Panyaya yemusoro nemutsipa screws, inotora kaviri-screw dhizaini ye lag screws uye compression screws.Iko kusanganiswa kwakasanganiswa kwe2 screws kunowedzera kupikisa kutenderera kwemusoro wemukadzi.
Munguva yekuisa iyo compression screw, iyo axial kufamba kweiyo lag screw inofambiswa neocclusal tambo pakati pe compression screw uye lag screw, uye iyo anti-kutenderera stress inoshandurwa kuita linear compression pamagumo ekutyoka, nekudaro ichiwedzera zvakanyanya. iyo inorwisa-kutenderera simba re screw.Cheka kuita.Iwo maviri screws akabatanidzwa akabatanidzwa kudzivirira iyo "Z" maitiro.
Magadzirirwo emagumo ekupedzisira kwembambo huru yakafanana neyekubatanidza prosthesis inoita kuti muviri wembambo uenderane ne medullary cavity, uye zvakanyanya maererano ne biomechanical maitiro e proximal femur.
Kuvhiya Matanho
Position: Murwere anogona kusarudza lateral kana supine chinzvimbo.Nemurwere ari pachinzvimbo chepamusoro, patafura yekushanda ine radiolucent kana orthopedic traction table.Rutivi rune hutano rwemurwere runowedzerwa uye rwakagadziriswa pachigadziko, uye rutivi rwakakanganiswa runotorwa 10 ° -15 ° kuti iite kuwirirana ne medullary cavity.
Kugadzirisa patsva: Dhonza nhengo yakakanganiswa nemubhedha wekukwevera usati washanda, uye gadzirisa nzira yekufambisa pasi pe fluoroscopy kuitira kuti nhengo yakakanganiswa ive mune zvishoma kutenderera kwemukati uye nzvimbo yekuwedzerwa.Mazhinji mafractures anogona kugadzikiswa zvakanaka.Preoperative reset inonyanya kukosha uye Nyaya yacho ndeyekuti, usaicheka nyore nyore kana pasina kuderedza kunogutsa.Izvi zvinogona kuchengetedza nguva yekushanda uye kuderedza kuoma panguva yekushanda.Kana kuderedzwa kwakaoma, iwe unogona kuita diki incision panguva yekushanda uye shandisa push rod, retractor, reduction forceps, nezvimwewo kubatsira kuderedza.Diki fractures Mativi emukati nekunze akaparadzaniswa, uye hapana chikonzero chekugadzirisa kakawanda.Magumo ekutyoka anogona kugadzikwa otomatiki kana compression screw yaiswa mukati mukati mekushanda.
Kuderedzwa kweiyo trochanter shoma: Dhizaini ye intramedullary nail haidi kuenderera kweiyo medial cortex.Kazhinji kutaura, hapana chikonzero chekudzikisa chidiki chetrochanter fracture fragment, nekuti iyo ishoma invasive yakavharwa yekudzikisa kuvhiyiwa ine kushoma kukonzeresa kutenderera kweropa kwekutyoka kupera, uye kuputsika kuri nyore kupora.Nekudaro, iyo coxa varus inofanirwa kugadziriswa isati yaiswa screw, uye nguva yekuenda pasi uye postoperative uremu-inotakura nguva inofanira kunonoka zvakakodzera.
Incision chinzvimbo: A 3-5 cm longitudinal incision inoitwa pamucheto wepamusoro wepamusoro wetrochanter apex inenge pamwero we anterior superior iliac spine.A Kirschner wire inogona kuiswa kune rumwe rutivi rwekunze kweproximal femur, uye inogadziriswa kuti ienderane neaxis yakareba yefemur pasi peC-arm fluoroscopy, kuitira kuti kuiswa kweiyo incision kwakanyatsojeka.
