Views: 28 Author: Site Editor Publish Time: 2022-09-26 Mfiase: Beaeɛ
Nnadewa a ɛwɔ intramedullary intramedullary (ESIN) a ɛma ɛyɛ den no yɛ ɔkwan a wɔtaa fa so yɛ oprehyɛn ma mmofra no bubu bere tenten. Wɔde di dwuma kɛse de sa radius, ulna, femur, ne ɛtɔ mmere bi a, tibia ne humerus a ɛpaapae a entumi nnyina no. Wɔde di dwuma nso de sa nnompe atenten a ɛyɛ ɔyare no mu akisikuru. Esin ma fracture fixation a wɔatoto mu a ɛbue fracture site no, mprɛnsa-point stability, na ɛkora tenten ne rotation wɔ transverse, short oblique fractures mu. Sɛ́ ade a wɔde hyɛ adesoa mu no, ɛma wotumi de ne nsa ne ne nan no tu ntɛm. Mpɛn pii no, woyi nnadewa a ɛyɛ mmerɛw a ɛyɛ mmerɛw sɛ ɛbɛbɔ wɔ memedullary intramedullary mu no fi hɔ bere a abubu no awie no.
Nneɛma a ɛkyerɛ sɛ esin wɔ asen mu akisikuru mu ne: mfe a wɔadi fi mfe 4 kosi 14 ne asen mu akisikuru wɔ adwenemhaw pii mu .
Ɔyarefo no si nnompe ho nhama a wɔde twe ade no so, na wɔayɛ no sɛnea abofra no nan kɛse te. fluoroscope no ho hia na ama wɔanya antero-posterior (AP) ne latero-lateral (LL) a ɛwɔ asen a ayɛ no ho mfonini na wɔde asi hɔ sɛnea ɛbɛyɛ a wobetumi ahu asen no ho mfonini afi asen so akɔ nkotodwe so. Wɔhwɛ sɛnea wobenya reduction no mu wɔ AP ne LL views no nyinaa mu, na wɔhwɛ nso sɛ rotation .
Ɛsɛ sɛ nnadewa no a wɔpaw no hwɛ mmara titiriw a ɛne sɛ wɔbɛpaw nnadewa no. Wobetumi de nkyekyem a edidi so yi adi dwuma sɛ ɔkwan foforo a wɔfa so yɛ ade foforo, a ɛne abofra no mfe a wadi no wɔ abusuabɔ:
- 6–8 mfe: 3 mm ntwemu;
- 9–11 mfe: 3.5 mm ntwemu;
- 12–14 mfe: 4 mm ntwemu.
Nnadewa no tenten ne kwan a efi distal nyin ntini no so kosi trochanter nyin ntini kɛse no so yɛ pɛ .
Proximal ne mfinimfini a ɛto so abiɛsa wɔ diaphyseal fractures a ɛwɔ proximal ne mfinimfini abiɛsa no mu, C-shaped approach, a wɔde nnadewa no ahyɛ retrograde mu denam distal metaphysis no so. Wɔ proximal fractures ho no, nnadewa no ano a ɛbɛn no no bɔ fam, bere a wɔ didiaphyseal fractures mfinimfini no, nnadewa no mfinimfini no yɛ kurukuruwa. Wɔ oprehyɛn no awiei no, wɔ transverse fractures ho no, asinasin no nya nkɛntɛnso sɛnea ɛbɛyɛ a wɔbɛkwati residual distraction, a ebetumi ayɛ nea ɛde ntini a ɛwɔ fam no tenten a ɛnyɛ pɛ no ba. Wɔ oblique anaa comminit a ɛpaapae no fam no, wɔkotow akyirikyiri ano no na ɛkɔhyɛ dompe no mu na ama wɔakwati sɛ wɔde asinasin no bɛkɔ akyirikyiri na wɔde nnadewa no atu akɔtra baabi foforo.
Abɔde mu su a ɛwɔ saa mpaapaemu yi mu ne sɛ ɛbɛma wɔayɛ 5–10 mm a ɛyɛ tiaa ntɛm ara wɔ oprehyɛn no akyi, a wobetua ho ka denam onyin a wɔbɛkanyan no bere a wɔrehyɛ abubuw no mu den no so .
