Kune marudzi maviri emaitiro ekuvhiya, mapuranga emapuranga uye pini intramuterllary Sarudzo inoenderana neiyo chaiyo saiti uye mhando yekupwanya.
Intramealary Pin Fixation ine zvakanakira kuratidzwa kudiki, kushoma kuremerwa, kushaikwa kwekugadzirisa kwekunze, etc. Izvo zvakaringana 1/3 Kune iyo yepazasi 1/3 kupwanyika, nekuda kweiyo hombe medullary cavity uye yakawanda inokwanisika pfupa
Ini ndakavhura-mukati-yemukati gadziriso yekukanganiswa kwe fract ye femur shaft ine intramedullary mbichana
(1.
Iyo yakazotevera incision inogadzirwa pamutsetse wepakati peiyo trochanter yeiyo femur, uye iyo musanganiswa wekutevera 3.5.5.2-16,3.5.2-2).
Iyo anteerolateral incisier, kune rumwe rutivi, inogadzirwa kuburikidza nemutsara wekunze kwegwendefa rePatella, uye rinowanikwa nemaperembudzi ezvipfuyo zvechikadzi (Fig 3.5.5.2-3).
. Cheka iyo periesteum yekuburitsa iyo yepamusoro uye yakaderera yakaputsika migumo ye femur inopwanya, uye kuburitsa chiyero kusvika pakukwana kuti zvinogona kucherechedzwa uye zvobva zvadzoreredzwa, uye bvisa matishu akapfava zvishoma sezvinobvira.
(3. Kana paine kudzikiswa kweiyo medullary cavity, iyo medullary cavity inowedzera inogona kushandiswa kunyatsogadzirisa uye kuwedzera iyo yemukati, kuitira kuti isingakwanisi kupinda uye kusakwanisa kuburitswa kunze. Gadzirisa iyo proximal yakaputsika mugumo, isa iyo intramedularly Hold Tsono yemukati inobviswa, inotungamirwa, yakapfuura nepamhepo kubva kune yakakura trochantter, uye ndokuzoiswa kune ndege yeicho chechikamu-chikamu. Yakavandudzwa intramedullary inodonhedza ine madiki anotenderedzwa anopera nemakomba ekubvisa. Ipapo hapana chikonzero chekuburitsa kunze uye kushandura kutungamirirwa, uye tsono inogona kurohwa uye ndokuzorohwa kamwechete. Nenzira imwe cheteyo, tsono inogona kuiswa retrogragragragrade nePini yeGrafu uye yakafumurwa kunze kweiyo Great Trochanteric Incision, uyezve iyo Intramedyry PIN inogona kuiswa muzvikamu pakati.
Kuwedzera kudzoreredzwa kwekupwanya. ANatomical alignment inogona kuwanikwa nekushandisa iyo inoshandiswa kweiyo proximal intramedullary pini mune conjunction ine pfupa piry pirry pirl pirthing, traction, uye kupwanyika. Kugadziriswa kunowanikwa neBone Relter, uye iyo Intramedullary Pini inozotyairwa kuitira kuti gungwa rekutyaira ratungamirwa kuenderana nekuenderana nekadzi curvature. Kupera kweshanhire kunofanira kusvika pachikamu chakakodzera chekupedzisira kwekupwanya, asi kwete kuburikidza ne cartilage layer, uye kuguma kweshanje kunofanirwa kusiiwa 2CM kunze kweTrochanter, kuti abviswe gare gare. (Fig 3.5.5.5.2-4).
Mushure mekugadziriswa, edza kungofamba kwekufamba kwegumbo uye kucherechedza chero kusagadzikana. Kana zvichidikanwa kutsiva iyo thicker intramedullary sindano, inogona kubviswa uye yakatsiviwa. Kana paine kusasunungurwa zvishoma uye kusagadzikana, chikwangwani chinogona kuwedzerwa kusimbisa iyo gadziriso. (Fig 3.5.5.2-4).
Ronda rakazoputirwa uye rakavharwa mumatunhu. Anti-ekunze kutenderera Plaster boot anoiswa.
Ii Plate Screw Yemukati Fixation
Kugadziriswa kwemukati ne Simbi Plate Screws inogona kushandiswa muzvikamu zvese zvechikadzi tsinde, asi yakaderera 1/3 inokodzera mhando yerudzi urwu rwekugadziriswa nekuda kwemweya wepakati. General Steel Plate kana AO Compression Steel ndiro inogona kushandiswa. Iyo yekupedzisira yakasimba uye yakasimba isina kugadziriswa pasina yekunze gadziriso. Nekudaro, hapana kana mumwe wavo anogona kudzivirira basa rekushushikana uye kutevedzera musimboti wesimba rakaenzana, izvo zvinoda kuvandudzwa.
Iyi nzira ine huwandu hwakakura hwakakura hwenzvimbo, kugadziriswa kwemukati, kunokanganisa kurapwa, uye zvakare kune zvikanganiso.
Kana paine kushomeka kwepinzvimbo yePIN, yekare frallary curvature kana chikamu chikuru chekusavimbika uye chakadzika-chezasi
.
. Iyo ndiro inofanirwa kuiswa pamusana wekutenderera kwetatu, zviyero zvinofanirwa kupfuura nekoreti pamativi ese maviri, uye kureba kwendima yacho kunofanirwa kunge kuri ka 4-5 yenguva yeiyo pfupa panzvimbo yakatsemuka. Kureba kweplate ndeye 4 kusvika ku8 nguva yedhirowa yefupa rakakombama. 6 kusvika 8 gomba mahwendefa anowanzo shandiswa mu femur. Zvikamu zvakakura zvepafupi zvepfupa zvinogona kuiswa pamwe nekuwedzera zviyero, uye nhamba yakakura yemapuzamu inogona kuiswa panguva imwe chete pane iyo medial dracture. (Fig 3.5.5.5.2-5).
Svina uye kuvhara mumatare. Zvichienderana nerudzi rweplate zviyero zvinoshandiswa, zvakasarudzwa kuti kana kusanyorera kunze kwekugadziriswa ne plaster.
Kutumira Nguva: Mar-27-2024
