Ngokuphathelene nezikulufu zekhanda nentamo, zamukela umklamo oyisikulufu esikabili wezikulufu ze-lag nezikulufu zokucindezelwa.Ukuhlanganiswa okuhlanganisiwe kwezikulufu ezi-2 kuthuthukisa ukumelana nokujikeleza kwekhanda lesifazane.
Ngesikhathi senqubo yokufaka isikulufu sokuminyanisa, ukunyakaza kwe-axial yesikulufu se-lag kuqhutshwa intambo ye-occlusal phakathi kwesikulufu sokucindezela kanye nesikulufu se-lag, futhi ingcindezi emelene nokuzungezisa iguqulwa ibe ukucindezela komugqa ekugcineni kokuphuka, ngaleyo ndlela kuthuthukise kakhulu. amandla e-anti-rotational of the screw.Sika ukusebenza.Izikulufu ezi-2 zihlanganiswe ngokuhlanganyela ukugwema umphumela "Z".
Ukuklanywa komkhawulo oseduze we-nail eyinhloko efana ne-joint prosthesis yenza umzimba we-nail uhambisane ne-medullary cavity, futhi uhambisane nezici ze-biomechanical ze-proximal femur.
Izinyathelo Zokuhlinza
Isikhundla: Isiguli singakhetha isikhundla se-lateral noma sangemuva.Ngesiguli esisendaweni e-supine, etafuleni elisebenza nge-radiolucent noma itafula le-orthopedic traction.Uhlangothi olunempilo lwesiguli ludonswa futhi lugxilwe kubakaki, futhi uhlangothi oluthintekile ludonswa ku-10 ° -15 ° ukuze kube lula ukuqondanisa ne-medullary cavity.
Ukusetha kabusha okunembile: Hlikihla isitho esithintekile ngombhede wokudonsa ngaphambi kokusebenza, bese ulungisa indlela yokudonsa ngaphansi kwe-fluoroscopy ukuze isitho esithintekile sibe sesimweni sokuzungezisa kancane kwangaphakathi kanye nesimo sokwengezwa.Ama-fracture amaningi angasethwa kabusha kahle.Ukusetha kabusha kwangaphambi kokuhlinzwa kubaluleke kakhulu futhi Iphuzu liwukuthi, ungayinqamuli kalula uma kungekho ukuncishiswa okwanelisayo.Lokhu kungasindisa isikhathi sokusebenza futhi kunciphise ubunzima phakathi nokusebenza.Uma ukunciphisa kunzima, ungenza i-incision encane ngesikhathi sokusebenza futhi usebenzise i-push rod, i-retractor, i-forceps yokunciphisa, njll ukusiza ukunciphisa.Ukuphuka okuncane Izinhlangothi zangaphakathi nezingaphandle zihlukene, futhi asikho isidingo sokulungisa ngokuphindaphindiwe.Isiphetho sokuphuka singasethwa kabusha ngokuzenzakalelayo lapho isikulufu sokuminyanisa sifakwa phakathi nokusebenza.
Ukwehliswa kwe-trochanter encane: Umklamo we-intramedullary nail awudingi ukuqhubeka kwe-cortex ephakathi.Ngokuvamile, asikho isidingo sokunciphisa ucezu oluncane lwe-trochanter fracture, ngoba ukuhlinzwa kokunciphisa okuvalekile okuvalekile kunomthelela omncane ekujikelezeni kwegazi kokuphela kokuphuka, futhi ukuphuka kulula ukuphulukisa.Kodwa-ke, i-coxa varus kufanele ilungiswe ngaphambi kokuba isikulufu sibekwe, futhi isikhathi sokuya phansi kanye nesikhathi sokuthwala isisindo se-postoperative kufanele sibambezeleke ngendlela efanele.
Isikhundla sokusikwa: I-3-5 cm ye-longitudinal incision yenziwa ekupheleni kwe-proximal ye-trochanter apex enkulu cishe ezingeni le-anterior superior iliac spine.Intambo ye-Kirschner ingafakwa ohlangothini olungaphandle lwe-proximal femur, futhi ilungiswe ukuze ihambisane ne-eksisi ende ye-femur ngaphansi kwe-C-arm fluoroscopy, ukuze ukuma kwe-incision kunembe kakhulu.
