Nnadewa a ɛwɔ medullary mu a woyi fi hɔ no yɛ adeyɛ a wɔyɛ daa, efisɛ wɔn a wɔyɛ no biara de nnwinnade a ɛfata a wɔde yi fi hɔ ma. Nanso, hia ankasa a ehia sɛ woyi nnadewa a ɛwɔ medullary no mu nyinaa fi hɔ no ntaa mma. Sɛ nnadewa a ɛwɔ medullary no mu no mu paapae pɛ a, tebea no bɛyɛ anifere titiriw. Saa bere yi de, nnwinnade ne akwan titiriw bi ho hia na wɔde ayi nnadewa a ɛwɔ medullary no mu no afi hɔ.
Universal intramedullary nail removal ne broken nail removal sets wɔ gua so, na saa sets yi betumi aboa ma wɔadi atifi hɔ ɔhaw ahorow no ho dwuma. Nanso, ɛnsɛ sɛ wɔyɛ anifuraefo oprehyɛn a wɔmfa nnwinnade titiriw biara nni dwuma.
Nhyehyɛe a wɔde yi nnadewa a ɛwɔ medullary no mu no ho hia yiye. Ansa na wobeyi nea wɔde ahyɛ mu no afi hɔ no, ɛsɛ sɛ wohu baabi a dua no wɔ na wokura mu. Ɛtɔ mmere bi a ɛyɛ den sɛ wobehu dua no ano wɔ X-ray so, na esiane eyi nti, nnuruyɛfo binom nkamfo nkyerɛ sɛ wɔmfa dua no kyɛw no nni dwuma gye sɛ ɛma nnadewa a ɛwɔ medullary no mu no tenten yɛ adwuma. Sɛ wuyi dua no ano awie a, fa akwankyerɛ nsa no fa nnadewa a ɛwɔ medullary no mu no, na afei kɔ so yi nnadewa a ɛtow no. Ɛsɛ sɛ yɛma ɛtra yɛn adwenem sɛ ɛsɛ sɛ woyi pin a wɔde to mu nyinaa ansa na wɔabɔ mmɔden sɛ wobeyi pin titiriw no. Sɛ wɔantumi anhu nea ɔyɛɛ nnadewa a ɛwɔ medullary no mu a, ɛho hia sɛ wɔda nnadewa a ɛwɔ medullary no akyi no adi yiye na ama ɔkwan a wɔfa so kyere no mu da hɔ, a asaawa no su ne ne kɛse ka ho, na wɔpaw adwinnade a ɛfata a wɔde yi mu. Sɛ ɛrentumi nyɛ yiye a, adwinnade a wɔde yiyi mu a ɛyɛ teateaa a wobɛpaw no betumi aboa ma wɔakyere nnadewa a ɛwɔ medullary no dua no mu. Sɛ wosusuw sɛ dompe no anyin akɔ nnadewa no tokuru no mu anaa nnadewa no ani a, wobetumi de hama a ɛtwetwe nnadewa no abɔ mu milimita kakraa bi ansa na wɔayi afi hɔ.
Wɔayɛ dua kyɛw ho nkyerɛkyerɛmu ahorow sɛnea ɛbɛyɛ a ɛbɛyɛ mmerɛw sɛ wɔbɛpaw wɔ oprehyɛn no mu na wɔahwɛ ahu sɛ wobeyi nnadewa a ɛwɔ medullary no mu.
![nnadewa a ɛwɔ medullary mu]()
Nnuruyɛfo pii a wɔn ho akokwaw abɔ akwan pii a wɔfa so yi nnadewa a abubu wɔ ntini mu no mua. Sɛ ɛho hia sɛ wobue abubuw no awiei a abubu no ma ɛho tew na wɔtew so a, wobetumi ayi nnadewa a ɛwɔ medullary no mu no afa awiei a abubu no mu. Wɔ ase hɔ no, yɛde akwan bi a wɔfa so yiyi nneɛma a enhia sɛ wɔda n’awiei a abubu no adi tiawa.
Sɛnea wobeyi nnadewa a abubu a wɔde cannulated ayɛ a ɛwɔ medullary mu no afi hɔ!
Mpɛn pii no, ɛnyɛ den koraa sɛ wobeyi nnadewa a ɛwɔ medullary a abubu no fã a ɛbɛn no afi hɔ. Sɛ woyi ɔfã a ɛbɛn no wie a, ɛbɛyɛ asɛnnennen sɛnea wobeyi ɔfã a ɛwɔ akyirikyiri no a wɔremmue asinasin a abubu no. Sɛ wosan yɛ proximal medullary canal no milimita kakraa bi a, ebetumi ama nnadewa a ɛwɔ akyirikyiri no ayɛ mmerɛw.
