Abɔta ƒe megbe ƒe malikenyenye ƒe atikewɔwɔ to ƒunukpeƒetetedɔ me

Zi geɖe la, megbe abɔta ƒe malikenyenye tsoa megbe ƒe ʋuʋu si wɔ nublanui alo abi si mewɔa nu boo aɖeke o si gbugbɔna dzɔna le kamedede alo dɔwɔna bubuwo me gbɔ, eye ƒe sia ƒe la, dɔléle 4.64 le ame 100000 ɖesiaɖe me ƒe sia ƒe. Woƒo nu tso amekokomɔnu geɖe siwo wozãna tsɔ daa megbe abɔta ƒe malikenyenye ŋu, siwo dometɔ aɖewoe nye lãkusi falɛfalɛwo dzadzraɖo kple ƒu ƒe ʋuʋu le ʋuʋu kple ƒunukpeƒetetedɔ ƒe amekoko. Gake amekoko ƒe kuxi siwo ŋu woka nya ta le kple alesi wogbugbɔ ŋku lé ɖe eŋu la sɔ gbɔ va ɖo 14% kple 67%. Vevietɔ la, wobua ƒu siwo wodo ɖe teƒeteƒewo ɖoɖo nyuie, alesi woatsɔ gavi aɖoe kple abi siwo kpe ɖe wo nɔewo ŋu dada be enye kuxi. Eyata ehiã be woatrɔ asi le amekokomɔnu ŋu.

Dɔwɔwɔ ƒe afɔɖeɖewo:

• Wowɔ dɔa le atike si wua alɔ̃dɔdɔ si wotsɔ ƒo ƒu kple regional block of intermuscular sulcus me.

• Le iliac crest nuƒoƒoƒu gome la, wozãa atike siwo naa alɔ̃dɔdɔ le teƒea ɖe ŋutigbalẽ te kple akɔta.

• Wotsɔ dɔnɔa da ɖe ƒutazikpui dzi eye eƒe megbe nanɔ dzogoe 45 ° dzi be wòate ŋu aƒo ka kple akɔta ƒe ta bliboe. Esi woŋe ƒu si wodo na ame vɔ la, woyi dɔwɔwɔa dzi, eye dɔnɔa nɔ anyi ɖe dzogoe si nye 70 ° dzi. Wohe dɔnɔa le mɔ si wozãna ɖaa si me dɔlékui mele o nu, eye wobɔbɔ dɔa ƒe alɔ ɖe ŋgɔ 30 ° to ka si hea kilogram 2 va ɖo 3 dzi.

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Ƒunukpeƒetetedɔ me dzodzro to ƒunukpeƒewo dzi

• Dɔwɔwɔ sia zãa mɔ eve alo etɔ̃ siwo dzi woato age ɖe eme. Woate ŋu azã ŋgɔgbe (E) ƒe mɔnu gbãtɔ hena ƒunukpeƒewo didi nyuie.

  
  

• Woate ŋu atsɔ dometsotsowo ade ƒunukpeƒewo tẽ to rotator dometsotsowo me. Le go aɖewo me la, manya wɔ be woatsɔ nukpɔkpɔmɔ̃a ade eme tẽ o (si fia be, abi ƒe lãkusi si ƒo xlã rotator dometsotsoa).

  
  

• Àte ŋu awɔ axadzi C ƒe mɔnu alo ŋgɔgbe axadzi D ƒe mɔnu, ale be nàte ŋu age ɖe teƒe si le acromion ƒe ta te, ale be nàte ŋu alé ŋku ɖe rotator lãmeka ƒe teƒea ŋu.

  
  

• Wozã arthroscopic radiofrequency ablation tsɔ ʋu rotator ƒe dometsotsoa.

  
  

• Woda toggle lever la ɖe ƒunukpeƒea to E ƒe mɔnu dzi be wòatrɔ dometsotsoa ɖe ƒunukpeƒea ƒe eme kpɔkpɔ ŋu.