Nquma indawo yokungena: indawo yokungena imaphakathi kancane ne-apex ye-trochanter enkulu, ehambisana nokuchezuka kwe-4° kwe-axis ende ye-medullary cavity ekubukeni kwangaphambili.Ekubukeni kwe-lateral, indawo yokungena yezipikili itholakala eksisi ende ye-medullary cavity;
Indawo Yokungenela Inaliti
IfakaGuidePin Fi-luoroscopy
Ngokuphelele Reamed
Njengoba isiphetho esiseduze sesipikili esikhulu se-InterTan siwugqinsi uma kuqhathaniswa, isikhonkwane singafakwa kuphela ngemva kokuvuselelwa kabusha okugcwele phakathi nokusebenza.Ukubuyisela kabusha okuseduze kufanele kumiswe lapho idivayisi ekhawulelayo yokugaya kabusha ithinta ithuluzi lokungena lesiteshi.Ukuthi i-distal femoral shaft ivuselelwa kabusha kuncike kusayizi we-medullary cavity.Uma i-X-reyi yangaphambi kokuhlinzwa ithola ukuthi imbobo ye-medullary ye-proximal femoral shaft ngokusobala incane, i-femoral shaft reamer kufanele ilungiswe ngaphambi kokuhlinzwa.Uma ukulungisa kabusha kunganele, kuzokwenza kube nzima ukufaka isikulufu.Ngesikhathi senqubo ye-screwing, ingase inyakaze ebangeni elincane Izingxenye ezingemuva ze-intramedullary nail kufanele zigwenywe, kodwa ukungqongqoza okunamandla emsileni wezipikili kufanele kugwenywe.Ukungqongqoza okunjalo kungabangela kalula ukuhlukana kwamathambo ngesikhathi sokusebenza noma ukususwa kabusha kokuphuka ngemva kokunciphisa.
Faka umkhono wokuvikela izicubu ezithambile, ubhoboze phakathi eduze kwentambo yomhlahlandlela usebenzisa i-drill, futhi wandise isiteshi se-femal esiseduze sozipho lwe-intramedullary (ngenhla kwesithombe);uma i-medullary cavity incane, sebenzisa i-remed drill ethambile ukuze wandise umgodi we-medullary ube ububanzi obufanele;xhuma umhlahlandlela faka isipikili esikhulu se-InterTAN emgodini we-medullary (ngezansi);
Pi-roximalLok
Ukubekwa kwesikulufu se-Lag
Ukubekwa kwesikulufu sokucindezela
Khipha isipikili sokukhiya i-distal
RimizwaLok
End Cup
Ukwelashwa Kwangemva Kokuhlinzwa
Ama-antibiotics ayesetshenziswa njalo ukuvimbela ukutheleleka emahoreni angu-48 ngemva kokuhlinzwa;i-heparin ye-heparin enesisindo esiphansi kanye namaphampu omoya asetshenziselwa ukuvimbela i-deep vein thrombosis (DVT) emaphethelweni aphansi, futhi izifo eziyisisekelo zezokwelapha zaqhubeka nokwelashwa.Ama-radiographs angenalutho we-pelvis kanye nama-radiographs e-anteroposterior kanye ne-lateral ye-joint hip ethintekile ayethathwa njalo ukuze aqonde ukunciphisa ukuphuka nokulungiswa kwangaphakathi.
Ngosuku lokuqala ngemva kokuhlinzwa, isiguli sakhuthazwa ukuba senze ukufinyezwa kwe-isometric kwe-quadriceps femoris endaweni e-semi-recumbent.Ngosuku lwesibili, isiguli sayalelwa ukuba sihlale embhedeni.Ngosuku lwesithathu, isiguli senziwa ngenkuthalo ukuzivocavoca kwe-hip namadolo embhedeni.Akukho ukuthwala isisindo esithweni esithintekile.Khuthaza iziguli ezikwazi ukuthwala ingxenye yesisindo esithweni esithintekile ngaphakathi kwebanga elibekezelelekayo emavikini ama-4 ngemuva kokuhlinzwa.Kancane kancane hamba nomuntu ohamba ngezinyawo onesisindo ngokusho kwe-X-ray yokulandela kumaviki angu-6 kuya kwangu-8.Iziguli ezingakwazi ukuhamba ngokuzimela futhi zine-osteoporosis enzima Ezigulini ezinokukhula okuqhubekayo kwe-callus yamathambo ku-X-ray, kancane kancane zingahamba ngesisindo ngaphansi kokusekelwa.
Umuntu Othintwayo: U-Yoyo (Umphathi Womkhiqizo)
TEL/Whatsapp: +86 15682071283
Isikhathi sokuthumela: May-08-2023
