Iyini i-DHS ne-DCS?
I-DHS (i-Dynamic Hip Screw)ukufakwa kokuhlinzwa okusetshenziselwa ngokuyinhloko ukwelapha ukuphuka kwentamo ye-femoral kanye nokuphuka kwe-intertrochanteric. Iqukethe isikulufu kanye nesistimu yepuleti ehlinzeka ngokulungiswa okuzinzile ngokuvumela ukucindezelwa okunamandla endaweni yokuphuka, okukhuthaza ukuphulukiswa.
I-DCS (Dynamic Condylar Screw)iyithuluzi lokulungisa elisetshenziselwa ukuphuka kwe-distal femur kanye ne-proximal tibia. Ihlanganisa izinzuzo zazo zombili izikulufu ze-cannulated (MCS) nezifakelo ze-DHS, ihlinzeka ngokuminyanisa okulawulwayo okushukumisayo ngezikulufu ezintathu ezihlelwe ekucushweni kukanxantathu okuhlanekezelwe.
Uyini Umehluko Phakathi kwe-DHS ne-D?CS?
I-DHS (I-Dynamic Hip Screw) isetshenziselwa ikakhulukazi ukuphuka kwentamo yesifazane kanye nokuphuka kwe-intertrochanteric, ihlinzeka ngokulungiswa okuzinzile ngesikulufu nesistimu yepuleti. I-DCS (I-Dynamic Condylar Screw) yakhelwe ukuphuka kwe-distal femur kanye ne-proximal tibia, ehlinzeka ngokuminyanisa okulawulwayo okuguquguqukayo ngokulungiselelwa kwesikulufu esingunxantathu.
Isetshenziselwa ini i-DCS?
I-DCS isetshenziselwa ukwelapha ama-fractures ku-distal femur kanye ne-proximal tibia. Isebenza kahle kakhulu ekuhlinzekeni ukuzinza nokukhuthaza ukuphulukiswa kulezi zindawo ngokusebenzisa ukucindezela okulawulwayo okuguquguqukayo endaweni yokuphuka.
Uyini Umehluko Phakathi kwe-DCS ne-DPL?
I-DPL (Dynamic Pressure Locking)kungolunye uhlobo lwesistimu yokulungisa esetshenziswa ekuhlinzeni amathambo. Nakuba kokubili i-DCS ne-DPL ihlose ukunikeza ukulungiswa okuzinzile kokuqhekeka, i-DPL ngokuvamile isebenzisa izikulufu zokukhiya namapuleti ukuze ifinyelele ukulungiswa okuqinile, kuyilapho i-DCS igxile ekucindezelweni okunamandla ukuze kuthuthukiswe ukuphulukiswa kokuphuka.
Uyini Umehluko Phakathi kwe-DPS ne-CPS?
I-DPS (Dynamic Plate System)futhiI-CPS (I-Compression Plate System)zombili zisetshenziselwa ukulungisa ukuphuka. I-DPS ivumela ukucindezelwa okuguquguqukayo, okungathuthukisa ukuphulukiswa kokuphuka ngokukhuthaza ukunyakaza kwe-interfragmentary ngesikhathi sokuthwala isisindo. I-CPS, ngakolunye uhlangothi, inikeza ukucindezelwa okumile futhi isetshenziselwa ukuphuka okuzinzile lapho ukucindezela okunamandla kungadingeki.
Uyini Umehluko Phakathi kwe-DCS 1 ne-DCS 2?
I-DCS 1 ne-DCS 2 ibhekisela ezizukulwaneni ezihlukene noma ukulungiselelwa kwesistimu ye-Dynamic Condylar Screw. I-DCS 2 ingase inikeze ukuthuthukiswa ngokomklamo, okokusebenza, noma amasu okuhlinza uma kuqhathaniswa ne-DCS 1. Nokho, umehluko othile ungancika ekubuyekezweni komkhiqizi kanye nentuthuko ohlelweni.
Ungayenza kanjani i-DHS?
I-DHS inqubo yokuhlinzwa esetshenziselwa ukwelapha ukuphuka kwe-proximal femur, okuhlanganisa ukuphuka kwe-intertrochanteric kanye ne-subtrochanteric. Inqubo ibandakanya lezi zinyathelo ezilandelayo:
I-1.Ukulungiselela Ngaphambi Kokuhlinzwa: Isiguli sihlolwe kahle, futhi ukuphuka kuhlukaniswa kusetshenziswa izifundo ze-imaging ezifana ne-X-ray.
