Periprothèse fracture bɛ furakɛ cogo di?

Kun

Senkɔni kɛrɛfɛla karilenw ye gɛlɛyaba ye kɔkolo joli-sira-funu na. A hakɛ min fɔra, o ye 3,5% ye san 20 jiginni fɔlɔ kɔfɛ, wa a bɛ bonya ni kolotugudaw caman cili ye. A ka ca a la, opereli senfɛ kariw bɛ tali kɛ jirisunw na minnu ma siman kɛ. A ka ca a la, kari bɛ kɛ baliku kɔrɔba barikamaw la minnu binna opereli kɔfɛ. Hali ni danfara bɛ diɲɛ kɔnɔ, siman ni siman tɛ jiribolo minnu na, dalilu jɛlen si tɛ yen min b’a jira ko siman jiri suguya kelen bɛ tali kɛ kari faratiba la ka tɛmɛ tɔ kelen kan. Vankuburu ka danfara sigicogo min bɛ senkɔniw karilenw kan, o kɛra operelikɛlaw fɛ kosɛbɛ, wa a jirala ko a bɛ se ka da a kan.

Nin kalan in kun fɔlɔ tun ye ka jɛɲɔgɔnya dɔn Vankuburukalo danfara siman ni siman tɛ jiribolo karilenw cɛ. Laɲini filanan tun ye ka danfara sɛgɛsɛgɛ banabagatɔw ka daminɛcogo la minnu ka kari suguya fila bɛ u la.

Fɛnw ni fɛɛrɛw

Sabalilen:

1. Banabagatɔ minnu bɛ tugu ɲɔgɔn na minnu ka proximal periprothèse fractures bɛ tugu ɲɔgɔn na.

2. Banabagatɔ minnu kɔkiliw karilen fɔlɔw bɛ u la, olu dɔrɔn de tun bɛ o la.

3. Banabagatɔ minnu karilen don opereli kɔnɔ, minnu ka kɔkili karilen don kokura, ani minnu karilen don farikolo yɔrɔw ni ɲɔgɔn cɛ, olu ma fara o kan.

   
   

Donanw sɛbɛnni:

1. Nizɛri radiyografu ani ɔridinatɛri tomografi min sinsinnen bɛ ɛntɛrinɛti sɛbɛnw ni sɛgɛsɛgɛliw kan.

2. Dakun fɔlɔ minnu sɛbɛnna, olu tun ye si hakɛ, cɛya ni musoya, farikolo girinya hakɛ, ani taama-taama dɔgɔyali sani a ka daminɛ walima a ka kɛ ladonbaga ye.

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Opereli kunnafoniw bɛ sɛbɛn:

1. Waati fo ka se a doncogo fɔlɔ ma, jolilabanaw taamasiɲɛw (kolodimi walima a karilen), jiribolo suguya (siman walima siman tɛ a la), ani kolotuguda suguya (jolici bɛɛ lajɛlen walima a tilancɛ) olu tun bɛ o la.

2. Ja lajɛ sɛbɛnw kɔnɔ minnu ɲɛfɔlen don kosɛbɛ, olu tun ye Vankuburu ka danfara, varus vertebral position ani Dorr danfara ye.

3. Stem geometry (conique walima compound for cemented stems, straight or wedge-shaped for un simented stem) sɛbɛnna ka da a jiracogo kan min bɛ kɛ ni rezow ye.

4. Vankuburukalo danfara dantigɛli tun sinsinnen bɛ ja lajɛw kan ani opereli kɔnɔ sɔrɔw kan opereli banabagatɔw la.

5. Jateminɛw kɛra ni fɛn caman sɛgɛsɛgɛli ye minnu bɛ taa ɲɛ T-test ani Fisher ka sɛgɛsɛgɛli tigitigi ye fɛn caman sɛgɛsɛgɛli suguya caman na walasa ka banaw daminɛcogo ni Vankuburukalo danfara suma ɲɔgɔn na, minnu bɛ jirisunw kuluw la minnu siman ni siman tɛ.

6. Kɔrɔbɔliw bɛɛ kɛra fan fila ye ni nafa hakɛ ye 0,05 ye. Jateminɛw kɛra ni GraphPad Prism version 8.0.0 ye.

   
   

Jaabiw

Banabagatɔ hakɛ:

1. Banabagatɔ 1181 de sɔrɔla dɔgɔtɔrɔso kunnafonidilan ɲininkali fɛ.

2. Banabagatɔ 978 minnu ka senkɔniw karilen tɛ periprothèse ye, olu ma fara a kan.

3. Banabagatɔ 203 tɔw cɛma, 8 karilen don opereli senfɛ, 6 karilen don revision periprothèse la, ani 17 ka karilen don kɔkolo kolotuguda sirilan na, o minnu bɔra ka fara o kan.

