Fractures o ka humerus me ka pohupani hale, a me ka pāʻewaʻewa

E like me ke ana helu aeaiiua, 7% o fractures o ka humerus mooolelo no. Similar poino e ala kuhikuhi manawa i Falls a me ka hahau ana. Fractures o ka humerus i ia i loko o nā wahi likeʻole o ka mea, i ka pu ma kekahi mau symptoms a me kekahi manawa pono kaʻawale kanaka hoʻokokoke mai.

Ka anatomical 'ole

Humerus ua maheleia i ekolu māhele: i ke kino a me ka diaphysis - ka mea, o ka mea mawaena konu loa, a me nā wēlau kapa epiphyses. Ke kaumaha ma muli o ka wahi o ka poho paipai fractures o ka luna, waena a emi humerus. Ke keena pauku ua i kapaia ka proximal a me ka distal lalo kahea. Diaphysis maheleia i hapakolu: o ka luna, waena, a ma lalo.

I huli ai oe, o ka epiphyses i ka luna '' ole, no ka mea, e komo i loko o na ami a me ka malama i nāʻiʻo. I ka luna o ka humerus poʻo a me ka mea semicircular anatomical'ā'ī - ke wahi koke ma lalo o ke poo. Ka mea, articular ili o ka maka hapa o ka'ūhā mua ami. mau tubercles, i malama like IeIIeYOA o nāʻiʻo aia ma lalo o ka anatomic'ā'ī. E kāhea aku iā ia nui a me ka uuku tubercles. Aka hoi iwi narrows, ho okumu i ka ai-kapa kīpoʻohiwiʻoki lāʻau lapaʻau'ā'ī. Lower humerus hookaawale poe e mau ami surfaces: he pāhawewe iwi forearm kiko'ī a poʻo condyle me ka ua hoʻokōʻia ke kinona, a hiki aku i ka ulnar aeie humerus.

I ka papa kuhikuhiE ano o fractures

Mea Maluna o fractures ua mālama 'ia i loko o kekahi mau aoao. Ma ka kekahi lima, humerus fractures Hoʻohui 'ia ma wahi, oa. E. By Oihana. Penei, kaʻawale fracture:

- ma ka proximal (luna) pauku;

- diaphysis (waena hapa);

- ma ka distal (lalo) pauku.

Ma hoʻi, i kēia mau papa e hou Wāwahi iʻano likeʻole. A he, he fracture hiki ke hana ia ma kekahi mau wahi i loko o ka hookahi kāleka a kokoke.

Ma ka kekahi lima, hiki ke maheleia poino i fractures, a me offset, a līkaia mamala (comminuted) fractures. A hoʻokaʻawale mea i hamama trauma (poino meʻaeʻae'aʻaʻa a me ka ili) a me ka paʻa. I ka Ia manawa i loko o ka ola Kīwala'ō ma lalo o ka hala.

Hoakaka ana o ke 'ano o ka fracture ma ka' Oihana

Ka popoiwi wahi i loko o ka proximal pauku hiki ke maheleia i loko o ke kūʻai '-articular paha articular. Me ka intraarticular (nadbugorkovom) poʻo wale a me ka anatomical ai o ka iwi i ke poino. Articular fracture Ua puʻunaueʻia i loko o tubercle o ka humerus a me ka fracture o kaʻoki lāʻau lapaʻau ai o ka nń ku.

Inā ka poino diaphysis i pee mau subspecies: fracture maluna kolu, waena a me lalo. Like nui o keʻano o ka fracture: ka pahi, keʻa,ʻoni iho, comminuted.

Distal hiki no hoi ke loli ma naʻano likeʻole. E hiki ke hoomaopopo articular supracondylar fracture, a me fractures o na condyles a me na ālai 'ana i ke kūʻai'-articular. ʻoi Mea Maluna distinguishes flexor a me ka extensor supracondylar a me ka transcondylar, intercondyloid Y a T-hoʻokino, a kaʻawale fracture condyles.

prevalence

I ka maʻamau o ke ola ma muli o ke Falls, a hahauʻano nui loli i ka luna o kaʻoki lāʻau lapaʻau ai, o ka waena kolu o ka diaphysis paha epicondyles haʻahaʻa o ka humerus. E haapau nei i fractures predominate, akā, e hiki pinepine e offset. Ua E hoi e kaulana i loaʻa i e hui i ka ia manawa kekahi mauʻano o nā fractures (pinepine i loko o ka hoʻokahi 'Oihana).

