[Ortho] Осложнение после остеосинтеза локтевой кости

[Alexey Semenisty]

пёп╡п╟п╤п╟п╣п╪я▀п╧ п░п╫я┌п╬п╫!

23.12.07, orthoforum на weborto.net <orthoforum на weborto.net> п╫п╟п©п╦я│п╟п╩:

>
> п÷я─п╦ п╡я│п╣п╪ я┐п╡п╟п╤п╣п╫п╦п╦ п╨ п▓п╟я┬п╣п╪я┐ п╬п©я▀я┌я┐, п░п╫п╢я─п╣п╧, п╫п╣ п╪п╬пЁя┐ я│ п▓п╟п╪п╦ я│п╬пЁп╩п╟я│п╦я┌я▄я│я▐ п©п╬
> п©п╬п╡п╬п╢я┐: "1/3 я┌я─я┐п╠я┤п╟я┌п╟я▐ п©п╩п╟я│я┌п╦п╫п╟ п╫п╣ п©я─п╦п╪п╣п╫я▐п╣я┌я│я▐ п╡ п╩п╣я┤п╣п╫п╦п╦ п╢п╦п╟я└п╦п╥п╟я─п╫я▀я┘
> п©п╣я─п╣п╩п╬п╪п╬п╡ п©я─п╣п╢п©п╩п╣я┤я▄я▐".


п╞ п©п╬п╩п╫п╬я│я┌я▄я▌ я│п╬пЁп╩п╟я│п╣п╫, п░п╫я┌п╬п╫, я│ п▓п╟я┬п╦п╪ п╫п╣я│п╬пЁп╩п╟я│п╦п╣п╪ я│ п░.п▓п╬п╩п╫п╬п╧. п■п╣п╧я│я┌п╡п╦я┌п╣п╩я▄п╫п╬
1\3 я┌я─я┐п╠я┤п╟я┌п╟я▐ п╣я┴п╣ п╨п╟п╨!!! п©я─п╦п╪п╣п╫я▐п╣я┌я│я▐ п╫п╟ п©я─п╣п╢п©п╩п╣я┤я▄п╣.



> п║п╬пЁп╩п╟я│п╣п╫, 1/3 я┌я─я┐п╠я┤п╟я┌п╟я▐ п©п╩п╟я│я┌п╦п╫п╟ п╫п╣ п╦п╪п╣п╣я┌ п╨п╬п╪п╠п╦п╫п╦я─п╬п╡п╟п╫п╫я▀я┘ п╬я┌п╡п╣я─я│я┌п╦п╧ п╢п╩я▐
> п╨п╬п╪п©я─п╣я│я│п╦п╦,


п░ п╡п╬я┌ п╥п╢п╣я│я▄ п╫п╣ я│п╬пЁп╩п╟я│п╣п╫! пё п╬я─п╦пЁп╦п╫п╟п╩я▄п╫п╬п╧ 1\3 я┌я─я┐п╠п╨п╦ п╬я┌п╡п╣я─я│я┌п╦я▐ я│ п╡п╬я─п╬я┌п╫п╦я┤п╨п╬п╪
 п╬п╡п╟п╩я▄п╫я▀п╣ п╦ п©п╬п╥п╡п╬п╩я▐я▌я┌ п╫п╣п╨п╬я┌п╬я─я┐я▌ п╨п╬п╪п©я─п╣я│я│п╦я▌ ( AO Principles..2000, p.174)



> я┤я┌п╬, п╠п╣п╥я┐я│п╩п╬п╡п╫п╬, п╡п╟п╤п╫п╬ п©я─п╦ я┌п╟п╨п╬п╪ я┌п╦п©п╣ п©п╣я─п╣п╩п╬п╪п╟.


п÷я─п╦ п╨п╟п╨п╬п╪ я┌п╦п©п╣ п©п╣я─п╣п╩п╬п╪п╟? п п╟п╤п╣я┌я│я▐, п╬п╠я│я┐п╤п╢п╟п╩п╬я│я▄ п╨п╬п╫п╨я─п╣я┌п╫п╬п╣ п╬я│п╩п╬п╤п╫п╣п╫п╦п╣.



