Kana tichitaura nezve screws dzemusoro nemutsipa, inoshandisa dhizaini yema screws maviri anorema uye anomanikidza. Kubatana kwakabatana kwema screws maviri kunowedzera kuramba kutenderera kwemusoro we femoral.
Munguva yekuisa sikuruu yekumanikidza, kufamba kweaxial kwesikuruu yekunonoka kunofambiswa netambo ye occlusal iri pakati pesikuruu yekumanikidza nesikuruu yekunonoka, uye kushushikana kwe anti-rotation kunoshandurwa kuita linear compression pamucheto wekutyoka, nokudaro zvichiwedzera zvakanyanya simba re anti-rotational resikuruu. Cheka mashandiro. Masikuruu maviri akabatana kuti asaite "Z".
Magadzirirwo emucheto wepazasi penzara huru akafanana neepazasi penzara anoita kuti muviri wenzara unyatsoenderana nepazasi penzara, uye unoenderana nehunhu hwemuviri wepazasi penzara.
Matanho Ekuvhiya
Chinzvimbo: Murwere anogona kusarudza nzvimbo iri kurutivi kana kuti yakarara. Murwere ari panzvimbo yakarara, patafura yekuvhiya ine radiolucent kana tafura yekudhonza majoini. Rutivi rwakanaka rwemurwere runodhonzwa uye runosungirirwa pabhuraketi, uye divi rakakanganiswa rinodhonzwa 10°-15° kuti zvive nyore kuenderana ne medullary cavity.
Kugadzirisazve kwakarurama: Kubata gumbo rakabatwa nemubhedha wekukweva usati wavhiyiwa, uye gadzirisa nzira yekukweva uchishandisa fluoroscopy kuitira kuti gumbo rakabatwa rive panzvimbo yekutenderera mukati uye yekukweva. Mazhinji emavanga anogona kugadziriswa zvakanaka. Kugadzirisa patsva usati wavhiyiwa kwakakosha zvikuru uye Pfungwa ndeyekuti, usaricheke zviri nyore kana pasina kudzikiswa kunogutsa. Izvi zvinogona kuchengetedza nguva yekuvhiyiwa uye kuderedza kuoma panguva yekuvhiyiwa. Kana kudzikiswa kwakaoma, unogona kuita kucheka kudiki panguva yekuvhiyiwa uye kushandisa push rod, retractor, reduction forceps, nezvimwewo kubatsira kudzikiswa. Mavanga madiki Mativi emukati nekunze akaparadzaniswa, uye hapana chikonzero chekugadzirisa kakawanda. Mugumo wekukweva unogona kugadziriswa otomatiki kana compression screw yaiswa mukati panguva yekuvhiyiwa.
Kuderedza kwetrochanter shoma: Kugadzirwa kwembambo yemukati medullary hakudi kuti medial cortex irambe iripo. Kazhinji, hapana chikonzero chekuderedza chidimbu che trochanter fracture, nekuti kushanda kwekudzikisa closed reduction kushoma hakukanganisi kufamba kweropa kwechikamu che fracture, uye fracture iri nyore kuporesa. Zvisinei, coxa varus inofanira kugadziriswa isati yaiswa sikuruu, uye nguva yekuenda pasi uye nguva yekutakura huremu mushure mekuvhiyiwa inofanira kunonoka zvakakodzera.
Nzvimbo yekucheka: Kuchekwa kwe 3-5 cm longitudinal kunoitirwa pamucheto we greater trochanter apex anenge padanho re anterior superior iliac spine. Waya yeKirschner inogona kuiswa kudivi rekunze re proximal femur, uye kugadziriswa kuti ienderane ne long axis ye femur pasi peC-arm fluoroscopy, kuitira kuti nzvimbo yekucheka ive yakarurama.
