Osteotomy - Iyini?

Osteotomy - eyohlinzwa ukuthi luhlose ukubuyisela elahlekile locomotor imisebenzi ngokusebenzisa yokufakelwa ithambo asike izidumbu zabantu. Ezimweni eziningi, isetshenziswa ukususa ukusonteka esitho, okuyinto ikuvumela ukuba ubuyele ikhono lesiguli Ukuzinakekela ehlanganisa nokuya nomaphi.

imiqondo Jikelele

Ukusebenza osteotomy wenziwa onekhono kakhulu ukuhlukumezeka ohlinzayo. Nokho, Uma uthi nhlá, kubonakala sengathi izinto ukungenela liyinkimbinkimbi futhi kudinga isikhathi esiningi at ekululameni kwesiguli, ukuhambisana nezincomo likadokotela ngizolivusa isiguli ezinyaweni zakhe ngokushesha.

Osteotomy - eyohlinzwa owenziwa esebenzisa amathuluzi akhethekile - osteotomes, Gigli ngamasaha, ngamasaha kagesi kanye namadivayisi ultrasonic. Asiza ukwenza izimbobo kungenelelwe wanquma ithambo. Ngemva lokuqoqa doti izinsalela awashintsheki nge ngezikulufo, izinaliti, amapuleti. Ngokungafani waphuka okungahleliwe, ukhonkolo sisetshenziswa akuvamile, ukuze ugweme ukuthuthukiswa okungenzeka contractures emalungeni.

ngezigaba

Kuye ubunjalo ukufinyelela tekusebenta izinhlobo osteotomy ezilandelayo:

1. Vula - sidinga ukufinyelela ithambo. Emva isikhumba imbobo, izicubu ongama futhi imisipha apharathasi, raspatory ahlukaniswe periosteum, ithambo bese dissected. Uma izicucu zezinsimbi zanda iqinile esimweni bokuphila, phezulu - yokusakaza.
2. Kuvaliwe - luqhutshwa ukufinyelela ngamasentimitha ambalwa. Imisipha kungukuthi asikwe futhi egqinsiwe ukuthola ithambo. Ngokusebenzisa ishizolo ahlukaniswe periosteum futhi eziningana amagalelo ngesando isibambo enqamula ithambo. imithambo yegazi nezinzwa ayaduduleka futhi fixed ngamathuluzi ezikhethekile zokugwema odalekayo kuwo. kuvame kakhulu ukuba kusetshenziswe i-osteotomy transverse.

Ukuma Imi Ulandela ukungenelela:

• lateral;
• ezitebhisini;
• etshekile;
• amazombe;
• swivel (eyindilinga, arcuate, nesigaxa emise, angularly).

Kuye umgomo, ukuhlinzwa iyona zinhlobo ezilandelayo:

• osteotomy zokulungisa;
• derotation;
• okuhloswe ngaso ekushintsheni obuphelele esitho;
• It ihlose ukwenza ngcono umsebenzi ukwesekwa.

Izinkomba lokungenela

Osteotomy - kuyinto udokotela wamathambo, okuyinto eyenziwa kulezi zimo ezilandelayo akuzona amenable yokwelapha olandelanayo:

• kwezinso azalwa naso noma bathenga futhi bone ukusonteka, ngezinga elikhulu of eside amathambo ijabulise (hip, ehlombe, ethangeni lesokudla);
• ankylosis - nakwenzeka umsebenzi ngokuhlanganyela ngenxa yokubakhona ukuvuvukala zezinzwa izicubu, uqwanga noma ithambo nobunjalo evele articular;
• azalwa naso hip dysplasia (dislocation);
• Ngokuvamile abantu baphuka izinqulu ukuthi kahle tho;
• osteomyelitis;
• khona izimila noma metastases;
• imiphumela yamathambo emlandweni;
• ubambe arthroplasty;
• omunye kwezinso azalwa naso of the system zemisipha.

