Nzira yekugadzirisa mukati mePFNA
PFNA (Proximal Femoral Nail Antirotation), nzara yemukati memedullary inorwisa kutenderera kwefemoral. Yakakodzera mhando dzakasiyana dzemapundu epakati pefemoral; mapundu epasi petrochanteric; mapundu epasi pemutsipa wefemoral; mapundu emutsipa wefemoral pamwe chete nemapundu emubato wefemoral; mapundu epakati petrochanteric pamwe chete nemapundu emubato wefemoral.
Main nail design maficha uye mabhenefiti
（1） Dhizaini huru yenzara yakaratidzwa nezviitiko zvinopfuura 200,000 zvePFNA, uye yakawana kuenderana kwakanakisisa nechimiro chemugero wemedullary;
（2）Kona yekubviswa kwechipikiri chikuru ine madhigirii matanhatu kuti zvive nyore kupinza kubva pamusoro pechipikiri chikuru chetrochanter；
（3）Nzambo ine maburi, iri nyore kuisa；
（4）Mugumo wekure wenzara huru une kusimba kwakati, izvo zviri nyore kuisa nzara huru uye zvinodzivirira kushushikana.
Chidimbu chemupendero:
(1) Kugadzika kwemukati kamwe chete panguva imwe chete kunopedzisa kudzivirira kutenderera uye kugadzikana kwekona;
(2) Chibage ichi chine nzvimbo yakakura uye dhayamita yepakati inowedzera zvishoma nezvishoma. Nekudzvanya mukati nekudzvanya pfupa rinodzima, simba rekunamatira rebanga rinotenderera rinogona kuvandudzwa, izvo zvinonyanya kukodzera varwere vane mavanga akatyoka;
(3) Chidimbu chemupendero chakabatanidzwa zvakasimba nepfupa, izvo zvinoita kuti pfupa rigare zvakanaka uye rirambe richitenderera. Mugumo wepakaputsika une simba guru rekuputsika uye kukanganisika kwevarus mushure mekunyudzwa.
Zvinhu zvinotevera zvinofanira kutariswa pakurapa kutyoka kwechiuno ne:Kugadziriswa kwemukati kwePFNA:
(1) Varwere vazhinji vakwegura vanotambura nezvirwere zvepakutanga uye havakwanisi kuvhiyiwa zvakanaka. Vasati vavhiyiwa, mamiriro emurwere anofanira kuongororwa zvakakwana. Kana murwere achikwanisa kushivirira kuvhiyiwa, kuvhiyiwa kunofanira kuitwa nekukurumidza sezvinobvira, uye nhengo yakakanganiswa inofanira kuvhiyiwa nekukurumidza mushure mekuvhiyiwa. Kudzivirira kana kuderedza kuitika kwematambudziko akasiyana-siyana;
(2) Upamhi hwechivharo chemukati medullary hunofanira kuyerwa pachine nguva usati wavhiyiwa. Upamhi hwechivharo chikuru chemukati medullary hudiki ne1-2 mm pane chivharo chaicho chemukati medullary, uye hachina kukodzera kuiswa zvine simba kudzivirira kuitika kwematambudziko akadai sekutyoka kwefemur ye distal;
(3) Murwere akarara, gumbo rakakanganiswa rakatwasuka, uye kutenderera kwemukati kuri 15°, izvo zviri nyore kuisa tsono yekutungamira nenzara huru. Kubata kwakakwana uye kuderedza kutsemuka kwakavharwa pasi pe fluoroscopy ndizvo zvinokosha pakuvhiyiwa kunobudirira;
(4) Kusashanda zvakanaka kwenzvimbo yekupinda yetsono huru yekurura kunogona kukonzera kuti sikuruu huru yePFNA ivharwe mugomba remukati kana kuti nzvimbo yebanga rekurura iri isina kuenzana, izvo zvinogona kukonzera kutsauka kwekutyoka kana kuchekwa kwemutsipa wefemoral nemusoro wefemoral nebanga rekurura mushure mekuvhiyiwa, zvichideredza mhedzisiro yekuvhiyiwa;
(5) Muchina weC-arm X-ray unofanira kugara uchitarisa kudzika uye kusimba kwetsono yekutungamira screw blade paunenge uchiskururwa, uye kudzika kwemusoro wescrew blade kunofanira kunge kuri 5-10 mm pasi pepamusoro pekartilage yemusoro wefemoral;
(6) Pakupwanyika kwemukati metrochanteric kana zvidimbu zvemakumbo marefu, zvinokurudzirwa kushandisa PFNA yakatambanudzwa, uye kudiwa kwekuderedzwa kwakavhurika kunoenderana nekuderedzwa kwekupwanyika uye kugadzikana mushure mekuderedzwa. Kana zvichidikanwa, tambo yesimbi inogona kushandiswa kusunga block yekupwanyika, asi inokanganisa kupora kwekupwanyika uye inofanira kudzivirirwa;
(7) Pakutsemuka kwakakamurwa pamusoro petrochanter huru, kuvhiyiwa kunofanira kuitwa zvinyoro-nyoro sezvinobvira kudzivirira kupatsanurwa kwezvidimbu zvakatsemuka.
Zvakanakira uye Zvisina Kukosha zvePFNA
Serudzi rutsva rwemudziyo wekugadzirisa intramedullaryPFNA inogona kutamisa mutoro kuburikidza ne extrusion, kuitira kuti mativi emukati nekunze e femur agone kutakura kushushikana kwakafanana, nokudaro ichizadzisa chinangwa chekuvandudza kugadzikana uye kushanda kwekugadzirisa kwemukati kwekutyoka. Mhedzisiro yakatarwa yakanaka nezvimwewo.
Kushandisa PFNA kune zvimwe zvipingamupinyi, zvakaita sekuoma kwekuisa sikuruu yekukiya yedistal, kuwedzera kwenjodzi yekutyoka kwakatenderedza sikuruu yekukiya, coxa varus deformity, uye kurwadziwa munzvimbo yepamberi pehudyu kunokonzerwa nekutsamwa kwebhandi re iliotibial.kugadziriswa kwemukati memedullarykazhinji kacho kune mukana wekuti fixation ikundikane uye break non-connection isashande.
Saka, kune varwere vakwegura vane mapfupa asina kugadzikana emukati metrochanteric uye vane osteoporosis yakanyanya, kutakura huremu hwepakutanga hakubvumirwi zvachose mushure mekutora PFNA.
Nguva yekutumira: Gunyana-30-2022
