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 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 no di dɛm, 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 ho 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

1. Nkyerɛkyerɛmu titiriw no te sɛ nea ɛfa asen kɔn mu a ɛpaapae ho, a ɛyaw wɔ mpɔtam hɔ, ɛho ahonhon ne dwumadi anohyeto a ɛwɔ ɔfã a ɛka ho no.

2. Esiane sɛ ɛyɛ extra-articular capsule fracture nti, anohyeto biara nni nkwaa capsule no so, enti 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 mu no te sɛ nea ɛwɔ femoral neck fracture mu no, nanso nea etwa to no nyɛ den pii sen 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 ne kotodwe a ɛbɔ ne akyi a ɛkyinkyini 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 yɛ nnompe 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 ɛtwetwe, mpɛn pii no ɛne akyi inter-rotor fracture.

Ɔkwan IV: Akisikuru a ɛwɔ afã 3 a wɔaka abom ne trochanter ketewa no a abubu a wɔabubu, a ebetumi de asen kɔn no a ɛpae ne trochanter kɛse no coronal ani a ɛpae bɛba.

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 wɔde hyɛ mu no wɔ 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 ɛmma 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 a enye 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 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 wɔn ho denneennen wɔ mu bere a wɔretwe no.

• Ɔsoro awiei no ma wotumi de nkɔnsɔnkɔnsɔn abien gu asen no ti 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 asen no mu no, na ɛmma wontumi nkyinkyin na ɛmma wontumi nkɔ baabiara a ɛyɛ tiaa na ɛma wotumi de wo 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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