Sarudza nzvimbo yekupinda: nzvimbo yekupinda iri pakati zvishoma nepamusoro pe greater trochanter, iyo inoenderana nekutsauka kwe 4° lateral kwe long axis ye medullary cavity pa frontal view. Pa lateral view, nail entry point iri pa long axis ye medullary cavity;
Nzvimbo yekupinda netsono
InsertaGuidePin Fluoroscopy
Zvizere Ryakagadzirwa
Sezvo mugumo weproximal wembambo huru yeInterTan wakakora zvishoma, mbambo inogona kuiswa chete mushure mekugadziriswa zvizere panguva yekuvhiyiwa. Kugadziriswa kweproximal kunofanira kumiswa kana mudziyo wekudzora wedhiri rekugadzirisa uchibata chishandiso chekupinda. Kuti distal femoral shaft yakagadziriswa here zvinoenderana nehukuru hwemhino yemedullary hwaonekwa. Kana X-ray isati yavhiyiwa ikaona kuti mhino yemedullary yemhino yeproximal femoral shaft yakamanikana zviri pachena, femoral shaft reamer inofanira kugadzirirwa usati wavhiyiwa. Kana kugadziriswa kwemhino kusina kukwana, zvichaita kuti zviome kuisa sikuruu. Munguva yekuvhiyiwa, inogona kuzununguka zvishoma. Zvikamu zveparutivi zvembambo yemukati medullary zvinofanirwa kudzivirirwa, asi kugogodza zvine simba pamuswe wechipikiri kunofanira kudzivirirwa. Kugogodza kwakadaro kunogona kukonzera kutsemuka kwemapfupa panguva yekuvhiyiwa kana kudzoserwa kwekutyoka mushure mekuderedzwa.
Isa chivharo chekudzivirira tissue yakapfava, boora netambo yekutungamira neboora, uye wedzera nzira yepamberi pechikadzi yembambo yemukati memedullary (mufananidzo uri pamusoro); kana mhango yemedullary yakamanikana, shandisa boora rakanyorova kuti uwedzere mhango yemedullary kusvika paupamhi hwakakodzera; batanidza gwara racho isa mbambo huru yeInterTAN mumhango yemedullary (pazasi);
PyakadereraLdanda
Kuisa sikuruu yekunonoka
Kuisa sikuruu yekudzvanya
Skurura chipikiri chinokiya chiri kure
RemoteLdanda
Mukombe weKupera
Kurapa Mushure mekuvhiyiwa
Mishonga inorwisa mabhakitiriya yaishandiswa nguva dzose kudzivirira hutachiona maawa makumi mana nemasere mushure mekuvhiyiwa; heparin calcium ine huremu hushoma uye pombi dzemhepo zvakashandiswa kudzivirira deep vein thrombosis (DVT) mumakumbo epasi, uye zvirwere zvekurapa zvakaramba zvichirapwa. MaX-ray epelvis uye anteroposterior uye lateral radiographs yehudyu yakakanganiswa zvaitorwa nguva dzose kuti zvinzwisiswe kuderedza kutyoka uye kugadzikana kwemukati.
Pazuva rekutanga mushure mekuvhiyiwa, murwere akakurudzirwa kuita isometric contraction ye quadriceps femoris ari panzvimbo yakarara zvishoma. Pazuva rechipiri, murwere akarayirwa kugara pamubhedha. Pazuva rechitatu, murwere akaitwa maekisesaizi ekuchinjika kwechiuno nemabvi pamubhedha. Hapana mutoro wekutakura uremu pagumbo rakakanganiswa. Kurudzira varwere vanokwanisa kutakura chikamu chehuremu pagumbo rakakanganiswa mukati menguva inobvumirwa mavhiki mana mushure mekuvhiyiwa. Famba zvishoma nezvishoma newalker ine mutoro wekutakura huremu zvichienderana nekutevera kweX-ray pamavhiki matanhatu kusvika masere. Varwere vasingagoni kufamba vega uye vane osteoporosis yakanyanya. Kune varwere vane kukura kwemapfupa anoramba achikura paX-ray, vanogona kufamba zvishoma nezvishoma nemutengo wekutakura huremu pasi pekutsigira.
Munhu wekutaura naye: Yoyo (Maneja weChigadzirwa)
Nhare/Whatsapp: +86 15682071283
Nguva yekutumira: Chivabvu-08-2023
