Ukuqhekeka kwe-Intertrochantteric kwe-akhawunti ye-femur ngo-50% we-hip fractures asebekhulile. Ukwelashwa okulondoloziwe kuthambekele ezinkingeni ezifana ne-vein thrombosis ejulile, embolism yamaphaphu, izilonda zengcindezi, kanye nezifo zamaphaphu. Izinga lokufa kungakapheli unyaka owodwa lidlula ama-20%. Ngakho-ke, ezimweni lapho isimo seziguli sivumela khona, ukungcoliswa kwangaphakathi kwangaphakathi kusenesikhathi kuyinto ekhethwayo yokwelashwa okukhethwayo kwama-intertrochanterteric fractures.
Ukulungiswa kwe-intramentundary Nail okwamanje kuyindinganiso yegolide yokwelashwa kwama-intertrochanterteric fractures. Ezifundweni ezithonya elithonya ukulungiswa kwangaphakathi kwe-PFNA, izinto ezifana nobude be-PFNA NEP, kanye nokwakhiwa kubikwe ezifundweni eziningi zangaphambili. Kodwa-ke, akucaci ukuthi ngabe ubukhulu besipikili esikhulu buthinta imiphumela esebenzayo. Ukubhekana nalokhu, izazi zakwamanye amazwe zisebenzise izinzipho ezihlanganayo ezinobude obulinganayo kepha ubukhulu obuhlukile ukulungisa ama-intertrochanterteric fracteric kubantu asebekhulile (iminyaka> 50), ehlose ukuqhathanisa noma ngabe kukhona umehluko emiphumeleni esebenzayo.
Lolu cwaningo lubandakanya amacala angama-191 e-Unilateral Interrochantteric Fractures, wonke aphathwa ngoPfna-II ekuhlelweni kwangaphakathi. Lapho i-trochance encane yayiphazamiseka futhi isetshenziswa, kwasetshenziswa isipikili esifushane sika-200mm; Lapho i-trochanter ephansi ibingaqondile noma ingavinjelwe, kwasetshenziswa isipikili esifushane se-170mm esifushane. Ububanzi besipikili esikhulu basuka ku-9-12mm. Ukuqhathanisa okuyinhloko ocwaningweni olugxile kulezi zinkomba ezilandelayo:
1. Ububanzi be-Trochanter obuncane, ukuhlola ukuthi ngabe ukuma kwakwejwayelekile yini;
2
3. Ibanga le-tip-apex (tad);
I-4.Nail-to-Canal Ratio (NCR). I-NCR iyisilinganiso sobubanzi obukhulu besipikili esibubanzi be-medullary canal diameter ku-distal Locking Screw Plane.
Phakathi kweziguli eziyi-191 ezifakiwe, ukusatshalaliswa kwamacala asuselwa kubude kanye nobubanzi besipikili esikhulu kuboniswa kulokhu okulandelayo:
I-NCR ejwayelekile ibingu-68.7%. Usebenzisa lesi silinganiso njengombundu, amacala ane-ncr enkulu kune-average kubhekwe njengeyunithi yobubanzi obukhulu, ngenkathi amacala ane-NCR ngaphansi kwesilinganiso esingu-Frener Pialie Mainter. Lokhu kuholele ekuhlukaniselweni kweziguli eqenjini eliphakeme eliphambili lezipikili (amacala angama-90) kanye neqembu eliphansi eliphansi (amacala ayi-101).
Imiphumela ikhombisa ukuthi abukho umehluko ophawule ngokwezibalo phakathi kweqembu eliphakeme eliphambili leqembu neqembu eliphansi le-apex maqondana nebanga le-tip-apex, i-KOVAL SCORE, inani lokuphulukisa, kanye nezinkinga zama-orthopedic.
Ngokufana nalolu cwaningo, kushicilelwe i-athikili ku- "Journal of Orthopedic Trauma" ngo-2021: [isihloko sendatshana].
Lolu cwaningo lufake iziguli ezindala eziyi-168 (iminyaka> 60) nokuqhekeka kwe-intertrochanterteric, konke kuphathwe ngezipikili ze-cephalomedullary. Ngokusekelwe kububanzi besipikili esikhulu, iziguli zahlukaniswa zaba yiqembu le-10mm neqembu elinobuso obukhulu kune-10mm. Imiphumela ibuye yaveza ukuthi abukho umehluko ophawuleka ngokwezibalo ngamanani wokuhlaziya (kungaba jikelele noma angatheleleki) phakathi kwamaqembu amabili. Ababhali bocwaningo basikisela ukuthi, ezigulini ezikhulile ezinama-intertrochanterteric fractures, besebenzisa ububanzi obuyi-10mm
Isikhathi sePosi: Feb-23-2024