> п²п╬,
> п╡п╬-п©п╣я─п╡я▀я┘, я┘п╦я─я┐я─пЁ п╡я│п╣пЁп╢п╟ п╪п╬п╤п╣я┌ п©я─п╦п╪п╣п╫п╦я┌я▄ п╨п╬п╪п©я─п╣я│я│п╦я─я┐я▌я┴п╣п╣ я┐я│я┌я─п╬п╧я│я┌п╡п╬
> (я─п╟п╥я─п╟п╠п╬я┌п╟п╫п╫п╬п╣ п░п·),


п²п╦пЁп╢п╣ п╫п╣ п╫п╟п╧п╢я┐ п╬п©п╦я│п╟п╫п╦я▐ п©я─п╦п╪п╣п╫п╣п╫п╦я▐ п╨п╬п╪п©я─п╣я│я│п╦я─я┐я▌я┴п╣пЁп╬ я┐я│я┌я─п╬п╧я│я┌п╡п╟ (п░п·) я│ 1\3
я┌я─я┐п╠я┤п╟я┌п╬п╧ п©п╩п╟я│я┌п╦п╫п╬п╧



> п╟ п╡п╬-п╡я┌п╬я─я▀я┘, я┤п╦я┌п╟я▐ я│я│я▀п╩п╨я┐, п╨п╬я┌п╬я─я┐я▌ п▓п╚ я│п╟п╪п╦ я│п╨п╦п╫я┐п╩п╦
> п╪п╬п╩п╬п╢п╬п╪я┐ п╨п╬п╩п╩п╣пЁп╣ (п∙п╡пЁп╣п╫п╦п╧ п╔п╟п╩п╦п╪п╟п╫ [п≤я─п╨я┐я┌я│п╨]) п╪я▀ п╪п╬п╤п╣п╪ п©я─п╬я┤п╦я┌п╟я┌я▄:One-third
> tubular plates are adequate only for very distal fractures
> (п©я─п╦п╪п╣п╫п╦я┌п╣п╩я▄п╫п╬ п╨ п©п╣я─п╣п╩п╬п╪я┐ п╩п╬п╨я┌п╣п╡п╬п╧ п╨п╬я│я┌п╦).


п∙я│п╩п╦ п╪п╬п╤п╫п╬, п╢п╟п╧я┌п╣ п╠п╬п╩п╣п╣ я┌п╬я┤п╫я▀п╧ п╟п╢я─п╣я│ пЁп╢п╣ я█я┌п╬ п╫п╟п©п╦я│п╟п╫п╬ п╢п╬я│п╩п╬п╡п╫п╬.
п░ п╡п╬я┌ п╫п╟ я│я┌я─ 174 ( AO Principles... 2000) п╢п╣п╧я│я┌п╡п╦я┌п╣п╩я▄п╫п╬ я│п╨п╟п╥п╟п╫п╬: ... As it
is only 1,0 mm thick, its ability to confer stability is somewhat limited.
However, it may be useful in areas with minimal soft-tissue covering, such
as the lateral malleolus, the olecranon and the distal end of the ulna



> п╒.п╣. п╡я│п╣ п╤п╣ п╦я│п©п╬п╩я▄п╥я┐п╣я┌я│я▐ п╡
> п╫п╣п╨п╬я┌п╬я─я▀я┘ я│п╩я┐я┤п╟я▐я┘.


п╒.п╣. п╡ п╫п╣п╨п╬я┌п╬я─я▀я┘ я│п╩я┐я┤п╟я▐я┘ п╢п╬п©я┐я│п╨п╟п╣я┌я│я▐. п²п╬ п╫п╟ AO Surgery Reference п╡ я│п╩я┐я┤п╟п╣
п╢п╦я│я┌п╟п╩я▄п╫я▀я┘ п©п╣я─п╣п╩п╬п╪п╬п╡ п╩п╬п╨я┌п╣п╡п╬п╧ п╨п╬я│я┌п╦ я─п╣п╨п╬п╪п╣п╫п╢я┐п╣я┌я│я▐ 2,4 LC-DCP (
http://www.aofoundation.org/portal/wps/portal/!ut/p/_s.7_0_A/7_0_96E/.cmd/ad/.c/6_0_5OI/.ce/7_0_96I/.p/5_0_7N5/.d/3?showPage=redfix&bone=Radius&segment=Distal&classification=23-A1.2&treatment=&method=ORIF+-+Open+reduction+internal+fixation&implantstype=Bridging+plate&approach=&redfix_url
)=




