I. Kungani isikulufu esifakwe ebhodweni sinembobo?
Zisebenza kanjani izinhlelo zezikulufo ezifakwe ku-cannulated? Kusetshenziswa izintambo ezincane ze-Kirschner (izintambo ze-K) ezibhobozwe ethanjeni ukuze kuqondiswe izindlela zezikulufo ngokunembile ezingcezwini ezincane zamathambo.
Ukusebenzisa izintambo ze-K kugwema ukubhoboza kakhulu imigodi yokulinganisa futhi kuvumela ukunamathela kwezingcezu zamathambo eziseduze ngesikhathi sokufakwa kwezikulufo. Amathuluzi angenalutho nezikulufo ezingenalutho kufakwa ethanjeni phezu kwezintambo ze-K. Ukufakwa kwezikulufo ezifakwe ku-cannulated kuyasiza emgogodleni wesibeletho ukuze kuqiniswe ukuphuka kwe-odontoid kanye nokwelapha ukungazinzi kwe-atlantoaxial.
Izikulufo ezifakwe ku-cannulation zinezinzuzo eziningana uma kuqhathaniswa nezikulufo ezingasetshenziswa ku-cannulation: 1) izintambo ze-K ziqondisa indawo yesikulufo ethanjeni;
2) indlela yokuqondisa ye-K-wire yenza kube lula ukuyishintsha uma indlela yokuqala yayingafanele;
3) izintambo ze-K zivumela ukuhlanganiswa okuqhubekayo kwezingcezu zamathambo ezingazinzile eziseduze;
4) Izintambo ze-K zivimbela ukunyakaza kwezingcezu zamathambo ezingazinzile ngesikhathi sokufakwa kwezikulufo.
Izinkinga ezihlobene ne-K-wire (ukuphuka, ukubekwa kabusha, kanye nokuthuthuka) zingancishiswa kusetshenziswa amasu okusebenza anembile. Uhlelo olukhethekile lwamathuluzi ezikulufo ezifakwe ku-cannulated lwakhiwe ngqo ukuze kufakwe i-cervical fixation engenhla ukuze kuvunyelwe ukubhoboza nge-percutaneous kusetshenziswa amadivayisi amade okufaka imihubhe, ama-tissue sheaths, ama-drill guides, kanye ne-K-wires ezinde. Lawa mathuluzi avumela ukulethwa kwezikulufo ezifakwe ku-cannulated nge-engeli ephansi emgogodleni ngokusebenzisa izindlela ezinde ezithambile zezicubu. Izikulufo ezifakwe ku-cannulated zinezinzuzo ezibalulekile uma kuqhathaniswa nezikulufo ezingezona ezifakwe ku-cannulated zokufaka i-cervical spine engazinzile ohlelweni.
II. Yisiphi isikulufu esifakwe amathini noma izinzipho ezingaphakathi kwe-meduallary ezingcono?
Zombili izinzipho zangaphakathi kwe-medullary kanye nezinzipho ezifakwe emathinini ziyimishini yezokwelapha esetshenziselwa ukulungisa ama-fracture angaphakathi. Ngayinye inezinzuzo zayo futhi ifanele izinhlobo ezahlukene zama-fracture kanye nezidingo zokwelapha.
| Uhlobo | Inzuzo |
| Isipikili se-Intramedullary | Umphumela wokuqinisa izinzipho ngaphakathi kwe-medullary ekuqhekekeni okuzinzile kwamathambo amade muhle, ngokulimala okuncane kanye nokopha okuncane. Ukuqinisa izinzipho ngaphakathi kwe-medullary kungokwe-central fixation. Uma kuqhathaniswa namapuleti ensimbi, izinzipho ngaphakathi kwe-medullary zingavikela nobuqotho be-extraosseous membrane, zivimbele ukuphulukiswa kokuqhekeka okulibazisekile, futhi zidlale indima ekugwemeni ukutheleleka. |
| Isikulufu Esifakwe Emathinini | Isetshenziswa kakhulu ezindaweni ezifana nokuphuka kwentamo ye-femoral, ngemiphumela ekhethekile yokuqinisa kanye nokucindezela. Ngaphezu kwalokho, umonakalo mncane kakhulu futhi akudingeki amapuleti ensimbi. |
III. Kunini lapho kufanele usebenzise khona izikulufo ze-cancellous vs cortical?
Izikulufo ezikhanseliwe kanye nezikulufo ze-cortical zombili ziyizinhlobo zokufakelwa kwamathambo ezisetshenziswa ekuqiniseni amathambo, kodwa zenzelwe izinhlobo ezahlukene zamathambo futhi zinezinhlelo ezihlukile:
Izikulufo Ezikhanseliwe Zenzelwe Ngokukhethekile ukusetshenziswa ezicutshini zethambo ezithambile, ezingaxinene kakhulu, nezithambile, ezivame ukutholakala emaphethelweni amathambo amade, njenge-femur kanye ne-tibia. Ngokuvamile zisetshenziswa ezindaweni lapho ithambo lingenazo izimbobo futhi lingaxinene kakhulu, njengezifunda ze-metaphyseal zamathambo amade. Zivame ukusetshenziswa ezinqubweni ezihilela umgogodla, i-pelvis, kanye nezingxenye ezithile zehlombe kanye ne-hip.
Izikulufo ze-Cortical zenzelwe ukusetshenziswa emathanjeni e-cortical aqinile, akha ungqimba lwangaphandle lwamathambo amaningi futhi aqinile kakhulu futhi anamandla kunethambo elikhanseliwe. Ngokuvamile asetshenziswa ezimweni lapho kudingeka khona amandla amakhulu nokuzinza, njengokulungiswa kwama-fractures ku-diaphysis (shaft) yamathambo amade. Asetshenziswa futhi kumadivayisi athile okulungisa angaphakathi kanye nama-plate.
Ngamafuphi, ukukhetha phakathi kwezikulufo ze-cancellous neze-cortical kuncike ohlotsheni lwethambo oluqinisiwe kanye nezidingo ezithile zenqubo yamathambo. Izikulufo ze-cancellous zifanelekela ithambo elithambile, elinezimbobo eziningi, kuyilapho izikulufo ze-cortical zilungele ithambo eliqinile nelithwala umthwalo.
Isikhathi sokuthunyelwe: Meyi-09-2025
