Akwan a edidi so yi mu nea ɛwɔ he na wɔfa so siesie intertrochanteric fractures?

Intertrochanteric fracture of the femur, a wɔsan frɛ no intertrochanteric fracture no yɛ extra-articular capsule a ɛpaapae. Nneɛma atitiriw a ɛda adi wɔ intertrochanteric fracture ho ne ɛyaw ne ɔfe a ɛho hia kɛse wɔ mpɔtam hɔ, ecchymosis a ɛtrɛw, ɔyarefo no a ontumi nnyina anaasɛ ontumi nnantew, ɛyɛ tiaa kɛse, ɔhonam akwaa a ɛka no no mu ne akyi a ɛkyinkyini, ne asen nkwaa no a ɛkɔ baabiara a ɛyɛ nnam ne nea ɛnyɛ adwuma no anohyeto.

Nyarewa a ɛtrɛw ho adesua

1. Wɔn mu dodow no ara fa nnompe mu yare ho, na ɛtaa ba wɔn a wɔn mfe akɔ anim mu, mmea dɔɔso sen mmarima.

2. Nea ɛba no fa abusuakuw, ɔbarima ne ɔbea nna ne ɔmantam ho.

3. opira a ɛtaa ba wɔ wɔn a wɔn mfe akɔ anim mu no, mfe a obi adi wɔ intertrochanteric fracture of femur mu no yɛ mfe 75.2. Nsonsonoe titiriw biara amma wɔ mfe a mmarima ne mmea adi wɔ intertrochanteric fracture no mu.

4. Esiane mogya a ɛkɔ trochanter no mu nti, akisikuru no ntaa nsa, nanso ɛnyɛ den sɛ ɛbɛba hip inversion, na nsɛnnennen pii wɔ hɔ a mpa so a wɔde bere tenten ahome wɔ ayarefo a wɔn mfe akɔ anim mu, na ɔyare ne owu dodow yɛ 15%-20%, enti wɔfrɛ no akisikuru a etwa to wɔ wɔn a wɔn mfe akɔ anim mu.

Adwinnade a ɛma obi pira

1. Mmabun a wɔadu mpanyin afe so dodow no ara yɛ wɔn a wɔapirapira a ahoɔden kɛse wom, ɛsɛ sɛ wɔhwɛ amemene, koko, yafunu ne apirakuru no afã afoforo; nkwakoraa ne mmerewa dodow no ara yɛ onyin dwumadi of the limbs coordination response agility decline and fall caused by.

2. Basabasayɛ tẽẽ: nkɛntɛnso tẽẽ wɔ trochanter beae kɛse no so. Sɛ nipadua no de ahoɔden a ɛwɔ akyi hwe fam bere a ɛrehwe ase no a.

3. Basabasayɛ a ɛnteɛ: wɔkyinkyim nipadua no bere a wɔrehwe ase no, na wɔde asen no hyɛ adwennwen a ɛne sɛ wɔbɛdannan ne anim akɔ anim bere koro mu.

4. Pathological fracture, nnompe mu akisikuru a ɛtaa ba no mu biako.

5. Basabasayɛ a ɛnteɛ na ɛde intertrochanteric fracture ba titiriw.

Nneɛma a ɛda adi wɔ ayaresabea

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2. Esiane sɛ ɛyɛ extra-articular capsule fracture nti, anohyeto biara nni nkwaa capsule no so, enti dɛmdi a ɛwɔ akyi a ɛkyinkyini tiaa (digrii 90) a ɛwɔ akwaa a ɛwɔ fam no mu no yɛ aniberesɛm kɛse.

3. Axial percussion ɛyaw a ɛba.

4. Mpɔtam hɔ mogya a ɛba no mu yɛ den kakra, na ebia honam ani akuru a ɛtrɛw kɛse bɛba.

5. Wɔ ayarefo a wɔn mfe akɔ anim mu no, wɔtaa nyinyin sen ayarefo a wɔwɔ asen kɔn mu, na ayarefo no fã kɛse bi adi kan anya akisikuru.