4. Banabagatɔ 172 bɛɛ lajɛlen donna a la bɔli kɔfɛ.

5. Kari bɛɛ kɛra binkanni kɔfɛ. Senkɔni kolo siman kulu karilen don mɔgɔ 84 la ni siman tɛ u la

6. Karilen 88 de tun bɛ o kulu kɔnɔ.

   
   

Daɲɛw daminɛcogo:

1. Danfaraba tun bɛ kuluw ni ɲɔgɔn cɛ u si hakɛ la, waati min na fo ka se a doncogo fɔlɔ ma, joli segincogo taamasiɲɛw senkɔniw kɔ karilenw na, joli segin fɔlɔ, varus jirisun bilali, ani farikolo girinya hakɛ.

2. Kɛrɛnkɛrɛnnenya la, siman kulu kɔnɔ, u fanba tun ye joli-sira-funu ye.

3. Danfaraba si tun tɛ kuluw ni ɲɔgɔn cɛ ka ɲɛsin cɛya ni musoya ma, Dorr ka danfara, ani jiginni ɲɛfɛ bana ka se walima ladonbagaw ka jigiya dɔgɔyali.

4. Siman kulu la, jirisun fanba tun ye sɔgɔsɔgɔninjɛ ye ani tɔw tun ye dilancogo jɛlenw ye.

5. Siman tɛ kulu min na, a jirisun fanba tun bɛ tilennen ani tɔw tun bɛ kɛ i n’a fɔ jirisun.

   
   

Vankuburu ka kuluw:

1. VancouverB2 karilenw bɛ tila ka kɛ karicogo danfaralen naani ye: comminuted 'burst', clamshell, ani helical patterns minnu ɲɛfɔra ka tɛmɛ, ani 'reverse' clamshell cogoya kɔlɔsira kura. O seriyali jiracogo jiralen dɔ jiralen don ni X-ray ye ani ja min bɛ bɛn o ma, o jiralen don (Ja 1).

2. Burst ni spiral fractures tun bɛ tali kɛ kosɛbɛ jirisunw na minnu siminlen don, k’a sɔrɔ flap fractures tun bɛ tali kɛ kosɛbɛ jirisunw na minnu ma siman kɛ.

3. Kɔlɔsili kɔsegin cogoya Kɛra o cogo kelen na jirisun fla bɛɛ la.

4. Vankuburukalo danfara suguya fitininw, n’o ye B2 kari suguya naani ye minnu ɲɛfɔra sanfɛ, ni jirisunw jateminɛcogo ye, o bɛ kari suguya caman taabolo jira.

Ka jɛkafɔ kɛ

Fɔ ka na se bi ma, nin ye kalanba ye min bɛ se ka jɛɲɔgɔnya min bɛ jirisunw kɛrɛfɛla karilenw ni siman tɛ minnu na, olu ni Vankuburu ka danfara cɛ, olu suma ɲɔgɔn na tigitigi:

• Danfaraba si tun tɛ jɛɲɔgɔnya la jiribolo siman ni simanbali cɛ Vankuburu suguya A, B walima C karilenw na. VancouverB2 karilenw hakɛ tun ye kelen ye kulu fila bɛɛ la, o b’a jira ko jirisun sabatilenw ni jirisunw karilenw sɔrɔli hakɛ kelen ye farikolo lamini karilenw na kulu fila bɛɛ la.

• O ni Fenelon ni a ɲɔgɔnnaw ta tɛ kelen ye. sɛgɛsɛgɛli kɛra periprothèse fractures kan ni siman ni siman tɛ. A jɛlen don ko banabagatɔ minnu karilen don Vankuburu B2 ni B3 la, olu hakɛ ka ca kosɛbɛ.

• Phillips ni a ɲɔgɔnnaw. ka 'burst' cogoya dɔ ɲɛfɔ min tigɛlen don kosɛbɛ siman jiribolo yɔrɔw la minnu bɛ kɛ ni koniki ye ani 'crack' siman jakite kɛrɛfɛ, o ni 'axe head' bɛ tali kɛ ɲɔgɔn na. A jirala ko nin kari in ni siman jirisunw bɛ tali kɛ ɲɔgɔn na kosɛbɛ nin kalan in kɔnɔ.

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• Nin kari ninnu ka tiɲɛni ka ca, o bɛ hami bila kolo baarakɛbaliya la, wa o kariw ka teli ka kɛ ni siman bɔli ye ni hakilisigi ye ani ka tɛmɛ ni jirisunba ye min bɛ wele ko distal bearing stem.