Fracture o ka humeral poo, ka anatomical, aʻoki lāʻau lapaʻau ai i ka kūpuna nui pinepine. I ka lalo pauku Ua pinepine hampered i loko o nā keiki ma hope o ka ino haule: intercondylar fractures a transcondylar ka mea, i ole uncommon. kino iwi (diaphysis) susceptible i fractures pinepine lawa. Ka mea, e ku oe ma ka hopena ma luna o ka poʻohiwi, i pono i kau mai maluna o ka kuʻekuʻe aku ai ka straightened lima.

Fractures o ka proximal hapa

No ka mea, ke kūʻai '-articular fracture loaʻa ka humeral poo, a waiho ma hope pono o kona anatomical'ā'ī. Ma ka hihia mua ia e ke comminuted fracture a dislocation aiiieieoaeuii malama. I ka lua o ka hihia i ke ka hopena i hōʻike fracture ka wā otlomok anatomical ai ua hoʻolauna i loko o ke poo a me ke ahiahi, luku aku ia. I kauoha-hana ino otlomok hiki ke Wāwahi nō hoʻi, akā, me ka nui offset.

Nō hoʻi, pōʻino i ka proximal hapa o ka fracture nā ka nui tuberosity o ka humerus a me ka meaʻuʻuku: chrezbugorkovye poe a me bumps. mea hiki e ole wale i haule ma luna o kona poʻohiwi, akā, i ka wa a keu aku nō koke Muscle contraction. Fracture o ka tubercle o ka humerus hiki ke ukali e nui fragmentation me pohupani hale i ke koena ai a ma ka neʻe ia ma lalo o akromedialny kaʻina 'ole ia, a waho. Ua poino ke ana ia o ka pololei ino paha dislocation o ka poohiwi.

Ka loa, he pono ole o ka fracture o kaʻoki lāʻau lapaʻau ai o ka poohiwi. Ke kumu loa pinepine lilo ana he kulu. Inā ka lima i ka manawa o ka hewa i ia ai haawiia mai, alaila, e nana adduktsionny abduction a iwi fracture, ka hopena i hōʻike fracture hiki ke hiki mai me ka awelika hope kulana i ka wa a ka distal apana nahaha ua wahahee i loko o kekahi keena pauku.

Ke fracture hiki e ka poʻe i loko o kekahi mau wahi. Iwi laila maheleia i mau a hiki i eha apana. No ka laʻana, ka mea anatomical'ā'ī fracture hiki e ukali ma ke kaawale ana o kekahi a me nā tubercles fractureʻoki lāʻau lapaʻau'ā'ī fracture complemented poo a me ka 'ole. D.

Symptoms o ka fracture i loko o ke keena'ūhā pauku

Ke kūʻai '-articular fracture o ka' Oihana pu ma ka edema a kahe ana ke koko i loko o ka ami. Visually poʻohiwi piʻina ma ka buke. He He ola puʻe ma luna o ke poʻo. 'ā'ī o ka humerus fracture oia ke eha me ka hoʻopoepoe hula a me ka aloha. I ka hopena i hōʻikeʻia fracture o kaʻoki lāʻau lapaʻau ai o ke noi i ka'ūhā mua ami hiki ole ke hehiʻana. Inā he mea pohupani hale, ka mea e hoʻololi i ka iho (axis) o ka lala. Ma o ka wahi o ka ami mea hiki kahe ana ke koko, nani, a me ka popopalaoa a pau. I ka ikeia ma ka ili o ka'ūhā mua perednenaruzhnoy ano pokou kūlana kiʻekiʻe ke kamailio e pili ana i adduktsionnom i ka huli, a ina ikeiaʻe la e ia retraction, e hoike mai i ka abduction.

Iʻoki lāʻau lapaʻau fracture o ka humerus hiki i pathological ka hoʻoneʻe. Fractures me ka pohupani hale nui a fragmentation ke aeie i kaʻeleu neʻeʻana, a hiki i ka uuku haawe ana ma luna o ka paepae komo huila, a OE neʻe i pahi eha. Ka noho pilikia loa o keʻano ma i ka'ā'ī o ka humerus fracture ia lŘlŘ me nā pōʻino, jamming, koikoi ala o ka neurovascular laulau. 'ōpā o keia laau ke kumu edema, emi ma ka pā lonoaʻili, venous stasis a hiki lōlō a me ka paresis lima.