Sɛ wɔde nucleus tenten anaa laparoscopic forceps di dwuma a, ɛtɔ mmere bi a wobetumi akyere ɔfã a ɛwɔ akyirikyiri no na wɔayi afi hɔ yiye. Nanso, ntama atenten ntumi nkura mu denneennen, na sɛ woyi no yiye a, egyina sɛ ebia ɔfã a ɛwɔ akyirikyiri no ayɛ mmerɛw anaa.
Ɛtɔ mmere bi a, sɛ wode nnadewa a ɛyɛ tratraa a ɛwɔ medullary mu anaa manual reamer kɔ nnadewa a abubu a ɛwɔ akyirikyiri no mu a, ɛboa ma woyi fi hɔ. Bere a wɔreka kar no, ɛsɛ sɛ wɔkora distal locking pin no so na amma akyirikyiri fã no ankɔ baabi foforo bere a wɔreka kar no. Sɛ intramedullary nail a ɛyɛ tratraa anaa manual reamer no nya ne distal fã no nkitahodi denneennen wie a, yi distal locking nail no na afei bɔ san kɔ akyi na yi distal fã a abubu no.
Nhoma pii bɔ amanneɛ wɔ nnwinnade a wɔde nhama ayɛ a wɔde yi nnadewa a abubu a wɔde kankyee ahyɛ mu no fã a ɛwɔ akyirikyiri no ho. Wobetumi de akwankyerɛ nhama pii a ɛne ne ho di nsɛ wɔ dade a wɔde yiyi mu no kwankyerɛ so ahyɛ nnadewa a ɛwɔ medullary no mu a ɛyɛ tokuru no ma na wɔakwati sɛ wɔbɛpaapae bere a wɔreyi no. Ɛtɔ mmere bi a, ɔkwan a wɔfa so de nhama a wɔde kyekyere nneɛma pii ho no nso yɛ ɔkwan foforo a wɔfa so de nhama a wɔde yiyi nneɛma fi mu ananmu.
![Nnadewa a wɔde yiyi mu a wɔde cannulated a abubu]()
Awiei koraa no, sɛ atifi hɔ akwan a wɔfa so yi proximal removal no nyinaa ankosi hwee a, wobetumi abɔ mmɔden sɛ wobeyi intramedullary nail no afi akyirikyiri. Sɛ nhwɛso no, woyi asen mu nnadewa a ɛwɔ akyirikyiri no fã bi a abubu fa ɔkwan bi a wɔabue mu wɔ asen a ɛwɔ akyirikyiri no mu fa kotodwe nkwaa no mu. Wɔde drill no kyerɛ nnadewa a ɛwɔ medullary no awiei a ɛwɔ akyirikyiri no, na ɔkwan a wɔabue no sõ araa ma ebetumi afa kwankyerɛ hama a ngodua ano ayɛ a gasket wom. Wɔde akwankyerɛ hama no fa nnadewa a ɛwɔ medullary no mu tokuru no mu kɔ akyi na epue fi proximal femur no bue mu, na ngodua ti a ɛwɔ spacer no betumi ama nnadewa a abubu a ɛwɔ akyirikyiri no afi proximal femur no mu. Wobetumi de ɔkwan a ɛte saa ara adi dwuma wɔ tibia no ho, na wɔde akwankyerɛ waya no a ɛwɔ akyirikyiri a wɔabue wɔ mfinimfini malleolus no mu no ahyɛ akyi. Ɛtɔ da bi a, wɔde Steiner waya bi fa ɔkwan a wɔabue no mu na wɔbɔ no bɔ nnadewa a abubu no wɔ akyirikyiri awiei no, sɛnea ɛbɛyɛ a nnadewa a abubu no betumi akɔ akyirikyiri kakra, na ɛboa ma wɔde akwankyerɛ ade no hyɛ akyi na woyi nnadewa a abubu no fi hɔ.
Sɛnea wobeyi nnadewa a ɛyɛ den a abubu a ɛwɔ medullary mu no afi hɔ!
Mpɛn pii no, ɛyɛ den sɛ wobeyi nnadewa a ɛyɛ den a ɛwɔ medullary mu no afi hɔ sen nnadewa a wɔde cannulated ayɛ a ɛwɔ medullary mu. Akwan a wɔfa so yi fi hɔ no bi ne sɛ wɔbɛsan ayɛ proximal medullary cavity no na wɔakyere nnadewa a abubu a ɛwɔ akyirikyiri no yiye. Wobetumi de laparoscopic claw hooks adi dwuma de akyere nnadewa a abubu a ɛwɔ akyirikyiri no. Nhoma ahorow no nso bɔɔ amanneɛ sɛ wɔde afiri titiriw bi a wɔde kyekyere nnadewa no dua ho ahyia. Nanso, ebia nnwinnade ahorow a wɔde di dwuma no rentumi nte nnadewa a abubu a ɛwɔ akyirikyiri no mu yiye. Wɔ eyi mu no, ɛsɛ sɛ wɔtow nnadewa a abubu no fi dompe no ano foforo. Mfiridwuma nnyinasosɛm no te sɛ nea ɛwɔ nnadewa a wɔde cannulated intramedullary nail no mu no. Fa nnwinnade te sɛ soft drills ne hard guide pins bɔ nnadewa a abubu a ɛwɔ akyirikyiri no tẽẽ kɔ proximal awiei.
