Senkɔni karilenw ɲɛfɔli
Senkɔni karilenw (a bɛ fɔ fana ko senkɔniw karilenw) bɛ kariw jira minnu bɛ bɔ senkɔni kɔ da la ka taa se senkɔni fitinin sanfɛ hakɛ ma. A jiracogo dɔw ye sigida dimi, funu, fɛnɲɛnamafagalan ye. Banabagatɔw tɛ se ka taama, ni bolokɔni min bananen don, o bɛ surunya, ka a wuli, ka a kɔkanna wuli, ani ka kɔkolo joli lamagacogo danma.
O kari ninnu bɛ kɛ 3% - 4% ye farikolo karilenw bɛɛ la ani 35,7% kɔkili karilenw na. A bana bɛ caya ni mɔgɔ si hakɛ ye, a ka ca mɔgɔ minnu si tɛmɛna san 70 kan, wa a ka ca musow la ka tɛmɛ cɛw kan.
Anatomie appliquée des fractures intertrochantériques de la femur
Ward ka Triangle (Kɔrɔɲɔgɔnma sabatilen).
Yɔrɔ saba min bɛ se ka tiɲɛ, o bɛ sɔrɔ cɛmancɛ yɔrɔ la, senkɔni kɔ trabeculae bɛ tɛmɛ yɔrɔ min na. Mɔgɔkɔrɔba minnu koloci bɛ u la, o yɔrɔ bɛ fa tuluma dɔrɔn de la.
Senkɔniw ka Calcar
Kolotuguda dɔ min bɛ sɔrɔ kɔfɛ - cɛmancɛ la ka taa senkɔni kɔ ni jiribolo cɛtigɛyɔrɔ la ka taa a fɛ fo ka se trochanter fitinin ma. O ye senkɔni kɔfɛla - cɛmancɛ-kɔnɔna janya ye ka don kansɛri kolo la ani a ye doni eccentrique bilayɔrɔ ye senkɔni kɛrɛfɛ.
Hip Bone Trabeculae ka jatebɔ
Senkɔni gɛrɛgɛrɛ ka masin fanga hakɛ jateminɛni:
(1) Jate 6nan; (2) Kalanso 5nan; (3) Kalanso 4nan; (4) Kalanso 3nan; (5) Kalanso 2nan; (6) Kalanso 1nan
Jogincogo minnu bɛ sɔrɔ senkɔni karilenw na minnu bɛ sɔrɔ senkɔniw ni ɲɔgɔn cɛ
Jogin minnu bɛ fanga caman sɔrɔ Banabagatɔ fitininw na
A ka ca a la, banabagatɔ fitiniw ni ɲɔgɔn cɛ kari bɛ sɔrɔ fanga caman joginw fɛ i n’a fɔ binkanni ka bɔ sanfɛ ani mobili kasaara. Nin ko ninnu bɛ se ka kɛ sababu ye ka kari kojugu, wa banabagatɔw ka kan ka kɔlɔsi kosɛbɛ ni joginda minnu bɛ tali kɛ u la, i n’a fɔ u kunkolo, kɔkolo, ani barajuru ni kɔnɔbara yɔrɔw.
Banabagatɔ kɔrɔbaw ka binkanni sababuw
Mɔgɔkɔrɔbaw ka sɔgɔsɔgɔninjɛ karilen 90% bɛ sɔrɔ binkanni fɛ. Fɛn minnu bɛ kɛ sababu ye ka mɔgɔkɔrɔbaw ka bin, olu ye ɲɛnayelibaliya, farikolo fanga dɔgɔyali, tansiyɔn sabatili, faritanabanaw, joli siraw banaw, ani kolo ni kolotugudaw banaw.
Ni bin bɛ na ni kari ye, o bɛ dɔn ni nin fɛn duuru ninnu ye: koloci juguya, bin sira, kɛrɛnkɛrɛnnenya la ni kɔkili walima yɔrɔ min ka surun kɔkolo la, o ye dugukolo gosi, farikolo tangalanw tɛ se ka dɔ bɔ bin fanga la, kɔkili nɔgɔlenw tɛ se ka fanga caman minɛ, ani kɔkolo kolo fanga dɔgɔyali.
Fariya suguyaw ni walekɛcogo
Fariyako tilennen : Jogin minnu fanga ka bon, olu bɛ kɛ ka ɲɛsin kɔkili ma, i n’a fɔ sirabakan kasaara walima binkanni yɔrɔ min na kɔkili bɛ tiɲɛ, o bɛ na ni kari ye.
Fariyako siratigɛ la: Farikolo jiginni bɛ kɔkili bila varus ni forward angulation stress la. Ni trochanter fitinin ye fulcrum ye, a bɛ degun kosɛbɛ, wa a bɛ se ka kɛ fana ko iliopsoas farikolo samali nɔ bɛ yen, ka kolotuguda dɔ dilan min bɛ i n’a fɔ wuluwulu. Trochanter belebeleba fana bɛ se ka kɛ kolo yɔrɔ dɔ ye min faralen don ɲɔgɔn kan ka a sababu kɛ gluteus medius farikolo samali barikama ye.
