Opereli min bɛ kɛ ka dɔgɔya, o bɛ kɛ ka ɲɛsin a dakunw kariw ma minnu ka dɔgɔn.

Dakabanɔgɔ ye fɛɛrɛ ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ fɛn ye min bɛ se ka kɛ sababu ye ka joli bɔli sabati, ni bana tɛ a la, ni bana tɛ a la, ni a bɛ kɛnɛya teliya la, ni a bɛ se ka dɔgɔya kosɛbɛ furakɛli musakaw la, ani ni a bɛ se ka kɛ ka kɔkiliw dajilen ni a ka pin fixation intramedullaires ye, i n’a fɔ kɔnɔbara basigilenw, senkɔniw, senkɔniw ni kɔkiliw, senkɔniw, kɔkiliw, kɔkiliw, karilenw, a ɲɔgɔnnaw, minnu bɛ joli bɔli tiɲɛ ni dɔ bɔli ye tigɛcogo la.

a senkɔni karilen don .

(i) Traction .

Banabagatɔ bɛ bila dilan kan, ka tibial tuberosity traction kɛ ni a tigi sen bɛ a la cogo la min tɛ a sen don a la ni kɔnɔna jiginni nɔgɔman ye. Janya girinya bɛ danfara ka bɔ mɔgɔ ni mɔgɔ la, a ka ca a la, a bɛ kɛ kilo 6-9 ye, wa a janya man kan ka tɛmɛ sanga 12 kan. Banabagatɔ 90% bɛ se ka jɔyɔrɔfalen sɔrɔ ni u samali ye.

(b) dagalen manipule repositioning .

Ni traction ma se ka repositioning requirements sɔrɔ, manuel repositioning bɛ se ka fara a kan, epidural anestezi kɔnɔ:

1. MC elvenny ka fɛɛrɛ .

O kun ye ka basibɔn labɛn, ka kɛnɛma-yɔrɔ lamaga-lamaga ani ka dɔ fara a minɛcogo fanga kan, ka sɔrɔ ka a kɔnɔna lamaga ani ka a kɔnɔna na, a bɛ farikolo yɔrɔ min bɛ a la, o kɔsegin walasa ka se ka a jɔyɔrɔ sɔrɔ kokura.

2. LeadBetter fɛɛrɛ .

Banabagatɔ bɛ da duguma, ka kɔ ni gɛnɛgɛnɛ min bananen don, o kɔrɔta ni 90° ye, ka a senkɔniw senkɔniw janya miniti 2 fo miniti 3 kɔnɔ, o kɔfɛ, a kɔnɔna na, a bɛ a farikolo yɔrɔ min bananen don, aw bɛ a wuli ka a wuli dɔɔni dɔɔni, ka a tigi farikolo yɔrɔ min bananen don, o jigin nɔgɔya la, ani ni sen min bananen don, o tɛ kɛ i n’a fɔ a bɛ wuli ka bɔ kɛnɛma, a fanba bɛ a jira ko a bɛ se ka segin a cogo kɔrɔ la. Sani kɔnɔna-filɛli ka kɛ, C-Arm masin tun bɛ kɛ ka sɛgɛsɛgɛli kɛ.

(c) Percutanée peint de prying technique .

If repositioning is not achieved by the above methods, it usually indicates either that the femoral head has been broken or that there has been a rotational separation between the head and neck (Figure 1A), or that there is an insertion somewhere between the head and neck. (O bɛ se ka kɛ nakɔ II, III walima IV suguya o suguya la). O cogo la, ka a tigi farikolo yɔrɔ min bananen don, o wuli ka a kunkolo ni a kɔ kari, o tɛ nɔ bɔ tuguni. Walasa ka aw yɛrɛ tanga tigɛ ni yɔrɔ wɛrɛ ma, pikirijikɛlan min bɛ kɛ ka ɲɛgɛnɛ kɛ, o bɛ se ka kɛ ka kariyɔrɔ bila yɔrɔ wɛrɛ la.

• Kolo lamini 3,0- ka se 3,5 ma, o bɛ don a jɔlen na fari la, a bɛ tɛmɛ santimɛtɛrɛ 1 fo santimɛtɛrɛ 2 kan, a bɛ sɔrɔ a kɔnɔbara basigilen ni a senkɔniw kunbere la, ka taa a bila senkɔni kun ɲɛfɛ ka taa a bila senkɔni kun cɛmancɛ la C-arm machine (Jaa 1B).

