma ka Ilizarov nakeke

Keia papa hana i ka mea e hiki ai, e lawe pu i ka hakina, a kōkua ai i nā lākou kokololio kuʻi nukeliu o me kokeʻoki kino. I mea no ke aha la keia iaoia ua kapaia extrafocal osteosynthesis.

E hoʻomaka, i ka hoʻomanawanui noi i ka huila o ka orthopedic mea ana i iwi hakina i paa. A laila, e pili ana i ka pule mau i ka loaa kaʻina hana ma hope o ka noi ana o ka mea ma i ka wahi, kahi o nā huila, hoola, a hoʻomaka i ke kaʻina hana o ka iwi kuʻi nukeliu. Iwi koena ai i nā hoʻokokoke mai kekahi i kekahi, e luku hua'ōlelo i palapala, a'ōpā wahahee ami.

Eia ka mea, he fixation, i mea, ke kahua o calluses a me ke kaʻina o ka ossification. Kēia manawa ka lōʻihi, akā, ka mea, he pomaikai, a 'aʻole i koi kuikawa ana. Ke hoomanawanui E lawe nā wikamina, ai pono, a haawi aku i ka hewaʻano.

Eia hoi, he mea ka hope wā o ka hoʻopulapula, manawa a na olelo a pau e pono e like me ke kauka, a e kekahi lākou o kūikawā kino. Maikaʻi i ia manawa, noonoo iho la ia e hele, o 'Amelika.

Intra- a extramedullary osteosynthesis

An pono ka hana o ka lapaʻau meaʻoki lāʻau lapaʻau intramedullary hoʻololi kemikala. Ma mua o ka hooko ana mai i kona kauka e lawe aku oe i ka poino palupalu nā'aʻaʻa, a e ole i ka periosteum a me ke koko clots. Ma hope iho o ia ka paʻa ana hoʻi iwi hakina me ka kūikawā kui. Ka eha ma hope oʻoki kino sutured ma ka papa, ma kona wahi e noho i ka uuku me ka makaʻu no.

Ma extramedullary osteosynthesis o ka iwi koena ai hoʻopaʻaʻia Supraspinous laka. Ua ua ikaika loa o Paulo ma luna o ka iwi poino, a ma hope o ka splice una hakina i wehe 'ia ma ka oki.

No laila, i ana no ka 'atikala ma ka au mamuli pseudarthrosis. Ma ka hopena, ka mea e e hoʻomaopopo i ke kamepiula kumumea no ka ho okumu ana o kekahi mau wahahee malama i keʻano o ka endocrine maʻi, heʻino pahaʻano (uiki, waiʻona hainā), obesity, ilihuneʻai a me ka nele o physical haʻawina. Nolaila, ke ola i Hawaii, e emi i ka pilikia o keia maʻi.