Osteotomy - He aha ka keia?

Osteotomy - heʻoki lāʻau lapaʻau hana e AIM e hoihoi aku i ka nalowale locomotor mana maʻimi hoʻopunipuni iwi dissection. Ma ka hapanui o na hihia, ka mea, ua hoʻohana 'ia e wehe i ka lala deformation, a leie aku oe e hoʻi waiwai i ka hoʻomanawanuiʻana i ka pakiko-malama a me ka hoʻoneʻe.

General manaÿo

Hana osteotomy ua hana ma ka loa o kona mākaukau trauma surgeon. Ma mua kilohi ia mea i ka piʻiʻana i luna 'a me ka pono o ka puu o ka manawa ma ka hoomanawanui i ka loaa, nae, kaʻaeʻana i ke kauka i ka koi ia e hoala mai i ka hoʻomanawanui i kona mau wawae koke.

Osteotomy - ka hana a ua lawe mai ka mea o kūikawā hana - osteotomes, Gigli pahi olo, uila nā pahi olo, a kani ultrasonic nä manaʻo. Ka mea, ke kōkua i ka hana i nā puka ma ka wahi uao ai ', aʻokiʻoki aʻela i ka iwi. Ma hope o kaʻohiʻohi'ōpala hoʻi iwi hakina i paa me nā kui nao, paipu, papa. Haʻalele Random fractures, puna nou ana la o ua noi kākaʻikahi, i mea e pale hiki kūpono 'ana o contractures ma na ami.

Mea Maluna

Ke kaumaha ma muli o ka 'ano o ka hana ana ke kōkua o ke kēiaʻano osteotomy:

1. Open - pono komo i ka iwi. Ma hope iho o ka ili incision, subcutaneous'aʻaʻa a me ka Muscle i hoʻomākaukauʻia, hookaawale raspatory periosteum, iwi, a laila dissected. Ka'ōpala hoʻi ua paa ia ma ka physiological kulana, luna - e kipaku.
2. Pani '- mālama' ia ma ke kōkua o ke kekahi mau kenimika. ʻO nāʻiʻo ka mea, e oki, a pona e kiʻi i ka iwi. Ma ka hoʻohana 'ana i chisel hoʻokaʻawaleʻia periosteum a me kekahi mau hāmare makani ma ka i lawelawe, dissect iwi. Koko na moku a me nā aʻalolo i kulaʻi a ua paa me ka kūikawā hana, e pale aku ā 'inoʻino kekahi ia lakou. Loa pinepine hoʻohana no ka transverse osteotomy.

Ke kinona o ka oki i kēia mau uao ai ':

• kīloi paʻewa;
• staircase;
• kēlā;
• zigzag;
• kāna mau (spherical, arcuate, auka-hoʻokino, angularly).

Ke kaumaha ma muli o ka pahu hopu,ʻoki kino o ka mea i kēia? Ueo:

• corrective osteotomy;
• derotation;
• nona ma hoʻololi i ka lōʻihi o ka lala;
• Ua AIM e hoʻoikaika 'i ke kuleana pili i kākoʻo.

Nāʻikepili no ka 'uao

Osteotomy - Ua orthopedicʻoki kino, i ka mea i hana i loko o ka kēia mau hihia i ole amenable i ka makeʻe kulana Inc:

• congenital a kēia abnormalities a me ka iwi deformation, he nui loa o ka lōʻihi omo iwi (ke ki kala,'ūhā mua,'ūhā);
• ankylosis - impossibility o ka hui hana ku i ke alo o nā adhesions connective'aʻaʻa, cartilage a iwi ano o ka articular surfaces;
• congenital Hip dysplasia (dislocation);
• fractures i pono fused;
• osteomyelitis;
• imua o ka hikoko a me metastases;
• na waiwai o rickets ma ka moʻolelo;
• e paʻa ana arthroplasty;
• ka mea'ē aʻe congenital abnormalities o ka musculoskeletal nenoaiu.

Ke hana ua hoʻohana 'ia i loko o ka mea hoʻonani kula: osteotomy o ka ihu,? Ee lehalehu t contours, ka meaʻehaʻeha mana o na ā.

Contraindications

Aia nō i ka helu o nā kumumea, i ke alo o ka iʻoki kino ua hoolohi:

• maʻi o infectious ano i ka manawa o ka mea koi osteotomy iwi paha mau pule ma muaʻoki kino;
• maʻi o na nenoai naehana hanu a me ka mea'ōnaehana mānowai koko decompensated;
• mimikō;
• au o ka gestation o ke keiki;
• ʻaʻa puʻuwai a hepatic hoʻopilikia;
• i ke alo o ka purulent rashes a me nā ano ma kekahi wahi kahi i mea e pono ke lawe mai ma-laina ke kula.

Pono a me ka keakea

Noke, ao ke ano o ka 'uao e mama ka eha (ina kekahi) a me ka hoihoi hou ia ana o Hawaii kuleana pili i. No ka laʻana, osteotomy o ke kuli, e hoʻopau eha i ka hele, e hoʻi ma flexor a me ka extensor papa, wehe i ka adhesions o ka articular surfaces. Ka maʻi aɃe kona Holomua.

Ke keakea o ka manawa kūpono o ka pilikia makapō asymmetry o ka lala a me ami. A, ina o ka hoʻomanawanui, e pono ai i ka ami hope arthroplasty, ka mea e e oi paʻakikī, e lawe mai ma hope o ka osteotomy.

hiki complications

Osteotomy - i hana i na mea he nui no ka makahiki hou, e emi i ka pilikia o postoperative complications. Eia naʻe, i kekahi 'ākeʻakeʻa o'ē aʻe i loko o ke kanaka kino o ke kumu o ka pilikia, no ka mea, ma ka hou e qualifying ke hoʻohana hoʻomalu, mākou e kamaʻilio e pili ana i na ano kanaka o ka hoʻomanawanui.

