Pfungwa yekupararira kwehurefu yakatanga kuongororwa neSvistours Gluck Interny International International Intern Per Prearce Arthroplasty. Iyo prostisisis yakagadzirwa naDentist J. Porter Michaels kubva Paris, uye humhuterastemyakagadzirwa nesimbi yeplatin simbi uye yakasungirirwa parafin-yakafukidzwa rubber musoro ne waya yekuumba yakamisikidzwa. Mhedzisiro yekutanga yemurwere yaive inogutsa, asi iyo prostistsis yakazobviswa mushure memakore maviri nekuda kwekudzokorora kwakawanda kweTberculosis. Uku ndiko kuedza kwekutanga kwakaitwa nevanhu mukutsiva kwekunyepedzera.
Muna 1951, Frederick KRUEGER akashandisa kushandiswa kwechinhu chinonyanya kukosha prostising prostising prostisis yemavhitamu uye kuumbwa kubva kune proximal humerus ye cadaver. Izvi zvakashandiswa zvinobudirira kurapa murwere wechidiki ane osteonecrosis yemusoro wehuwandu
Asi tsiva yemazuva ano yehurumende yakagadzirwa uye yakagadzirwa nefudzi guru Charles Neer. Muna 1953, kuitira kuti vagadzirise zvisingagutsi zvekurapa kwaro kwekuvhiringidza kweProeral humeral humaral presthesis, iyo yakavandudzwa kakawanda mumakumi maviri emakore, zvichiteerana. Yakagadzirirwa yechipiri uye yechitatu chizvarwa prosties.
Mukutanga kwema1970, kuitira kuti vagadzirise kuputika kwemapfudzi muvarwere vane simba redraro (RTSA) yakatanga kuratidzwa neeer, asi nekuda kwekutadza kwekutanga kweiyo glenoid chikamu, pfungwa yacho yakazotorwa. Muna 1985, Paul Grammont akavandudzwa neyengwaru neeer, achifamba pakati pekutenderera nepakati uye nekukasira kugadzirisa dambudziko reRotor.
Dhizaina nheyo dzeTrans-pfudzi prostisesa
Reverse befu arthroplasty (RTSA) inodzosera hukama hweAnatomical hwemafudzi rechisikigo kuti vadzore kugadzikana. RTSA inogadzira yakazara yakazara uye yepakati yekutenderera (Cor) nekuita glenoid side convex uye humi musoro wepasi padanho rekutsigira. Iyo Biomechancal Basa rezvizere kweiyo yakazara kuti udzivise musoro wehukama kubva pakufambisa kumusoro kana iyo dectoid tsandanyama zvibvumirano kuti ubudise ruoko rwekumusoro. Chimiro cheRTSA ndechekuti iyo inotenderera nzvimbo yeiyo yekufambisa yakabatana uye chinzvimbo chehuwandu hwepamusoro hukama hwemafudzi hwakasikwa hunokwidziridzwa mukati uye pasi pasi. Dzakasiyana rrta prosthesis zvigadzirwa zvakasiyana. Musoro wehuwandu unosundwa pasi ne25 ~ 40mm uye akafambisa mukati ne5 ~ 20mm.
Kuenzaniswa neyakasikwa pfumbaniso yemuviri wemunhu, mukana wepakungwa wekusimuka kwemukati kweCom Iyo torque imwe chete, uye ichi chikamu chinoitawo kuti kutorwa kwemusoro wenyanzvi hakuchisiri kutsamira pane kushushikana kweiyo rotator.
Uku ndiko kugadzirwa uye biomechancs yertsa, uye zvingave zvishoma zvinonakidza uye zvakaoma kunzwisisa. Pane nzira iri nyore yekuzvinzwisisa here? Mhinduro ndeyekuti hongu.
Yekutanga ndiko kugadzirwa kweRTSA. Nyatso tarisa hunhu hweumwe neumwe mubatanidzwa wemunhu, tinogona kuwana mimwe mitemo. Majoini emunhu anogona kuve akagovaniswa mumapoka maviri. Imwe iri pedyo-trunk majoini semapfudzi uye chiuno, neye proximal kupera kwe "mukombe" uye mugumo weiyo "bhora".
