ukutshixa ipleyiti yoxande maxillofacial mini

Ipleyiti yokutshixa sisixhobo sokulungisa i-fracture enomngxunya otshixayo.Ipleyiti yokutshixa ivumela ithambo ukuba lidibane liqine ngakumbi kwipleyiti, lenze ilungu elinqunyulweyo lizinze ngakumbi emva kokumiswa kwakhona.

Iipleyiti zokutshixa zaqala ukusetyenziswa kwiminyaka eyi-20 edlulileyo kwi-spine kunye notyando lwe-maxillofacial ukuzinzisa iifractures ngelixa kunciphisa ukuchithwa kwezicubu ezithambileyo kunye nokulimala.

Ipleyiti yokutshixa sisixhobo sokulungisa i-fracture esinemingxuma enemisonto apho ipleyiti isebenza njengesixhobo sokulungisa i-Engile xa isikhonkwane esinentloko enemisonto sifakiwe.Zombini imingxuma yokutshixa kunye nengatshixwayo inokubonelelwa ngokufaka isikrufu esahlukileyo.Nayiphi na ipleyiti enokuthi ijijelwe kwi-fixed (stable) I-Angle screw okanye ibholiti ngokuyimfuneko ikukudityaniswa kwepleyiti etshixayo, kodwa ayixhomekekanga kwipleyiti yokutshixa. ngokupheleleyo kuxhomekeke kwisakhiwo sokutshixa ipleyiti yentsimbi ngokwayo.Umsantsa othile unokushiywa phakathi kwepleyiti yentsimbi kunye nomphezulu wethambo, osusa isiphumo esibi soqhagamshelwano olunzima phakathi kwepleyiti yentsimbi kunye nethambo, kwaye iphucula kakhulu unikezelo lwegazi kunye nokukhula kunye nokubuyiselwa kweperiosteum.Umahluko ophambili we-biomechanical phakathi kwepleyiti yentsimbi yemveli kunye nepleyiti yentsimbi yemveli kukuba le yokugqibela ixhomekeke kunxibelelwano lwethambo lwe-friction.

Isikrufu sokutshixa sisijiko sokuzicofa kwaye sinokusetyenziswa ngaphandle kokucofa okanye ukubhola kwethambo. Akukho xinzelelo phakathi kwepleyiti yentsimbi kunye nethambo lethambo, ngoko ke akukho xinzelelo kwiperiosteum, ukuze kukhuselwe unikezelo lwegazi lwe-periosteum. Ngokwemigaqo yotyando, inokufikelela kwiimfuno zotyando oluncinci, kwaye inokukhusela kakuhle unikezelo lwegazi lwendawo, ngoko ke akukho xinzelelo kwi-periosteum, ukukhusela unikezelo lwegazi lwe-periosteum. isikafula siyalastiki. Phambi komthwalo, kukho ukuvuselela uxinzelelo phakathi kweebhloko zokuphuka, ezilungele ukubunjwa kwefowuni kunye nokuphulukiswa kokuphuka.

Emva kokuqhekeka kwe-maxillofacial, ikakhulu ukunciphisa kunye nokulungiswa.Umqondiso obalulekileyo wokunciphisa ukuphuka komhlathi kukubuyisela ubudlelwane obuqhelekileyo be-occlusal yamazinyo aphezulu nangaphantsi, oko kukuthi, unxibelelwano olubanzi lwamazinyo.Ngaphandle koko kuya kuchaphazela ukubuyiswa komsebenzi we-mastication emva kokuphulukiswa kokuphuka.Kukho iindlela ezintathu eziqhelekileyo zokusetha kwakhona:

I-1.Ukunciphisa ukukhwabanisa: kwinqanaba lokuqala lokuqhekeka komhlathi, icandelo le-fracture lisebenza ngokulinganayo, kwaye i-displaced fracture segment ingabuyiselwa kwindawo eqhelekileyo ngesandla.

I-2. Ukunciphisa i-Traction: emva kokuphuka komhlathi, emva kwexesha elide (ngaphezu kweeveki ezintathu ze-maxilla, ngaphezu kweeveki ezine ze-mandible), i-fracture inenxalenye ye-fibrous tishu yokuphulukisa, ukunciphisa i-manual ayiphumelelanga, indlela yokunciphisa i-traction ingasetyenziswa. i-arch splint, kwaye ke phakathi kwe-arch arch splint kunye ne-maxillary, kunye nebhendi encinci yerabha ye-elastic traction, ukwenzela ukuba ngokuthe ngcembe ibuyisele ubudlelwane obuqhelekileyo be-occlusal.Emva kokuphulwa kwe-maxillary fracture, ukuba i-fracture segment shifts back back, i-dental arch splint inokufakwa kwi-maxillary arch caption kunye ne-dentition ye-metal. Ukutsalwa kwe-elastic kungenziwa phakathi kwe-arch arch splint kunye ne-bracket yentsimbi, ukwenzela ukuba i-maxillary fracture segment ingabuyiselwa phambili.I-Horizontal gravity traction ingasetyenziselwa xa kufuneka i-traction force enkulu.

I-3.Ukunciphisa okuvulekileyo: Izibonakaliso zokunciphisa okuvulekileyo zibanzi.Ukunciphisa okuvulekileyo kufuneka kwenziwe xa isahlulo se-fracture sisuswa ixesha elide kwaye kukho ukuphulukiswa kwe-fibrous okanye ukuphulukiswa kwe-bony malalignment, kwaye ukunciphisa akukwazi ukufezekiswa ngokuguqulwa okanye ukunyathela. iphinde ihlanjululwe ukuze ibuyele kwindawo yayo eqhelekileyo.Ukunciphisa okuvulekileyo ngokuqhelekileyo kusetyenziselwa ukuphuka okutsha okanye ukuvuleka okuvulekileyo ngobunzima bokunciphisa ngesandla okanye ukungazinzi emva kokunciphisa.