Ubuchwepheshe be-Intramedullary nailing buyindlela evame ukusetshenziswa yokulungisa yangaphakathi ye-orthopedic.Umlando wayo ungalandelelwa emuva kuma-1940s.Isetshenziswa kabanzi ekwelapheni ukuqhekeka kwamathambo amade, ama-nonnunion, njll., ngokubeka i-intramedullary nail phakathi nendawo ye-medullary cavity.Lungisa indawo yokuphuka.Kulezi zinkinga, sizokwethula okuqukethwe okuhlobene nawe ngezinzipho ze-intramedullary.
Kalula nje, isikhonkwane se-intramedullary isakhiwo eside esinezimbobo zokukhiya eziningi kuzo zombili iziphetho ukuze kulungiswe iziphetho eziseduze nezikude zokuphuka.Ngokwezakhiwo ezahlukene, zingahlukaniswa zibe ziqinile, i-tubular, i-open-section, njll, ezifanele iziguli ezahlukene.Isibonelo, izinzipho eziqinile ze-intramedullary azikwazi ukumelana nokutheleleka ngenxa yokuthi azinayo indawo efile yangaphakathi.Ikhono elingcono.
Ukuthatha i-tibia njengesibonelo, ububanzi bomgodi we-medullary buhluka kakhulu ezigulini ezahlukene.Ngokuya ngokuthi kuyadingeka yini ukuphinda kwenziwe kabusha, izipikili ze-intramedullary zingahlukaniswa zibe izipikili ezivuselelwe kabusha nezingezona kabusha.Umehluko usekutheni ama-reamers adinga ukusetshenziselwe ukubuyisela kabusha i-medullary, okuhlanganisa nemishini eyenziwa ngesandla noma kagesi, njll., futhi izinsimbi zokubhola ezinkulu ngokulandelana zisetshenziswa ukuze kwandiswe imbobo ye-medullary ukuze kuthwale izinzipho ezinkulu ze-intramedullary.
Kodwa-ke, inqubo yokwanda komnkantsha ilimaza i-endosteum, njengoba kuboniswe esithombeni, futhi ithinta ingxenye yomthombo wegazi wethambo, okungase kuholele ku-necrosis ye-avascular yesikhashana yamathambo wendawo futhi kwandise ingozi yokutheleleka.Kodwa-ke, kuhlobene nezifundo zomtholampilo ziyaphika ukuthi kunomehluko omkhulu.Kukhona nemibono eqinisekisa ukubaluleka kokuvuselelwa kabusha kwe-medullary.Ngakolunye uhlangothi, izinzipho ze-intramedullary ezinobubanzi obukhulu zingasetshenziselwa ukuvuselela kabusha kwe-medullary.Amandla nokuqina kuyakhula ngokukhula kobubanzi, futhi indawo yokuxhumana ne-medullary cavity iyanda.Kukhona nombono wokuthi ama-chips amathambo amancane akhiqizwa ngesikhathi sokunwetshwa komnkantsha nawo adlala indima ethile ekufakweni kwethambo le-autologous.
Impikiswano eyinhloko esekela indlela yokungavuseleli ukuthi inganciphisa ingozi yokutheleleka kanye ne-pulmonary embolism, kodwa okungenakunakwa ukuthi ububanzi bayo obuncane buletha izici zemishini ezibuthakathaka, okuholela ekutheni izinga lokusebenza kabusha liphakeme.Njengamanje, izinzipho eziningi ze-tibial intramedullary zivame ukusebenzisa izipikili ze-intramedullary ezinwetshiwe, kodwa okuhle nokubi kusadingeka kukalwe ngokusekelwe kusayizi we-medullary cavity kanye nezimo zokuphuka.Isidingo se-reamer ukunciphisa ukungqubuzana ngesikhathi sokusika futhi sibe nomtshingo ojulile kanye ne-shaft encane yobubanzi, ngaleyo ndlela kuncishiswe ukucindezela emgodini we-medullary nokugwema ukushisa ngokweqile kwamathambo nezicubu ezithambile ezibangelwa ukungqubuzana.I-Necrosis.
Ngemuva kokufakwa kwe-intramedullary nail, ukulungiswa kwesikulufa kuyadingeka.Ukulungiswa kwesikulufu sendabuko kubizwa ngokuthi ukukhiya okumile, futhi abanye abantu bakholelwa ukuthi kungabangela ukulibaziseka ukuphulukiswa.Njengokuthuthuka, ezinye izimbobo zezikulufo zokukhiya zenzelwe umumo oyisiyingi, obizwa ngokuthi ukukhiya okuguquguqukayo.
Okungenhla yisingeniso sezingxenye ze-intramedullary nailing.Kumagazini olandelayo, sizokwabelana nawe ngenqubo emfushane yokuhlinzwa kwezipikili ze-intramedullary.
Isikhathi sokuthumela: Sep-16-2023
