Nzira yekudzivirira sei 'in-out-in' kuiswa kwefemoral neck screws panguva yekuvhiyiwa?

“Pakutyoka kwemutsipa kwevakadzi vasiri vachembera, nzira inonyanyo shandiswa mukati ndiyo 'inverted triangle' ine screws nhatu.Makukuru maviri akaiswa padhuze kune anterior uye posterior cortices yefemoral neck, uye imwe screw yakaiswa pazasi.Mukuona kwe anteroposterior, ma screws maviri epadyo anopindirana, achigadzira '2-screw' pateni, nepo mukuona kwe lateral, '3-screw' pateni inocherechedzwa.Iyi gadziriso inoonekwa seyakanyanya kunaka nzvimbo yekuisa screws. "

“Iyo inonzi medial circumflex femoral artery ndiyo inonyanya kupa ropa kumusoro wemukadzi.Kana mascrews akaiswa 'in-out-in' pamusoro peiyo posterior yehuro yemukadzi, inoisa njodzi yeiatrogenic vascular kukuvara, zvinogona kukanganisa kubuda kweropa kumutsipa wemukadzi uye, zvichikonzera kuporeswa kwemapfupa. "

"Kudzivirira kuitika kwechiitiko che'in-out-in' (IOI), apo screws dzinopfuura nekunze kwecortex yehuro yemukadzi, ichibuda mucortical bone, uye kupindazve muhuro hwemukadzi uye musoro, nyanzvi mukati nekunze. vakashandisa nzira dzakasiyana dzekuongorora dzebetsero.Iyo acetabulum, iri pamusoro pekunze kweiyo femoral mutsipa, ndeye concave depression mufupa.Nokudzidza hukama huri pakati pema screws akaiswa pamusoro pemashure ehuro hwemukadzi uye acetabulum mune anteroposterior view, munhu anogona kufanotaura kana kuongorora njodzi yescrew IOI.

▲ Mufananidzo unoratidza cortical bone imaging yeacetabulum mu anteroposterior view of the hip joint.

Chidzidzo chacho chaisanganisira varwere ve104, uye hukama huri pakati pekortical bone yeacetabulum nemashure emashure akaongororwa.Izvi zvakaitwa kuburikidza nekuenzanisa pa-X-rays uye inowedzerwa ne postoperative CT reconstruction kuti iongorore hukama huri pakati pezviviri.Pakati pevarwere ve104, 15 yakaratidza zvakajeka IOI chiitiko pa-X-rays, 6 yakanga ine data isina kukwana yekufungidzira, uye 10 yakanga ine screws yakamira pedyo zvakanyanya nepakati pemutsipa wemukadzi, zvichiita kuti kuongororwa kusashanda.Naizvozvo, huwandu hwemakumi manomwe nenhatu ematare edzimhosva akabatanidzwa mukuongorora.

Mumakesi makumi manomwe nenhatu akaongororwa, paX-rays, makesi makumi mana nemaviri aive nema screws akaiswa pamusoro pe cortical bone yeacetabulum, ukuwo makumi matatu nerimwe aive nema screws pazasi.CT simbiso yakaratidza kuti chiitiko cheIOI chakaitika mu59% yezviitiko.Ongororo yedata inoratidza kuti paX-rays, screws yakaiswa pamusoro pecortical bone yeacetabulum yaive nekunzwa kwe90% uye chaiyo ye88% mukufanotaura chiitiko cheIOI.

▲ Case One: Hip joint X-ray mu anteroposterior view inoratidza screws yakaiswa pamusoro pe cortical bone yeacetabulum.CT coronal uye transverse maonero anosimbisa kuvapo kweIOI phenomenon.

▲ Nyaya Yechipiri: Hip joint X-ray mu anteroposterior view inoratidza screws yakamira pasi pe cortical bone yeacetabulum.CT coronal uye transverse maonero anosimbisa kuti posterior screws ari zvachose mukati pfupa cortex.