ʻO 2.6% o nā haki āpau o ka pākeke nā haki clavicular, a hiki i ka 80% e hana ʻia ana ma ka ʻāpana midshaft. Mai ka hoʻomaka ʻana o nā makahiki 1990, ua manaʻo ʻia ke kaʻina hana hoʻokele conservative i hāpai ʻia e Neer ʻo ia ka lāʻau lapaʻau mua no nā haki clavicular. Eia nō naʻe, ua hōʻoia nā haʻawina he nui ʻaʻole hiki i ka lāʻau lapaʻau ʻoki ʻole ke mālama i ka hōʻemi ʻana i nā haki clavicular midshaft i hoʻoneʻe nui ʻia a i ʻole i hoʻokaʻawale ʻia, e hopena ana i ka neʻe ʻana a me ka hoʻopōkole ʻana i hoʻonui ʻia, kahi e hoʻokiʻekiʻe nui ai i nā pilikia o ka malunion symptomatic a me ka nonunion. Eia kekahi, ua hōʻike nā hōʻike e ʻeha nā mea maʻi i mālama ʻia me ke ʻoki ʻole i ka ikaika poʻohiwi i emi. No laila, ua loaʻa i ke komo ʻana o ke ʻoki kino ka makemake nui no nā mea maʻi me nā haki clavicular i nā makahiki i hala iho nei, i waena o ia mau mea ua hoʻohana nui ʻia ka hoʻemi wehe a me ka hoʻopaʻa ʻana i loko (ORIF) me ka hoʻopaʻa ʻana o ka pā.

No kēlā mau haki paʻakikī, ua kālele ke kauka i kahi ʻenehana hoʻopaʻa i hoʻonui ʻia me nā mini-plates. Hana like kēia mau papa me nā wili lag akā hāʻawi i ka noi maʻalahi. Ua hōʻike pū nā nānā ʻana intraoperative i ke kūpaʻa paʻa, a ua hoʻokō ʻia nā hopena lapaʻau maikaʻi me kā lākou hoʻohana ʻana i nā haki patellar comminuted. Ma ke kaha kiʻi ʻana i ka noiʻi e hōʻoia ana e hāʻawi ka hoʻopaʻa ʻana i ka pālua-papa i ke kūpaʻa mechanical lawa, ua hoʻohana ke kaukaoʻO ka ʻeha hope loamʻIniplohie hoʻopaʻa i nā ʻāpana haki liʻiliʻi i ka ʻāpana iwi nui, e hoʻololi pono ana i nā ʻano haki paʻakikī i nā hoʻonohonoho maʻalahi. Ua maʻalahi ka hōʻemi ʻana o nā ʻili haki ma hope, a ukali ʻia e ke kau ʻana o kahi ʻoi aku ka maikaʻipā hoʻopaʻa laka(LCP). No ka hōʻemi ʻana i ka ʻeha periosteal, ua hana ʻia nā ʻoki liʻiliʻi wale nō e hōʻike i nā wahi i hoʻokomo ʻia ai nā wili, e hoʻokō ana i ka hoʻopaʻa ʻana e kūlike me nā kumumanaʻo o ka minimally invasive plate osteosynthesis (MIPO).

Hihia Lapaʻau

Ua hana ʻia ka loiloi ma mua o ke ʻoki ʻana o ke ʻano o ka haki me ka hoʻohana ʻana i nā kiʻiʻoniʻoni X-ray a me nā scan CT i hana hou ʻia 3D. Ua ʻike ʻia kahi maʻi kāne 22 makahiki me ka haki clavicular midshaft ʻākau i loaʻa i ka wā o nā hana haʻuki. Ua hōʻoia ka radiograph clavicular anteroposterior (a) a me ka radiograph oblique apical (b) no ka ʻano hoʻokaʻawale AO/OTA 15.2C (comminuted multifragmentary fracture). Ua hōʻike nā kiʻi CT i hana hou ʻia ʻekolu-dimensional o ka mea maʻi i kahi nānā stereoscopic o ka hoʻonohonoho haki spatial, e hāʻawi ana i nā hōʻike anatomical intuitive no ka hoʻolālā ma mua o ke ʻoki ʻana.

Ua hoʻonoho ʻia ka mea maʻi ma ke kūlana noho kahakai ma lalo o ka anesthesia laulā, me ke poʻo a me ka ʻāʻī e hoʻohuli ʻia mai ka ʻaoʻao hana. Ma hope o ka disinfection maʻamau a me ka draping sterile, ua hōʻailona ʻia ke ʻano holoʻokoʻa o ka clavicle a me kahi haki me kahi māka ʻoki ma lalo o ke alakaʻi fluoroscopic e kahi lima C. Ua hana ʻia kahi ʻoki transverse ma kahi o 5 cm ka lōʻihi (e kūlike ana i ka lōʻihi o ka ʻāpana haki) ma ka laina haki clavicular. HoʻokahiPapa Clavicle Titanium(2.0 mm ka liʻiliʻiPapa Clavicle Orthopedic) ua hoʻopili ʻia e kōkua i ka hōʻemi ʻana i ka haki.

Papa clavicleua hoʻohana ʻia e hoʻopili a hoʻopaʻa i nā ʻāpana iwi ʻano wedge a i ʻole i ʻoki ʻia i nā ʻāpana haki nui. Ma hope o ka hoʻololi ʻana i ka haki paʻakikī i kahi hoʻonohonoho maʻalahi mechanical, hoʻopaʻa ʻia me kahi ʻoi aku ka maikaʻipapa laka lapaʻauua hana ʻia. Ua kau ʻia kahi clavicular LCP (3.5 mm superior clavicular LCP system) ma luna o ka ʻili cortical superior o ka clavicle a ua hoʻokomo ʻia ma o ke ʻano hana minimally invasive plate osteosynthesis (MIPO).

Ua ʻaʻahu ka mea maʻi i kahi kaula no nā lā 7 mua ma hope o ke kaʻina hana e hōʻoluʻolu i ka ʻeha, a ukali ʻia e ka hoʻomaka ʻana o nā hoʻomaʻamaʻa neʻe. I 8 mau pule ma hope o ke kaʻina hana, ua hoʻomaka ʻia ka hoʻomaʻamaʻa hoʻoikaika ʻiʻo i ka wā i hōʻoia ai nā radiographs i ka hui ʻana o ka iwi a ua hōʻike ka loiloi lapaʻau i ka ʻeha iki. Ua loaʻa koke nā hoʻokolohua X-ray (ʻike clavicular anteroposterior a me ka ʻike clavicular apical oblique) ma hope o ke ʻoki ʻana a ma kēlā me kēia kipa hahai ma waho.

Inā makemake ʻoe e ʻike hou e pili ana i kaNā Papa Laka Clavicle Orthopedicka ʻike, e ʻoluʻolu e nīnau maikāhea iā mā˚ou; e hāʻawi kā mākou hui iā ʻoe i ke kākoʻo ʻoihana a me nā pane.