  
  

• Esi woda ƒunukpeƒea kpɔ bliboe vɔ la, woda lãkusi falɛfalɛ ƒe abi kple abi siwo do ƒome kplii siwo nye glenoid kple humeral ƒu ƒe bu (si nye megbe glenoid nuyi, ƒunukpeƒe ƒe atikekui, glenoid marginal lesion kple reverse Hill Sachs ƒe abi) kpɔ.

  
  

• Esi woda ƒunukpeƒetetedɔa kpɔ nyuie le ƒunukpeƒetetedɔ me eye woɖo kpe dzesi siwo sɔ dzi vɔ la, woxɔ ƒu siwo wodo ɖe lãme na ame.

  
  

Ƒuwo dodo na ame ƒe nuŋeŋe kple edzadzraɖo

• Woxɔ bicortical autograft la tso ipsilateral anterior iliac crest me be woatsɔ akpɔ akɔta ƒe lãkusi ememetɔ ta. Wɔ ŋutigbalẽ ƒe lãɖeɖe abe sentimeta 2 ene le ŋgɔgbe ƒe akɔta ƒe akpa si le etame megbe eye wòadidi sentimeta 2 le ta la te le akɔta ƒe ta gbɔ be nàƒo asa na abi ƒe wɔwɔ si atsyɔ akɔta la tẽ.

  
  

• Esi wokpɔ cortical bone α kple β vɔ la, wotsɔ Kirschner pin eve siwo sɔ kple wo nɔewo de axadzi cortex me to doa me, si wotsɔ coracoid screw legbe eve siwo tso Arthroscopic Latarjet mɔ̃a me de tsã (Fig. 1).

  
  

• Woɖoa mɔfianu la ƒe asiléƒe ɖe dzi ale be woate ŋu atsɔ ƒu si wodo la asɔ kple kɔ si le megbe si le anyime si nye glenoid la le ŋutilã ƒe wɔwɔme nu. Mɔfianu la ƒe ɖoɖo ɖea mɔ be woatia dzigbe ƒe ʋuƒoa be wòanye ƒu ƒe akpa si le ƒunukpeƒea.

  
  

• Emegbe, tu hollow coracoid process step drill la ɖe Kirschner ka la dzi eye nàku do eve siwo ƒe didime nye 2.9mm le ƒu ƒe ʋuƒoa me. Woɖe drill bit kple Kirschner pin la ɖa. Hafi nàtsɔ tame nutsyɔnu la ade do si me woɖea doa le me la, tsɔ etame nutsyɔnu ƒe pɔmpia ƒo doa.

  
  

• Ne etame ƒe nutrenu nya ɖo teƒea ko la, zã ʋuʋudedi alo ƒu ƒe hɛ nàtsɔ akpɔ iliac crest ƒe titina lãkusi ta eye nàŋe 2-cm × 1-cm × 1-cm grafts (Nɔnɔmetata 2 kple 3). Ne woŋe ƒu si wodo la vɔ la, wotsɔa ƒu ƒe ʋuƒoa doa ka kple coracoid process sleeve eye wozãa coracoid process screw didi eve siwo me do le tsɔ wɔa unit si woate ŋu atrɔ asi le vaseɖe eƒe nɔƒe mamlɛtɔ (Fig. 4).

  
  

• Wotsɔ tsi si me tsi tona ƒe mɔ̃ tu abi si le iliac crest la ŋu ƒuƒoƒo ɖesiaɖe eye wozãa abi si wotsɔ blaae. Emegbe nàtrɔ asi le dɔwɔwɔ ƒe kplɔ̃a ƒe megbe ŋu wòanye dzogoe 70 °.

