Ama-fractures wesifunda se-intertrochanterteric of the femur account ngo-50% we-hip fractures futhi uhlobo oluvame kakhulu lokuqhekeka ezigulini ezikhulile. Ukulungiswa kwezipikili kwe-intramentundary kuyindinganiso yegolide yokuthola ukwelashwa kokuhlinzwa kwe-intertrochanterteric fractures. Kukhona ukuvumelana phakathi kodokotela abahlinzayo be-orthopedic ukugwema "imiphumela emifushane" ngokusebenzisa izipikili ezinde noma ezimfushane, kepha akukho ukuvumelana kwezipikili ezinde noma ezimfishane.
Ku-theory, izipikili ezimfishane zingafinyeza isikhathi sokuvimbela, zinciphise ukulahleka kwegazi, futhi zigweme ukugqama, ngenkathi izipikili ezinde zinikeza ukuqina okungcono. Ngesikhathi senqubo yokufaka izipikili, indlela ejwayelekile yokulinganisa ubude bezipikili ezinde ukukala ukujula kwe-PIN efakiwe. Kodwa-ke, le ndlela imvamisa ayinambitheki kakhulu, futhi uma kunokuphambuka kobude, ukufaka esikhundleni isikhonkwane esijwayelekile kungaholela ekulahlekelweni kwegazi okukhulu, kwandise ukuncipha kwegazi, futhi kwandise isikhathi sokuhlinzwa. Ngakho-ke, uma ubude obudingekayo besipikili se-intramedullary buhlolwe ngokulingana, inhloso yokufaka izipikili ingatholakala emzameni owodwa, ukugwema ubungozi obungejwayelekile.
Ukubhekana nale nselelo yomtholampilo, izazi zakwamanye amazwe zisebenzise ibhokisi elihlanganisiwe lezipikili lezipikili (ibhokisi) ukuze lihlole ngobude bobude besipikili se-intrametuvary ngaphansi kwe-fluoroscopy, okubizwa ngokuthi "inqubo yebhokisi". Umphumela wohlelo lokusebenza lwe-Clinical ulungile, njengoba kwabelwane ngalo ngezansi:
Okokuqala, beka isiguli embhedeni we-traction futhi wenze ukuncishiswa okujwayelekile okuvalekile ngaphansi kwe-troction. Ngemuva kokuthola ukuncishiswa okugculisayo, thatha izipikili ezingenakuvinjwa (kufaka phakathi ibhokisi lokupakisha) bese ubeka ibhokisi lokufaka ngaphezulu kwe-femur ye-femur yemlenze ethintekile:
Ngosizo lomshini we-C-arm Fluoroscopy, ireferensi yesikhundla seProximal ukuvumelanisa ukuphela kweProximal yesipikili se-intramedullary nge-cortex ngaphezulu kwentamo yabesifazane futhi uyibeke ekuqageleni indawo yokungena yesipikili esingenayo.
Lapho isikhundla se-proximal segculisayo, gcina isikhundla se-proximal, bese ucindezela ingalo ye-C-FORET lapho uqeda ukude futhi wenze i-fluoroscopy ukuthola umbono wangempela we-knee ngokuhlangana kwedolo. Isithenjwa se-distal isikhundla yi-intercondylar notch ye-femur. Faka esikhundleni isipikili se-intramedullary ngobude obuhlukile, okuhlose ukufeza ibanga phakathi kokuphela kwe-distal of feavelval naiping Lokhu kukhombisa ubude obufanele besipikili se-intramedullary.
Ngaphezu kwalokho, ababhali bachaze izici ezimbili zokucabanga ezingakhombisa ukuthi i-intramerary nail inde kakhulu:
1. Ukuphela kwe-distal kwesipikili se-intramedullary kufakwa engxenyeni eyi-1/3 ye-Patellofemoralioraliore
2
Abalobi basebenzise le ndlela ukukala ubude bezipikili ezihlanganayo ezigulini ezingama-21 futhi bathola isilinganiso sokunemba sama-95.2%. Kodwa-ke, kungahle kube nodaba olungaba khona ngale ndlela: Lapho i-intrameraryuntalullary nail ifakwe izicubu ezithambile, kungahle kube nomphumela wokukhulisa ngesikhathi se-fluoroscopy. Lokhu kusho ukuthi ubude bangempela be-intramerary nail esetshenzisiwe kungadinga ukuba mfushane kancane kunesilinganiso sokubambisana. Ababhali babona le nto ezigulini ezikhuluphele futhi baphakamisa ukuthi ngenxa yeziguli ezikhuluphele kakhulu, ubude besipikili esingenamiphakathi kufanele bufinyezwe ngokulinganiswa ngesikhathi sokuphela kwesipikili se-FemulAry isipikili se-femurvary se-airmer.
Kwamanye amazwe, izipikili ezihlekisayo zingahlanganiswa ngawodwana futhi zifakwe inzalo, kepha ezimweni eziningi, ubude obuhlukahlukene bezipikili ezihlanganisiwe buxubana ndawonye futhi buhlangene nabakhiqizi. Ngenxa yalokhu, kungenzeka kungenzeki ukuhlola ubude besipikili se-intramedullary ngaphambi kokubulala inzalo. Kodwa-ke, le nqubo ingaphothulwa ngemuva kokuthi kufakwe amadrape wokunyusa.
Isikhathi Sokuthumela: APR-09-2024