Kɛnɛyaso kɔnɔ, senkɔni karilenw ka danfara minnu bɛ sɔrɔ senkɔniw ni ɲɔgɔn cɛ
Evans ka danfara
A bɛ kɛ ka caya kɛnɛyaso baarakɛcogo la. Evans ye intertrochanteric fractures tila ka kɛ suguya fila ye:
Sugu fɔlɔ:Trans - trochanteric fractures Ka kɛɲɛ ni sabatili ye ka kɔn a dɔgɔyali ɲɛ ani a dɔgɔyali kɔfɛ, a bɛ tila ka taa a fɛ ka kɛ suguya fitinin 4 ye:
I: A yɔrɔ fila karilen don k’a sɔrɔ a ma wuli.
Ib : Kari yɔrɔ fila ni jiginni bɛ kɛ, cɛmancɛla ɲɛda bɛ kɛ cogo la min tɛ tiɲɛ, wa kari bɛ sabati a dɔgɔyali kɔfɛ.
c: Trochanter fitinin bɛ hɔrɔnya, a karilen bɛ wuli ani a bɛ kɛ ni varus deformity ye; walima trochanter belebeleba ye kolotuguda danfaralen ye.
Id: Ka fara sɔgɔsɔgɔninjɛ ni ɲɔgɔn cɛ kari kan, sɔgɔsɔgɔninjɛ belebelebaw ni kolotugudaw bɛɛ bɛ kɛ kolotugudaw ye minnu tɛ kelen ye, ni varus deformité ye.
Olu la, suguya I ni 1b ye suguya sabatilenw ye, tɔw ye suguya sabatibaliw ye.
Sugu filanan:Kɔrɔlen - kɔsegin-kɛrɛnkɛrɛnnenw ni ɲɔgɔn cɛ kari
suguya II ye kɔsegin - sɔgɔsɔgɔninjɛ karilen ye, ni kari sira bɛ janya ka bɔ sɔgɔsɔgɔninjɛ belebeleba jukɔrɔ ka taa sɔgɔsɔgɔninjɛ fitinin sanfɛyɔrɔ la.
AO Daɲɛgafe
A suguya : Kari nɔgɔman minnu bɛ kɛ yɔrɔ fila la, olu bɛ tɛmɛ sɔgɔsɔgɔninjɛ fɛ, ni kolo cɛmancɛ kolotuguda ni kɔkanna kolotuguda min ma tiɲɛ, o dɛmɛ ka ɲɛ.
Ka kɛɲɛ ni intertrochantérique layini ye.
Trochanter belebeleba sababu fɛ.
Ka tɛmɛ trochanter fitinin fɛ.
Sugu A2 : Kari minnu bɛ kɛ ka tɛmɛ trochanter fɛ, ni cɛmancɛ kolotuguda karilenw bɛ kɛ yɔrɔ fila la, nka kɔkanna kolotugudaw bɛ to a cogo la.
Ni cɛmancɛ kari yɔrɔ kelen ye.
Ni cɛmancɛ kari yɔrɔ caman bɛ a la.
A bɛ janya ka tɛmɛ santimɛtɛrɛ 1 kan trochanter fitinin jukɔrɔ.
A suguya : Reverse - intertrochanteric fractures, ni kɛrɛfɛla karilenw fana bɛ yen.
Oblique (Oblique) ye.
Kɛrɛnkɛrɛnnenya la.
Komini kɛra.
A ka c’a la, suguya A1.1 fo A2.1 bɛ jate sabatilen ye, ani suguya A2.2 fo A3.3 bɛ jate sabatibali ye.
Opereli furakɛli min bɛ kɛ ni senkɔni karilenw ye minnu bɛ sɔrɔ senkɔniw ni ɲɔgɔn cɛ
Opereli furakɛli kun jɔnjɔn ye ka se ka sɔgɔsɔgɔninjɛ karilen siri kosɛbɛ a dɔgɔyalen kɔfɛ. Fiɲɛ jɔli jɔli bɛ bɔ nin fɛn ninnu na: kolo cogoya, kari suguya, dɔgɔyali, kɔnɔna sirilan dilanni, ani kɔnɔna sirilan bilayɔrɔ.
San laban ninnu na, kɔnɔnatumuw bɛ labɛn ka taa a fɛ, minnu bɛ kɛ ka ɲɛgɛnɛsira karilenw furakɛ. Olu dɔw la, ɲɛgɛnɛsiralabanaw, i n’a fɔ PFNA ani INTERTAN, olu bɛ kɛ ka caya i n’a fɔ kɔnɔnatumuw sirili minɛn jɔnjɔn.
