Usimende wamathambo we-Orthopedic uyinto yezokwelapha esetshenziswa kakhulu ekuhlinzeni kwamathambo. Isetshenziswa kakhulu ukulungisa izitho zokufakelwa zamalunga ezenziwe ngokwenziwa, ukugcwalisa izikhala zezinkinga zamathambo, kanye nokunikeza ukwesekwa nokuqina ekwelapheni ukwaphuka. Igcwalisa igebe phakathi kwamalunga okwenziwa kanye nezicubu zamathambo, inciphisa ukuguguleka futhi ihlakaze ukucindezeleka, futhi ithuthukise umphumela wokuhlinzwa kokushintsha amalunga.
Ukusetshenziswa okuyinhloko kwezipikili zesimende samathambo yilezi:
1. Ukulungisa ama-fracture: Usimende wethambo ungasetshenziswa ukugcwalisa nokulungisa izindawo zokuphuka.
2. Ukuhlinzwa Kwamathambo: Ekuhlinzeni Kwamathambo, usimende wamathambo usetshenziselwa ukulungisa nokwakha kabusha izindawo zamalunga.
3. Ukulungiswa kwezinkinga zethambo: Usimende wethambo ungagcwalisa izinkinga zethambo futhi ukhuthaze ukuvuselelwa kwezicubu zethambo.
Okufanelekile, i-bone cement kufanele ibe nezici ezilandelayo: (1) ukujova okwanele, izakhiwo ezihlelekayo, ukuhlangana, kanye ne-radiopacity yezakhiwo zokuphatha ezifanele; (2) amandla anele okusebenza ukuze kuqiniswe ngokushesha; (3) ukuvuleka okwanele ukuvumela ukujikeleza koketshezi, ukufuduka kwamaseli, kanye nokukhula kwamathambo amasha; (4) i-osteoconductivity enhle kanye ne-osteoinductivity ukukhuthaza ukwakheka kwamathambo amasha; (5) ukubola okulingene ukuze kuhambisane nokumuncwa kwezinto ze-bone cement nokwakheka kwamathambo amasha; kanye (6) amakhono okulethwa kwemithi asebenzayo.
Ngawo-1970, kwakusetshenziswa usimende wamathamboilungaUkufakwa kwe-prosthesis, futhi ingasetshenziswa njengezinto zokugcwalisa nokulungisa izicubu kwezokwelapha amathambo kanye nodokotela bamazinyo. Njengamanje, ama-bone cement asetshenziswa kakhulu futhi acwaningwa kakhulu afaka i-polymethyl methacrylate (PMMA) bone cement, i-calcium phosphate bone cement kanye ne-calcium sulfate bone cement. Njengamanje, izinhlobo ze-bone cement ezisetshenziswa kakhulu zifaka i-polymethyl methacrylate (PMMA) bone cement, i-calcium phosphate bone cement kanye ne-calcium sulfate bone cement, phakathi kwazo i-PMMA bone cement kanye ne-calcium phosphate bone cement yizona ezisetshenziswa kakhulu. Kodwa-ke, i-calcium sulfate bone cement inomsebenzi omubi webhayoloji futhi ayikwazi ukwakha izibopho zamakhemikhali phakathi kwe-calcium sulfate grafts kanye nezicubu zamathambo, futhi izowohloka ngokushesha. I-calcium sulfate bone cement ingamuncwa ngokuphelele zingakapheli amasonto ayisithupha ngemva kokufakwa emzimbeni. Lokhu konakala okusheshayo akufani nenqubo yokwakheka kwamathambo. Ngakho-ke, uma kuqhathaniswa ne-calcium phosphate bone cement, ukuthuthukiswa kanye nokusetshenziswa kwemitholampilo kwe-calcium sulfate bone cement kulinganiselwe. I-PMMA bone cement iyi-polymer ye-acrylic eyakhiwe ngokuxuba izingxenye ezimbili: i-liquid methyl methacrylate monomer kanye ne-dynamic methyl methacrylate-styrene copolymer. Ine-residue ephansi ye-monomer, ukumelana nokukhathala okuphansi kanye nokuqhekeka kokucindezeleka, futhi ingadala ukwakheka kwamathambo amasha futhi inciphise ukwanda kwemiphumela emibi ebangelwa ukuqhekeka ngamandla aphezulu kakhulu okuthambekela kanye nokuqina. Ingxenye eyinhloko yempuphu yayo yi-polymethyl methacrylate noma i-methyl methacrylate-styrene copolymer, kanti ingxenye eyinhloko yoketshezi yi-methyl methacrylate monomer.
I-PMMA bone cement inamandla amakhulu okubamba kanye ne-plasticity, futhi iqina ngokushesha, ngakho iziguli zingavuka embhedeni zenze imisebenzi yokuvuselela ngokushesha ngemva kokuhlinzwa. I-plasticity yayo inesimo esihle kakhulu, futhi opharetha angenza noma yikuphi ukuqina ngaphambi kokuba i-plasticity ye-cement iqine. Izinto ezisetshenziswayo zisebenza kahle ngokuphepha, futhi aziboli noma zimuncwe umzimba womuntu ngemva kokwakheka emzimbeni. Isakhiwo samakhemikhali sizinzile, futhi izakhiwo zemishini ziyaqashelwa.