Figure 1. Woƒo ɖusime iliac crest ƒu nu ƒu esime dɔnɔa nɔ ƒutazikpui ƒe nɔnɔme me. Wotsɔa Kirschner ƒe aŋe eveawo ɖoa teƒe ɖeka kple mɔ̃ si fiaa mɔ mɔ̃ si me woɖea ka eve le, eye mɔ̃a ƒe asiléƒea nɔa dzi. (Ant, ŋgɔgbe; DCG, eve casing mɔfiala; Inf, ete Post, megbe; Sup, dzi.)

Figure 2. Ne dɔnɔa le ƒutazikpui ƒe nɔnɔme me la, woxɔa ɖusime akɔta ƒe ƒu ƒe ƒuƒoƒo. Ɖe drill bit kple Kirschner ka le axadzi platform si le iliac crest cortex ƒe do vɔ megbe, eye emegbe nàde 'hats' 2 eme. (Ant, ŋgɔgbe; DCG, eve casing mɔfiala; Inf, ete; Post, megbe; Sup, dzigbe; TH, tame kposɔ.)

Figure 3. Ne dɔnɔa le ƒutazikpui ƒe nɔnɔme me la, woxɔa ɖusime akɔta ƒe ƒu ƒe ƒuƒoƒo. Iliac crest ƒe akpa si le eme la nɔa anyi nenema ne woŋe nusi wotsɔ doe la vɔ. (Ant, ŋgɔgbe; Inf, ete; IT, kplɔ̃ ememetɔ; Post, megbe; Sup, tame.)

Figure 4. Dzra ƒu ƒe ƒuƒoƒo ɖo ɖe axadzikplɔ̃a dzi. Esi woŋe ƒu si wodo la vɔ la, wotsɔa ʋuka eve siwo xea mɔ na ƒu la doa ka kple ƒunukpeƒe evea. (Ant, ŋgɔgbe; DCG, cannula eve ƒe mɔfiame; IBG, iliac bone dodo; Inf, ete; Post, megbe; Sup, etame.)

Mɔdodo ƒe dzesi siwo le megbe kple mɔ siwo dzi woato age ɖe eme

• Zi geɖe la, wozãa mɔ̃ eve va ɖo etɔ̃. Taɖodzinuae nye be woana megbe A ƒe gege ɖe eme nasɔ kple glenohumeral ƒunukpeƒe ƒe fli alesi woate ŋui. Eyata ƒunukpeƒekpɔmɔ̃e kpɔa edzi. Eyata wowɔa esia koŋ le dɔwɔwɔ vɔ megbe tso ŋgɔgbe axadzi ƒe mɔnu.

  
  

• Wotsɔa ŋgɔgbe ƒe mɔnu E dana ɖe rotator lãmeka ƒe teƒe si le biceps lãmekaa tame, si ate ŋu aɖe glenoid ƒe nugbɔ ƒe megbe akpa afia bliboe (Tabla 1).

  
  

• Zi geɖe la, megahiã be woagazã mɔ̃ bubuwo o; Gake ne ehiã la, woate ŋu azã megbekpa dzi B ƒe gege ɖe eme to megbekpa dzi (le kpɔɖeŋu me, be woatsɔ akpɔ aɖuɖɔtoe siwo kpe ɖe wo nɔewo ŋu gbɔ).

  
  

• Le mɔ nyuitɔ nu la, Mɔdodo A nanɔ glenohumeral ƒunukpeƒe ƒe fli ƒe axadzi tututu.

  
  

• To mɔnu E ƒe ŋgɔgbe kple megbekpɔkpɔ me la, tsɔ akɔta ƒe aŋe 2 de megbe le didiƒe si nye sentimeta 2.5 va ɖo 3, eye nàtsɔ ƒunukpeƒea ade eme wòasɔ ɖe wo nɔewo nu le ga 7 kple ga 9 ƒe nɔnɔmewo me (ɖusime abɔta).

  
  

• Wɔ ŋutigbalẽ ƒe lãɖeɖe le aŋe 2 la dome eye nàzãe abe megbe A ƒe mɔnu ene (Nɔnɔmetata 5A kple B).

