Kutyoka kwemutsipa wemukadzi kunowanzojairika uye kunogona kukuvadza kukuvadza kune vanachiremba vemapfupa, nehuwandu hwehuwandu hwevasina kubatana uye osteonecrosis nekuda kweropa risina simba.Kunyatsoita uye kuderedzwa kwakanaka kwekuputsika kwemutsipa wevakadzi ndiyo kiyi yekubudirira kugadzirisa mukati.
Kuongorora Kuderedza
Sekureva kweGadheni, chiyero chekudzikisira kwekutyoka kwemutsipa kwemukadzi kuri 160 ° mufirimu remapfupa uye 180 ° mune lateral firimu.Inoonekwa seyakagamuchirwa kana iyo Bindu index iri pakati pe155 ° uye 180 ° mune yepakati uye lateral nzvimbo mushure mekuderedzwa.
X-ray kuongorora: mushure mekuvhara kuderedzwa, chiyero chekugutsikana kwekuderedza kunofanira kugadziriswa nekushandisa mifananidzo yepamusoro ye-X-ray.Simom naWyman vakaita makona akasiyana-siyana e-X-ray mushure mekuvharwa kuderedzwa kwekuputsika kwemutsipa wemukadzi, uye vakawana kuti Mafirimu e-X-ray chete akanaka uye anotevera anoratidza kuderedzwa kweanatomical, asi kwete kuderedzwa kweanatomical chaiyo.Lowell akaratidza kuti convex pamusoro pemusoro wemukadzi uye concave pamusoro pemutsipa wechikadzi inogona kubatanidzwa kune S-curve mune yakajairika anatomical. mamiriro ezvinhu.Lowell akakurudzira kuti iyo convex yepamusoro yemusoro wemukadzi uye iyo concave pamusoro pemutsipa wechikadzi inogona kuumba S-yakaita curve pasi peyakajairika mamiriro eanatomical, uye kana S-yakaita curve isiri yakatsetseka kana kunyange tangent mune chero chinzvimbo paX- ray, inoratidza kuti anatomical repositioning haina kuwanikwa.
Inverted triangle ine zvimwe zviri pachena biomechanical zvakanakira
Semuenzaniso, mumufananidzo uri pazasi, mushure mekutyoka kwemutsipa wefemur, kupera kwekutyoka kunoiswa kune kushushikana kunonyanya kusimba muchikamu chepamusoro uye kudzvinyirira muchikamu chezasi.
Zvinangwa zvekugadzirisa kuputsika ndezvekuti: 1.kuchengetedza kurongeka kwakanaka uye 2. kurwisa tension stress zvakanyanya sezvinobvira, kana kushandura tension stress kuita compressive stress, izvo zvinopindirana nemusimboti wetension banding.Naizvozvo, iyo inverted triangle mhinduro ine 2 screws pamusoro inonyatso kukwirisa kune orthotic triangle mhinduro ine siruu imwe chete pamusoro kuti igadzirise kusimba.
Kurongeka uko 3 screws akaiswa mukutyoka kwehukadzi kwakakosha:
Iyo yekutanga screw inofanira kunge iri muromo weiyo inverted triangle, pamwe chete nenguva yechikadzi;
Yechipiri screw inofanira kuiswa kumashure kusvika pasi pekatatu inverted, pamwe nemutsipa wechikadzi;
Sikuru yechitatu inofanira kuva nechemberi kusvika kumucheto kwezasi kwekatatu kakapinzwa, padivi rekunetsana kwekutyoka.
Sezvo femoral neck fractures inowanzobatanidzwa ne osteoporosis, screws ine shoma screw grip kana isina kusungirirwa kumucheto uye bhonzo rakaderera munzvimbo yepakati, saka kubatanidza mupendero sepedyo sezvinobvira kune subcortex inopa kugadzikana kuri nani.Ideal position:
Nheyo nhatu dzekugadzirisa zvipikiri zvisina mhasuru: padyo nekumucheto, parallel, inverted zvigadzirwa
Ajacent zvinoreva kuti 3 screws ari mukati memutsipa wefemur, sepedyo neperipheral cortex sezvinobvira.Neiyi nzira, iyo 3 screws sese inogadzira kudzvanywa kwepamusoro pane yese yekutyoka kwepasi, nepo kana 3 screws isina kukwana discrete, kudzvanywa kunowanzo kuve kwakafanana-kufanana, kushoma kugadzikana uye kushoma kurwisa torsion uye kugera.
Postoperative Functional Exercises
Zvigunwe zvekusimudza uremu zvinogona kuitwa kwemavhiki gumi nemaviri mushure mekugadzirisa kuputsika, uye chikamu chekutakura uremu chinogona kutangwa mushure memavhiki gumi nemaviri.Mukupesana, kune Pauwels mhando III kuputsika, kugadzirisa neDHS kana PFNA kunokurudzirwa.
Nguva yekutumira: Jan-26-2024