>  ... п╬я┤п╣п╫я▄ п╫п╣ п╩я▌п╠п╩я▌, п╨п╬пЁп╢п╟
> п╡п╪п╣я│я┌п╬ п╬п╠я┼я▐я│п╫п╣п╫п╦п╧ (п╬ п╨п╬я┌п╬я─я▀я┘, п╨я│я┌п╟я┌п╦, п╡п╣п╤п╩п╦п╡п╬ п©п╬п©я─п╬я│п╦п╩п╦) п╪п╬п╩п╬п╢п╬пЁп╬
> п╨п╬п╩п╩п╣пЁя┐ п©п╬я│я▀п╩п╟я▌я┌ я┤п╦я┌п╟я┌я▄ п╡п╣я│я▄ я─п╟п╥п╢п╣п╩ Surgery.


п·я┌п╡п╣я┤п╟я▐ п╫п╣ п╫п╟ п╡я│п╣ п╡п╬п©я─п╬я│я▀, п╥п╟п╢п╟п╡п╟п╣п╪я▀п╣ п╫п╟ я└п╬я─я┐п╪п╣, п╣я│я┌я▄ я│п╪я▀я│п╩ п©п╣я─п╣я│п╨п╟п╥я▀п╡п╟я┌я▄,
я┌п╬ я┤я┌п╬ п╩я▌п╠п╬п╧ п©п╬п╩я▄п╥п╬п╡п╟я┌п╣п╩я▄ п╦п╫я┌п╣я─п╫п╣я┌п╟ (п╟ п╥п╫п╟я┤п╦я┌ п╦ п©п╬я│п╣я┌п╦я┌п╣п╩я▄ я█я┌п╬пЁп╬
я└п╬я─я┐п╪п╟) п╪п╬п╤п╣я┌ п╩п╣пЁп╨п╬ п╫п╟п╧я┌п╦ п╡ п╣пЁп╬ п╠п╣п╥пЁя─п╟п╫п╦я┤п╫я▀я┘ п©я─п╬я│я┌п╬я─п╟я┘, п╨п╬я─я─п╣п╨я┌п╫п╬ п╬п╠п╬п╥п╫п╟я┤п╦п╡
я┐я│п╩п╬п╡п╦я▐ п╦ я┌п╣п╪я┐ п©п╬п╦я│п╨п╟ п©я─п╟п╨я┌п╦я┤п╣я│п╨п╦ п╫п╟ п╩я▌п╠п╬п╪ п©п╬п╦я│п╨п╬п╡п╬п╪ я│п╟п╧я┌п╣
п≤ п╪п╬п╩п╬п╢п╬п╪я┐ п╦ п╪п╟я┌п╣я─п╬п╪я┐ я┌я─п╟п╡п╪п╟я┌п╬п╩п╬пЁя┐ п╫п╦п╨п╬пЁп╢п╟ п╫п╣ п©п╬п╪п╣я┬п╟п╣я┌ п╩п╦я┬п╫п╦п╧ я─п╟п╥ п╥п╟п╧я┌п╦ п╫п╟
я─п╣я│я┐я─я│ AO Surgery Reference

пёп╤ п╨я┌п╬-п╨я┌п╬, п╟ п▓я▀ п╠я▀ п╪п╬пЁп╩п╦ п╦ п╬п╠я┼я▐я│п╫п╦я┌я▄.


п°п╬пЁ - п╫п╣ п╥п╫п╟я┤п╦я┌ п╬п╠я▐п╥п╟п╫.

 п║ я┐п╡п╟п╤п╣п╫п╦п╣п╪, п░.п║п╣п╪п╣п╫п╦я│я┌я▀п╧.
> п⌠п п▒ Б└√ 13, п°п╬я│п╨п╡п╟.
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