Nyaya yekusarudza kuwanda kwezvipikiri zve intramedullary kune refu tubular mapfupa emakumbo ezasi.

Intramedullary nailing ndiyo chiyero chegoridhe chekurapa kwekuvhiya kwe diaphyseal fractures yeakareba tubular mapfupa mumakumbo ezasi. Inopa zvakanakira senge kudiki kwekuvhiya kukuvadzwa uye yakakwira biomechanical simba, ichiita kuti inowanzoshandiswa mu tibial, femoral, uye humeral shaft fractures. Clinically, kusarudzwa kwe intramedullary chipikiri dhayamita kazhinji kunofarirwa gobvu rinobvira chipikiri chinogona kuiswa nepakati reming, kuve nechokwadi kugadzikana kukuru. Zvisinei, kana kukora kwembambo ye intramedullary kunokanganisa zvakananga kuparara kwekuputsika kunoramba kusinganzwisisiki.

Muchinyorwa chakapfuura, takakurukura chidzidzo chekuongorora kukanganiswa kweiyo intramedullary chipikiri dhayamita pamapfupa ekuporesa kune varwere vanopfuura makumi mashanu vane intertrochanteric fractures. Mhedzisiro yacho yakaratidza kuti hapana mutsauko wehuwandu mukutyoka kuporesa mazinga uye reoperation mitengo pakati peboka re10mm neboka rine zvipikiri zvakakora kupfuura 10mm.

Bepa rakaburitswa muna 2022 nenyanzvi kubva kuTaiwan Province rakasvikawo pamhedziso yakafanana:

Chidzidzo chinosanganisira varwere ve257, avo vakagadziriswa ne intramedullary misumari yedhayamita 10mm, 11mm, 12mm, uye 13mm, yakakamura varwere mumapoka mana zvichienderana nehupamhi hwembambo. Zvakaonekwa kuti pakanga pasina mutsauko wehuwandu muhuwandu hwekuporesa kuputsika pakati pemapoka mana.

Saka, iyi ndiyowo nyaya yekuputsika kwetibial shaft?

Muchidzidzo chinotarisirwa chekuongorora chinosanganisira varwere makumi matanhatu, vatsvakurudzi vakapatsanura varwere makumi matanhatu zvakaenzana mumapoka maviri e30 rimwe nerimwe. Boka A rakagadziriswa nembambo dzakatetepa dze intramedullary (9mm dzevakadzi uye 10mm dzevarume), nepo Boka B rakaiswa zvipikiri zvakakora zve intramedullary (11mm yevakadzi uye 12mm yevarume):

Mhedzisiro yacho yakaratidza kuti pakanga pasina misiyano yakakura mumhedzisiro yekiriniki kana kufungidzira pakati pezvipikiri zvakatetepa uye zvakakora intramedullary. Pamusoro pezvo, zvipikiri zvakatetepa intramedullary zvakabatanidzwa nepfupi yekuvhiya uye fluoroscopy nguva. Pasinei nokuti mbambo yakakora kana nhete yedhayamita yakashandiswa, kudzoreredza zvine mwero kwakaitwa kusati kwaiswa chipikiri. Vanyori vanoratidza kuti kune nyore tibial shaft fractures, yakaonda dhayamita intramedullary misumari inogona kushandiswa kugadzirisa.