Ukuphuka kwentamo yesifazane kuwukulimala okuvamile futhi okungase kube yingozi kakhulu kodokotela abahlinzayo bamathambo, okunezehlakalo eziphezulu zokungewona inyunyana kanye ne-osteonecrosis ngenxa yokunikezwa kwegazi okuntekenteke. Ukunciphisa okunembile nokuhle kwe-femoral neck fractures kuyisihluthulelo sokulungiswa okuphumelelayo kwangaphakathi.
Ukuhlola Ukuncishiswa
Ngokusho kwe-Garden, indinganiso yokunciphisa ukuphuka kwentamo yesifazane esusiwe ingu-160° efilimini yamathambo kanye no-180° kufilimu engemuva. Kubhekwa njengokwamukelekayo uma inkomba Yengadi iphakathi kuka-155° no-180° endaweni emaphakathi neseceleni ngemva kokwehliswa.
Ukuhlolwa kwe-X-ray: ngemva kokunciphisa okuvaliwe, izinga lokwaneliseka lokunciphisa kufanele linqunywe ngokusebenzisa izithombe ze-X-ray ezisezingeni eliphezulu. USimom no-Wyman baye benza ama-engeli ahlukene we-X-ray ngemva kokunciphisa okuvaliwe kokuphuka kwentamo yesifazane, futhi bathola ukuthi kuphela amafilimu e-X-ray amahle kanye ne-lateral abonisa ukuncishiswa kwe-anatomical, kodwa hhayi ukuncishiswa kwe-anatomical ebusweni bangempela be-conductors kanye ne-anatomical ye-conductible ye-conductible ye-conductible ye-conductible ye-conductible ye-conductible ye-conductible ebusweni. i-concave surface yentamo ye-femoral ingaxhunywa ku-S-curve esimweni esivamile se-anatomical. U-Lowell uphakamise ukuthi indawo eyi-convex yekhanda lesifazane kanye ne-concave yentamo yesifazane ingakha ijika elimise okuka-S ngaphansi kwezimo ezijwayelekile ze-anatomical, futhi uma ijika elimise okuka-S lingabushelelezi noma lithambile kunoma iyiphi indawo ku-X-ray, iphakamisa ukuthi ukumiswa kabusha kwe-anatomical akukafinyelelwa.
Unxantathu ohlanekezelwe unezinzuzo ezisobala kakhulu ze-biomechanical
Njengesibonelo, emfanekisweni ongezansi, ngemva kokuphuka kwentamo ye-femur, ukuphela kokuphuka kubhekene nokucindezeleka okunamandla kakhulu engxenyeni engenhla futhi kucindezela engxenyeni engezansi.
Izinjongo zokulungisa ukuphuka yilezi:1. ukugcina ukuhleleka okuhle kanye 2. nokulwisana nezingcindezi eziqinile ngangokunokwenzeka, noma ukuguqula izingcindezi eziqinile zibe yizingcindezi ezicindezelayo, ezihambisana nomgomo wokuhlanganisa i-tension banding. Ngakho-ke, isixazululo sikanxantathu esihlanekezelwe esinezikulufu ezingu-2 ngaphezulu ngokusobala siphakeme kunesixazululo se-orthotic esingunxantathu esinesikulufu esisodwa ngenhla ukuze simelane nengcindezi yokuqina.
Ukuhleleka lapho izikulufu ezi-3 zibekwe khona lapho kuphuke intamo yesifazane kubalulekile:
Isikulufu sokuqala kufanele sibe ichopho likanxantathu ohlanekezelwe, eduze nomzuzu wesifazane;
Isikulufu sesibili kufanele sibekwe ngemuva kwesisekelo sikanxantathu ohlanekezelwe, eduze kwentamo yesifazane;
Isikulufu sesithathu kufanele sibe ngaphambili emaphethelweni aphansi kanxantathu ohlanekezelwe, ohlangothini olushubile lokuphuka.
Njengoba ukuphuka kwentamo yesifazane kuvame ukuhlotshaniswa ne-osteoporosis, izikulufu zine-screw grip elinganiselwe uma zingaxhunywanga onqenqemeni futhi isisindo samathambo sincane endaweni ephakathi, ngakho ukunamathisela unqenqema eduze ngangokunokwenzeka ku-subcortex kunikeza ukuzinza okungcono. Indawo ekahle:
Izimiso ezintathu zokulungisa izipikili ezingenalutho: eduze konqenqema, i-parallel, imikhiqizo ehlanekezelwe
Okuseduze kusho ukuthi izikulufu ezi-3 zingaphakathi kwentamo ye-femur, eduze ne-peripheral cortex ngangokunokwenzeka. Ngale ndlela, izikulufi ezi-3 sezizonke zidala ukucindezela kwendawo yonke indawo ephukile, kuyilapho uma izikulufi ezi-3 zingahlukani ngokwanele, ingcindezi ivame ukufana nephuzu, izinzile futhi imelane kancane ne-torsion kanye nokugunda.
I-Postoperative Functional Exercises
Ukuzivocavoca okukhomba uzwane okuthwala isisindo kungenziwa amasonto angu-12 ngemva kokulungiswa kwe-fracture, futhi ukuzivocavoca okuncane okuthwala isisindo kungaqala ngemva kwamasonto angu-12. Ngokuphambene, kuma-Pauwels uhlobo lwe-III yokuphuka, ukulungiswa nge-DHS noma i-PFNA kuyanconywa.
Isikhathi sokuthumela: Jan-26-2024
