Kutyoka kwechiuno pakati petrochanteric kunokonzera 50% yekutyoka kwechiuno muvanhu vakwegura. Kurapa kwakarongeka kunowanzo kukonzera matambudziko akadai se deep vein thrombosis, pulmonary embolism, pressure longs, uye hutachiona hwemapapu. Huwandu hwerufu mukati megore rimwe hunodarika 20%. Saka, muzviitiko apo mamiriro emuviri wemurwere anobvumira, kuvhiyiwa kwekutanga kwemukati memuviri ndiyo nzira inonyanya kufarirwa yekutyoka kwechiuno pakati petrochanteric.
Kugadziriswa kwemukati wezano mukati memudumbu ndiyo nzira yakanakisisa yekurapa kutyoka kwemukati memudumbu. Muzvidzidzo pamusoro pezvinhu zvinopesvedzera kugadziriswa kwemukati memudumbu kwePFNA, zvinhu zvakaita sehurefu hwenzara dzePFNA, angle yevarus, uye dhizaini zvakataurwa muzvidzidzo zvakawanda zvekare. Zvisinei, hazvisati zvajeka kana ukobvu hwenzara huru huchikanganisa mhedzisiro yekushanda. Kuti vagadzirise izvi, nyanzvi dzekune dzimwe nyika dzakashandisa nzara dzemukati memudumbu dzine hurefu hwakaenzana asi hwakasiyana kugadzirisa kutyoka kwemukati memudumbu muvanhu vakwegura (vane makore anopfuura makumi mashanu), vachivavarira kuenzanisa kana paine mutsauko mumhedzisiro yekushanda.
Chidzidzo ichi chaisanganisira nyaya 191 dzekutyoka kwetsinga dzemusana dzinoti unilateral intertrochanteric fractures, dzese dzakarapwa nePFNA-II internal fixation. Kana tsinga diki yakatyoka ndokubviswa, nzara pfupi ye200mm yakashandiswa; kana tsinga diki yakabviswa kana kuti isina kubviswa, nzara pfupi ye170mm yakashandiswa. Dhayamita yenzinga huru yaive pakati pe9-12mm. Kuenzanisa kukuru muchidzidzo ichi kwakatarisana nezviratidzo zvinotevera:
1. Upamhi hushoma hwetrochanter, kuti uone kana nzvimbo yacho yaive yakajairika;
2. Hukama huripo pakati pechikamu chepakati chemusoro nemutsipa nechikamu chiri kure, kuti tiongorore kunaka kwekudzikira;
3. Nharaunda yeTip-Apex (TAD);
4. Chiyero chenzara-ku-mugero (NCR). NCR chiyero chedhayamita huru yenzara kusvika kudhayamita yemugero wepakati padivi resikuruu rinokiya.
Pakati pevarwere 191 vakabatanidzwa, kugoverwa kwezvirwere zvichibva pakureba uye dhayamita yenzara huru kunoratidzwa mumufananidzo unotevera:
Avhareji yeNCR yaive 68.7%. Tichishandisa avhareji iyi semuganho, vanhu vane NCR yakakura kupfuura avhareji vaionekwa sevane dhayamita hombe yechipikiri, nepo vanhu vane NCR iri pasi peavhareji vaionekwa sevane dhayamita hombe yechipikiri. Izvi zvakaita kuti varwere vagovaniswe muboka reThick Main Nail (90 kesi) neboka reThin Main Nail (101 kesi).
Zvakabuda zvinoratidza kuti pakanga pasina musiyano wakakosha pakati peboka reThick Main Nail neboka reThin Main Nail maererano neTip-Apex Distance, Koval score, kunonoka kupora, kuvhiyiwazve, uye matambudziko emapfupa.
Zvakafanana nekudzidza uku, pane chinyorwa chakabudiswa mu "Journal of Orthopaedic Trauma" muna 2021: [Musoro weChinyorwa].
Chidzidzo ichi chaisanganisira varwere 168 vakwegura (vane makore anopfuura 60) vane mitsetse yakatyoka pakati pechiropa, vese vakarapwa nenzara dze cephalomedullary. Zvichibva padhayamita yechiropa chikuru, varwere vakakamurwa kuva boka re 10mm neboka rine dhayamita inodarika 10mm. Zvakabuda zvakaratidzawo kuti pakanga pasina mutsauko wakakosha muhuwandu hwekuvhiyiwazve (kungave kwese kana kuti kwete kwekutapurirana) pakati pemapoka maviri aya. Vanyori vechidzidzo ichi vanoti, muvarwere vakwegura vane mitsetse yakatyoka pakati pechiropa, kushandisa mitsetse mikuru ine dhayamita ye 10mm kwakakwana, uye hapana chikonzero chekuisanganisa zvakanyanya, sezvo ichigona kuwana mhedzisiro yakanaka yekushanda.
Nguva yekutumira: Kukadzi-23-2024