Ɔyarefo no gyinabea ne ne siesie Ɔyarefo no si nnompe ho pon no so sɛnea ɛbɛyɛ a ɛbɛyɛ mmerɛw sɛ wɔbɛtew so. fluoroscope no a ɛwɔ hɔ no yɛ ahyɛde ma oprehyɛn no mu tumi a wɔde di dwuma. Ɛsɛ sɛ kotodwe no ka oprehyɛn no ho .
Wɔde nnadewa a ɛyɛ den no hyɛ antegrade mu bere nyinaa wɔ proximal metaphysis no mu, wɔ antero-lateral ne anteromedial mmeae .
Nnadewa no ntwemu no gu ahorow bɛyɛ mm 2.5 kosi 4, na egyina mfe a ɔyarefo no adi so. Wɔma kwan ma wɔde hama no di dwuma de ma nnadewa no kɔ anim nanso ɛsɛ sɛ wɔde ahwɛyiye di dwuma.
Wɔnam nnadewa no ntwemu ne sɛnea wɔbɔ no so na ɛhwɛ ma ɛtew so.
Ɛnsɛ sɛ wɔde nnadewa no ka cancellous bone a ɛwɔ distal metaphysis no mu ansa na wɔatew so pɛpɛɛpɛ; Sɛ ɛnte saa a, akwan a wɔfa so siesie no betumi ama nnompe no ayɛ basaa.
Ansa na ɛbɛnya impaction no, wɔhwɛ asinasin a ɛkyinkyini no mu na, wɔ varus a aka a ɛwɔ hɔ no mu no, wɔsiesie eyi denam nnadewa a wɔbɔ no so dodo no so. Wɔ oprehyɛn no awiei no, wɔtwe traction na asinasin no nya nkɛntɛnso.
Wɔ comminited fractures ho no, nnadewa no ano a ɛbɛn dompe no ano no kotow 90° na ɛkɔ cortical dompe no mu na amma wɔantumi anhwɛ asinasin no wɔ akyirikyiri.
Nneɛma a ɛkyerɛ sɛ esin wɔ humeral fractures mu no gu ahorow gyina baabi a abubu no so: proximal metaphysis anaa diaphysis. Wɔ humerus a wɔyɛ no oprehyɛn kɔn mu no mu a ɛpaapae no, wɔkyerɛ sɛ esin no so tew efisɛ ɛtew bere a wɔde ma obi ntumi nkɔ baabiara wɔ ayaresa a wɔde di dwuma wɔ ɔkwan a ɛyɛ mmerɛw so no so .
Wɔ diaphyseal fractures ho no, wɔkyerɛ sɛ wɔde elastic nails di dwuma ɛmfa ho sɛ ɛwɔ hɔ radial nerve lesions.
Wɔde nnadewa no a wɔde hyɛ mu no hyɛ nnadewa no mu denam retrograde kwan no so. Wohu nsɛntitiriw a wɔde hyɛ mu no wɔ supracondylar beae no akyi fã, a ɛwɔ akyi-akyi kwan ne nea ɛbɛn . Wɔde drill na ɛyɛ mmeae a wɔde kɔ mu no efisɛ cortical dompe a ɛwɔ saa beae yi no yɛ den yiye. Nnadewa no ntwemu gu ahorow fi mm 2.5 kosi 3.5, na wɔakotow pɛpɛɛpɛ. Wɔde nsa nhyɛso a ɛda hɔ gyina hɔ ne kankyee a ɛkyinkyini na ɛhyɛ nnadewa no mu. Sɛ wɔantumi antew mpaapaemu a ɛwɔ metaphyseal a ɛbɛn no mu no so yiye a, nnadewa no a ɛkyinkyini 1800 no ma saa so tew yi yɛ mmerɛw. Nanso, sɛ wɔtew so a, wɔde Kirschner akwankyerɛ-wire bi gu proximal fragment no mu ansa na wɔatew so abue. Wɔ oblique diaphyseal fractures ho no, ɛho hia sɛ wokwati nnadewa no fi medullary canal no mu na ɛkɔ akyi kɔ radial nerve sulcus no mu. Bere a nnadewa abien no nyinaa atwa beae a abubu no akyi no, ɛka no ma ɛkɔ cancellous dompe a ɛwɔ proximal metaphysis no mu.
