Indlela yokulungisa yangaphakathi ye-PFNA
I-PFNA (Ukuvimbela Ukuzungeza Kwezinzipho Zesifazane Esiseduze), uzipho lwe-proximal femoral olulwa nokujikeleza ngaphakathi kwe-medullary. Lufanele izinhlobo ezahlukene zokuphuka kwe-femoral intertrochanteric; ukuphuka kwe-subtrochanteric; ukuphuka kwesisekelo sentamo ye-femoral; ukuphuka kwentamo ye-femoral kuhlanganiswe nokuphuka kwe-femoral shaft; ukuphuka kwe-femoral intertrochanteric kuhlanganiswe nokuphuka kwe-femoral shaft.
Izici eziyinhloko zokuklama izinzipho kanye nezinzuzo
（1）Umklamo oyinhloko wezipikili uboniswe ngamacala angaphezu kuka-200,000 e-PFNA, futhi ufinyelele ukuhambisana okuhle kakhulu nokwakheka komsele we-medullary；
（2） I-engeli yokuthumba yezinzipho eziyinhloko engamadigri ayi-6 ukuze kube lula ukuyifaka kusukela esicongweni se-trochanter enkulu；
（3）Izipikili ezingenalutho, kulula ukuzifaka；
（4）Ingxenye ekude yesipikili esiyinhloko inokuguquguquka okuthile, okulula ukuyifaka isipikili esiyinhloko futhi igweme ukugxilisa ingqondo ekucindezelekeni.
I-spiral blade:
(1) Ukulungiswa kwangaphakathi okukodwa ngesikhathi esisodwa kuqeda ukuphikiswa kokujikeleza kanye nokuzinza kwe-angular;
(2) I-blade inendawo enkulu ebusweni kanye nobubanzi obukhula kancane kancane phakathi. Ngokufaka nokucindezela ithambo elikhanseliwe, amandla okubambelela e-helical blade angathuthukiswa, okuyinto efaneleka kakhulu ezigulini eziqhekekile;
(3) I-helical blade ifakwe kahle nethambo, okuthuthukisa ukuqina futhi imelane nokujikeleza. Isiphelo sokuqhekeka sinamandla amakhulu okuwa kanye nokukhubazeka kwe-varus ngemva kokumuncwa.
Amaphuzu alandelayo kufanele anakwe ekwelapheni ukuphuka kwe-femoral nge:Ukulungiswa kwangaphakathi kwe-PFNA:
(1) Iningi leziguli esezikhulile lihlushwa izifo eziyisisekelo zezokwelapha futhi alikwazi ukubekezelela ukuhlinzwa. Ngaphambi kokuhlinzwa, isimo sesiguli esijwayelekile kufanele sihlolwe ngokuphelele. Uma isiguli sikwazi ukubekezelela ukuhlinzwa, ukuhlinzwa kufanele kwenziwe ngokushesha ngangokunokwenzeka, futhi isitho esithintekile kufanele sisetshenziswe ngokushesha ngemva kokuhlinzwa. Ukuvimbela noma ukunciphisa ukuvela kwezinkinga ezahlukahlukene;
(2) Ububanzi bomgodi we-medullary kufanele bulinganiswe kusengaphambili ngaphambi kokuhlinzwa. Ububanzi be-nail eyinhloko yangaphakathi kwe-medullary buncane ngo-1-2 mm kunomgodi wangempela we-medullary, futhi akufaneleki ukubekwa ngobudlova ukuze kugwenywe ukwenzeka kwezinkinga ezifana nokuqhekeka kwe-distal femur;
(3) Isiguli silele phansi, isitho esithintekile siqondile, kanti ukujikeleza kwangaphakathi kungu-15°, okulungele ukufakwa kwenaliti yokuqondisa kanye nozipho oluyinhloko. Ukudonsa okwanele kanye nokunciphisa ukuqhekeka okuvaliwe ngaphansi kwe-fluoroscopy kuyizihluthulelo zokuhlinzwa okuphumelelayo;
(4) Ukusebenza okungalungile kwendawo yokungena yenaliti yomhlahlandlela wesikulufu esiyinhloko kungabangela ukuthi isikulufu esiyinhloko se-PFNA sivalwe emgodini we-medullary noma indawo ye-spiral blade ibe yinqaba, okungase kubangele ukuphambuka kokuncipha kokuphuka noma ukusika ukucindezeleka kwentamo ye-femoral kanye nekhanda le-femoral yi-spiral blade ngemva kokuhlinzwa, kunciphisa umphumela wokuhlinzwa;
(5) Umshini we-X-ray wengalo ye-C kufanele uhlale unake ukujula kanye nokungajwayelekile kwenaliti yomhlahlandlela we-screw blade lapho uyifaka, futhi ukujula kwekhanda le-screw blade kufanele kube ngu-5-10 mm ngaphansi kobuso be-cartilage yekhanda le-femoral;
(6) Uma kuqhekeka ama-subtrochanteric ahlanganisiwe noma izingcezu ezinde ze-oblique fracture, kunconywa ukusebenzisa i-PFNA ende, futhi isidingo sokunciphisa okuvulekile sincike ekunciphiseni kokuqhekeka kanye nokuqina ngemva kokunciphisa. Uma kudingeka, ikhebula lensimbi lingasetshenziswa ukubopha ibhlogo lokuqhekeka, kodwa lizothinta ukuphulukiswa kokuqhekeka futhi kufanele ligwenywe;
(7) Uma kuqhekeka amanxeba phezulu kwe-trochanter enkulu, ukuhlinzwa kufanele kube mnene ngangokunokwenzeka ukuze kugwenywe ukuhlukaniswa okuqhubekayo kwezingcezu zamanxeba.
Izinzuzo kanye nokulinganiselwa kwe-PFNA
Njengohlobo olusha lweidivayisi yokulungisa i-intramedullary, i-PFNA ingadlulisa umthwalo ngokusebenzisa i-extrusion, ukuze izinhlangothi zangaphakathi nezangaphandle ze-femur zikwazi ukuthwala ukucindezeleka okufanayo, ngaleyo ndlela kufezwe injongo yokuthuthukisa ukuzinza nokusebenza kahle kokulungiswa kwangaphakathi kwama-fracture. Umphumela ozinzile muhle njalo njalo.
Ukusetshenziswa kwe-PFNA kunemikhawulo ethile, njengobunzima bokubeka isikulufu sokukhiya esikude, ingozi eyengeziwe yokuphuka eduze kwesikulufu sokukhiya, ukukhubazeka kwe-coxa varus, kanye nobuhlungu endaweni yangaphambili yethanga okubangelwa ukucasuka kwebhande le-iliotibial.ukulungiswa kwe-intramedullaryngokuvamile kunengozi yokwehluleka kokulungiswa kanye nokungaxhumani kokuphuka.
Ngakho-ke, ezigulini esezikhulile ezinezinkinga zokuphuka kwe-intertrochanteric ezingazinzile kanye ne-osteoporosis enzima, ukuthwala isisindo kusenesikhathi akuvunyelwe nhlobo ngemva kokuthatha i-PFNA.
Isikhathi sokuthunyelwe: Septhemba-30-2022