Kodwa-ke, kusenezinkinga ezithile, njengokubangela ukucindezeleka okuphezulu ngezikhathi ezithile emgodini womnkantsha ngesikhathi sokugcwaliswa, okubangela amaconsi amafutha ukuthi angene emithanjeni yegazi futhi abangele i-embolism. Ngokungafani namathambo abantu, amalunga okwenziwa angase akhululeke ngokuhamba kwesikhathi. Ama-monomer e-PMMA akhipha ukushisa ngesikhathi se-polymerization, okungase kubangele umonakalo ezicutshini noma emaseli azungezile. Izinto ezakha usimende wethambo zinobuthi obuthile, njll.
Izithako ezisesimendeni samathambo zingase zibangele ukusabela kokungezwani komzimba, njengokuqubuka, i-urticaria, ukuphelelwa umoya kanye nezinye izimpawu, futhi ezimweni ezimbi kakhulu, kungase kube nokushaqeka kwe-anaphylactic. Ukuhlolwa kokungezwani komzimba kufanele kwenziwe ngaphambi kokusetshenziswa ukuze kugwenywe ukusabela kokungezwani komzimba. Ukusabela okubi kusimende samathambo kufaka phakathi ukusabela kokungezwani komzimba kwesimende samathambo, ukuvuza kwesimende samathambo, ukukhululeka kwesimende samathambo kanye nokuhlukana. Ukuvuza kwesimende samathambo kungabangela ukuvuvukala kwezicubu kanye nokusabela okunobuthi, futhi kungalimaza ngisho nemizwa kanye nemithambo yegazi, okuholela ezinkingeni. Ukuqina kwesimende samathambo kuthembekile impela futhi kungahlala iminyaka engaphezu kweyishumi, noma ngisho iminyaka engaphezu kwamashumi amabili.
Ukuhlinzwa kwesamente yamathambo kuyindlela ejwayelekile yokuhlinzwa engangenisi kakhulu, futhi igama layo lesayensi yi-vertebroplasty. Isamente yamathambo iyinto eyenziwe nge-polymer enomswakama omuhle ngaphambi kokuqina. Ingangena kalula emhlane ngenaliti yokubhoboza, bese isakazeka ngemifantu yangaphakathi yokuqhekeka kwemisipha; isamente yamathambo iyaqina cishe ngemizuzu eyi-10, ifake imifantu emathanjeni, kanti isamente yamathambo eqinile ingadlala indima esekelayo ngaphakathi kwamathambo, okwenza amathambo aqine. Yonke inqubo yokwelapha ithatha imizuzu engama-20-30 kuphela.
Ukuze kugwenywe ukusabalala ngemva kokujova ngesamente yamathambo, kuye kwakhiqizwa uhlobo olusha lwedivayisi yokuhlinzwa, okungukuthi idivayisi ye-vertebroplasty. Yenza ukusika okuncane emhlane wesiguli futhi isebenzisa inaliti ekhethekile yokubhoboza ukubhoboza umzimba womgogodla esikhumbeni ngaphansi kokuqapha kwe-X-ray ukuze kusungulwe umzila osebenzayo. Bese kufakwa ibhaluni ukuze libumbe umzimba womgogodla ocindezelwe ophukile, bese kuthi isamente yamathambo ifakwe emzimbeni womgogodla ukuze kubuyiselwe ukubukeka komzimba womgogodla ophukile. Ithambo elikhanseliwe emzimbeni womgogodla liqiniswa ngokwandiswa kwebhaluni ukuze kwakhiwe isithiyo sokuvimbela ukuvuza kwesamente yamathambo, kuyilapho kunciphisa ingcindezi ngesikhathi sokujova ngesamente yamathambo, ngaleyo ndlela kunciphisa kakhulu ukuvuza kwesamente yamathambo. Kunganciphisa ukwanda kwezinkinga ezihlobene nokuphumula kombhede okuphukile, njenge-pneumonia, izilonda zokucindezeleka, izifo zomgudu womchamo, njll., futhi kugweme umjikelezo omubi we-osteoporosis obangelwa ukulahlekelwa amathambo ngenxa yokuphumula kombhede isikhathi eside.
Uma kwenziwa ukuhlinzwa kwe-PKP, isiguli kufanele sivame ukuphumula embhedeni zingakapheli amahora ama-2 ngemva kokuhlinzwa, futhi singaphenduka sibheke eceleni. Phakathi nalesi sikhathi, uma kukhona umuzwa ongavamile noma ubuhlungu buqhubeka nokuba bubi, udokotela kufanele aziswe kusenesikhathi.
Qaphela:
① Gwema imisebenzi emikhulu yokujika okhalweni kanye nokugoba;
② Gwema ukuhlala noma ukuma isikhathi eside;
③ Gwema ukuthwala izinsimbi noma ukugoba ukuze uqoqe izinto phansi;
④ Gwema ukuhlala esihlalweni esiphansi;
⑤ Vimbela ukuwa nokuphindeka kwamathambo aqhekeke.
Isikhathi sokuthunyelwe: Novemba-25-2024
