Udaba lokukhetha ubukhulu bezinzipho zangaphakathi kwe-medullary zamathambo amade ashubhu ezitho ezingezansi.

Ukuzinamela nge-intramedullary kuyindinganiso yegolide yokwelashwa kokuhlinzwa kokuphuka kwe-diaphyseal kwamathambo amade ane-tubular ezithweni ezingezansi. Kunikeza izinzuzo ezifana nokulimala okuncane kokuhlinzwa kanye namandla aphezulu e-biomechanical, okwenza kube yinto evame ukusetshenziswa kakhulu ekuqhekekeni kwe-tibial, femoral, kanye ne-humeral shaft. Ngokwezokwelapha, ukukhethwa kobubanzi bezinzipho ze-intramedullary kuvame ukukhetha isinzipho esikhulu kakhulu esingafakwa ngokulungiswa okulinganiselwe, ukuqinisekisa ukuzinza okukhulu. Kodwa-ke, ukuthi ukujiya kwezinzipho ze-intramedullary kuthinta ngqo yini isibikezelo sokuqhekeka akukacaci.

Esihlokweni esandulele, sixoxe ngocwaningo oluhlola umthelela wobubanzi bezinzipho ngaphakathi kwe-medullary ekuphulukisweni kwamathambo ezigulini ezingaphezu kweminyaka engu-50 ezinezinhlungu ze-intertrochanteric. Imiphumela ayibonisanga mehluko wezibalo emazingeni okuphulukiswa kwama-fracture kanye namazinga okusebenza kabusha phakathi kweqembu elingu-10mm kanye neqembu elinezinzipho ezijiyile kuno-10mm.

Iphepha elanyatheliswa ngo-2022 yizazi ezivela eSifundazweni saseTaiwan nalo lafinyelela esiphethweni esifanayo:

Ucwaningo oluhilela iziguli ezingu-257, ezazilungisiwe ngezinzipho zangaphakathi kwe-medullary ezinobubanzi obungu-10mm, 11mm, 12mm, kanye no-13mm, lwahlukanisa iziguli zibe amaqembu amane ngokusekelwe kububanzi bezinzipho. Kwatholakala ukuthi akukho mehluko wezibalo emazingeni okuphulukiswa kokuphuka phakathi kwamaqembu amane.

Ngakho-ke, ingabe lokhu kunjalo nangokuqhekeka okulula komgodi we-tibial?

Esifundweni sokulawulwa kwamacala esasizoba khona esihilela iziguli ezingu-60, abacwaningi bahlukanise iziguli ezingu-60 ngokulinganayo ngamaqembu amabili anama-30 ngalinye. Iqembu A laqiniswa ngezinzipho ezincane zangaphakathi kwe-medullary (9mm kwabesifazane kanye no-10mm kwabesilisa), kanti iQembu B laqiniswa ngezinzipho ezinkulu zangaphakathi kwe-medullary (11mm kwabesifazane kanye no-12mm kwabesilisa):

Imiphumela ibonise ukuthi akukho mehluko obalulekile emiphumeleni yezokwelapha noma ekuthathweni kwezithombe phakathi kwezinzipho ezincane nezinkulu zangaphakathi kwe-medullary. Ngaphezu kwalokho, izinzipho ezincane zangaphakathi kwe-medullary zazihlotshaniswa nezikhathi ezimfushane zokuhlinzwa kanye ne-fluoroscopy. Kungakhathaliseki ukuthi kusetshenziswe isinzipho esinobukhulu noma obuncane, ukuhlehliswa okulinganiselwe kwenziwa ngaphambi kokufakwa kwezinzipho. Abalobi basikisela ukuthi ekuqhekekeni okulula komgodi we-tibial, izinzipho zangaphakathi kwe-medullary ezinobukhulu obuncane zingasetshenziswa ukuze kuqiniswe.