Kusweka kwa clavicular kumachititsa 2.6% ya kusweka kwa akuluakulu, ndipo 80% imapezeka m'chigawo cha midshaft. Kuyambira kumayambiriro kwa zaka za m'ma 1990, njira yosamalira yokonzedwa ndi Neer yakhala ikuonedwa ngati njira yoyamba yothandizira kusweka kwa clavicular. Komabe, kafukufuku wambiri watsimikizira kuti chithandizo chosagwiritsa ntchito opaleshoni nthawi zambiri sichichepetsa kusweka kwa clavicular midshaft komwe kwasokonekera kwambiri kapena kwatha, zomwe zimapangitsa kuti kusunthika pang'onopang'ono komanso kufupika kwapakati, zomwe zimawonjezera chiopsezo cha malunion ndi non-unity. Kuphatikiza apo, malipoti asonyeza kuti odwala omwe amathandizidwa popanda opaleshoni amavutika ndi kuchepa kwa mphamvu ya phewa. Chifukwa chake, opaleshoni yakhala ikukondedwa kwambiri ndi odwala omwe ali ndi kusweka kwa clavicular m'zaka zaposachedwa, pakati pawo omwe amachepetsa kuchepetsa ndi kukhazikika kwamkati (ORIF) pogwiritsa ntchito plate fixation.

Pa ma fracture ovuta otere, dokotalayo adayang'ana kwambiri njira yomangira yomwe idawonjezeredwa ndi ma mini-plates. Ma plates awa amagwira ntchito mofanana ndi zomangira zotsalira koma amapereka ntchito yosavuta. Kuwona kwa opaleshoni kunawonetsanso kukhazikika kwamphamvu, ndipo zotsatira zabwino zachipatala zapezeka pogwiritsa ntchito ma fractures a patellar omwe adasweka. Pogwiritsa ntchito kafukufuku wotsimikizira kuti ma dual-plates amapereka kukhazikika kokwanira kwa makina, dokotalayo adagwiritsa ntchitoomatenda a rhetopedicminipmochedwakuti tigwirizire zidutswa zazing'ono zosweka ku gawo lalikulu la fupa, zomwe zasintha bwino mawonekedwe ovuta a kusweka kukhala mawonekedwe osavuta. Kuchepetsa pambuyo pake kwa malo osweka kunathandiza, kutsatiridwa ndi kuyika kwapamwambalocking compression plate(LCP). Pofuna kuchepetsa kuvulala kwa periosteal, mabala ochepa okha ndi omwe adapangidwa kuti awonetse malo omwe amalowetsa screw, zomwe zimapangitsa kuti zikhale zofanana ndi mfundo za minimally invasive plate osteosynthesis (MIPO).

Mlandu Wachipatala

Kuwunika mawonekedwe a kusweka kwa fupa kunachitika asanayambe opaleshoni pogwiritsa ntchito mafilimu a X-ray ndi ma CT scan opangidwanso ndi 3D. Wodwala wamwamuna wazaka 22 anapezeka ndi kusweka kwa clavicular midshaft komwe kumachitika panthawi yamasewera. Chithunzi cha anteroposterior clavicular x-ray (a) ndi chithunzi cha apical oblique x-ray (b) zinatsimikizira kuti kuswekako kunali kwa mtundu wa AO/OTA 15.2C (comminuted multifragmentary fracture). Zithunzi za CT zomangidwanso ndi magawo atatu za wodwalayo zinawonetsa mawonekedwe a stereoscopic a mawonekedwe a kusweka kwa fupa, zomwe zinapereka umboni womveka bwino wa kapangidwe kake ka opaleshoni isanachitike opaleshoni.

Wodwalayo anaikidwa pampando wa pagombe pansi pa mankhwala oletsa ululu, mutu ndi khosi zitapendekeka kuchokera kumbali ya opaleshoni. Pambuyo poyeretsa khosi nthawi zonse komanso kupukuta khosi lopanda tizilombo toyambitsa matenda, mawonekedwe onse a clavicle ndi malo osweka anaikidwa chizindikiro cha opaleshoni motsogozedwa ndi fluoroscopic ndi mkono wa C. Kuduladula kopingasa pafupifupi 5 cm m'litali (kofanana ndi kutalika kwa malo osweka) kunapangidwa motsatira mzere wa clavicle fracture.Mbale ya Titanium Clavicle(2.0 mm yaying'onoMbale ya Clavicle ya Mafupa) idagwiritsidwa ntchito kuthandiza kuchepetsa kusweka kwa mafupa.

Mbale ya ClavicleZinagwiritsidwa ntchito kulumikiza ndi kukonza zidutswa za mafupa zooneka ngati mphero kapena zodulidwa ku zigawo zazikulu zosweka. Pambuyo posintha kusweka kovuta kukhala mawonekedwe osavuta, kumangika ndi chowongolera chapamwambambale yotsekera zachipatalakunachitika. Chipangizo cha clavicular LCP (3.5 mm superior clavicular LCP system) chinayikidwa pamwamba pa cortical ya clavicle ndipo chinayikidwa kudzera mu njira ya minimally invasive plate osteosynthesis (MIPO).

Wodwalayo anavala sling kwa masiku 7 oyambirira a opaleshoni kuti achepetse ululu, kenako anayamba kuchita masewera olimbitsa thupi osiyanasiyana. Patatha milungu 8 opaleshoni itatha, maphunziro olimbitsa minofu anayamba atangotsimikizira kuti mafupa agwirizana ndipo kuwunika kwachipatala kunasonyeza ululu wochepa. Kuyezetsa kwa X-ray (kuonera clavicular anteroposterior ndi kuwona clavicular apical oblique) kunapezeka nthawi yomweyo atangochita opaleshoni komanso paulendo uliwonse wotsatira wodwala.

Ngati mukufuna kudziwa zambiri zaMbale Zotsekera za Clavicle za Orthopedicchidziwitso, chonde musazengerezeLumikizanani nafe; gulu lathu lidzakupatsani chithandizo cha akatswiri ndi mayankho.