Kutyoka kwemutsipa wemukadzi kunowanzoonekwa uye kunogona kukanganisa zvikuru vanachiremba vemapfupa, nekuda kweropa risina kusimba, kuwanda kwekutyoka kwemutsipa wemukadzi kusina kubatana uye osteonecrosis kwakakwira, kurapwa kwakakodzera kwekutyoka kwemutsipa wemukadzi kuchiri kukakavadzana, nyanzvi zhinji dzinofunga kuti varwere vane makore anopfuura makumi matanhatu nemashanu ekuberekwa vanogona kutariswa kuti vabatwe arthroplasty, uye varwere vari pasi pemakore makumi matanhatu nemashanu ekuberekwa vanogona kusarudzwa kuti vabatwe internal fixation surgery, uye kukanganisa kukuru pakuyerera kweropa kunokonzerwa nekutyoka kwemutsipa wemukadzi wechidiki wechikamu che ...
Zvinotevera ndizvo zvinoitika pakutyoka kwemutsipa wefemoral kuti tikurukure maitiro ekugadzirisa mutsipa wemukati uchishandisa sikuruu ine kannulated.
Ⅰ Ruzivo rwekutanga nezvenyaya yacho
Ruzivo rwemurwere: murume ane makore makumi mana nemashanu ekuberekwa
Chichemo: kurwadziwa kwehudyu yeruboshwe uye kusaita zvakawanda kwemaawa matanhatu.
Nhoroondo: Murwere akawira pasi achigeza, zvichikonzera kurwadziwa muhudyu yekuruboshwe uye kudziviswa kwekushanda, izvo zvaisagona kuderedzwa nekuzorora, uye akapinda muchipatara chedu nekutyoka kwemutsipa wefemur yekuruboshwe paradiographs, uye akapinda muchipatara aine pfungwa dzakachena uye mweya wakashata, achinyunyuta nezvekurwadziwa muhudyu yekuruboshwe uye kudziviswa kwekushanda, uye akanga asina kudya uye akanga asina kuzvisunungura kubva pakufamba kwedumbu kechipiri mushure mekukuvara.
Ⅱ Kuongorora Muviri (Kuongorora Muviri Wese & Kuongorora Nyanzvi)
T 36.8°C P87 kurova/min R20 kurova/min BP135/85mmHg
Kukura kwakajairika, kudya kwakanaka, nzvimbo isina kugadzikana, pfungwa dzakachena, kushanda pamwe chete pakuongorora. Ruvara rweganda rwakajairika, runopfava, hapana mapundu kana mapundu, hapana kukura kwema lymph nodes ari pamusoro mumuviri wese kana munzvimbo yemuno. Saizi yemusoro, chimiro chakajairika, hapana kurwadziwa kwekumanikidzwa, huremu, bvudzi rinopenya. Mapundu ese ari maviri akaenzana pahukuru uye akatenderera, ane chiedza chinonzwa. Mutsipa waive wakapfava, trachea yaive pakati, thyroid gland haina kukura, chipfuva chaive chakaenzana, kufema kwaive kwakapfupika zvishoma, hapana kusagadzikana pa cardiopulmonary auscultation, miganhu yemoyo yaive yakajairika pakurova, kurova kwemoyo kwaive 87 beats/min, rhythm yemoyo yaive Qi, dumbu raive rakati sandara uye rakapfava, hapana kurwadziwa kwekumanikidzwa kana marwadzo ekudzokera shure. Chiropa ne spleen hazvina kuonekwa, uye hapana kurwadza muitsvo. Diaphragms dzepamberi nedzepashure hadzina kuongororwa, uye hapana kuremara kwemusana, makumbo ekumusoro nemakumbo erudyi epasi, nekufamba kwakajairika. Kufema kwaivepo pakuongorora kwetsinga uye kufema kwaivepo.
Pakanga pasina kuzvimba kuri pachena kwehudyu yekuruboshwe, kurwadziwa kuri pachena pakati pegono rekuruboshwe, kupfupika kwekutenderera kwekunze kwegumbo reruboshwe, kunyorova kwegumbo reruboshwe (+), kusashanda zvakanaka kwehudyu yeruboshwe, kunzwa uye kushanda kwezvigunwe zvishanu zvegumbo reruboshwe zvakanga zvakanaka, uye kuputika kwetsinga dzemusana kwetsoka kwaive kwakajairika.
Ⅲ Kuongororwa kwekubatsira
Firimu reX-ray rakaratidza: kutyoka kwemutsipa wekuruboshwe wefemoral subcapital, kutyoka kwemugumo wakatyoka.
Zvimwe zvese zvakaongororwa nemakemikari, X-ray yechipfuva, bone densitometry, uye ultrasound yemavara etsinga dzakadzika dzemakumbo epasi hazvina kuratidza kusarongeka kuri pachena.