PFNA min bɛ kɛ ka senkɔni karilenw furakɛ
PFNA bɛ kɛ kolociw la minnu tɛ sabati i n’a fɔ Evans Ic, Id, ani Type II. A bɛ baara kɛ ka ɲɛ, a bɛ se ka wuli ka wuli ka bɔ a nɔ na, opereli waati ka surun, joli bɔli ka dɔgɔn, gɛlɛya ka dɔgɔn, ani a ka surun ka nɛgɛ tigɛ ka bɔ a kɛrɛfɛ, o bɛ furakɛli nafa jɛlenw jira.
PFNA jiralen don kolotugudaw ni ɲɔgɔn cɛ karilenw na minnu tɛ sabati (i n’a fɔ Evans suguya Ic, Id ani II). A bɛ baara kɛcogo ɲuman jira ni wulicogo ɲuman ye, opereli waati ka surun, joli bɔli bɛ dɔgɔya, ani gɛlɛya caman tɛ a la. O sistɛmu ka helical blade dilancogo bɛ kolo minɛ ka ɲɛ, ka fanga minɛcogo barikama di a ma ani ka dɔ bɔ kosɛbɛ tigɛcogo la ka bɔ senkɔni kun na, o bɛ furakɛli nafa danfaralenw di.
INTERTAN min bɛ kɛ ka senkɔniw karilenw furakɛ
Bi furakɛli fɛɛrɛw yiriwali fɛ, INTERTAN ye wulu suguya kura ye min dilannen don kɛrɛnkɛrɛnnenya la senkɔni karilenw furakɛli kama. A nɛgɛba in tigɛyɔrɔ ye trapezoidal ye. Ni a kɛra ka fara ɲɔgɔn kan ni proximal interlocking combined nail ye, a bɛ se ka 'Z' nɔ bali. Ni aw ye wulu filanan dɔ fara a kan min bɛ bɔ senkɔni kun na, o bɛ dɔ fara lag kurukuruni jiginni kɛlɛli nɔ kan. Nin wulu min bɛ kɛ ɲɛgɛnɛsira kɔnɔ, o bɛ kɛ ka caya, wa a bɛnnen don banabagatɔw ma minnu koloci jugumanba bɛ u la.
INTERTAN ye wuluwulu kura ye min dilannen don kɛrɛnkɛrɛnnenya la senkɔniw ni ɲɔgɔn cɛ karilenw kama, o bɛ ɲɛtaa jira bi furakɛli fɛɛrɛw la. A wuluba bɛ ni tigɛli ye min bɛ kɛ ni trapezoidal ye walasa ka sabatili sabati. Dakun min bɛ kɛrɛfɛ, o bɛ baara kɛ ni fɛn dɔ ye min bɛ ɲɔgɔn cɛ (lag screw ani compression screw), o bɛ 'Z-effect' (kurun kelen bɛ kɔsegin ka bɔ yɔrɔ min na ka tɔ kelen don senkɔni kun na) bali kosɛbɛ. Set screw wɛrɛ bɛ a to lag screw ka projɛ ka taa a fɛ senkɔni kunkolo kɔnɔ, o bɛ dɔ fara a ka jiginni kɛlɛli seko kan. Nin wulu in taamasiɲɛw ka ca, wa a bɛnnen don kɛrɛnkɛrɛnnenya la banabagatɔw ma minnu koloci jugumanba bɛ u la.
CHANGZHOU MEDITECH TECHNOLOGIE CO., LTD. Bamako, Mali. a kɛrɛnkɛrɛnnen don kolotugudaw la minnu bɛ se ka baara kɛ kosɛbɛ ani opereli furakɛcogo kɔrɔlenw. O ye baarakɛda ye min bɛ se ka baara kɛ ni fɛɛrɛ kuraw ye, min bɛ ɲinini ni yiriwali, fɛn dilanni, feereli ani baarakɛcogo fara ɲɔgɔn kan.
Ka tugu 'Innovation Driven, Pursuit of Excellence' hakilila la, a ka tɔn ka fɛn dilannenw bɛɛ lajɛlen bɛ kɔkolo, wuluwuluw kɔnɔ, da tugulanw, kɛnɛma sirili, jogindaw, ɲɛda ni ɲɛdawolo, baganw furakɛli, kuran baarakɛminɛnw, minɛn jɔnjɔnw, ani balonw. Nin fɛn dilannen ninnu bɛ yɔrɔ kolomaw jira fɛɛrɛ kuraw la kɛnɛyako siratigɛ la, minnu cɛsirilen don ka opereli suguya bɛɛ lajɛlen ni dannaya bɛ se ka da minnu kan diɲɛ dɔgɔtɔrɔw ma. A ka fɛn dilannen suguya caman n’a ka fɛɛrɛko seko sabatilenw fɛ, a ka baarakɛda bɛ furakɛli fɛɛrɛw yiriwali n’u sɔrɔli sabati kosɛbɛ.
Ja minnu tara o kɛnɛ in senfɛ, n’olu ye jɛɲɔgɔnyaw kɛ ni operelikɛlaw ni tilabagaw ye, olu y’a jira ko jɛkafɔ hakili ani jɛkafɔ jɛlen don banabagatɔw ladonni ɲɛtaa la.
