Ni Inter Rotator ka kari kɔnɔna na, o ma se ka kɛ, o bɛ kɛ cogo di?

A ka ca a la, kɔkolo karilenw bɛ se ka mɔgɔkɔrɔba 500 000 de minɛ Ameriki san o san. U bɛ nɔba bila ɲɛnamaya kɛcogo ɲuman na, sisan u bɛ kɛ 3-7% ye dɔgɔtɔrɔso kɔnɔ saya la ani san kelen saya hakɛ ye 19,4-58% ye. Kɔnɔbara karilenw bɛɛ tilancɛ ɲɔgɔn ye intertrochanterie (IT) kari ye. Fɛn fila minnu bɛ kɛ ka a kariw furakɛ, olu ye cephalomedullary nail (CMN) ani sliding hip screw (SHS) ye.

Hali ni ɲɛtaa kɛra fɛɛrɛtigɛ la, kolo tiɲɛni ni a jɔli dɛsɛ i n’a fɔ senkɔni kunkolo doncogo bɛ kɛ hali bi, wa a bɛ se ka tiɲɛni kɛ. Kɔsa in na, sɛgɛsɛgɛliw y’a jira ko rezekisiyɔn hakɛ bɛ se 6% ma ni bi fɛnw dontaw ye. Farati minnu bɛ fixation dɛsɛ la olu ye tip-tip distance (TAD) >25 mm ye, kariyɔrɔ tɛ se ka kɛ yɔrɔ wɛrɛ la, karicogo basigibaliw, cephalic spikes minnu bɛ sɔrɔ senkɔni kun cɛmancɛ la walima a cɛmancɛ jukɔrɔ, ani kɔnɔbara basigilen kɔnɔna jiginni. Kɔrɔya ni koloci fana bɛ tali kɛ fixation dɛsɛ la.

Banabagatɔw ni fɛɛrɛw .

O kɛra sɛgɛsɛgɛli ye min kɛra kɔfɛ banabagatɔw kan minnu furakɛra baarada fila la minnu sigilen bɛ kɛnɛyako siratigɛ la duguba kɔnɔ. Operelikɛla fila (JS ni BC) ka ko kɛlenw ɲininkali kɛra banabagatɔ bɛɛ la minnu ye siman-sɔrɔli-sɔrɔ-sira-ko-labɛnni sɔrɔ IT jɔli fɔlɔ dɛsɛlen kɔ k’a ta san 2018 zanwuyekalo la ka se sɛtanburukalo san 2021 ma, o kɔfɛ, Institution Review Board sɔnna o ma. Siman barikalan baara kɛli seginnkanni opereli senfɛ, o tiɲɛna ni Electronic Medical Record (EMR) lajɛ ye opereli sɛbɛnw ni opereli kɔfɛ radiyografuw kan. An ye banabagatɔ bɛɛ fara a kan minnu bɛ fanga siman fanga sɔrɔ seginkanni na CMN fɔlɔ dɛsɛlen kɔfɛ walima SHS fixation of IT kariw (Jaa 1). An ye banabagatɔw bɔ kɛnɛ kan minnu kɔkiliw walima u ka ɲɛgɛnɛsiraw karilen don, banabagatɔ minnu ma se ka u labɛn kokura ni siman barika bonya ye, ani banabagatɔ minnu ye jolilabanaw sɔrɔ u ka segin-ka-bɔ opereli fɔlɔ waati la.

Jaa 1. Muso min si bɛ san 76 la, o ye kɔnɔboli sɔrɔ kɔnɔbara la walasa ka senkɔni (A) ka kari ka bɔ ɲɔgɔn na (A), ni kɔdimi basigilen bɛ a la kalo 2 o kɔfɛ ka a sababu kɛ a doncogo ye (B).

Opereli fɛɛrɛw .

Banabagatɔ minnu bɛ fiɲɛ bila u la fɔlɔ ni CMN ye, an ye kungolodimi fɛn caman sɛmɛntiya ani ka kolo siman barika bonya. A daminɛ na, santimɛtɛrɛ 5 tigɛcogo dɔ kɛra sɔgɔsɔgɔninjɛ belebele kɛrɛfɛ, ɲɛminɛlan nɛgɛ dɔ tun bɛ bila nɛgɛbere kɛrɛfɛyɔrɔ la, ka kolo bɛɛ bɔ nɛgɛbere kɛrɛfɛla la ni reamɛri dafalen ye. O kɔfɛ, hexagonal screwdriver dɔ kɛra ka fixation vis lajɔ CMN sanfɛ (Jaa 2).

Jaa 2, operasɔn kɔnɔ fluoroskopi min bɛ fɛnɲɛnamafagalan (héxagonal viseur) jira min bɛ se ka set screw (sɛrɛsi min bɛ kɛ ni nɛgɛ ye) ye ani ka a lajɔ.

