Kuputsika kwenharaunda ye intertrochanteric yefemur account ye 50% yehudyu kuputsika uye ndiyo inowanzoita rudzi rwekuputsika muvarwere vakwegura.Intramedullary nail fixation ndiyo chiyero chegoridhe chekuvhiya kurapwa kwe intertrochanteric fractures.Pane kubvumirana pakati pevavhiyi vemapfupa kuti vadzivise "shorts effect" nekushandisa mbambo refu kana pfupi, asi ikozvino hapana kubvumirana pamusoro pechisarudzo pakati pezvipikiri zvenguva refu uye pfupi.
Mukufungidzira, zvipikiri zvipfupi zvinogona kupfupisa nguva yekuvhiya, kuderedza kurasikirwa kweropa, uye kudzivisa kudzokororwa, nepo zvipikiri zvirefu zvichipa kugadzikana kuri nani.Panguva yekupinza zvipikiri, nzira yakajairika yekuyera kureba kwembambo refu ndeyekuyera hudzamu hwepini yegwara rakaiswa.Zvisinei, nzira iyi kazhinji haina kunyatsojeka, uye kana pane kureba kutsauka, kutsiva intramedullary chipikiri kunogona kutungamirira pakurasikirwa kukuru kweropa, kuwedzera kukuvadzwa kwekuvhiya, uye kuwedzera nguva yekuvhiya.Nokudaro, kana urefu hunodiwa hwechipikiri che intramedullary hunogona kuongororwa zvisati zvaitika, chinangwa chekuisa chipikiri chinogona kuwanikwa mukuedza kumwe chete, kudzivisa njodzi dzinoshandiswa.
Kugadzirisa dambudziko iri rekiriniki, nyanzvi dzekune dzimwe nyika dzakashandisa intramedullary chipikiri chekuisa bhokisi (Bhokisi) kufanovhiya kuongorora kureba kweiyo intramedullary chipikiri pasi pefluoroscopy, inonzi "Bhokisi maitiro".The Clinical application effect yakanaka, sezvakagoverwa pazasi:
Kutanga, isa murwere pamubhedha wekudhonza uye ita muitiro wakavharwa kuderedzwa pasi pekudhonza.Mushure mekuwana kudzikiswa kunogutsa, tora isina kuvhurwa intramedullary mbambo (kusanganisira bhokisi rekurongedza) uye isa bhokisi rekurongedza pamusoro pe femur yegumbo rakabatwa:
Nerubatsiro rweC-arm fluoroscopy muchina, iyo proximal chinzvimbo chinonongedza kurongedza kuguma kweiyo intramedullary mbambo ne cortex pamusoro pemutsipa wemukadzi uye kuiisa pane fungidziro yeinopinda mbambo ye intramedullary.
Kana imwe nguva nzvimbo yeproximal ichigutsa, chengetedza nzvimbo yepamusoro, wobva wasundidzira C-ruoko kumagumo ekupedzisira uye ita fluoroscopy kuti uwane yechokwadi lateral maonero emabvi akabatanidzwa.Iyo distal position reference ndiyo intercondylar notch yefemur.Tsiva iyo intramedullary mbambo nehurefu hwakasiyana, uchivavarira kuwana chinhambwe pakati pekupedzisira kwechikadzi intramedullary chipikiri uye intercondylar notch yefemu mukati me 1-3 madhayamita eiyo intramedullary chipikiri.Izvi zvinoratidza kureba kwakakodzera kwembambo ye intramedullary.
Mukuwedzera, vanyori vakatsanangura maitiro maviri ekufungidzira anogona kuratidza kuti intramedullary mbambo yakarebesa:
1. Mugumo wekupedzisira we intramedullary nail inopindirwa mukati mechikamu che 1/3 chechikamu chepamusoro chepatellofemoral (mukati memutsara wakachena mumufananidzo uri pasi apa).
2. Mugumo wekupedzisira we intramedullary nail unopinzwa mukati katatu wakaumbwa nemutsara weBlumensaat.
Vanyori vakashandisa nzira iyi kuyera kureba kwezvipikiri zve intramedullary muvarwere ve21 uye vakawana chiyero chechokwadi che95.2%.Nekudaro, panogona kunge paine nyaya inogona kuitika nenzira iyi: kana chipikiri che intramedullary chikapinzwa munyama yakapfava, panogona kunge paine magnification maitiro panguva yefluoroscopy.Izvi zvinoreva kuti kureba chaiko kwembambo ye intramedullary inoshandiswa ingangoda kupfupika pane preoperative kuyerwa.Vanyori vakacherechedza chiitiko ichi muvarwere vakaoma uye vakaratidza kuti kune varwere vakaoma zvakanyanya, kureba kwechipikiri che intramedullary kunofanira kupfupikiswa zvine mwero panguva yekuyera kana kuvimbisa kuti kureba pakati pekupedzisira kweiyo intramedullary nail uye intercondylar notch yefemur iri mukati. 2-3 madhayamita eiyo intramedullary chipikiri.
Mune dzimwe nyika, zvipikiri zve intramedullary zvinogona kurongedzerwa mumwe nemumwe uye pre-sterilized, asi kazhinji, kureba kwakasiyana kwezvipikiri zve intramedullary zvinosanganiswa pamwe chete uye sterilized pamwe chete nevagadziri.Nekuda kweizvozvo, zvingave zvisingakwanisi kuongorora kureba kwembambo ye intramedullary isati yaitwa sterilization.Nekudaro, maitiro aya anogona kupedzwa mushure mekunge ma sterilization drapes aiswa.
Nguva yekutumira: Kubvumbi-09-2024