Ⅳ Kuongororwa uye kuongororwa kwakasiyana
Zvichienderana nenhoroondo yemurwere yekukuvara, kurwadziwa kwehudyu yekuruboshwe, kuganhurirwa kwemabasa, kuongororwa kwemuviri kwechikamu chezasi chekuruboshwe kupfupikisa kutenderera kwekunze, kurwadza kwegokora kuri pachena, kurwadziwa kwechikamu chezasi chekuruboshwe (+), kusashanda zvakanaka kwehudyu yeruboshwe, pamwe chete nefirimu reX-ray zvinogona kuonekwa zvakajeka. Kutyoka kwetrochanter kunogonawo kuva nekurwadziwa kwehudyu uye kuganhurirwa kwemabasa, asi kazhinji kuzvimba kwenzvimbo yacho kunoonekwa, nzvimbo yekumanikidza iri mutrochanter, uye kona yekutenderera yekunze yakakura, saka inogona kusiyaniswa nayo.
Ⅴ Kurapa
Kudzikisa kwakavharwa uye kugadzika kwemukati wezano rakavhurika kwakaitwa mushure mekuongororwa kwakazara.
Firimu repamberi pekuvhiyiwa rakaita serinotevera
Kufamba nekufamba nemukati megumbo rakakanganiswa nekudhonzwa kwegumbo rakakanganiswa nekubviswa zvishoma kwegumbo rakakanganiswa mushure mekugadziriswa uye fluoroscopy yakaratidza kudzorerwa kwakanaka.
Pini yeKirschner yakaiswa pamusoro pemuviri yakananga kumutsipa wefemoral kuti iongororwe, uye ganda diki rakachekwa zvichienderana nenzvimbo yekuguma kwepini.
Pini inotungamirwa inopinzwa mumutsipa wefemoral yakatarisana nepamusoro pemuviri nenzira yeKirschner pin uku ichiramba yakatsveyama kwepamberi kwemadhigirii angangoita gumi nemashanu uye fluoroscopy inoitwa.
Pini yechipiri inopinzwa nepaburi refemoral uchishandisa gwara rakafanana nerutivi rwezasi rwegwara repini yekutanga inopinzwa.
Tsono yechitatu inopinzwa yakatarisana nekumashure kwetsono yekutanga kuburikidza negwara.
Uchishandisa mufananidzo we fluoroscopic we divi re datya, mapini ese matatu eKirschner akaonekwa ari mukati memutsipa we femoral
Boora maburi uchienda kune pini yekutungamira, yera kudzika wobva wasarudza kureba kwakakodzera kwechipikiri chine mhango chakasungirirwa pamwe nepini yekutungamira, zvinokurudzirwa kutanga waisa chipikiri chemusana wechikadzi chechipikiri chine mhango, izvo zvinogona kudzivirira kurasikirwa nekugadziriswazve.
Skurura mamwe masikuru maviri akaputirwa muchina mumwe mushure memumwe woona nepakati
Kuchekwa kweganda
Firimu rekuongorora mushure mekuvhiyiwa
Zvichienderana nezera remurwere, rudzi rwekutyoka, uye kunaka kwemapfupa, kugadziriswa kwemukati kwezvipikiri zvisina kuvharwa kwakafarirwa, izvo zvine zvakanakira kukuvara kudiki, mhedzisiro yekusimbisa yakasimba, kushanda kuri nyore uye kuri nyore kugona, inogona kudzvanywa nesimba, chimiro chisina kuvhurika chinobatsira kudzikamisa kudzvanywa kwemumusoro, uye mwero wekupora kwekukuvara wakakwira.
Pfupiso
1 Kuiswa kwetsono dzaKirschner pamusoro pemuviri ne fluoroscopy kunobatsira pakuona nzvimbo nekwakananga kwetsono uye huwandu hweganda rakachekwa;
2 Mapini matatu eKirschner anofanira kunge akafanana, akatenderedzwa, uye ari pedyo nemupendero sezvinobvira, izvo zvinobatsira kuti kukuvara kugadzikane uye kudzvanywa kutsvedzerere gare gare;
3 Nzvimbo yekupinda yeKirschner pin yepasi inofanira kusarudzwa pamucheto wepamusoro wefemoral kuti ive nechokwadi chekuti pin iri pakati pemutsipa wefemoral, nepo magumo emapini maviri epamusoro achigona kutsvedzwa mberi nekumashure achitevedza mucheto wepamusoro kuti zviite nyore kunamira;
4 Usarovere pini yeKirschner yakadzika zvakanyanya panguva imwe chete kuti usapinde pamusoro pe articular, drill bit inogona kuboorwa nepakati pe fracture line, imwe ndeyekudzivirira kuboorwa nepakati pe femoral head, uye imwe inobatsira kuti nzara dziome;
5. Zvikuruu zvisina maburi zvakasungirirwa mukati menguva pfupi uye zvishoma nezvishoma, sarudza kuti kureba kwezvikuruu zvisina maburi kwakarurama, kana kureba kwacho kusiri kure zvakanyanya, edza kudzivirira kutsiva zvikuruu kakawanda, kana osteoporosis, kutsiva zvikuruu zvisingashande, kuti murwere azive kuti zvinogadzirisa zvikuruu zvinobudirira, asi kureba kwezvikuruu kwakaipa zvishoma pane kureba kwekugadziriswa kusina kushanda kwezvikuruu zviri nani!
Nguva yekutumira: Ndira-15-2024