I-2.I-anesthesia: I-anesthesia ejwayelekile noma i-anesthesia yesifunda (isb, i-anesthesia yomgogodla) ilawulwa.
3.I-Incision and Exposure: I-lateral incision yenziwa phezu kwe-hip, futhi imisipha ihlehliswa ukuze iveze i-femur.
I-4.Ukunciphisa Nokulungiswa: Ukuphuka kuncishisiwe (kuqondiswe) ngaphansi kokuqondisa kwe-fluoroscopic. Isikulufu esikhulu sokukhansela (i-lag screw) sifakwa entanyeni nasekhanda lesifazane. Lesi sikulufu sifakwe ngaphakathi komkhono wensimbi, onamathiselwe epuletini elinamathele ku-lateral femoral cortex ngezikulufu. I-DHS ivumela ukuminyanisa okuguquguqukayo, okusho ukuthi isikulufu singashelela ngaphakathi komkhono, sikhuthaze ukucindezelwa kokuphuka nokuphulukiswa.
I-5.Ukuvalwa: I-incision ivaliwe ngezingqimba, futhi ama-drain angase abekwe ukuvimbela ukwakheka kwe-hematoma.
Iyini i-PFN Surgery?
I-PFN (I-Proximal Femoral Nail) enye indlela esetshenziselwa ukwelapha ukuphuka kwe-femoral proximal. Kubandakanya ukufakwa kwe-intramedullary nail emseleni wesifazane, okunikeza ukulungiswa okuzinzile kusuka ngaphakathi kwethambo.
Iyini i-Z Phenomenon ku-PFN?
I-"Z phenomenon" ku-PFN ibhekisela enkingeni engaba khona lapho isipikili, ngenxa yokwakheka kwaso namandla asetshenzisiwe, singabangela ukugoqa kwe-varus yentamo yesifazane. Lokhu kungaholela ekungalungisweni kahle kanye nemiphumela emibi yokusebenza. Kwenzeka lapho ijiyomethri yezipikili namandla asetshenziswayo ngesikhathi sokuthwala isisindo kubangela ukuthi isipikili sifuduke noma siwohloke, okuholela ekuguquguqukeni komumo othi “Z” esiziphongweni.
Yikuphi Okungcono: I-Intramedullary Nail noma i-Dynamic Hip Screw?
Ukukhetha phakathi kwe-intramedullary nail (efana ne-PFN) kanye ne-Dynamic Hip Screw (DHS) kuncike ezicini eziningana, okuhlanganisa uhlobo lokuphuka, ikhwalithi yethambo, nezici zesiguli. Ucwaningo lubonise ukuthi i-PFN ngokuvamile inikeza izinzuzo ezithile:
1.Ukulahleka Kwegazi Okuncishisiwe: Ukuhlinzwa kwe-PFN ngokuvamile kuholela ekulahlekelweni kwegazi elincane uma kuqhathaniswa ne-DHS.
I-2.Isikhathi Sokuhlinzwa Esifushane: Izinqubo ze-PFN zivame ukushesha, zinciphisa isikhathi ngaphansi kwe-anesthesia.
3.Ukugqugquzelwa Kwangaphambi kwesikhathi: Iziguli ezelashwa nge-PFN zivame ukuhlanganisa futhi zithwale isisindo ngaphambi kwesikhathi, okuholela ekululameni okusheshayo.
4.Izinkinga Ezincishisiwe: I-PFN ihlotshaniswe nezinkinga ezimbalwa, ezifana nokutheleleka kanye ne-malunion.
Kodwa-ke, i-DHS ihlala iyinketho esebenzayo, ikakhulukazi ezinhlotsheni ezithile zokuphuka okuzinzile lapho ukwakheka kwayo kunganikeza ukulungiswa okusebenzayo. Isinqumo kufanele senziwe ngokusekelwe ezidingweni zesiguli ngasinye kanye nolwazi lukadokotela ohlinzayo.
Ingabe I-PFN Ingasuswa?
Ezimweni eziningi, i-PFN (I-Proximal Femoral Nail) ayidingi ukususwa uma ukuphuka sekupholile. Kodwa-ke, ukususwa kungase kucatshangelwe uma isiguli sithola ukungakhululeki noma izinkinga ezihlobene nokufakelwa. Isinqumo sokususa i-PFN kufanele senziwe ngokubonisana nodokotela wamathambo owelaphayo, kucatshangelwa izici ezifana nempilo yonke yesiguli kanye nezingozi ezingaba khona kanye nezinzuzo zenqubo yokususa.
Isikhathi sokuthumela: Apr-19-2025