Figure 5. (A) Dɔnɔa nade dzesi ŋutigbalẽ si wotso la ahadzrae ɖo le dzogoe 70 ° ƒe anyinɔƒe, ɖusime abɔta kple E ƒe gege ɖe eme ƒe nukpɔkpɔ me. Be woate ŋu awɔ ɖeka nyuie wu le megbe A ƒe mɔnu kple glenohumeral joint line dome la, wotsɔa akɔta ƒe aŋe eve dea megbe be woakpɔ dzesi si fia be wotso ŋutigbalẽa.

(B) Dɔnɔ si ŋu aŋea le le 70 ° ƒe anyinɔƒe ƒe nɔnɔme me ƒe nukpɔkpɔ to ƒunukpeƒetetedɔ, ɖusibɔta, kple elektrɔnik agbo nu. (Ant, ŋgɔgbe; DCG, mɔfianu si wotsɔna ƒoa ka eve; Gl, glenoid; Inf, ete; Post, megbe; Pc, megbe capsule; Sn, aklã ƒe aŋe; Sup, dzi.)

Glenoid dzadzraɖo

• Wotoa megbe (A) ƒe ʋuƒoa dzi tsɔa dɔwɔnua dea eme.

  
  

• Ðe labrum kple megbeƒu tso 7 va ɖo 10 (ɖusime abɔta) to VAPR kple lãgbalẽŋudɔwɔnu zazã me (Fig. 6A kple B, Video 1).

  
  

• Tsɔ ƒunukpeƒetetedɔ ƒo megbe glenoid kɔa vaseɖe esime ƒu si le ʋu dom la nadze eye yameʋua nadzra ɖo (Fig. 7). Ne glenoid kɔa nya sɔ ko la, wokekea megbe A ƒe gege ɖe eme ɖe enu be wòate ŋu ato graft kple double coracoid cannula me.

  
  

• Woate ŋu azã scalpel la atsɔ akeke lãmekawo ƒe mama kple cystotomy ɖe enu, gake woate ŋu azã blunt rectangular trocar (subscapular passage) atsɔ akeke mɔa ɖe enu (Nɔnɔmetata 8).

Figure 6. (AB) Glenoid dzadzraɖo ƒe nukpɔkpɔ le ƒunukpeƒetetedɔ te, dɔnɔ si bɔbɔ nɔ 70 ° ƒe dzogoe dzi, ɖusime abɔta, elektrɔnik mɔnu ƒe dzedzeme. Le glenoid la dzadzraɖo me la, zã VAPR kple lãgbalẽŋudɔwɔnu nàtsɔ aɖe glenoid ƒe nuyi kple megbeƒu ƒe lãkusi ɖa tso ga 7:00 va ɖo ga 10:00. (Ant, ŋgɔgbe; Gl, glenoid; Hh, humeral ta; Inf, ete; Pc, megbe capsule; Post, megbe; Sup, dzi; V, VAPR.)

Figure 7. Arthroscopic visualization of glenoid dzadzraɖo: dɔnɔa nɔ anyi ɖe dzogoe si nye 70 °, ɖusibɔta, E-portal view. Glenoid ƒe kɔ si le megbe ƒe vuvu le glenoid dzadzraɖo me. (Ant, ŋgɔgbe; B, burr; Gl, glenoid; Inf, ete; Pgn, megbe glenoid kɔ; Post, megbe; Sup, dzi.)

Figure 8. Arthroscopic visualization of glenoid dzadzraɖo: dɔnɔa nɔ anyi ɖe dzogoe si nye 70 °, ɖusibɔta, E-portal view. Tsɔ trocar si me mekɔ o nadzi megbe A ƒe mɔnu. (Ant, ŋgɔgbe; Bt: trocar si me mekɔ o; Gl, glenoid; Inf, ete; Pc, megbe capsule; Post, megbe; Sup, etame.)