Sarudza nzvimbo yekupinda: nzvimbo yekupinda inopindirana zvishoma nepamusoro peiyo trochanter yakakura, iyo inofananidzwa ne 4 ° lateral kutsauka kweiyo axis yakareba ye medullary cavity pakatarisana nechemberi.Pamusoro pekuona kwemashure, nzvimbo yekupinda yembambo inowanikwa pane axis yakareba ye medullary cavity;
Tsono Yekupinda Nzvimbo
IsertGuidePin Fluoroscopy
Zvizere Reamed
Sezvo magumo ekupedzisira eInterTan main nail ari mukobvu, chipikiri chinogona kungopinzwa mushure mekudzokorora kuzere panguva yekuvhiya.Iyo proximal reming inofanira kumiswa kana mudziyo wekurambidza we reming drill ukabata yekupinda chiteshi chishandiso.Kunyangwe iyo distal femoral shaft yakadzokororwa zvinoenderana neiyo Saizi yemedullary cavity inotarwa.Kana preoperative X-ray ikaona kuti medullary cavity ye proximal femoral shaft zviri pachena kuti yakamanikana, femoral shaft reamer inofanira kugadzirirwa kusati kwaitwa.Kana iyo reming isina kukwana, zvinoita kuti zviome kuisa screw.Munguva yekugadzira screwing, inogona kuzununguka mudiki diki Zvikamu zvemashure zve intramedullary nail zvinofanirwa kudziviswa, asi kugogodza zvine chisimba pamuswe wechipikiri kunofanira kudziviswa.Kugogodza kwakakasharara kwakadaro kunogona kukonzera kupatsanuka kwepfupa panguva yekushanda kana kudzoreredzwa kwekutyoka mushure mekuderedzwa.
Pinza iro rakapfava rinodzivirira matishu, pinza mukati pamwe newaya yegwaro nechibooreso, uye wedzera chiteshi chefemoral cheiyo intramedullary chipikiri (pamusoro pemufananidzo);kana iyo medullary mhango yakamanikana, shandisa remed yakapfava drill kuti uwedzere medullary cavity kusvika pahupamhi hwakakodzera;batanidza mutungamiri isa InterTAN mbambo huru mukati me medullary cavity (pazasi);
ProximalLock
Lag screw placement
Compression screw placement
Kara mudistal locking chipikiri
RemoteLock
End Cup
Postoperative Kurapa
Mishonga inorwisa mabhakitiriya yaigara ichishandiswa kudzivirira utachiona maawa makumi mana nemasere mushure mekuvhiyiwa;yakaderera-molecular-weight heparin calcium uye mapombi emhepo zvakashandiswa kudzivirira yakadzika vein thrombosis (DVT) mumucheto wezasi, uye zvirwere zvehutano zvekutanga zvakaramba zvichirapwa.Plain radiographs yepelvis uye anteroposterior uye lateral radiographs yejojo yehudyu yakakanganiswa yaigara ichitorwa kuti inzwisise kuderedza kuputsika uye kugadziriswa kwemukati.
Pazuva rokutanga mushure mekuvhiyiwa, murwere akakurudzirwa kuita isometric contraction ye quadriceps femoris mune imwe nzvimbo yakasara.Pazuva rechipiri, murwere akarayirwa kuti agare pamubhedha.Pazuva rechitatu, murwere aishingaira kuita hudyu uye mabvi maitiro ekufambisa pamubhedha.Hapana chinorema panhengo yakabatwa.Kurudzirai varwere vanokwanisa kutakura chikamu chehuremu pamakumbo akabatwa mukati mehutano hunoshivirira mavhiki e4 mushure mekushanda.Zvishoma nezvishoma famba nemufambi ane uremu-kutakura maererano ne-X-ray kutevera pa6 kusvika kumavhiki masere.Varwere vasingakwanisi kufamba vakazvimiririra uye vane osteoporosis yakaoma Kune varwere vane pfupa rinoramba richikura paX-ray, vanogona kufamba zvishoma nezvishoma nekutakura uremu pasi pekutsigirwa.
Munhu Wokuonana: Yoyo (Chigadzirwa Manager)
TEL/Whatsapp: +86 15682071283
Nguva yekutumira: Chivabvu-08-2023