![yi nnadewa a ɛyɛ den a abubu wɔ medullary mu no fi hɔ]()
Sɛnea wobeyi nnadewa a abubu a ɛka bom wɔ medullary mu no afi hɔ!
Mpɛn pii no, wobetumi de skrudraiver a ɛne no hyia no ayi skru a ɛka bom no ti anaa ɔfã a ɛbɛn no afi hɔ. Ɛtɔ mmere bi a, nkɔnsɔnkɔnsɔn a ɛka bom no nhama betumi akɔ dompe no mu, na ɛho hia sɛ wɔde nhama ne skrudraever twe skru no ti ho hyia na ama wɔabue. Ebia skru ti a asɛe no behia nnwinnade titiriw a wɔde yi fi hɔ, te sɛ nneɛma a wɔde yi nneɛma a wɔde si hɔ a ɛwɔ mu te sɛ nea wɔde nhama ayɛ a wɔde hyɛ mu. Ɛtɔ mmere bi a, skru a abubu no fã a ɛwɔ akyirikyiri no mu yɛ hare koraa, na ennya skru titiriw no a wobeyi afi hɔ no so nkɛntɛnso, na sɛ ɛnka ayaresa adwuma a edi hɔ no a, wobetumi agyaw no wɔ nipadua no mu. Nanso ɛtɔ mmere bi a nnadewa a ɛwɔ akyirikyiri a abubu betumi ama iatrogenic fracture bere a wɔayi nnadewa titiriw no, na ɛho hia sɛ woyi fi hɔ. Ɔkwan a wɔtaa fa so yɛ no ne ɔkwan a wɔfa so pia skru no fi mu, kyerɛ sɛ, wɔtwe skru titiriw no kɔ ne gyinabea a edi kan no, sɛnea ɛbɛyɛ a skru tokuru a ɛwɔ dompe no ani no bɛkɔ nkyerɛwde koro no ara mu ne tokuru a ɛtow tokuru a ɛwɔ intramedullary nnadewa no mu no, na wɔde Steiner waya, malleus poma ketewaa bi anaa skru draiver yi skru a abubu no fi hɔ. Wɔpia pin no fa pin tokuru a ɛwɔ contralateral cortex no mu fi mu na woyi fa baabi a wɔatwa no soronko so.
Sɛnea Wɔtɔ Nnompe a Wɔde Si Nnompe Mu ne Nnompe Ho Nnwinnade!
Ma CZMEDITECH , yɛwɔ nneɛma a edi mũ yiye a ɛyɛ nnompe oprehyɛn a wɔde hyɛ nipadua mu ne nnwinnade a ɛne no hyia, nneɛma no ka ho akyi berɛmo mu nneɛma a wɔde hyɛ nipadua mu, nnadewa a ɛwɔ medullary mu, trauma mprɛte, mprɛte a wɔde to mu, cranial-maxillofacial a ɛwɔ anim, afiri a wɔde yɛ nipadua no, nnwinnade a wɔde anyinam ahoɔden yɛ, abɔnten so fixators, ntini mu nhwehwɛmu, mmoa ho ayaresa ne nnwinnade a wɔde boa wɔn.
Bio nso, yɛasi yɛn bo sɛ yɛbɛkɔ so ayɛ nneɛma foforo na yɛatrɛw nneɛma ahorow mu, sɛnea ɛbɛyɛ a yebedi nnuruyɛfo ne ayarefo pii oprehyɛn ahiade ho dwuma, na yɛama yɛn adwumakuw no nso asi akan kɛse wɔ wiase nyinaa nnompe a wɔde hyɛ nipadua mu ne nnwinnade adwuma no nyinaa mu.
Yɛde nneɛma kɔ wiase nyinaa, enti wubetumi di yɛn ho nkɔmmɔ wɔ email address song@orthopedic-china.com na woanya asɛm bi a wontua hwee, anaa fa nkra mena wɔ WhatsApp so na woanya mmuae ntɛmntɛm +86- 18112515727 .
Sɛ wopɛ sɛ wuhu nsɛm pii a,kliki CZMEDITECH na woahu nsɛm pii.