Fracture o ka tuberosity nui o ka humerus i nā poʻohiwi eha, o ka oi aku i ka wa e huli ae i kou lima ma. Holo ana o ka'ūhā mua hui e wāwahiʻia, e ola.

Symptoms o diaphyseal fracture

Fractures o ka humerus i loko o ka diaphyseal māhele 'āina i' ano, he pono ole. Aia ka hoʻokano, eha, a me uncharacteristic o ka hoʻoneʻe i ka lesion paena. Koena ai e neʻe aku i loko o kekahiʻaoʻao. Lima ana e ke hehiʻana. Hiki hemorrhage. Fractures me ka naeaeaa ikaika hiki ke ike a hiki i ka maka kapa ole ma ka poohiwi ke kanana nei. Inā kahahānai nā aʻalolo ua poino, he mea hiki ole ke straighten i ka palaki a me ka manamanalima. Eia naʻe, e noiʻi i ke ano o ka poho pono i ka X-Ray.

Fractures o ka distal a me kā lākou mau symptoms

Fractures o ka distal māheleʻia i loko o keu-articular (supracondylar extensor ole flexor) a me ke kūʻai '-articular (condylar, transcondylar, fractures capitate elevation ole humerus hihia). Haunaele ma keia Oihana alakai i deformation o ke kuʻekuʻe aku ami. No hoi, he mea eha a me ka nani, a me ka hele i kaupalena, a ola.

Supracondylar flexion hana ana ma hope o ka haule ana ma ka alo lima, e alakai i ka nani o ke kahua o ka poino,ʻeha a me ka hiki i ka mea kapa ole maka hooloihiia mai o ka forearm. Extensor ikea ka wā pererazognutosti lima i loko o ka haule ana, visually hoʻopōkole 'i ka forearm, a hele pu no hoi ma kaʻeha a me ka nani. Oia fractures hiki e hui pū me ka i ka wā hoʻokahi dislocation o ka ami.

Mawaho condyle fractures pinepine hele pu me ke kulu ma luna o kekahi i lalo lima lima, a ala trauma, a me ka wahi lulu wanaao ae ina haule iho ma luna o kona mau kuʻekuʻe. Aia ua haanou ana i loko o ke kuʻekuʻe aku ia wahi, eha, a me kekahi manawa huahuaʻe a kahe ana ke koko ma ke ami wale. Ana ma ke kuʻekuʻe aku i kaupalena ', o ka oi aku no ka hemorrhage.

ka wā e haule ana ma ka pololei o ka lima Capitate eminence fracture hiki ke kānāwai. I kaupalena 'ana i loko o ka' ehaʻeha ka hui a me ka eha. Nō kāu, keia mea he paʻa fracture o ka humerus.

First kōkua a me ka lapaʻau '

Inā e manaʻo ai he fracture lala pono e pono paa, e pale aku i ka mea hōʻemi o ke kulana. E hiki no hoi ke hoʻohana analgesics no ka eha ke ola. Mahope, e like me ka hikiwawe e loaa ana e lawe mai i ka luahi a hiki i ka haukapila no ka pololeiʻike, a me ka 'oihana kōkua.

Diagnosing hiki fracture ma luna o ka luna symptoms, akā, hiki ke loaa ka hualoaʻa hope ma hope o radiography wale. Ana i nā kiʻi i loko o kekahi nā wānana waiwai, e möakäka hou i ka piha kiʻi. Fractures o ka humerus kekahi manawa implicitlyʻia maila lākou laila, paʻakikī, eʻike mai sprains, ke kanana nei a me paopao koke mai oia, a pono e he okoa lapaau.

Lapaʻau o nīnūnē fractures

Fracture o humerus me pohupani hale pono immobilization o ka lala puna a pakele kaʻa 'ohua. Complications i loa pohihihi keia. Inā he mea he hōʻemi iki pāʻewaʻewa, ka mea, ua hana e reposition i ka hope immobilization. Ma kekahi hihia, ua lawa ka mea hoʻonoho o ka weheʻia splint, i loko o nā piha i hoʻopaʻa 'ia ua koi' ia.

