Osteotomy - ke eng see?

Osteotomy - mokgwa wa ho buoa e ikemiseditse ho tsosolosa tse lahlehileng mesebetsi locomotor ka maiketsetso dissection masapo. Maemong a mangata, e sebelisoa ho tlosa leoto deformation, e lumella u ho khutlisetsa matla a mokuli ho intša tlhokomelo le tsamaiso.

bopa dikgopolo tsa kakaretso

Opereishene osteotomy o etsoa ke haholo nang le tsebo ho sithabela ngaka e buoang. Ka chebo ea mahlo ho bonahala hore ho kenella ke rarahaneng le hloka nako e ngata ho hlaphoheloa mokuli Leha ho le joalo, a latele likhothaletso le ngaka e tla tsosa le mamello ho maoto a hae ka potlako.

Osteotomy - e tshebetso eo e phethahatsoa ka lisebelisoa khethehileng - osteotomes, Gigli lisakha, lisakha motlakase le galena disebedisweng tse ding. Ba thusa ho etsa hore le masoba ka tsereletsi sebaka le khaola ea masapo. Ka mor'a ho bokella likhechana maloanlahla lesapo ba tsitsitseng le woman stage, linale, lipoleiti. Ho fapana le fractures tšohanyetso, samente liheloe e sebelisoa ka seoelo, e le hore ho qoba ho khoneha ntshetsopeleng ya contractures ka manonyeletso.

tlhophiso

Ho itšetlehile ka mofuta wa ho fihlella tshebetso latelang mefuta osteotomy:

1. Open - hloka phihlelo lesapo la. Ka mor'a hore letlalo incision, subcutaneous dinama tse nyenyane tse 'me mesifa sethusathuto, raspatory arohane periosteum, lesapo ebe dissected. maloanlahla e tsitsitseng le boemong ba fisioloji, top - liheloe.
2. Koaloa - khanna ka phumantsho ya emetse disentimitara tse seng kae. Mesifa ha ba khaola le mekhahlelo ho fumana ho lesapo la. Ka ho sebelisa chisel arohane periosteum le ho otla 'maloa hamore ka mohele go kgaoganya masapo. methapo ea mali le methapo ea kutlo tse sutumelletsa le e tsitsitseng le lisebelisoa e khethehileng ho qoba ho senya bona. Hangata ka ho fetisisa sebelisoa bakeng sa osteotomy ho parola.

Sebopeho sa sehiloeng a latelang tsereletsi:

• lateral;
• boipelaetso litepising;
• oblique;
• zigzag;
• swivel (chitja, arcuate, chesele e bōpehileng joaloka, angularly).

Ho itšetlehile ka hore sepheo, ho buuoa ke mefuta e latelang:

• lokisang osteotomy;
• derotation;
• ikemiseditse ho fetola bolelele ba leoto ho;
• Ho e ikemiseditse ho ntlafatsa tšehetso mosebetsi.

Ho bonahala ho kenella

Osteotomy - ke ea masapo buuoa, eo o etsoa maemong a latelang ha li amenable ho phekolo mekhoa e tloaetsoeng:

• congenital kapa fumana tsela e sa tloaelehang le masapo deformation, ka tsela e itseng e khōloanyane ea nako e telele masapo tubular (noka, mahetla, serope);
• ankylosis - khoneha ya mosebetsi e kopanetsoeng ka lebaka la ho ba teng ha adhesions connective dinama tse nyenyane tse, lefufuru kapa lesapo tlhaku tsa bokaholimo articular;
• congenital noka dysplasia (dislocation);
• fractures hore nepo fused;
• osteomyelitis;
• boteng ba lihlahala kapa metastases;
• liphello tsa rickets historing;
• tšoere arthroplasty;
• le tse ling tse sa tloaelehang congenital ea tsamaiso ea musculoskeletal.

opereishene e sebediswa tšimong setlolo: osteotomy nko, khalemela contour sefahleho, mesebetsi tsositsoeng ea mehlahare ea.

Contraindications

Ho na le lintlha tse 'maloa, ho ba teng ha tseo ho buoa e lieha:

• mafu a tlhaho a tšoaetsanoang ka nako eo ha hlokahala osteotomy lesapo kapa libeke tse peli pele ho buuoa;
• mafu a ea tsamaiso ea matšoafo le pelo decompensated;
• lefu la tsoekere;
• nako ea emara ngoana;
• renal kapa e amanang le sebete kholofalo;
• ho ba teng ha purulent rashes kapa mofuta tse ling ka sebaka seo ho sona ho ke ke ho hlokahala hore ho phetha ka-line fihlella.

Le melemo le mathata afe

likarolo tse ntle tsa kenella ba easing bohloko (haeba leha e le efe) le ho tsosolosoa ha mosebetsi likoloi. Mohlala, osteotomy ea lengole tla felisa bohloko nakong eo ke sisinyehang, qalella flexor le extensor mosebetsi, tlosa adhesions tsa bokaholimo articular. Lefu lena le khaotsa letotong lona.

The bozangi litomba ke monyetla oa ho bonwang asymmetry ea maoto le matsoho kapa manonyeletso. Ho feta moo, haeba mokuli o tla hloka kopanetsoeng Phetolo arthroplasty, ho tla ba thata le ho feta hore a phethe ka mor'a osteotomy ena.

mathata khoneha

Osteotomy - e opereishene eo ka lilemo tse ngata ba ntlafala ho fokotsa kotsi ya mathata postoperative. Leha ho le joalo, ho na le tshitiso efe kapa efe ya maemo a mang ka 'mele oa motho ke mohloli oa kotsi, hobane ho phaella ho tšoanelehele sebetsa setsebi, re bua ka litšobotsi motho oa mokuli.