• Walasa ka prisi fanga barika bonya, kolocilan filanan bɛ se ka don milimɛtɛrɛ 4-5 la ka kɛɲɛ ni nin pikirijikɛlan ye, ni pikirijikɛlan laban bɛ to fari kɔkan.

• Trochanter belebeleba fɛ, kolocilan fila minnu janya ye milimɛtɛrɛ 3,5 ye, olu bɛ sɔgɔ ka kɛɲɛ ni kɔnɔbara basigilen kɛrɛ ye ani ɲɛfɛla kɔrɔtalen, ka se senkɔniw kɔkolo karilen dakun yɔrɔjan ma (aw kana tɛmɛ ka bɔ a karilen na) ani ka furakisɛ laban to fari kɔfɛ.

• Baarakɛla bɛ furakisɛ kɔ fila minɛ ni bolo fila ye ani ka kunkolo ni kɔ karilen yɔrɔw ladilan walasa ka ɲɔgɔn bɛn ni dɛmɛbaga ka jɛkafɔ ye (Jaa 1C-E).

• O ɲɔgɔndan bɛ wasa, kolo lamini pinɛ min bɛ don sɔgɔsɔgɔninjɛ belebeleba la, o bɛ siri senkɔni kun na walasa ka a jɔ waati dɔɔni kɔnɔ, ani o kɔfɛ, kurukuru caman bɛ don senkɔni kun na (Ja 1F).

Dɔgɔyali fɛɛrɛ datugulen min ɲɛfɔlen don sanfɛ, o bɛ se ka dɔgɔya wajibiyalen sɔrɔ senkɔniw kɔ karilenw na 98% ɲɔgɔn na. Ni a karilen don, a datugulen don walima a tigɛra, a ɲɛfɔcogo ka ɲi. A ka c’a la, kari-yɔrɔ-ko hakɛ min jiralen bɛ X-ray kan, o ka dɔgɔ ni kari-yɔrɔ-ko hakɛ yɛrɛ ye. Ikomi kari ɲɔgɔndan bɛ nɔ bila kari kɛnɛyali la ani ka se ka senkɔni kunkolo nécrose se ka kɛ, a ka kan ka jateminɛ kɛ ka ɲɛ ka ɲɛsin X-ray filimu ma kari sinsinni kɔfɛ. Ni S-cogo kurulen ma nɔgɔya walima ka tigɛ, a b’a jira ko senkɔniw kɔ karilen ma se farikolo yɔrɔ jiginni ma (Jaa 2).

Jaa 1 Senkɔniw ka kɔ karilenw bɛ sigi kokura ni percutanée needle prying ye .

Jaa 2 Senkɔniw ka kɔ karilenw X-rayw ni kɛnɛma kurulen bɛ to sen na farikololabɔli la ani kɛnɛma kurulen tigɛlenw na minnu tɛ alatomikɛli ye.

femoral stem fracture .

O dagalen dɔgɔyali fɛɛrɛ bɛ se ka dɛmɛ don senkɔniw kari karili la ka sɔrɔ a ma farikolo yɔrɔ nugulama walima joli sira si tiɲɛ fo ka se kari laban ma, wa a bɛ se ka kɛ ka kɔnɔnatumuw labɛn ni nɛgɛ ye min bɛ sɔrɔ kɔnɔbara kɔnɔ.

• Anestezi epidurali kɔrɔ, banabagatɔ dalen bɛ dilan kan (a farikolo yɔrɔ min bananen don, o fari ma saniya nin waati in na), dɛmɛbaga kelen bɛ bolokɔni minɛbaga minɛ, o bɛ banabagatɔ bolo minɛ, a bɛ banabagatɔ ka cɛmancɛ juru sama ni fini ye walasa ka a ka bolokɔni minɛ, ni a farikolo yɔrɔ dɔ bɛ a yɛrɛ la, ani a ka teli ka a yɛrɛ tanga a ma (a ka ca a la, a bɛ a yɛrɛ tanga ni a ye a yɛrɛ tanga ni a ye a yɛrɛ tanga. samali, ani a bɛ se ka latilen a yɛrɛma ni samali ye, o la baarakɛla mago bɛ dɔrɔn ka ɲɛfɛla-kɔfɛ-kɔfɛ ani kɛrɛfɛ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-ko ɲɛnabɔ).