Nā hana fractures o proximal hapa ae ekolu lā ma hope, e hana UHF a me kaʻume mākenēki Inc, a ma hope 7-10 lā e hoʻomaka 'ana o ke kuʻekuʻe aku a me na pulima oʻu ami, electrophoresis, UFO, lomilomi a me ka ultrasound waiū. Mahope o 3-4 pule o ka puna Longuet a kūikawā clamps e puku i ka lole wili, mau physical Inc a me nā kaʻina hana.

Ke ola pau ka hakina me kaʻoki kino

More nui nā palapū e like me fracture aʻoki lāʻau lapaʻau ai fracture o ka humerus me ka pohupani hale kauoha repositioning, puna lole wili a me ka pololei, m-Ray i loko o ka haukapila. Puna hiki e pili no 6-8 pule. He mea pono e hoʻoneʻe i nā lima a me nā manamana, mai ka ia la ae, ma hope o 4 pule, e hiki ke hana OE neʻe o ka poohiwi hui, e kōkua ana i kona lima maikai, alaila, e hele i ka hana neʻe. E möakäka hou hoʻopulapula nā physical Inc, massages, mechanotherapy.

Ka nele no kaʻoki lāʻau lapaʻau 'uao

Ma kekahi mau hihia, repositioning mea hiki ole no ka mea, o ka mea fragmentation ikaika paha wale, aole e haawi i ka i makemake i nā hualoaʻa. Inā he mea he fracture o ka humerus ia me kaʻoki kino koi 'ia e kū ai i ka hoʻohui pū' ia o ka hakina. Ikaika pāʻewaʻewa, naha, a me ka hakina, lolelua ka fracture paena e koi ole wale reposition a me ka osteosynthesis a - hoʻopunipuni i ka piha'ā paipu, nā kui nao, papa. No ka laʻana, ka fracture o ka ai o ka humerus me ka piha lakou hoopuehu ana koena pono ke haka pono maila papa Kaplan-Antonov, paipu, a me ka mea nana i ulana Vorontcova Klimov, kui a me ka laau hahau, pela ae ho'āʻo ana i ka hanana o angular pohupani hale ma ka ulana. Shards e malama i kuʻi nukeliu nā kui nao a me Ilizarov. Ka leki a skeletal traction ua hoʻohana 'ia no ka hou mamala fractures o ka lalo kāleka, ma hope i ka luhi o ua superimposed a paa physiotherapy.

Fractures epicondyle ole pohupani hale e noi mai ana e lei ana puna lole wili i 3 pule. Offset e koiʻoki lāʻau lapaʻau 'uao. Condylar (intercondylar a me ka transcondylar) fractures i pinepine pu ma pohupani hale o ka iwi koena ai, a hoʻohana. Reposition ma keia hihia ua i hamama e hōʻoia i ka hoihoi hou ia ana o ka pololei kulana o ka articular surfaces, a e osteosynthesis. Next pili restorative lapaau i loko o ka luna '.

Lapaʻau o ka huikau fracture

Fracture o ka humerus me ka pohupani hale, pu ma ka pōʻino i ka kahahānai nā aʻalolo, pono ke hoʻohālike o ka iwi koena ai a me ka makeʻe kulana hana o nā aʻalolo. Fracture immobilized hoʻokō lāʻau Inc i ke aʻalolo ke regenerate iho. Hope hoʻohui physical Inc a me physical Inc. Akā, inā ua i hoihoiia ke aʻalolo functionality i loko o kekahi mau mahina, a laila,ʻoki kino ua hana.

Ma ka loa loa hihia, i ka wa a na iwi, ua ikaika nui hakina, o ka hakina hiki ke wehe 'ia, ma hope i ua koi' ia ke prosthesis. Ka poohiwi ami prosthesis ua hoʻohana 'ia kahi o ke poo. Inā excessive poino kuapuʻu nāʻiʻo hiki ke sutured pololei i ka humerus.

Iapaau ana o kekahi fracture pono kaʻaeʻana i nā koi a pau o ka poe akamai, e like me ka pono me ka nui kokoke i ka hoʻopulapula. Immobilization a me ka piha i koe i ka poino ili honua e ho'ōla UAIAaIN ma ka kekahi haawe ana. Papa o ka physiotherapy, physical Inc, lomilomi a me ka like loa ke kaʻina hana i e lawelawe hou ma mua, hoʻokahi houʻana, a me kekahi mau haʻahaʻa a piha ke ola. Ua mea i nui, e hana pololei hooko aku i na koi no ka hoʻopulapula ma ka home, a lawe malama o ka hou-eha.