• Capello ni a ɲɔgɔnnaw. ye 'flip-flop' kari dɔ ɲɛfɔ min bɛ tali kɛ jirisunw na minnu ma siman kɛ, wa sɔrɔw bɛ o sɔrɔ in jira. O kari bɛ bɔ sɔgɔsɔgɔninjɛ belebele cɛmancɛ la, ka taa fo cɛmancɛla ɲɛda la, ka kɛrɛfɛla mara, min bɛ sɔgɔsɔgɔninjɛ fitinin yɔrɔ jan. Talar yɔrɔ bonya ani a jiribolo jigincogo ye jirisun basigibaliya taamasiɲɛw ye minnu bɛ sɔrɔ rezow fɛ. Kalan tɛmɛnenw y’a jira ko jɛɲɔgɔnya nafama bɛ nin kari in ni jirisunw ni siman tɛ minnu na ni farikolo yɔrɔw ni u cogoyaw ye minnu bɛ i n’a fɔ jirisunw, wa nin ɲinini in bɛ o jɛɲɔgɔnya in sinsin.

• Grammatopolous ni a ɲɔgɔnnaw bɛ helikili karicogo caman ɲɛfɔ periprothèse karilenw na ni siman ye, a ka c’a la, o bɛ tali kɛ wedge fragments isolated ani comminution juguman na. Helikili kari hakɛ min bɛ siman jiribolo la, o cayara kosɛbɛ nin seri in kɔnɔ, o bɛ se ka kɛ sababu ye ka kariw ka teli ka kɛ siman jiribolo tubabu lamini na ka jɛnsɛn cogo la min ni kolo dabɔlen bɛ tali kɛ ɲɔgɔn na.

• Sɛgɛsɛgɛli min kɛra ni rezow ye, o kɛra sababu ye ka farikolo yɔrɔ dɔw karilen caman sɔrɔ, ɲininikɛlaw ye kari cogoya dɔ kɔlɔsi, min ma ɲɛfɔ fɔlɔ sɛbɛnw kɔnɔ. Kari bɛ bɔ cɛmancɛ-kalan na min bɛ tɛmɛ kɛrɛfɛ-kɔnɔna fɛ, ka cɛmancɛ-kɔnɔna to a cogo la. Nin kari suguya in bɛ wele ko 'reverse' clamshell kari, o min jatera Vankuburu B2 karilen ye min bɛ kɛ tuma bɛɛ.

• Nin tɔgɔ in sugandira kun fila de kama: fɔlɔ, a ye 'flip' ja ye min bɛ kɛ ni filɛlikɛlan ye, filanan, a bɛ kɛ i n’a fɔ senkɔni kɔkanna karilen kɔseginlen, ni o cogo kelen na, a bɛ kɛ ni abductor ka supralateral displacement ye min bɛ proximal fragment sama O kari suguw kɛra ni jirisunw ye minnu siman don ani minnu ma siman kɛ (Jaa 2).

• Hali ni nin ɲinini in kun tun tɛ ka furakɛli kɔlɔlɔw sɛgɛsɛgɛ, nin ɲinini in kɔnɔ, a ka c’a la, flip-flop karilenw tun bɛ lajɛ kokura ni joli-sira-funu ye min bɛ kɛ ni doni-ta-yɔrɔ yɔrɔjan ye ani ka kariyɔrɔ kɛrɛfɛyɔrɔw siri ni serɛkili filiw walima ni platiw ye.

• Banabagatɔ min furakɛra ni nin fɛɛrɛ in ye, o misali dɔ jiralen don, min bɛ kɛnɛya sɔrɔli jira (Jaa 3).

Jaa 2 Flip-top karicogo kɔsegincogo.

Jaa 3 Arthroplastie ni cerclage wire fixation ka ɲɛsin kɔfɛla karilenw ma.

Kuncɛli

Ka kɛɲɛ ni Vankuburu ka danfara sigicogo ye, ɲɛgɛnɛsira kari suguyaw bɛ kɛ ni farikolo yɔrɔ karilenw ye minnu bɛ kɛ ni siman ni siman tɛ minnu na. O la, jirisun sabatilenw ni jirisunw sabatibaliw sɔrɔli karilen kɔfɛ, o tun bɛ bɛn kulu fila ninnu ma. VancouverB2 karicogo danfaralen naani dɔnni, hali ni flip-flop inverted cogoya kura kɔlɔsira, o bɛna operelikɛlaw dɛmɛ ka jirisunw basigibaliya dɔn. Kalan nataw ka kan ka kɛ walasa ka jɛɲɔgɔnya sɛgɛsɛgɛ kari suguya ni furakɛli fɛɛrɛ cɛ walasa ka nin ɲinini in sɔrɔlenw nafa dɔn kɛnɛyako siratigɛ la.

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