• The operator uses both arms to encircle the affected limb and holds the hands together (Figure 3 and Figure 4), and corrects the anterior-posterior and lateral displacement of the fracture at once by using the oblique clamping force of both forearms.

• Misali la, ni senkɔni karilen yɔrɔ surun bɛ wuli ka bɔ kɛnɛma ka taa ɲɛfɛ, bolokɔni kelen bɛ kɛ ka kariyɔrɔ gɛrɛgɛrɛ yɔrɔ digidigi ka taa kɔnɔna na ani ka jigin. Fɔɔnɔ tɔ kelen bɛ yɔrɔjan karilen yɔrɔ digi kɛnɛma ka taa san fɛ walasa ka juru ta fanga la min bɛ se ka ɲɔgɔn sɔrɔ (furakɛli dɔgɔtɔrɔ ka kan ka jateminɛ ɲuman kɛ kariyɔrɔ jiginni sira ni a jiginni yɔrɔ janya kan sani a ka segin a cogo kɔrɔ la), walasa kari ka se ka segin a cogo kɔrɔ la waati dɔ la. Segin-ka-bɔ-yɔrɔ-ko senfɛ, dɛmɛbaga ka kan ka dɔ fara a ka fanga kan ani ka a kɔkili bali ka wuli.

• Ni kari laban basigilen bɛ lap, kolo sɔgɔli mankan nɔgɔman ka kan ka mɛn, nin waati in na, dɛmɛbaga ka kan ka janya mara hali bi, nka a ka kan ka dɔ bɔ a samali fanga la.

• Ni kari bɛ bɛn C-arm masin ma (ni ɲɔgɔndanbaliya dɔɔnin bɛ yen hali bi, aw bɛ fɛn dɔw ladilan walasa ka a dɔn ko kari laban bɛ bɛn ɲɔgɔn ma), ka janya mara, ka farikolo yɔrɔ min bɛ bana in na, ka o kɛ ani ka finimugu tigɛ, ka sɔrɔ ka nɛgɛberew siri.

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Jaa 3 Kɔnɔna-kɔfɛ-kɔfɛ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-la.

Jaa 4 Senkɔniw ka jiribolo karilenw sigicogo kura sɛmɛnan .

• Banabagatɔ minnu ka kariyɔrɔ ka bon, ni u ma se, ni u ma se, ni u karilen don walima ni u karilen don, opereli kɛyɔrɔ bɛ se ka kɛ ka dɔ bɔ ni fanga dɔw ye, o fana bɛ se ka senkɔniw ka jiribolo karilenw dɔgɔyali dafalen dafa ka ɲɛ.

• A kɛlen kɔ ka bolokɔni min bɛ a la, o bilali kɔfɛ janyalan kan walasa ka a sama ani ka C-Arm sɛgɛsɛgɛli kɛ, o b’a jira ko kariyɔrɔ jiginni min bɛ kɛ ɲɔgɔn kan, o latilenna, bolokɔni min bananen don, o dakun yɔrɔjan bɛ se ka ladilan ka taa a fɛ walasa ka se ka ɲɔgɔndɛmɛ ni ɲɔgɔndɛmɛ lasegin ka taa a fɛ, o min bɛ kɛ ka ɲɛsin senkɔniw ma.

• Ikomi cɛya fasaw ka jɔrɔnanko bɛ se ka kɛ sababu ye ka farikolo yɔrɔ nugulamaw siri senkɔniw kari la, o la, senkɔniw ka jiribolo karilen fanba bɛ se ka ɲɔgɔndan sɔrɔ min bɛ mɔgɔ wasa kosɛbɛ orthogonal X-ray ja la.