Graft ƒe ɖoɖo kple eɖoɖo ɖe teƒe ɖeka

Wotsɔa nusi wotsɔ doe la to megbegbo la me eye asiléƒea dze ŋgɔ dzi (Nɔnɔm. 9) eye womae to lãmeka kple ƒunukpeƒetetedɔa me vaseɖe esime wògogo megbeƒu ƒe kɔ eye wòsɔ kple ƒunukpeƒea ƒe ƒunukpeƒe. Ele be afɔɖeɖe sia nalé fɔ ɖe dzadzraɖo ɖe mama ŋu, vevietɔ infraspinatus fascia si le ɣie eye wòsẽ la ʋuʋu kple mɔxexe ɖe graft la ƒe toto nu.

• Ele vevie be woazã scalpel blade la atsɔ aʋu fascia la ŋutɔ. Ne ehiã la, le amekokoa ƒe akpa si kplɔe ɖo me la, ne tsi si le dodom le abɔta le vevie akpa be wòalé abɔta ƒe nyaƒoɖeamenu si sɔ la, woate ŋu azã dɔwɔnuwo atsɔ axe abi si wowɔ dɔ na la ƒe akpa aɖe (le kpɔɖeŋu me, abi ƒe nulénuwo).

  
  

• Wotsɔa coracoid cannula la dana ɖe ƒunukpeƒea ƒe akpa si sɔ ale be Kirschner ka kple gavi siwo kplɔe ɖo la nagage ɖe ƒunukpeƒea ne wole edem o.

  
  

• Wotsɔ Kirschner ka eve siwo didi milimeta 1.5 to coracoid process screws siwo me do le la me be woatsɔ aɖɔ graft la ɖo ɖe megbe glenoid kɔ dzi (Fig. 10).

  
  

• Mele be Kirschner ka la dede eme nawu 40mm be woaƒo asa na toto le ŋgɔgbe glenoid kɔ me o, si ate ŋu agblẽ nu le ŋgɔgbe ahɔhɔ̃mekawo ƒe wɔwɔme ŋu, togbɔ be subscapularis lãmeka ƒe akpa aɖe koe le kɔa kple ahɔhɔ̃mekawo ƒe wɔwɔme dome be wòakpɔ eta hã.

Figure 9. Dɔnɔa tsɔ graft la de 70 ° ƒe anyinɔƒe, eye wòlé ŋku ɖe ɖusime abɔta kple megbeƒu ŋu. Wotsɔa nusi wotsɔ doe la dea eme to megbegbo la nu eye asiléƒea dze ŋgɔ etame. (Ant, ŋgɔgbe; DCG, eve casing mɔfiala; Inf, ete; Post, megbe; Sup, dzi.)

Figure 10. Arthroscopic visualization of graft positioning, dɔnɔ si bɔbɔ nɔ 70 ° ƒe dzogoe dzi, ɖusime abɔta, E ƒe mɔnu kpɔkpɔ. Kirschner-kplu eve siwo wotsɔ de eme la nana nusi wotsɔ doe ɖe megbe glenoid kɔa dzi la li ke. (Ant, ŋgɔgbe; Gl, glenoid; IBG, iliac bone graft; Inf, ete; Kw, Kirschner ka; Post, megbe; Sup, etame.)

Esi wònye be wokpɔa ƒunukpeƒekpɔmɔ̃ si ƒe didime nye 30 ° la tso ʋuka si le agbo nu la ƒe ŋgɔgbe ta la, le dzɔdzɔme nu la, elɔ̃na be yeaʋuʋu nusi wotsɔ doe la ɖe dzogoe aɖe dzi, si wɔnɛ be eƒe akpa si le ete la dzena nyuie tsɔ wu be wòanɔ dzɔdzɔe. Ele vevie be woakpɔe ɖa be ƒu si wodo na ame la ate ŋu adzɔ kokoko le ƒua dodo vɔ megbe hã.