Mathata a ya osteotomy mofuta ofe kapa ofe a ka ba o reng:

• tshwaetso ya leqeba le ho buoa - hloka ho kgethwa ha tekanyetso makala tsa phekolo lithibela-mafu;
• Koala maloanlahla a le masapo likhechana - o etsoang tsoa le e nngwe hape reposition fixation;
• lieha logan ea masapo - e behiloeng mehahong multivitamin tse entsoeng ka mesaletsa likarolo bohlokwa (khalsiamo, phosphorus, le magnesium, zinki);
• eaba ba etsa sustava- ba bohata hloka kenella eketsehileng;
• parestezii- tlōla letlalo nahanela ka tshebetso sebakeng loketseng ho motsoako oa makala a methapo ea kutlo (a hloke kalafo eketsehileng, ho lokisa ka boeona e);
• ho hana kentsoeng litho tsa maiketsetso - Phetolo kopanetsoeng ke ke ho hlokahala.

lokisang osteotomy

Phetha tsamaiso joalo le sebelisitsoe ka phoso accrete fracture, congenital likoli lesapo, ntshetsopele ya ankylosis kapa pseudoarthrosis, deformities la masapo a ka maoto le phytoteratology dilenaneo mosebetsi, ho felisa mefokolo bonwang le setlolo.

Pele ho kenella e phethahatsoa X-ray itlhahloba, eo lumella ho bolela ka ho toba lefelo la lesapo la, beha bokamoso ba dissection le, ka kakaretso lesapo bophelo. Haeba ho hlokahala, k'homphieutha, kapa MRIs. Ba bang kaofela ba phuputso e entsoeng ho ba abeloa batho ka bomong traumatologist.

opereishene o etsoa sepetlele e khethehileng. Ka nako ea ho kenella - ka 3-4 lihora tse ngata, ho itšetlehile ka bophahamo ba modumo ea mekgwa ya tshebetso ya ho hlokahala. Mora dissection la likhechana lesapo ba tsitsitseng ke Ilizarov (opereishene e ka lipheletsong ba) kapa disebediswa tsa ho khethehileng metallic tse tshelwa ka kotloloho ka lesapo (osteotomy maoto).

Ilizarov sethusathuto ke sebopeho e khethehileng o ile a sebelisa ka traumatology le malwetse a bakeng sa ho lokisa sepeiti, compression kapa otlolla likhechana lesapo boemo batlang ka nako e telele ea nako.

Ka mor'a opereishene atlehe taolo: x-ray, e le hore ho hlalosa ho lokisa sepeiti nepahetse.

Mathata a lokise osteotomy

mathata khoneha ka mora khalemelo ea maemo pathological kenyeletsa:

• matla bohloko, e seng cropped analgesics tloaelehileng;
• ho hlōleha ha likarolo tse Link tsa mochine kapa ya dibopeho tsa tšepe;
• ntshetsopeleng ya mali;
• hematoma sebopeho;
• displacement ea lesapo mangeta a amanang le ho e mong le e tse ling tse ka e 'ngoe ea lifofane e;
• tse ling mathata a kakaretso.

Osteotomy tšimong ea ho phekola meno le ho buoa maxillofacial

Tšimong meno e osteotomy phethile mohlahare, e leng e ka sebetsa jwalo ka e tshebetsong ikemetseng kapa e le ho ba sethaleng sa Tsamaiso sa ho buoa. Sebelisoa ka kapa fractures koala, ho lokisa malocclusion. Incisions entsoe hammoho bolelele ba molars mohlahareng.

Mora fixation ka fisioloji mohlahare boemo ba superimposed compressive tlamisa, lokisa le marameng le selelu area. Hang-hang a khethoa e lithibela-mafu e le hore ba qobe ho ntshetsopele ya suppuration le sebopeho sa osteomyelitis. Pakeng tsa meno le lefisa ba bang ba marenene sebaka sa e hlokomela setsebi letsatsi le letsatsi. Esengelaki batonga ngai yango ba tlosoa ka mor'a libeke tse 2, 'me le woman stage hore tšoara mohlahare ka khoeli ho tlatsa mohato kalafo lateloa ke phekolo orthodontic.

Naheng ea ho buuoa ka molomo le maxillofacial e sebediswa osteotomy nasal, e leng karolo ea rhinoplasty ena. Ho sesupo for:

• bohlokoa ho khopama ha nasal borokho;
• phahameng qeto masapo;
• tlhokeho ya bone bone displacement kamanong le nasal septum.

Ka ho phetha nko osteotomy ngaka a bue leshano mathata bokgabane: koalang nasal Vault hump tlosa le ogee kotlobane backrest eo, narrowing tsa marako lehlakoreng. The setsebi ba hlokomele hore dissection ya dinama tse nyenyane tse lesapo e ka ama patency tsa airway e ka holimo, ka hona, ka nako ya tshebetso hapa litšobotsi tse anatomical le fisioloji ba le mamello ho khetheha.

Mefuta osteotomy nasal:

• lateral (bohale), phethile perforation kapa mola motheo oa;
• medial (Center);
• hodimo;
• lipakeng.

Mofuta oa kenella sebediswa e khethileng ka bomong, e kentse bothata mokuli, ka morero oa ho buuoa, puso ea dinama tse nyenyane tse lesapo, le hlokahalang bophahamo ba modumo ea phekolo ho buoa.

osteotomy efe kapa efe lokela ho phethahatsoa ka mor'a ho tsosa boemo ba sireletsehile maloetseng ana. E tla sebeletsa e le e thibelang e ka tekanyo e itseng bakeng sa ntshetsopele ya mathata le ho etsa maemo e ntle le e nepahetseng lesapo logan.