Wogye tom sɛ nnompe mu ayaresa a wɔde ma wɔ nsateaa mu a ɛpaapae no, nanso wonim anohyeto ahorow a wɔma ho kwan a ɛwɔ angulation a wɔayɛ no foforo ara kwa a wɔayɛ no foforo no yiye. Sɛ wɔboro saa anohyeto ahorow yi so anaasɛ wɔ nnompe mu ayaresa a entumi nyɛ adwuma yiye ho no a, wɔkyerɛ sɛ wɔtew so ne esin wɔ anim a ɛpaapae mu .
Operative technique Ɔyarefo no si akyi decubitus, a ne nsateaa a ɛka no wɔ radiotransparent pon no so.
Nnadewa a wɔde di dwuma no ntwemu no gu ahorow fi 2.5 kosi 3 mm. Ɛkame ayɛ sɛ ulnar nnadewa no yɛ tẽẽ, bere a radial nail no wɔ bending a wɔahyɛ no agyirae sɛnea ɛbɛyɛ a ɛbɛsan ayɛ pronatory curve a ɛwɔ radius no mu no.
Mpɛn pii no, fixation fi ase wɔ dompe a ɛyɛ mmerɛw sɛ ɛbɛtew so no so. Wɔ radius no fam no, wohu baabi a ɛkɔ mu wɔ distal metaphysis no mu, wɔ distal growth cartilage no atifi, wɔ nsateaa a ɛtrɛw ne ntiantiaa a ɛwɔ nsateaa no mu no ntam. Cortical dompe no nam ntwitwiridii ketewaa bi so da adi na wotutu tokuru bi, na ɛyɛ kɛse denam kyinhyia a ɛkɔ so no so. Wɔde nnadewa no hyɛ medullary canal no mu kosi baabi a abubu no. Wɔyɛ mpaapaemu no so tew na wɔde nnadewa no kɔ anim kɔ fragment a ɛbɛn no mu wɔ fluoroscopic control ase .
Wɔyɛ ɔkwan a ɛte saa ara ma ulna no, de antegrade kwan no di dwuma, a beae a ɛkɔ mu wɔ olecranon no mfinimfini fã no.
Ma Czmeditech , yɛwɔ aduru a wɔde yɛ nnompe mu oprehyɛn a edi mũ yiye ne nnwinnade a ɛne no hyia, nneɛma a ɛka ho ne . akyi berɛmo a wɔde hyɛ nipadua mu ., nnadewa a wɔde hyɛ nipadua no mu ., Trauma mprɛte ., Mprɛte a wɔde to mu ., atiridiinini-maxillofacial ., Nneɛma a wɔde yɛ nipadua no ., Nnwinnade a ɛma ahoɔden ., abɔnten so fixators ., Arthroscopy ., Mmoa ho ayaresa ne wɔn adwinnade a ɛboa.
Bio nso, yɛasi yɛn bo sɛ yɛbɛkɔ so ayɛ nneɛma foforo na yɛatrɛw nneɛma a wɔyɛ mu, sɛnea ɛbɛyɛ a yebedi nnuruyɛfo ne ayarefo pii oprehyɛn ahiade ho dwuma, na yɛasan nso ama yɛn adwumakuw no asi akan kɛse wɔ wiase nyinaa nnompe mu nneɛma a wɔde hyɛ nipadua mu nyinaa mu.
Yɛde kɔ amannɔne wɔ wiase nyinaa, enti wubetumi . Wo ne yɛn nkasa wɔ email address song@orthopedic-china.com ma quote a wontua hwee, anaa fa nkra bi mena wɔ WhatsApp so ma mmuae ntɛm +86-18112515727.
Sɛ wopɛ sɛ wuhu nsɛm pii a, klik . Czmeditech na woahwehwɛ ho nsɛm pii.
Abenfo tibial intramedullary nail: nnompe mu oprehyɛn a ɛma ɛyɛ kɛse .
Multi-lock humeral intramedullary nail: Nkɔso a ɛba wɔ mmati mu akisikuru ayaresa mu .
Titanium Elastic Nail: Ano aduru foforo a wɔde hyɛ mu ma ɛpaapae .
Femoral intramedullary nail: Ano aduru a ɛhyɛ bɔ ma asen mu akisikuru .
Asen mu a wɔadan no akyi no nnadewa: ɔkwan a ɛhyɛ bɔ a wɔfa so yɛ asen mu akisikuru .
Tibial intramedullary nail: ano aduru a wotumi de ho to so ma tibial fractures .