I-intramenduvary kilingkuyindlela ejwayelekile esetshenziswa ama-orthopedic yangaphakathi yokulungiswa kwangaphambi kweminyaka yo-1940. Kusetshenziswa kabanzi ekwelapheni kokuqhekeka kwamathambo amade, okungewona ama-Unions, kanye nokunye ukulimala okuhlobene. Le ndlela ifaka ukufaka isikhonkwane se-intramedullary emseleni ophakathi kwethambo ukuzenzisa isayithi lokuphuka. Ngamagama alula, i-intrametullary nail iyisakhiwo eside esiningiukukhiya isikulufaIzimbobo zombili iziphetho, ezisetshenziselwa ukulungisa amaphethelo we-proximal kanye ne-distal of fracture. Ngokuya ngesakhiwo sabo, izipikili ezihlekisayo zingahlukaniswa njengezinto eziqinile, ze-tubular, noma ezivulekile, futhi zisetshenziselwa ukwelapha izinhlobo ezahlukene zeziguli. Isibonelo, izipikili eziqinile eziqinile zinokumelana kangcono nokutheleleka ngenxa yokuntuleka kwawo kwesikhala sangaphakathi.
Yiziphi izinhlobo zama-fractures ezilungele izinzipho ezihlekisayo?
I-intramenduvary nailkungukufakelwa okuhle kokwelashwa kwe-diaphyseal fractures, ikakhulukazi ku-femur naseTibia. Ngokusebenzisa amasu ahlaselayo kancane, izipikili ezi-intramenduvaty zinganikeza ukuzinza okuhle ngenkathi kunciphisa ukulimala kwezicubu ezithambile endaweni yokuphuka.
Ukuncishiswa okuvaliwe kanye nokuhlinzwa kwe-intramerationary ukukhanyisa ukuhlinzwa kunezinzuzo ezilandelayo:
Ukuncishiswa okuvaliwe kanye ne-intramenduvaltary Kiling (CRIN) kunezinzuzo zokugwema ukuvela kwesiza se-Fracture futhi kunciphise ubungozi bokutheleleka. Ngokuvela okuncane, kugwema ukudilizwa okuthe xaxa kwezicubu ezithambile nomonakalo wokuhlinzekwa kwegazi endaweni ye-Fracture, ngaleyo ndlela kuthuthukise izinga lokuphulukisa lokuqhekeka. Ngezinhlobo ezithile zeI-Proximal Bone Fractures, UCrin anganikeza ukuqina okwenele kokuqala, okuvumela iziguli ukuthi ziqale ukunyakaza okuhlangene kusenesikhathi; Inenzuzo futhi ngokuya ngokuthwala ingcindezi ye-axial ngokuqhathaniswa nezinye izindlela zokulungiswa kwe-eccentric ngokuya nge-biomechanics. Kungavimbela kangcono ukukhululeka kokulungiswa kwangaphakathi ngemuva kokuhlinzwa ngokwandisa indawo yokuxhumana phakathi kokufakelwa kanye nethambo, okwenza kulungele iziguli nge-osteoporosis.
Kusetshenziswe eTibia:
Njengoba kukhonjisiwe esifanekisweni, inqubo yokuhlinzwa ibandakanya ukwenza incision encane ye-3-5 cm kuphela ngenhla kwe-tibial tubercle, bese ifaka izikulufo ezikhiyiwe ezingama-2-3 ngokuvimbela ukukhishwa okungaphansi kwe-1 cm emithonjeni engezansi. Uma kuqhathaniswa nokwehliswa okuvulekile kwendabuko nokulungiswa kwangaphakathi ngepuleti lensimbi, lokhu kungabizwa ngokuthi yindlela evuselelayo ngempela.
Kusetshenziswe ku-femur:
1.Incerlocking umsebenzi we-feavely Locked inteil ye-intramentultary:
Kubhekiswa emandleni alo okumelana nokujikeleza ngendlela yokukhiya yesipikili se-intramedullary.
2.Charfition of the Lovalded Nail Evaderary:
Ngokwemigomo yokusebenza: Izipikili ezijwayelekile ezivalekile ezivalekile nokwakhiwa kabusha okukhiyiwe kwezipikili zomhlaba wonke; Ngokuyinhloko enqunywe ngokudluliselwa kwengcindezi kusuka ku-hip ehlanganiswe kuhlangothi oluhlanganisiwe, nokuthi ngabe izingxenye ezingenhla nezingezansi phakathi kwabajikelezi (ngaphakathi kwe-5cm) zizinzile. Uma kungazinzile, kwakhiwa kabusha ukuhanjiswa kwengcindezi ye-HIP.
Ngokwesilinganiso
2.1 Izipikili ezijwayelekile zokuxhumana kwe-intramenduval
Umsebenzi oyinhloko: I-Axial Stress Statilization.
Izinkomba: Ukuqhekeka kwe-Fleam Sheff (akusebenzi kuma-subtrochantteric fractures)
2.2 Ukwakhiwa kabusha kwenziwa kabusha nge-intrametullary nail
Umsebenzi oyinhloko: Ukudluliswa kwengcindezi kusuka ku-hip kuya ku-Feofter Shaft akukuzinzile, futhi ukuqina kokudluliswa kwengcindezi kulesi sigaba kudinga kwakhiwe kabusha.
Izinkomba: 1. Ukuqhekeka okuphansi; 2
I-PFNA futhi uhlobo lokwakhiwa kabusha-uhlobo lwe-intramendulrary nail!
2.3 Indlela yokukhiya distring ye-inteil ye-intrametullary
Indlela yokukhiya edayiswayo ye-intrametullary nails iyahlukahluka ngokuya ngomenzi. Ngokuvamile, isikulufa esikhiyiwe esisodwa esikhiyiwe sisetshenziselwa izipikili zabesifazane abasezingeni eliphakeme, kodwa ngenxa yezimpawu zowesifazane ezihlasela noma zibeke izinzipho ezi-intramendulting, izikulufo ezikhiyiwe ezimbili noma ezintathu ngokukhiya okunamandla kuvame ukusetshenziselwa ukuthuthukisa ukuqina okuguquguqukayo. Zombili lezi zipikili zabesifazane nezindilinga ze-tibial zihlelwe ngezikulufo ezikhiyiwe ezimbili.
Isikhathi sePosi: Mar-29-2023
