Nails intramedullaire stabilisées élastiques (ESIN) ye fɛɛrɛ ye min bɛ kɛ ka denmisɛnniw kolo karilenw sabati opereli fɛ. A bɛ kɛ ka caya walasa ka senkɔniw, senkɔniw, senkɔniw, ani tuma dɔw la senkɔniw ni senkɔniw karilenw furakɛ minnu tɛ sabati. A bɛ kɛ fana ka denmisɛnw kolo janw kari banaw furakɛ. ESIN bɛ kari dafalenw jɔli kɛ k’a sɔrɔ a ma kariyɔrɔ da wuli, ka sabati yɔrɔ saba la, ani ka janya ni jiginni mara kariw la minnu bɛ kɛ kariw la, minnu bɛ kɛ ɲɔgɔn fɛ, minnu ka surun. I n’a fɔ doni tila-tila fɛn donta, a bɛ a to senkɔni ka lamaga joona. A ka ca a la, wuluwulu minnu bɛ sabati ni sɔgɔsɔgɔninjɛ ye, olu bɛ bɔ karilen kɛnɛyalen kɔfɛ.
Senkɔniw karilenw
ESIN taamasiɲɛw senkɔniw karilenw na, olu ye : san 4 ni san 14 cɛ ani senkɔniw karilenw joginda caman kɔnɔ .
Banabagatɔ bɛ bila kolotugudaw samali tabali kan, ka butiki bonya bɛ bɛn den sen hakɛ ma. Fluoroscope ka kan ka kɛ walasa ka cɛya bananen ɲɛda ɲɛfɛla (AP) ni kɔfɛla (LL) ye, wa a bɛ bila cogo la walasa senkɔni ka se ka ye ka bɔ kɔkili la ka taa a bila gɛnɛgɛnɛ hakɛ la. Dɔgɔyali sɔrɔli bɛ lajɛ AP ni LL filɛli fila bɛɛ la, wa jiginni fana bɛ sɛgɛsɛgɛ .
Nɛgɛw sugandili Nɛgɛw cɛmancɛ ka kan ka sariyaba labato wuluw sugandili la. Nin danfara in bɛ se ka kɛ fɛn wɛrɛ ye, min bɛ tali kɛ den si hakɛ la:
- san 6–8 : a cɛmancɛ ye milimɛtɛrɛ 3 ye ;
- san 9–11 : a cɛmancɛ ye milimɛtɛrɛ 3,5 ye ;
- San 12–14 : a cɛmancɛ ye milimɛtɛrɛ 4 ye.
wuluw janya bɛ bɛn ni janya ye ka bɔ yɔrɔjan bonya kolosinsinnan na ka taa a bila trochanter bonya kolosinsinnanba la .
Diaphyse karilenw
Kɛrɛfɛla ni cɛmancɛ sabanan Ni diaphyse karilen don proximal ni cɛmancɛ sabanan na, C cogo la, ni nɛgɛw donna kɔfɛ ka tɛmɛ distal metaphyse fɛ, o bɛ sugandi. Ni sɔgɔsɔgɔninjɛ karilenw don, wuluw kɛrɛfɛla kun bɛ kɔrɔta, ka sɔrɔ diaphyse cɛmancɛ karilenw na, wulu cɛmancɛ bɛ kuru. Opereli laban na, ni a karilen don, ni a yɔrɔ dɔw karilen don, walasa ka u yɛrɛ tanga fɛn tolenw ma, o min bɛ se ka kɛ sababu ye ka bolokɔniw janya ɲɔgɔn tɛ. Ni kariw kɛra oblique walima comminuted, a yɔrɔjan kuncɛ bɛ kɔrɔta ka a gosi kolo la walasa ka a tanga teleskɔpi ma a yɔrɔw la ani ka wuluw ka taa yɔrɔ wɛrɛw la.
Nin kari ninnu ka teli ka kɛ sababu ye ka milimɛtɛrɛ 5–10 surunya opereli kɔfɛ o yɔrɔnin bɛɛ, o bɛna musaka bɔ ni bonya lawulili ye kari karilen sabatili waati
Tibial karilenw
Banabagatɔ sigicogo ni a labɛnni Banabagatɔ bɛ bila kolotugudaw tabali kan walasa ka dɔ bɔ a dɔgɔyali nɔgɔya. Fluoroscope sɔrɔli ye wajibi ye opereli kɔnɔ. opereli yɔrɔ ka kan ka kɛ gɛnɛgɛnɛ ye .
Nɛgɛw doncogo
Nɛgɛw bɛ don tuma bɛɛ ɲɛfɛla la metafisiki kɛrɛfɛ, ɲɛfɛla ni ɲɛfɛla yɔrɔw la .
A kunsigi janya bɛ ɲɔgɔn ta milimɛtɛrɛ 2,5 ni milimɛtɛrɛ 4 cɛ, ka kɛɲɛ ni banabagatɔ si hakɛ ye. Marto kɛli walasa ka wuluw ɲɛfɛ, o bɛ sɔn nka a ka kan ka kɛ ni hakilijagabɔ ye.
Dɔgɔyali jogo bɛ sabati ni nɛgɛ cɛmancɛ ye ani a kɔrɔta hakɛ.
Nɛgɛw man kan ka gosi distal metaphyse kolo kansɛri la sani dɔgɔyali ka dafa; n’o tɛ, latilenni fɛɛrɛw bɛ se ka kolotugudaw sabati.