• Ne wonya ƒo ƒu kple megbe glenoid ƒe axadzi ko la, ɖe coracoid screw didi gbãtɔa ɖa eye nàku bicortical glenoid tunnel si keke 3-2mm ɖe Kirschner ka la dzi.

  
  

• Le afɔɖeɖe sia me la, ele vevie be nànɔ anyi kpoo le kamedede gbãtɔ megbe. Ele be kpekpeɖeŋudɔwɔlawo natsɔ asi eveawo alé be na wo (Nɔnɔmetata 11).

  
  

• Ele be wòadzra ɖo be yeade Kirschner-kplu etɔ̃lia doa me, elabena zi geɖe la, Kirschner-kplu si le eƒe nɔnɔme gbãtɔ me la léa mɔ̃a me le lɔlɔ̃nu faa to doa me.

  
  

• Ele be woakpɔ nyuie be woagaɖe Kirschner ka la ɖa ne wole drill bit la hem to coracoid sleeve la me o. Emegbe, tsɔ Latarjet-gavi si ƒe didime nye milimeta 4.5 si ƒe akpa aɖe ka la de Kirschner ka la me (Nɔnɔm. 12) eye nàtsɔe ade eme bliboe be nusi wotsɔ ƒoe la nagatrɔ o, eye emegbe nàku gavi si le etame la. Le mɔ nyuitɔ nu la, mele be gavi la ƒe didime nawu milimeta 32 va ɖo 36 o.

  
  

• Didime ɖesiaɖe si lolo wu milimeta 40 hiã be woalé ŋku ɖe eŋu nyuie, elabena esia ate ŋu atso dzogoe si dzi ʋuʋudedi la le ne wotsɔe sɔ kple glenoid ƒe anyime gbɔ, si ate ŋu ana ʋuʋudedi la naʋuʋu. Le afɔɖeɖe sia me la, woate ŋu aɖɔ alesi gbegbe graft ɖoe ɖo kokoko to glenoid la tɔtrɔ ƒo xlã gavi si le ete la me.

  
  

• Ne wotsɔ gavi gbãtɔ (si le ete) de eme vɔ la, woate ŋu aɖe Kirschner-ka gbãtɔa ɖa. De gavi evelia hã eme nenema ke.

  
  

• Ne ède gavi 2 eme eye nèɖe Kirschner ka la ɖa vɔ la, zã nusi wotsɔna dzroa nu me le Mɔ A dzi nàtsɔ akpɔ afisi wotsɔ gavi mamlɛtɔ le (Nɔnɔmetata 13). Ele be woatsɔ ʋuʋudedi atso lãkusia ƒe akpa ɖesiaɖe si do ɖe gota, eye mele be woaɖɔ lãkusi falɛfalɛ aɖeke ɖo be ƒunukpeƒewo nagasẽ o.

Figure 11. Woɖo graft la ɖe teƒe si woɖoe ɖo eye woɖɔe ɖo. Dɔnɔa nɔ anyi ɖe dzogoe si nye 70 ° dzi eye wokpɔ eƒe ɖusibɔta tso dziƒo. Le nusi wotsɔ dea lãme na ame ƒe tomekuku me kple emegbe la, na mɔfiala la nanɔ anyi kpoo kple asi eveawo be K-ka la nagaɖe mɔa o. (Ant, ŋgɔgbe; DCG, mɔfianu si wotsɔna ƒoa ka eve; Kw, Kirschner ka; Post, megbe; Sup, etame.)

Figure 12. Arthroscopic visualization of graft fixation, dɔnɔ si bɔbɔ nɔ 70 ° dzogoe dzi, ɖusibɔta, elektrɔnik mɔnu ƒe dzedzeme. Latarjet screw si le ete si ƒe didime nye 4.5mm si ƒe akpa aɖe wotsɔ ka blae la nɔa Kirschner pin la tame gbã. (Ant, ŋgɔgbe; Gl, glenoid; IBG, iliac bone graft; Inf, ete; S, screw; Post, megbe; Sup, etame.)