Imwe mhando ndeye distal joints yakadai semabviuye maElbows, neye proximal kupera kuve "bhora" uye yekupedzisira kupera kuve "mukombe".
Urongwa hwakatorwa nemapiyona ezvekurapa kana uchigadzira mapepa ekutanga emapfupa emazuva ekutanga ezvirongwa zvechipfupi zvebendekete zvakanyanya sezvazvinogona, saka zvirongwa zvese zvakagadzirwa nemucheka weproximal se "mukombe" uye mugumo we "bhora". Vamwe vaongorori vakatogadzira nenzira yemaune "nemaune" kuve vakakura uye vakadzika kuitira kuti vawedzere kugadzikana kwejoini, zvakafanana nemunhuhip pamwe chete, asi zvakazoonekwa kuti kuwedzera kugadzikana kwakawedzera kuwanda kwekutadza, saka dhizaini iyi yakakurumidza kugamuchirwa. ramwa. RTSA, kune rumwe rutivi, inodzosera chimiro chechisikigo chefudzi rechisikigo, vachipinda "bhora" uye "mukombe", muchiuno "chiunganidze se" belbow "kana" ibvi "kana" Uku kuchinja kwakapedzisira kwakazogadzirisa matambudziko mazhinji uye kusava nechokwadi kwekutsiva kwekunze kwekutsiva, uye nezviitiko zvakawanda, kushanda kwenguva refu uye kwenguva pfupi uye kwenguva refu kwakanyatsogadziriswa.
Saizvozvovo, dhizaini yeRTSA inoshanduka nzvimbo yekutenderera kubvumira kuwanda kwakawedzera kushungurudzwa kwekubudirira kwekubudirira, izvo zvinogona zvakare kucherechedzwa. Uye kana isu tichienzanisa nepfudzi redu kubatana kune anoona, zviri nyore kunzwisisa. Sezvinoratidzwa mumufananidzo pazasi, kushandisa iyo torque imwe chete mune iyo nzira (iyo yakazara contraction simba), kana iyo yakazara uye nzvimbo yekutanga inoshandurwa, iri pachena kuti torque (iyo yepamusoro ruoko ruoko) inogona kugadzirwa muB gwara.
Shanduko muRTSA's Center yeRortation ine maitiro akafanana, achibvumira yakagadzirirwa pfudzi kuti utange kutapwa pasina iyo rotator conff kushungurudzika. Semukati makatorwa akati: Ndipe uzere uye ini ndinogona kutamisa nyika yose!
RTSA Zviratidzo uye Kupesana
Chinyorwa chechinyorwa cheRTSA inotenderera cuff Kukwirisa kumusoro kwemusoro wemubatanidzwa kunokonzerwa nemurume asina kujairika emuchadenga ari pasi pechiitiko cheDeltoid mushure mekutongwa. CTA yakajairika muvakadzi vakuru, uko kune yakasarudzika "pseudoparalysis" inogona kuitika.
Iko kushandiswa kwefudzi Arthroplasty, kunyanya RTSA, yakawedzera zvakanyanya mumakumi maviri emakore apfuura. Zvichienderana nemhedzisiro yekutanga yeRNTSA application, iko kukura kwekushandiswa kwehunyanzvi hwekuvhiya, uye kushandisirwa kwehunyanzvi hwechiratidzo, saka, pfudzi rakawanda Arthroplasty parizvino zvakaitwa nerthsa.