Sani impaction ka kɛ, a yɔrɔw jiginni bɛ lajɛ ani ni varus deformité tolen bɛ yen, o bɛ latilen ni nɛgɛ dɔ kɔrɔta kojugu ye. Opereli laban na, traction bɛ lafiya ani ka a yɔrɔw tiɲɛ.
Ni kari tigɛlen don, wulu minnu bɛ to kolo kɔkan, olu kɛrɛfɛla kunw bɛ kɔrɔta ni 90° ye ka u gosi kɔkolo kolo la walasa ka a yɔrɔw bali ka teleskɔpi kɛ.
Humeral karilenw
ESIN taamasiɲɛw bɛ sɔrɔ kɔkolo karilenw na, olu bɛ danfara ka kɛɲɛ ni kariyɔrɔ ye: metaphyse proximelle walima diaphyse. Opereli kɔ karilenw na, ESIN bɛ jira barisa a bɛ dɔ bɔ a jɔli waati la min ka kan ka kɛ furakɛli kɔrɔlen na .
Ni diaphyse karilenw don, wuluwuluw tali bɛ jira hali ni nɛrɛmuguma joginda bɛ yen.
Nɛgɛw doncogo Nɛgɛw bɛ don ni kɔsegin fɛɛrɛ ye. A dondaw bɛ sɔrɔ supracondylar yɔrɔ kɛrɛfɛla la, u bɛ kɛ kɔfɛla-kɛrɛfɛla siratigɛ la ani u bɛ kɛ kɛrɛfɛyɔrɔ la . Donda yɔrɔw bɛ labɛn ni drill ye barisa kɔkolo kolo min bɛ o yɔrɔ la, o ka gɛlɛn kosɛbɛ. Nɛgɛw cɛmancɛ bɛ ɲɔgɔn ta milimɛtɛrɛ 2,5 ni 3,5 cɛ, wa u bɛ kɔrɔta cogo kelen na. Nɛgɛw bɛ don ni bolo degun jɔlen ye ani ka wuli ka wuli. Ni kari min bɛ kɛ metafisiyali kɛrɛfɛyɔrɔ la, o tɛ se ka dɔgɔya ka ɲɛ, wuluw jiginni 1800 bɛ o dɔgɔyali nɔgɔya. Nka ni dɔgɔyali tɛ se ka kɛ, Kirschner guide-wire bɛ bila proximal fragment kɔnɔ sani a ka da wuli. Ni diaphyseal fractures oblique kɛra, a nafa ka bon ka aw tanga wuluw ma ka bɔ medullary canal la ka taa kɔfɛ ka taa radial nerve sulcus kɔnɔ. Ni wulu fila bɛɛ tɛmɛna kariyɔrɔ kan, u bɛ gosi ka don kansɛri kolo la min bɛ wele ko proximal métaphyse.
Bolo ɲɛfɛla karilenw
Kolotugudaw furakɛli bolokɔniw karilenw na, o bɛ sɔn, nka dan minnu bɛ se ka kɛ, olu bɛ dɔn kosɛbɛ. Ni o dantigɛliw tɛmɛna walima ni kolotugudaw furakɛli ma ɲɛ, dɔgɔyali dagalen ni ESIN bɛ jira bolokɔniw karilenw na .
Opereli fɛɛrɛ Banabagatɔ bɛ bila kɔkolo la, ni bolokɔni min bananen don, o bɛ tabali kan min bɛ ye ni radiyo ye.
Nɛgɛ minnu bɛ kɛ, olu cɛmancɛ bɛ ɲɔgɔn ta milimɛtɛrɛ 2,5 ni milimɛtɛrɛ 3 cɛ. Ulnar nail bɛ ɲini ka tilennen, ka sɔrɔ radial nail bɛ ni kurukuru taamasiɲɛ ye walasa ka radius ka pronatory curve segin a cogo kɔrɔ la.
A ka ca a la, a jɔli bɛ daminɛ ni kolo ye min dɔgɔyali ka nɔgɔn. Radius (radius) ta fan fɛ, dondaw bɛ Sɔrɔ distal metaphyse (yɔrɔjan metafizi) la, distal growth cartilage sanfɛ, bolokɔnincinin janya ni surunw ka senkɔniw cɛ. Kɔnɔbara kolo bɛ bɔ kɛnɛ kan tigɛyɔrɔ fitinin dɔ fɛ ani dingɛ dɔ bɛ sɔgɔ, o bɛ bonya ni lamini lamaga ye. Nɛgɛ bɛ don ɲɛgɛnɛsira la fo ka se a kariyɔrɔ ma. karilenw dɔgɔyali bɛ kɛ ka wulu bila ɲɛfɛ ka don a kɛrɛfɛ yɔrɔ la , ni fluoroscopie kɔlɔsili ye .
O kɛcogo kelen bɛ kɛ ulna la, ni antegrade fɛɛrɛ ye, ni donyɔrɔ bɛ olecranon cɛmancɛ da la.
Cogo min na i bɛ se ka kolotugudaw ni kolotugudaw sancogo?
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Ka fara o kan, an cɛsirilen don ka to ka fura kuraw labɛn ani ka fɛn dilannenw caya, walasa ka dɔgɔtɔrɔw ni banabagatɔ caman ka opereli magow ɲɛ, ani fana k’an ka tɔn kɛ ɲɔgɔndanba ye diɲɛ kolotugudaw ni minɛnw baara bɛɛ la.
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