• Nka nin waati in na, dɛmɛ ɲuman sɔrɔbaliya ka bɔ kariyɔrɔ laban na girinya nɔ na, ​​senkɔniw ka kariyɔrɔ yɔrɔjan bɛ bɔ a fanba la kɔfɛ, wa o waati la, finimugu sterili bɛ se ka bila kariyɔrɔ kɔfɛla fan fɛ, min bɛ kɛ ka ɲɛgɛnɛsiralabanaw ni farilafasaw ni farigan kɔfɛla labɛn ani ka u farikolo labɛn. Distal fracture end bɛ se ka latilen ni brace janya ladilanni ye.

• Ni distal fracture segment kɔfɛla jiginni ma latilen hali bi, nail proximale bɛ se ka sigi sen kan percutaneously apex of the greater trochanter or the piriform fossa, ani o tuma na, a bɛ se ka kɛ ko a bɛ se ka kɛ sababu ye ka kɔnɔbara basigilen medullary caviter kɔnɔ, ani ka respositioning respositioning resposition, ani ka a kunbere kɔrɔtalen minɛ. Walasa ka senkɔni karilen kɛrɛfɛla digi kɔfɛ ni a bɛ kɛ ni a yɔrɔ segin-ka-bɔ-bere ka levier ye, o la, a bɛ se ka ɲɔgɔndɛmɛ segin a cogo kɔrɔ la ni kɔfɛ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ ye,

• Ni kari ka ɲɔgɔn sɔrɔ, ɲɛminɛlan jan dɔ bɛ don kariyɔrɔ yɔrɔjan na walasa ka seginkanni dagalen dafa. A bɛ se ka kɛ ko a bɛ se ka kɛ sababu ye ka joli-sira-funu, a minɛcogo, ani a kɛnɛma jiginni tiɲɛniw latilen minnu bɛ sɔrɔ senkɔni gɛrɛgɛrɛw ka kariw la minnu ka surun (Jaa 5).

• Walasa ka lateral displacement residual (kɛrɛfɛ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-la-sugu-yɔrɔ.

• Dɔgɔyali cogo wɛrɛ ye ka schanz nɛgɛ siri kolo la ka don kariyɔrɔ laban na min bɛ bɔ a nɔ na ani ka kari laban ladilan ni Schanz wulu ye walasa ka jigin da datugulen (Jaa 6). Ni a karilen don ka ɲɛ, o bɛ kɛ ka ɲɛ, o kɔfɛ, a bɛ kɛ ka fɛnɲɛnamafagalanw ka ɲɛgɛnɛsira kɔnɔna ni a yɔrɔjan medullary cavity (medullary cavity) don walasa ka kɔnɔna fiɲɛbɔli dafa (Jaa 7).

  
  

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Jaa 5 Manipule de la segment proximate de fracture pour closée repositionnement ni intramedullary repositioning rod .

Jaa 6 Dadon dɔgɔyali ni Schanz Nail ye min bɛ bila kolo fan kelen na kari laban na .

Jaa 7 Dakun min bɛ kɛ ka ɲɛgɛnɛsiralabanaw tigɛtigɛ yɔrɔ caman na, o bɛ kɛ ka ɲɛgɛnɛsiralabanaw tigɛtigɛ ni Schanz Nail ye .

Senkɔniw kari .

(a) Labɛnni ka kɔn opereli ɲɛ .

• Radiographie diagnostic (Sɔrɔcogo sɛgɛsɛgɛli) : senkɔni jateminɛcogo jateminɛlen ka kan ka kɛ fasa 3 ye: AnteroPosterior (Jaa 8), senkɔni yɔrɔ (15°) (Jaa 9), ani lateral (Jaa 10).

• Ni senkɔni joli joginna kosɛbɛ, kɔnɔna ni kɛnɛma senkɔni ni talu bɛna wuli ka bɔ u nɔ na ka se hakɛ 11 ma (Jaa 11). Radiographie statiques tɛ senkɔni joli sabatili jira ka ɲɛ. Degun radiyow ni MRI bɛ se ka senkɔni kolotuguda ni a senkɔniw tiɲɛni sabatili jateminɛ (Jaa 12).

• O cogo la, senkɔni jogin suguya ka kan ka dɔn ka ɲɛ ni a yɔrɔ min tɔɔrɔla, o jogincogo n’a ka kunnafoniw fɛ walasa ka a sigicogo ni a jɔli kɛcogo ɲɛ ka ɲɛ.