Ukusebenza isetshenziswa emkhakheni yezimonyo: osteotomy kwekhala, Oqondisa wabuka ebusweni, imisebenzi okhathazekile of imihlathi.

Izimo

Kunezindlela eziningana zici, khona lapho ukuhlinzwa imisiwe:

• izifo bemvelo ezithathelwanayo ngesikhathi lapho kudingeka osteotomy ithambo noma amasonto amabili ngaphambi kokuba sihlinzwe;
• yezifo izinhlelo zokuphefumula futhi senhliziyo decompensated;
• sikashukela;
• inkathi sokukhulelwa wengane;
• kwezinso noma hepatic ukungakhuli;
• khona ubovu ukuqubuka noma ezinye uhlobo endaweni lapho kuyadingeka ukuze bafeze on-line ukufinyelela.

Ngebuhle nebubi

ezicini ezinhle kokungenela kuthiwa ubuhlungu ubuhlungu (uma ikhona) kanye nokubuyiselwa motor umsebenzi. Ngokwesibonelo, osteotomy ka kwedolo uyobuqeda ubuhlungu ngesikhathi ukunyakaza, uqhube flexor futhi extensor umsebenzi, susa ukuvuvukala we evele articular. Lesi sifo eyeka inchubekelembili yayo.

Ububi ukuthi kungenzeka asymmetry okubonakalayo nemilenze noma amalunga omzimba. Ngaphezu kwalokho, uma isiguli kuzodingeka ilunga esikhundleni arthroplasty, kuzoba nzima ukuba afeze emva osteotomy.

yezinkinga kungenzeka

Osteotomy - eyohlinzwa okuyinto iminyaka eminingi ngcono ukuze kuncishiswe ingozi yokuthola nasezinkingeni ezilandela ngemva kokuhlinzwa. Nokho, noma yikuphi ukuphazamiseka nezinye izici eziningi emzimbeni womuntu ungumthombo ingozi, ngoba ngaphezu lesikwenta Uchwepheshe ezisebenza, sikhuluma ngezici ngabanye isiguli.

Izinkinga kwanoma iyiphi osteotomy uhlobo kungaba:

• isifo isilonda kuhlinzwa - kudinga ukuqashwa ukushaqeka ngemithamo yokwelapha ngemithi elwa namagciwane,
• offset doti futhi izinsalela - Kwenziwa olunye kabusha nenkanuko edlulele;
• Fusion kancane amathambo - esimisiwe izakhiwo multivitamin ukuthi yakhiwa izakhi ezibalulekile trace (calcium, phosphorus, magnesium, i-zinc);
• ukwakha sustava- zamanga edinga ezengeziwe;
• parestezii- ukwephulwa isikhumba ukuzwela ukusebenza endaweni ngenxa empambana amagatsha emsipheni (asidingi ukwelashwa eyengeziwe, ukulungiswa uqobo);
• ukwenqaba izimila - Ukushintshwa kwamajoyinti omzimba kuyadingeka.

osteotomy zokulungisa

Kuphethe inqubo enjalo isetshenziswa engalungile accrete ukwa, uyisithulu ithambo ukukhubazeka, ukuthuthukiswa ankylosis noma pseudoarthrosis, sengozini amathambo ngezinyawo kahle motor umsebenzi, ukuqeda ezibukwayo yezimonyo zamehlo.

Ngaphambi kokungenela Kwenziwa-X-ray luhlolo, okuvumela ukuba ucacise indawo wethambo, beka ngekusasa lophiko asike izidumbu zabantu, jikelele ithambo impilo. Uma kudingeka, i-computer, noma MRIs. Ezinye izindaba zika-inhlolovo babelwa ngamunye traumatologist.