O kɔfɛ, 1-2 cm transversale incision bɛ kɛ ka jigin iliotibial fascia (ITB) fascia fɛ. Kungolo nɛgɛ fɔlɔ bɛ bɔ ni reverse threaded guide ye (Jaa 3). Ni senkɔniw bɛ kɛ ni senkɔniw ye, ɲɛjiralan min bɛ kɛ ni kɔnɔnatumu ye, o bɛ kɛ ka siman bɔli bali ka don joli la (Jaa 3A). Kɛrɛnkɛrɛnnenya la, matiriyali pikiri kɛra fɔlɔ Triple Cannula kɛnɛma layini fila bɔlen kɔfɛ, ka sɔrɔ ka don yɔrɔ la min bɛ da lamini na, ka kɛnɛma layini fila don kokura.

Jaa 3, opereli senfɛ ɲɛfɛla (a) ani lateral (b) banabagatɔ wɛrɛ min bɛ senkɔni kunkolo jira ni kolo tiɲɛni ye min bɛ sɔrɔ a cɛmancɛ la.

O kɔfɛ, a bolokɔni bɛ sama ka sɔrɔ ka kari bɛ segin a cogo kɔrɔ la ka kɛ fɛnɲɛnamafagalan ye min bɛ se ka kɛ ka segin a cogo kɔrɔ la. Ni bana tɛ a la walima ni a bɛ kɛnɛya ni fiɲɛ ye, kolotugudaw bɛ kɛ ni 1/4' kolo gouge ye ni ɲɛfɛla fɛɛrɛ ye.O man teli ka kɛ, nka a bɛ kɛ kosɛbɛ ni a mago bɛ a la ka kɔnɔbara basigilen ɲɛ (target >130°).

O kɔfɛ, kurukuru walima sɔgɔlilan kura bɛ bila senkɔni kun na senkɔni kun na senkɔniw na, aw bɛ aw jija aw kana aw janto aw kana don kun na (Jaa 4). O kuru bɛ ​​bila ni laɲini ye ka a yɛrɛ tanga nɛgɛbere kɔrɔ ma, nka a bɛ a bolo sin a laban ma hali bi senkɔni kun cɛmancɛ la. (Jaa 5nan)

Jaa 4, ɲɛfɛla (a) ani kɔfɛla (b) banabagatɔ wɛrɛ min bɛ kerfing pikirijikɛlan donli jira kunkolo kura sira kan.

Jaa 5, operasɔn kɔnɔ fluoroskopi min bɛ cephalomedullary blade kura doncogo jira guide wire sira kan, o kɔfɛ, a sirilen don ni set vis ye.

A laban na, senkɔni kun bɛ fa ni kolo siman ye ni kolo siman pikiri ye (Jaa 6). Aw bɛ aw janto a la walasa aw kana bɔ joli la ni aw bɛ baara kɛ ni waati yɛrɛ la arajolakalanw ye ani ka siman kansɛri jugumanba ni a ɲɛsincogo ladilan.

Jaa 6, ja min bɛ siman caya jira a daminɛ na (a), fasa dɔɔni dɔɔni (b) fo ka se senkɔni kunkolo tiɲɛni ma (C).

Banabagatɔ minnu bɛ SHS fiɲɛ fɔlɔ sɔrɔ, an bɛ SHS bɔ ka CMN jan dɔ bila. A kɛlen kɔ ka santimɛtɛrɛ 5 tigɛ cɛmancɛ la, a bɛ ITB belebeleba jukɔrɔ ani ka ITB dɔn, o tigɛ bɛ tigɛ ka jigin ka taa a bila a kɛrɛfɛla la. Aw bɛ plati kuruw bɛɛ bɔ ni bololabɔlan bɛnnen ye ani ka o kɔfɛ plati lateral bɔ. O kɔfɛ, tension screws bɛ bɔ ni reverse thread guide ye i n’a fɔ a ɲɛfɔra cogo min ka tɛmɛ walasa ka kariyɔrɔ bila ka caya ka tɛmɛ valgus kan. O kɔfɛ, santimɛtɛrɛ 5 tigɛ bɛ kɛ trochanter belebeleba kun na i n’a fɔ a ɲɛfɔra cogo min ka tɛmɛ. Guide wire bɛ don trochanter belebeleba laban na min ka surun kosɛbɛ ani ka taa ɲɛ ka don senkɔniw na. Reamer da wulilen dɔ bɛ don GuideWire sira kan. O kɔfɛ, ɲɛminɛlan jan dɔ bɛ siri bolokɔni yɔrɔjan cɛmancɛ la patelli nivo jukɔrɔ. O kɔfɛ, reaming progressive (reaming progressive) kɛra fo ka yɛrɛyɛrɛli kɛ kɔkolo la. An ka banabagatɔ bɛɛ ye CMN nɛgɛ jan sɔrɔ ni TFN-advanced (TFNA) proximal femoral intramedullary nailing system (Depuy-Synthes, Raynham, MA) ye.