Semuenzaniso, anatomical yakazara pfudzi Arthroplasty (ATSA) yaive sarudzo yakasarudzika yefudzi pasina kutenderera Congole Pane zvinhu zvinotevera. Zvikonzero zvakakonzera kuenderana uku. Kutanga, kusvika gumi muzana yevarwere vanogashira ATSA yatove neyekutenderera cuff kubvaruka. Chechipiri, mune zvimwe zviitiko, "kuumbwa" kwekuvimbika kwe "basa" reiyo rotator cuff haina kukwana, kunyanya mune vamwe varwere vakwegura. Pakupedzisira, kunyangwe kana iyo rotator cuff ichinetseka panguva yekuvhiya, kunyanya nguva yekuvhiya inoitika nezera, kunyanya mushure mekusaziva kweAtheta nezve basa redunhu rotor. Ichi chiitiko chinowanzoitika muvarwere vakwegura kupfuura makore makumi manomwe. Naizvozvo, vamwe vanachiremba vanowedzera vakatanga kusarudza RTSA pavanotarisana nefudzi rakachena osteoarthritis. Mamiriro ezvinhu aya akave nekufunga kutsva kuti RTSA inogona zvakare kuve sarudzo yekutanga kune varwere vane osteoarthritis ine osteoarthritis ine nzvimbo yakaoma yekutenderera cuff yakakwenenzverwa chete pazera chete.
Saizvozvo, munguva yakapfuura, kune isina kurarurika rotator cuff misodzi (mrCT) isina nzira inosanganisira kuderera kwechidimbu, chidimbu rotator cuff kuvakazve, uye nzira yepamusoro yekuvakazve. , chiyero chekubudirira chinosiyana. Zvichienderana nehunyanzvi uye nekubudirira kushandiswa kwertsa mumamiriro ezvinhu akasiyana-siyana, vazhinji vanoshanda navo nguva pfupi yadarika vakaedza Rt
Mukupfupikisa, kuwedzera kune cta, zviratidzo zvechiratidzo zvinowedzera zveRTSA zvinosanganisira raragration hurefu pasina kuzvidza misodzi. kuzvimba, uye kudzokorora kwembambo discocations.
Kune mashoma kupesana kuRTSA. Kunze kwekuti azere kukakavara kweiyo yekunyepedzera yekubatanidza yakadaro seutachiona, isiri-yekushanda kwemhasuru yetsindu ndeyekupesana zvachose kuRTSA. Pamusoro pezvo, proximal humerus, kukuvara kwakazaruka uye kukuvara kwepfungwa plexus kunofanirawo kufungwa nekupokana, nepo oxillary nerve kukuvara kunofanirwa kufungwa nezvakarongeka.
Post-inoshanda kutarisirwa uye kugadzirisa
Misimboti yekudzoreredza kugadzirwazve:
Kuunganidza kushingairira kwevarwere nekuda kwekuvandudzwa uye kusimbisa zvinotarisirwa zvine mwero kune varwere.
Inoderedza kurwadziwa uye kuzvimba, uye inodzivirira marongero ekuporesa, asi subscappularlarus kazhinji haifanire kuchengetedzwa.
Anterior dislocation yefudzi rinogona kuitika pamwe chete munzvimbo dzekupedzisira dze hypellecension, adduction uye kutenderera kwemukati, kana kutapwa nekunze nekutenderera kwekunze. Naizvozvo, kufamba kwakadai sedzidzo dzinofanira kudzivirirwa kwemavhiki mana kusvika matanhatu mushure mekuvhiyiwa. Izvi zvinzvimbo zvine njodzi yekusa discation.
Mushure memavhiki mana kusvika matanhatu, zvichiri kudiwa kutaura naye uye kuwana mvumo kubva kune chiremba anovhiya asati atanga mafambiro ari pamusoro nepinzvimbo.
Kubata kwevashandi vekudzosera kunofanirwa kuitwa kutanga pasina kurema uye nekuita kurema-kuremerwa, kutanga pasina kuramba uye nekupokana uye wozotanga.
Parizvino, hapana chakaomesesa uye kugadzikana kugoverwa, uye kune misiyano huru mune dzakasiyana-siyana dzehunyanzvi hwekuongorora.
Zviitiko zvemurwere zvekurarama kwezuva nezuva (ADLS) zano (0-6 vhiki):
Kupfeka
Kurara
Zuva nezuva kurovedza muviri (0-6 vhiki):
Active Elbow Flexion
Pese Pfupi Fexion
Sichuan Chenanhui Tulonology CO, LTD.
WhatsApp: +8618227212857
Kutumira Nguva: Nov-21-2022