Complications o kekahi ano osteotomy hiki e:

• maʻiʻaʻai o kaʻoki lāʻau lapaʻau eha - pono i ka hookohu o ka hawewe nā māhele o antibiotic Inc;
• offset'ōpala hoʻi a me ka iwi koena ai - ua lawe mai me ka hou reposition fixation;
• kali kuʻi nukeliu o na iwi - waeia multivitamin pono a pau o ia i haku o ka nui kumumea oihana mua (kalipuna, phosphorus, makanekiuma, kiniki);
• ho okumu i wahahee sustava- pono hou 'uao;
• parestezii- kueʻili pā lonoaʻili ma wahi hana ku i ke kuʻina o ke aʻalolo lālā (e kauoha mai i nā lapaʻau, ka hoʻoponopono 'ana iho);
• rejection o implants - ami hope mea pono.

corrective osteotomy

E hali ana mai ia i ka hana ua hoʻohana 'ia i loko o ka hewa accrete fracture, congenital iwi mā, e ulu ai o ka ankylosis a pseudoarthrosis, deformities o ka wāwae iwi me kaʻole Hawaii hana, e hoʻopau pilikia makapō mea hoʻonani mā.

Ma mua o ka piʻiʻana ua lawe mai X-Ray keia hookolokolo ana, e leie aku ai i ke koho 'ia i ka wahi o ka iwi, kau i ka wā e hiki mai ana o ka dissection, ka nohona ma iwi ola. Inā pono, he kamepiula, a MRIs. Ke koena o ke anamanaʻo i ia pākahi traumatologist.

Ke hana ua hana ma ka hana kūikawā haukapila. Ka lōʻihi like 'ole o ka' uao - ma kahi 3-4 hola, ke kaumaha ma muli o ka buke o ka mea kupono kaʻina hana. Ma hope o dissection o ka iwi koena i paa e Ilizarov (ana hana ma luna o nāʻaoʻao) a kūikawā mea hao maalea, e hiki i injected 'ana i loko o ka iwi (osteotomy wāwae).

Ilizarov i hoʻomākaukauʻia mea he kūikawā 'ole hoʻohana i ka traumatology a me orthopedics no ke haka pono maila, mīkini'opihia a me kona iwi hakina ma ka makemake kulana no ka wā lōʻihi o ka manawa.

Ma hope o ka hana, lawe mai i ka mana hoʻomalu m-Ray, hiki e hoakaka i ka pololei ke haka pono maila.

Complications corrective osteotomy

Hiki complications ma hope o? Iaea o pathological olelo nā:

• ikaika eha,ʻaʻole paʻapūʻike mau analgesics;
• ole o ka mea mawaho loa o ka mīkini 'ole o ka mea hiki ke hooheheeia hale;
• hooulu ana o ke kahe ana ke koko;
• hematoma ho okumu;
• pohupani hale o ka iwi mamala pili i kekahi i kekahi, i loko o kekahi o nā Kekoa;
• kekahi mau complications.

Osteotomy i loko o ke kahua o ka dentistry a me ka maxillofacialʻoki kino

Ma ke kahua niho kahua osteotomy i hana iwia, a hiki ke hana me he kuokoa ana a me ke kahua o kaʻoki lāʻau lapaʻau ina hana. Hoʻohana 'ia i loko o offset paha fractures, e ao malocclusion. Incisions i i ma ka lōʻihi o ka iwi ā molars.

Ma hope o fixation ma physiological iwia wahi superimposed compressive lole wili, hoʻopunipuni nā pāpālina, a chin wahi. Koke kohoia i antibiotic i mea e pale 'ana o ka suppuration a me ka ho okumu ana o osteomyelitis. Ma waena o nā niho hoʻokō i kekahi mau nui aʻe ana no ka wahi a ua malamaia kela la i keia hoʻomalu. e wehe Stitches ma hope o 2 pule, a me na nā kui nao e malama i ka iwi ā i loko o ka mahina, e hoʻokō 'ia i ka iapaau ana pae ukali ma orthodontic Inc.

Ma ke kahua o ke ku una, a maxillofacialʻoki kino ua hoʻohana 'nasal osteotomy, i ka hapa o ka rhinoplasty. He he PAaIEN no:

• nui ei o ka nasal alahaka;
• kiʻekiʻe hooholo o ka iwi;
• i ka pono no ka iwi pohupani hale ma ka pili ana i ka nasal septum.

I lawe mai i ka ihu osteotomy ka surgeon e moe aesthetic pilikia: panina nasal vault kuapuʻu pōpilikia 'ana, a straightening i ka curvature o ka backrest, me ka hou ana o kaʻaoʻao pā. Ke hoʻomalu pono lawe i mooolelo ia o ka dissection o ka iwi'aʻaʻa e loli i ka patency o ke keena airway, nolaila, i hana pio anatomical a me physiological ano o ka ua hoʻomanawanui.

Kind nasal osteotomy:

• kīloi paʻewa (maka), lawe mai i ka perforation paha laina kumu;
• medial (Center);
• luna;
• waena.

Ano o ka 'uao hoʻohana ua wae pākahi, e lawe i loko no o ka hoomanawanui i ka pilikia, o ka manao o ka hana, i ka noho ana o ka iwi'aʻaʻa, ka mea e pono ai ka leo o keʻoki lāʻau lapaʻau lapaau.

Kekahi osteotomy e halihaliia oia iwaho ma hope e hoohaunaele ana i ka nui o ka e hoʻonele. Ia e malama aku ai i ke kāohi ana no ka hooulu ana i complications a me ka hana ana i ka maikai a me ka pono iwi kuʻi nukeliu.