Ukuqhekeka kwe-temperal intertrochantteric kungukuphazamiseka okuvame kakhulu kwe-hip ekusebenzeni kwemitholampilo futhi kungenye yezindawo ezintathu ezivame kakhulu ezihambisana ne-osteoporosis kubantu asebekhulile. Ukwelashwa okulondoloziwe kudinga ukuphumula kombhede okuhlala isikhathi eside, kubeka izingozi eziphakeme ze-Spores Sores, izifo ze-pulmonary, embolism ye-pulmonary, i-vein vein thrombosis, nezinye izinkinga. Ubunzima babahlengikazi bubalulekile, futhi isikhathi sokutakula yinde, sibeka umthwalo osindayo emphakathini kanye nemindeni. Ngakho-ke, ukungenelela kokuhlinzwa kusenesikhathi, noma nini lapho kuvumelezeka, kubalulekile ukufeza imiphumela esebenzayo esebenzayo ku-HIP Fractures.
Njengamanje, i-PFNA (PRESMAL FEOVERARE Nail Antirotation System) Ukulungiswa kwangaphakathi kubhekwa njengendinganiso yegolide yokuhlinzwa kwe-hip fractures. Ukuthola ukwesekwa okuhle ngesikhathi sokuncishiswa kwe-HIP Fractures kubalulekile ngokuvumela ukuzivocavoca okusebenzayo. I-Intraperative Fluoroscopy ifaka phakathi i-anteroposteror (AP) kanye nokubukwa okulandelayo ukuhlola ukuncishiswa kwe-anterial anterial cortex. Kodwa-ke, izingxabano zingavela phakathi kwemibono emibili ngesikhathi sokuhlinzwa (ie, zihle ngokubuka okulandelayo kepha hhayi ekubukeni kwe-anteroporester, noma okuphambene nalokho). Ezimweni ezinjalo, kuhlolwe ukuthi ukuncishiswa kuyamukeleka nokuthi ukulungiswa kuyadingeka yini ukuthi kube yinkinga yabasebenzi abayinselele kwabasebenza emtholampilo. Izazi ezivela ezibhedlela ezifuywayo ezinjengesibhedlela saseMpumalanga nesibhedlela saseZhongshan sezikhulume ngalolu daba ngokuhlaziya ukunemba kokuhlola ukwesekwa okuhle nokungahambi kahle ngaphansi kwe-Anteroposteral CT COPANSAL SCANS njengezinga.
▲ Umdwebo ukhombisa ukwesekwa okuhle (a), ukwesekwa okungathathi hlangothi (b), kanye nokuxhaswa okungemuhle (c) amaphethini we-hip fractures ekubukeni kwe-anteroposterteor.
▲ Umdwebo ukhombisa ukwesekwa okuhle (D), ukwesekwa okungathathi hlangothi (e), kanye nokuxhaswa okungemuhle (f) amaphethini we-hip fractures ekubukeni kwangemuva.
I-athikili ifaka idatha yecala kusuka ezigulini eziyi-128 ezine-hip fractures. Izithombe ze-Intraperative Anteroposterial kanye ne-lateral zanikezwa ngokwahlukana kodokotela ababili (eyodwa enesipiliyoni esincane kanye nesipiliyoni esiningi) ukuhlola ukwesekwa okuhle noma okungekuhle. Ngemuva kokuhlola kokuqala, kwaqhutshwa kabusha ngemuva kwezinyanga ezi-2. Izithombe ze-CT Postperative ze-CT zinikezwe koprofesa onolwazi, onqume ukuthi ngabe leli cala lilize noma alinalo yini, lisebenza njengezinga lokuhlola ukunemba kokuhlolwa kwezithombe ngodokotela ababili bokuqala. Ukuqhathanisa okuyinhloko esihlokweni kungokulandelayo:
(1) Ingabe kukhona umehluko obaluleke ngokwezibalo emiphumeleni yokuhlola phakathi kodokotela abanolwazi olunolwazi futhi onolwazi ngokwengeziwe ekuhlolweni kokuqala nokwesibili? Ngokwengeziwe, i-athikili ihlola ukuvumelana kwamaqembu phakathi kwamaqembu anolwazi olunolwazi futhi anolwazi lokuhlola zombili kanye nokuguquguquka kwe-intragroup phakathi kokuhlolwa okubili.
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Imiphumela Yocwaningo
1. Kumijikelezo emibili yokuhlola, nge-CT njengezengezo zereferensi, kwakungekho umehluko ophawuleka ngokwezibalo ngokuzwela, ukucaciswa, amazinga amanga, namanye amapharamitha ahlobene nokuhlolwa kwekhwalithi yokunciphisa ngokusekelwe kwi-Intrapeaperative X-Rays phakathi kwalo odokotela ababili.
2.Kuwukuhlola kwekhwalithi yokuncipha, kuthatha ukuhlolwa kokuqala njengesibonelo:
- Uma kunesivumelwano phakathi kokuhlolwa kwe-anteroposteror kanye ne-lateral (okuhle noma kokubili okungekhona okuhle), ukwethenjwa kokubikezela ikhwalithi yokunciphisa ku-CT yi-100%.
- Uma kunokungaboni ngaso linye phakathi kokuhlolwa kwe-anteroposteror kanye ne-lateral, ukwethenjwa kwezinqubo zokuhlola i-lateral ekubikezeleni ikhwalithi yokunciphisa ku-CT iphakeme.
▲ Umdwebo ukhombisa ukwesekwa okuhle okuboniswe ekubukeni kwe-anteropostermeor ngenkathi kuvela njengongenathemba ekubukeni kwangemuva. Lokhu kukhombisa ukungahambisani emiphumeleni yokuhlola phakathi kokubukwa kwe-anteroposteror kanye nokubukwa kwamuva.
▲ Ukwakhiwa kabusha kwe-CT enobukhulu obuthathu kunikezela ngezithombe eziningi zokubukwa, ukukhonza njengezinga lokuhlola ikhwalithi yokunciphisa.
Kumazinga wangaphambilini wokuncishiswa kwama-intertrochantteric fractures, ngaphandle kokusekelwa okuhle nokubi, kunomqondo wokusekelwa kwe- "neatter", okusho ukuncishiswa kwe-anatomical. Kodwa-ke, ngenxa yezinkinga ezihlobene nesinqumo se-fluoroscopy nokungaqondani kwamehlo komuntu, ukuncishiswa kweqiniso "kweqiniso" akuhlali kuphambuka ekunciphiseni "okuhle" noma "okungalungile". Iqembu eliholwa nguZhang Shimin esibhedlela iThangpu eShanghai eshicilele iphepha (ireferensi ethile ekhohliwe, angayazisa uma othile angakunikeza imiphumela emihle yokuphazamiseka ngokuqhathaniswa nokuncishiswa kwe-anatomical. Ngakho-ke, ukucubungula lolu cwaningo, kufanele kwenziwe khona lolu cwaningo, kufanele kwenziwe imizamo ngesikhathi sokuhlinzwa ukuze kufinyelelwe ukwesekwa okuhle ekubuyiselweni kwe-intertrochanterteric, zombili ekubukeni kwe-anteroposteronder kanye nasemuva.
Isikhathi Sokuposa: Jan-19-2024