Ukusebenza wenziwa esibhedlela ezikhethekile. Ubude kokungenela - amahora angaba ngu-3-4, kuya ngevolumu yiziphi izinqubo ezidingekayo. Ngemva asike izidumbu zabantu of izinsalela awashintsheki ngu Ilizarov (operation kwenziwa emachosheni) noma amadivayisi ezikhethekile metallic ukuthi injected ngqo ithambo (osteotomy unyawo).

Ilizarov apharathasi isakhiwo ekhethekile esetshenziswa traumatology kanye amathambo ngoba fixing, kokucindezelwa noma esisuka izinsalela kule sikhundla oyifunayo phezu isikhathi eside.

Ngemva kokuhlinzwa eyenziwa ukulawula x-ray, okuvumela ukuchaza kokungathembeki lesifanele.

Izinkinga osteotomy zokulungisa

yezinkinga ezingenzeka ngemuva ukulungiswa kwezimiso sokugembula zihlanganisa:

• ubuhlungu eqinile, hhayi ukunqampunwa analgesics ezivamile;
• ukwehluleka izingxenye sangaphandle umshini noma metal izakhiwo;
• ukuthuthukiswa ukopha;
• hematoma kumiswa;
• displacement we izinsalela isihlobo nomunye iyiphi izindiza;
• nezinye izinkinga jikelele.

Osteotomy emkhakheni amazinyo nokuhlinzwa maxillofacial

Emkhakheni yamazinyo osteotomy wenziwa emhlathini, okuyinto ingaba njengesihluthulelo eyohlinzwa ezimele noma njengoba isigaba phakathi nenqubo yokuhlinzwa. Asetshenziswa offset noma waphuka, ukulungisa malocclusion. Sebeziqhumbuza zenziwa kanye ubude molars emhlathini.

Ngemva nenkanuko edlulele ku bokuphila emhlathini isikhundla esikhulu ngebhandeshi compressive, ukulungisa izihlathi kanye kwesilevu ndawo. Ngokushesha esimisiwe i-antibiotic ukuze ugweme ukuthuthukiswa suppuration kanye kumiswa osteomyelitis. Phakathi kwamazinyo aso abeke abanye gum ngoba indawo lapho siyenzeka ongoti nsuku zonke. Stitches ziyasuswa ngemuva 2 amaviki, futhi ngezikulufo ukuthi ubambe emhlathini inyanga ukuqedela isigaba ukwelashwa kulandele yokwelapha orthodontic.

Emkhakheni wezingalo ukuhlinzwa temlomo na maxillofacial isetshenziswa osteotomy acinene, okuyinto ingxenye rhinoplasty. Kuyinto inkomba:

• ukuhlanekezela abalulekile kwebhuloho acinene;
• isinqumo eliphezulu amathambo;
• isidingo ithambo ukufuduka maqondana septum acinene.

Lapho efeza ekhaleni osteotomy udokotela ohlinzayo ukuba aqambe amanga izinkinga tebuciko: ukuvala acinene egumbini idolo ukususwa kanye eqondisa ugobile we backrest, ukuvaleka izindonga side. Lo chwepheshe kufanele inake ukuthi asike izidumbu zabantu ithambo izicubu kungathinta patency we umgudu eliphezulu, ngakho-ke, ngesikhatsi operation ethumba izici yokwakheka bokuphila isiguli esithile.

Izinhlobo osteotomy acinene:

• lateral (onqenqemeni), bafeza perforation noma umugqa isisekelo;
• medial (Centre);
• phezulu;
• Lesisemkhatsini.

Uhlobo kokungenela esetshenziswa kuyakhethwa ngamunye, ikhumbula inkinga lesiguli, ngenhloso ukusebenza, isimo kwezicubu amathambo, ivolumu kudingekile yokwelashwa kuhlinzwa.

Noma yimuphi osteotomy kumele kwenziwe ngemva kokukhulisa ezingeni amasosha omzimba. Izosebenza njengoba isilinganiso izifo sokuthuthukiswa yezinkinga ukudala izimo okulungileyo nokufanelekile ithambo Fusion.