• Tuma dɔw la, senkɔniw cɛmancɛ kari nɔgɔman bɛ se ka kɛ 'maisonneuve fracture' ye min ka gɛlɛn kosɛbɛ, o fana bɛ fibula kari proximal ani ligament joginni faralen ɲɔgɔn kan, o la tibiofibula bɛɛ ka kan ka sɛgɛsɛgɛ ni radiyo ye.

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Jaa 8 ɲɛfɛ ni kɔfɛyɔrɔ .

Jaa 9 Senkɔniw (15° ka bɔ kɔnɔna jiginni na) .

Jaa 10 Lateral position .

Jaa 11 A bɛ iko kariyɔrɔ jiginni faralen don ɲɔgɔn kan ni dislocation ye .

Jaa 12 Degun Radiographe (San saba ka tiɲɛni) .

(ii) Anestezi .

A ka ca a la, senkɔniw ni sɔgɔsɔgɔninjɛ anestezi bɛ ta.

(c) Segin kɛcogo fɛɛrɛ .

The posterior-external rotation type of closed repositioning is performed in the order of external ankle-internal ankle-posterior ankle-inferior tibiofibular union. The posterior rotation-internal rotation type is performed in the order of internal ankle-external ankle.

• Ni kɔfɛla jiginni suguya IV bɛ a la, banabagatɔ bɛ bila a kɔ la ani ka gɛnɛgɛnɛ wuli 90° la walasa ka misiden ka kirinni lafiya.

• Dɛmɛbaga fila bɛ cɛya ni sen yɔrɔ popliteal minɛ u kelen-kelen bɛɛ la, wa u samali bɛ kɛ kari tiɲɛni sira fɛ (janya fanga man kan ka tɛmɛ a dan kan walasa ka joginni juguya).

• Dɛmɛbaga min bɛ sen sama, o bɛ sen wuli ka don a kɔnɔ walasa ka kɛnɛma jiginni tiɲɛni latilen (Jaa 13). K’a sɔrɔ a bɛ yɔrɔjan dakun digidigi ka taa tibial fan fɛ ani ka distal tibia sama ka taa fibular fan fɛ, dɛmɛbaga bɛ wuli a kɔnɔna na ani a bɛ senkɔniw joli janya kɔfɛ walasa ka kɛnɛma senkɔni ni talu jiginni latilen (Jaa 14).

• Aw bɛ kɔnɔna jiginni-kɔnɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ mara. O kɔfɛ, kɔfɛ senkɔni karilen bloki bɛ minɛ bolokɔni fila bɛɛ fɛ, bolokɔni naani bɛ senkɔni yɔrɔjan lamini, ani bolokɔni fila bɛɛ bɛ gɛrɛ ani ka sɔgɔsɔgɔ yɔrɔjan, ka sɔrɔ ka senkɔni yɔrɔjan sama ka jigin walasa ka kɔfɛla senkɔni lasegin (Jaa 15).

• A laban na, baarakɛla bɛ senkɔni cɛmancɛ gɛrɛntɛ ka segin kɔfɛ ani ka jigin ni bolokɔnincininw ye walasa k’a lasegin a cogo kɔrɔ la (Jaa 16). Dɛmɛbaga fila bɛ sen ni senkɔni mara kɔnɔna-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ-yɔrɔ la.

Jaa 13 Kɛnɛyaji jiginni tiɲɛniw tiɲɛni .

Jaa 14 Aw bɛ kɛnɛma senkɔniw ni taluw la kɛrɛfɛla jiginni latilen .

Jaa 15 kɔfɛ senkɔniw jiginni latilenni .

Jaa 16 Kɔnɔna senkɔniw jiginni latilenni .

O kɔfɛ-yɔrɔ-ko-yɔrɔ-ko-yɔrɔ-ko-yɔrɔ-ko ye 'kɔnɔna-kɔnɔna-ko-yɔrɔ-ko-yɔrɔ-ko-yɔrɔ-ko-kɔrɔ-ko ye wa a bɛ Kɛ ka Kɛɲɛ ni kɔnɔna-kɔnɔna-kɔnɔna-sen ye.

Orthopedic Implants ani Orthopedic Instruments (Fɛn minnu bɛ se ka kɛ ka ɲɛgɛnɛ kɛ) san cogo min na, o ye .

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