Nhwehwɛmu a wɔyɛe

Abakɔsɛm a ɛfa ahodwiriw a ɛda adi pefee, ɛyaw a ɛba wɔ ɔhonam akwaa a ɛka no mu, ne sɛnea obi ntumi nkɔ baabiara no ho. Akwaa a ɛwɔ fam no a ɛyɛ tiaa ne akyi a ɛkyinkyini no da adi kodu 90°. Mpɛn pii no, ɛho hia sɛ wɔyɛ X-ray nhwehwɛmu na ama wɔahu sɛnea wɔahu yare no na wogyina radiograph ahorow no so kyerɛw nsɛm. Nsɛnkyerɛnne a ɛwɔ intertrochanteric fracture ho no te sɛ nea ɛwɔ femoral neck fracture mu no, nanso nea etwa to no nyɛ den pii sɛ kan no wɔ ɛyaw a ɛwɔ mpɔtam hɔ, ɛho ahonhon, dwumadi a ɛyera, ne ɔhonam akwaa a ɛka no a ɛyɛ tiaa no ho, na ɔhonam akwaa a ɛka no no mu dodow no ara wɔ asen a ɛbɔ kakra ne kotodwe a ɛbɔ ne akyi a ɛkyinkyin no mu dɛmdi, a mpɛn pii no ɛyɛ 45°-60°.

Korɔ

AO ne Evans-Jensen akisikuru no ne akisikuru ahorow abien a wɔtaa de di dwuma, na wɔ abien yi mu no, AO abubuw no ne nea wɔtaa de di dwuma.

Evans-Jensen a ɔrekyerɛw nsɛm

Type I: Intertrochanteric fracture a ɛnyɛ den a fracture line a ɛkɔ fam fi soro kɔ fam, a entumi nkɔ baabi foforo na entumi nnyina pintinn.

Type II: Displacement a ɛka ho ne rotor avulsion fracture ketewaa bi, nanso femoral spur no nni dɛm (femoral spur no yɛ dompe mprɛte a ɛyɛ den a ɛwɔ femoral kɔn ne nipadua a ɛka bom wɔ rotor ketewa no mu tɔnn.

Type III: Trochanteric fracture kɛse a wɔaka abom ne fracture a ɛboaboa ano wɔ femoral spur no mu, a ɛtu kɔ baabi foforo, a mpɛn pii no ɛne akyi inter-rotor fracture.

Ɔkwan IV: Afã 3 a ɛpaapae a wɔde ka ho ne trochanter ketewa no a abubu a wɔabubu, a ebetumi de asen kɔn ne asen kɛse no atiridiinini a ɛpaapae aba.

Ɔkwan V: akyi akyi ne mfinimfini akisikuru a wɔmfa mmoa (a ɛyɛ ahorow III ne IV a wɔaka abom).

Type R: anim intertrochanteric fracture a oblique fracture line fi superior medial kosi inferior lateral, a ebia ɛne rotor fracture ketewaa bi ne femoral spine a wɔsɛe no wɔ abusuabɔ.