Figure 13. Arthroscopic visualization of graft positioning, dɔnɔ si bɔbɔ nɔ 70 ° ƒe dzogoe dzi, ɖusibɔta, E ƒe mɔnu kpɔkpɔ. Ne ède gavi eve eme eye nèɖe Kirschner ka la ɖa vɔ la, lé ŋku ɖe teƒe mamlɛtɔ si woado ka le ŋu. Ƒumeŋuɖui sia ƒomevi ƒe nutete nyo eye dada ƒe nɔƒe aɖeke mele eme o. (Ant, ŋgɔgbe; Gl, glenoid; Hh, humeral ta; IBG, iliac bone graft; Inf, ete; Post, megbe; Sup, dzi.)

Le amekoko megbe la, wotsɔ 20 ° abduction angle kple neutral rotation ɖo abɔta ŋu kwasiɖa 6:

• Le ŋufɔke le dɔwɔwɔ vɔ megbe la, dze abɔta, abɔta kple asi ƒe ʋuʋu ƒe kamedede si mewɔa naneke o gɔme. Ele be woaƒo asa na alɔ̃dɔdɔ kple ʋuʋu si me vevesese le.

  
  

• Le kwasiɖa 3 me la, dze kamedede siwo me wowɔa nu vovovowo le gɔme.

  
  

• Ne woɖo kpe lãkusia ƒe liƒo dzi to fotoɖeɖe le kwasiɖa 6 le dɔwɔwɔ nɛ vɔ megbe me vɔ la, woate ŋu adze kamedede sesẽ gɔme.

  
  

• Le kamedefefewɔla siwo le didim be yewoahaya kabakaba gome la, ele be woawɔ kɔmpiuta dzi tomography le amekokoa megbe ɣleti 3 be woatsɔ ada graft integration kpɔ.

  
  

Ale Si Nàƒle Ƒumeŋuɖuiwo Kple Ƒumeŋuɖui Dɔwɔnuwo?

Elabena CZMEDITECH , míekpɔa adzɔnuwo ƒe hatsotso si de blibo ŋutɔ si me ƒumeŋuɖui ƒe amekoko ƒe nusiwo wotsɔ dea ame me kple dɔwɔnu siwo sɔ kplii, nusiwo dometɔ aɖewoe nye akɔta ƒe akpa siwo wotsɔ dea ame me, ɖa siwo le lãkusi me, trauma plate, ʋuƒo si wotsɔ xea mɔ na nu, cranial-maxillofacial ƒe tagbɔ, ametia ƒe ŋutilã ƒe akpa aɖe, elektrikdɔwɔnuwo, gotagome fixators, ƒunukpeƒetetedɔ (arthroscopy)., lãwo ƒe dɔlélewo gbɔ kpɔkpɔ kple woƒe kpeɖeŋutɔ dɔwɔnuwo.

Tsɔ kpe ɖe eŋu la, míeɖoe kplikpaa be míayi edzi anɔ atike yeyewo wɔm eye míakeke adzɔnuwo ƒe hatsotsowo ɖe enu, ale be míakpɔ ɖɔkta kple dɔnɔ geɖe ƒe amekoko ƒe nuhiahiãwo gbɔ, eye míana míaƒe dɔwɔƒea hã nate ŋu aʋli ho geɖe wu le xexeame katã ƒe ƒumeŋuɖui kple dɔwɔnuwo ƒe dɔwɔƒe bliboa me.

Míeɖoa nu ɖe ​​xexeame katã, eyata àte ŋui te ɖe mía ŋu le email adrɛs song@orthopedic-china.com hena nyayɔyɔ femaxee, alo ɖo gbedasi ɖe WhatsApp hena ŋuɖoɖo kaba +86- 18112515727 .

Ne èdi be yeanya nyatakaka bubuwo la,zi edzi CZMEDITECH be nàkpɔ nyatakaka bubuwo.