Jɛkafɔ

An ka fɛɛrɛ bɛ baara kɛ ni kolo siman barika bonya ye seginkanni waati la. Kolow siman fanga sɔrɔli kolosinsinnanw jɔli fɔlɔ la, o ye sɛgɛsɛgɛli kɛ, wa a ye biomekaniki ni kɛnɛyako jateminɛ ɲumanw jira. Kɔsa in na, seginnkanni dɔ y’a jira ko kolosinsinnanw fanga bonya bɛ na ni dɛsɛ doni caman ye, ka fɛnw donli dɔgɔya, ani ka gɛlɛya ni opereli segin ka dɔgɔya ni a bɛ tali kɛ fiɲɛbɔli la min tɛ barika sɔrɔ. Kalan min kɛra ni mɔgɔw ye, n’u bɛ kɛ santiri caman kɔnɔ, o fana y’a jira ko CMN jiginni kɛcogo kura walima a taamasiɲɛw tɛ siman-sɔrɔ-jɛkulu la ni i ye a suma ni ko wɔɔrɔ ye minnu tɛ fanga sɔrɔ kulu la.

Hip fracture ratality (sɔgɔsɔgɔninjɛ) ka ca. Kɔsa in na, sɛgɛsɛgɛliw y’a jira ko 3-7% bɛ sɔrɔ dɔgɔtɔrɔso kɔnɔ, ni san kelen saya bɛ dɔgɔya ka bɔ 19,4% na ka se 58% ma. Kɛrɛnkɛrɛnnenya la, a jirala ko a karilenw bɛ 27% sɔrɔ saya la san kelen kɔnɔ. An ka kɛnɛyaso seriyaliw y’a jira ko mɔgɔ si ma sa dɔgɔtɔrɔso kɔnɔ ani ko san kelen saya hakɛ ye 13,6% ye, o hakɛ ka dɔgɔn kosɛbɛ ni i ye a suma ni sɛbɛnw ye. Ikomi dilan daminɛni opereli kɔfɛ, o bɛ tali kɛ saya dɔgɔyali la, taamacogo ɲuman ni baarakɛcogo ɲuman an ka seriw kɔnɔ, o bɛ se ka saya hakɛ dɔgɔyalen ɲɛfɔ an ka banabagatɔw la.

Kuncɛli

Siman-sɔrɔ-cogo-labɛnni-sigi ye fɛɛrɛ ɲuman ye, min tɛ mɔgɔ tɔɔrɔ, ani min musaka ka dɔgɔ, ka ɲɛsin fɛnɲɛnamafagalanw ka kari-yɔrɔ-yɔrɔ-ko dɛsɛ ma banabagatɔ kɔrɔbaw la minnu kolo-sɔrɔ-minɛn bɛrɛ bɛnnen don.

Banabagatɔ minnu ka fɛnɲɛnamafagalanw ka kari fɔlɔw ma se ka sigi senkan, o kɔfɛ, u bɛ se ka segin u cogo kɔrɔ la ani ka siman tigɛ furakɛli la, olu ye kɛnɛyako ni ɲɛnamaya kɛcogo ɲuman sɔrɔ waatijan kɔnɔ. O kɛcogo tun bɛ kɛ dɔrɔn ko minnu na asetabulɛri joli yɔrɔ fanba tun bɛ mara ani ka kungolodimi to a ka to senkɔniw kɔ kɔnɔ. Ni an y’a jateminɛ ko banakɔtaa ka segin-ka-bɔnyew dannabagatɔw bɛ banabagatɔ kɔrɔbaw la, nin wale in bɛ layidu jira gɛlɛyabaw la minnu bɛ se ka dɔgɔya ani ka dɔgɔya ka ɲɛ, ka sɔrɔ ka opereli waati ni musaka dɔgɔya banabagatɔ kulu in na.

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

Kosɔn CzMedItech , an bɛ ni kolotuguda opereli fɛnw ye minnu dafalen don kosɛbɛ ani minɛnw minnu bɛ bɛn o ma, o ye fɛn ye . Spine Implants ., Nails intramedullaires ., Plate de traume ., locking plate ., kunkolo-maxillo-facial ., Prothèse ., Seko ni dɔnko baarakɛminɛnw ., kɛnɛma fixateurs ., Arthroscopie ., Baganw ladonni n’u dɛmɛnanw.

Ka fara o kan, an b’an jija ka fɛn kuraw dilan tuma bɛɛ ani ka fɛn dilannenw caya, walasa ka dɔgɔtɔrɔw ni banabagatɔ caman ka opereli magow ɲɛ, ani fana k’an ka tɔn kɛ ɲɔgɔndan ye diɲɛ kɔnɔ kolotugudaw ni minɛnw dilanni bɛɛ la.

An bɛ taa jamana wɛrɛw la, o la aw bɛ se ka . Aw ye anw sɔrɔ email adrɛsi la song@orthopedic-china.com ka sɔrɔ ka quotation sɔrɔ fu, walima ka ci bila WhatsApp kan walasa ka jaabi teliya sɔrɔ +86- 18112515727 .

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