AO a wɔde kyerɛw nsɛm

A1.1 Fracture line no fa inter-rotor line no mu

A1.2 Mpaapaemu a ɛfa trochanter kɛseɛ no mu

A1.3 Mpaapaemu a ɛtwam wɔ trochanter ketewa no ase

A2.1 Dompe asinasin 1 a wɔabubu a ɛpaapae

A2.2 Nnompe asinasin pii a wɔabubu a ɛpaapae

A2.3 Mpaapaemu a ɛtrɛw bɛboro cm 1 wɔ trochanter ketewa no ase

A3.1 Nsusuwii a ɛyɛ mmerɛw a ɛyɛ oblique

A3.2 Nsusuwii a ɛyɛ mmerɛw a ɛyɛ transverse

A3.3 Wɔde ahyɛde ma

Ayaresa ahorow

Mpɛn pii no, sɛnea dompe a abubu no mu a wɔde besi hɔ no gyina pintinn no gyina nneɛma anum so: sɛnea dompe no te, sɛnea abubu no, nea ɛso tew, nea wɔpaw sɛ wɔde si dompe no mu, ne gyinabea a emu no besi bere a wɔde toto dompe no ho. Fracture repositioning ho hia ma pintinn wɔ mu fixation akyi na ɛsɛ sɛ wɔde si wɔn ani so sɛ wobenya anatomic reposition anaasɛ stable non-anatomic reposition. Sɛ yɛbɛbɔ no mua a, botae a ɛwɔ baabi a wɔbɛsan de asi baabi foforo ne sɛ wobenya akisikuru no a ɛbɛgyina pintinn. Wobetumi atoto ɔkwan a wɔfa so san de si baabi foforo no mu anaasɛ wɔatwitwa mu. Ɛmfa ho sɛnea akisikuru no mu yɛ den no, ɛsɛ sɛ wodi kan sɔ hwɛ sɛ wɔbɛtew so a wɔatoto mu.

• Tumi a Wɔde Hip Dowel (DHS) .

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Mfaso titiriw a ɛwɔ DHS Power Hip Screws so.

• Skru no wɔ tumi a emu yɛ den a ɛma ɛyɛ den wɔ asen ti no mu, wɔ nnompe mu yare mpo mu.

• Afiri a ɛtwetwe ade a ɛwɔ nsateaa no mu no mma nnadewa no awiei nkɔ asen no ti anaa acetabulum no mu na tumi a ɛtwe ade ba fam no nkɔ dompe no mu tẽẽ.

• Power gliding mechanism no ma mpaapaemu no kɔ so tra hɔ na ɛtew non-union so.

• Ɛwɔ dwumadie mmienu a ɛne nhyɛsoɔ ne gliding, a ɛwɔ nhyɛsoɔ tumi a ɛyɛ nnam ne nea ɛntena hɔ.

  
  

• Tumi a Wɔde Hip Dowel (DCS) .

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  DCS ne mprɛte a wɔde twa digrii 95 ma anticrotal fractures:

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Mfaso titiriw a ɛwɔ DCS tumi condylar skru no so ne.

• Ebetumi apaw baabi a skru no bɛhyɛn mu yiye sɛnea tebea pɔtee a ɛwɔ abubuw no mu te, na adwumayɛ no yɛ nea ɛfata.

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• Power compression tension screw no wɔ anim a ɛfata wɔ mprɛte no ho, a ɛne biomechanical ahwehwɛde ahorow a ɛwɔ asen no mu no hyia. Bere a wɔresoa emu duru no, wodi kan de tumi bɔne no gu mprɛte no basa tiaa no so na afei wɔpete kɔ skru biara so, ma enti nhyɛso no petepete na nea wɔde si hɔ no yɛ den soronko.

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• DCS nkɔnsɔnkɔnsɔn dodow a ɛdɔɔso kakra wɔ baabi a abubu no ma ɛyɛ den kɛse, na wobetumi abɔ baabi a abubu no ho ban na wɔasiesie, na ɛnam so ma oprehyɛn akyi nsɛnnennen a ɛba no so tew.

Proximal Femoral Locking Intramedullary Nail (PFN) a Ɛbɛn Asen no Mu Nnadewa a Ɛbɛn Asen no Mu .

Mfaso a ɛwɔ PFN fixation so.

• Nnadewa nketewa diameter (mpɛn pii no 9mm), wobetumi de kar akɔ mu a enni dilation. (ɛkorɔn sen Gamma nnadewa no akyi a ɛyɛ den no - 17mm)

• PFN no awiei a ɛbɛn no wɔ camber a ɛbɛyɛ digrii 6, na ɛtew valgus no anim na ɛmma enhia sɛ wɔtwe emu denneennen bere a wɔretwe no.

• Ɔsoro awiei no ma wotumi de nkɔnsɔnkɔnsɔn abien gu asen ti no mu, na wɔde nkɔnsɔnkɔnsɔn a ɛko tia ɛkyinkyini ne nnadewa abien a ɛwɔ asen no kɔn mu ka ho, na ɛma ɔbrɛ a ɛko tia no yɛ kɛse.

• Ɔkwan a ɛda tokuru a wɔde to mu a ɛwɔ akyirikyiri ne nnadewa titiriw no awiei a ɛwɔ akyirikyiri (tapered extension) ntam no ware, na ebetumi atew adwennwen a ɛwɔ asen no mu no so.

• Sɛ wɔde toto ho a, adwenemhaw a ɛba fam koraa.

Gammar nnadewa a wɔde yɛ nnadewa

Mfaso a ɛwɔ Gammar nnadewa a wɔde si hɔ so.

• Ɛyɛ ɔkwan a wɔfa so de hyɛ nipadua no mu a ɛnyɛ den pii a wɔtwitwa mu ketewaa bi na ɛmma obi nnya ahodwiriw kɛse.

• Gamma nnadewa no ka asen no atifi ne asen kɔn no bom denneennen denam nnadewa a ɛwɔ medullary mu ne tension screw a wɔaka abom so, na nnadewa a ɛwɔ akyirikyiri a ɛkyekyere ne ho no na ɛkyekyere nnadewa a ɛwɔ medullary no mu, na ɛmma wontumi nkyinkyin na ɛmma wontumi nkɔ baabiara a ɛyɛ tiaa na ɛma wotumi de ho to so.

Gammar nkɔsoɔ - PFNA

Mfinimfini fixator a wɔpaw (PFNA).

• An ideal built-in ma intertrochanteric fractures a entumi nnyina wɔ femur no mu.

• Ɛde asen no ti ne kɔn no si hɔ denneennen na esiw baabi a abubu no awiei a ɛkyinkyini no ano.

• Siw nsɛnnennen te sɛ nnompe a ɛhwe ase esiane nnompe a ɛsan twetwe bere a wɔahwere mfinimfini mmoa, inversion deformity, ne nea wɔde ahyɛ mu no a wotwa fi asen ti no mu no ano.

• Ɛkame ayɛ sɛ ɛfata ma intertrochanteric abubuw nyinaa, titiriw ma intertrochanteric abubuw a entumi nnyina (sɛ nhwɛso no, anterior intertrochanteric fractures) ne osteoporosis a wɔaka abom.

• Nsɛnnennen bi da so ara wɔ hɔ, te sɛ asen ti a ɛpae, a ɛmma wontumi mfa nneɛma afoforo a wɔde hyɛ nipadua no mu nsi ananmu.

Nkwaa a Wɔde Nneɛma Ayɛ a Wɔde Si ananmu

Nsɛnkyerɛnne a ɛkyerɛ sɛ wɔbɛyɛ oprehyɛn a wɔde sesa nkwaa a wɔde nsa ayɛ a ɛkyerɛ sɛnea asen no mu abubu wɔ intertrochanteric:

• Mfe a wɔadi boro mfe 80.

• Intertrochanteric a ɛpaapae a ɛyɛ mmerɛw na entumi nnyina.

• Nnompe mu nnompe mu yare da adi, na ɛyɛ den sɛ wobesiesie nnompe mu ntini a wɔde si hɔ yiye.

• Anohyeto titiriw biara nni asen anaa kotodwe a wɔde keka ne ho ansa na wɔapira no ho.

• Nipadua nyinaa tebea betumi agyina oprehyɛn ayaresa no ano.

Ayarefo a wontumi nsa wɔn yare wɔ mpa so bere tenten.

Mfaso a ɛwɔ so: oprehyɛn akyi a wɔde si fam ntɛm. Kwati nsɛnnennen a ɛba mpa so. Trɛw nkwagye bere mu na ma asetra tu mpɔn.

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 .

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