Ènya ŋutinya si ku ɖe atitsotso le lãkusi me ŋua?

Ƒumeŋuɖui si le lãkusi me ƒe vava trɔ asi le ƒu ƒe gbagbã didiwo dada ŋu. Togbɔ be aɖaŋu sia nɔ anyi ƒe alafa geɖe hã la, meɖo ɖoƒe si wòle fifia gbɔ o vaseɖe ƒe alafa 20 lia ƒe afã evelia me.

Mɔ si dzi woato akpɔ dzidzedze la menɔa bɔbɔe ɣesiaɣi o, elabena agbalẽnyala geɖe tsɔ ɖikeke kple gbetɔame do go aɖaŋua le ƒe alafa 20 lia ƒe afã gbãtɔ me. Egbea, to nu yeyewo dodo ɖe ŋgɔ le gaŋutinunya, amekokomɔnu kple fluoroscopic aɖaŋuwo me la, ƒu ƒe gbagbãƒe didiwo ƒoƒo va zu dzidzenu si wozãna tsɔ léa be na ƒu ƒe gbagbã didiwo.

Ŋgɔyiyi siwo wowɔ le amegbetɔ ƒe nugbagbeŋusẽ ŋuti sidzedze me na woate ŋu awɔ egbegbe aɖaŋu sia. Egbegbe ɖaƒoƒo ɖe lãkusi me ƒe dzesi enye be dɔlékuiwo ƒe agbɔsɔsɔ si medea ame dzi o, abi sue aɖe koe nɔa eŋu, eƒe gbagbãƒea te ŋu nɔa te nyuie, eye dɔnɔa te ŋu ʋãna enumake.

Ŋutinya me toto si wowɔ le nyati sia me ƒe taɖodzinue nye be woaƒo nu tso alesi ɖa si le lãkusi me ƒe tɔtrɔ ŋu kpuie, ate gbe ɖe eƒe nu vevi veviwo dzi, aɖe ɣeyiɣi si me wozã ɖa si le lãkusi me zi gbãtɔ kple eƒe tɔtrɔ emegbe afia, eye woaɖe teƒe si ɖa si le lãkusi me le le egbegbe ƒumeŋuɖui kple nuveviwɔame ŋuti nunya me afia (le kpɔɖeŋu me, Nɔnɔmetata 1).

Intramedullary nail ƒe dzidzi

Blema Egiptetɔwo zã mɔ̃ aɖe si wotsɔ dea aɖuɖɔtoe me si ɖi ɖaƒoƒo gbã. Anɔ eme be amekoko me beléle na ame ƒe gbagbãdɔ sesẽwo menɔ anyi ƒe geɖe enye sia o.

Gake nusi ŋu kakaɖedzi le enye be blema Egiptetɔwo si aŋɔsisimɔnu gãwo nɔ si tso woƒe dzixɔse be woafɔ ame kuku ɖe tsitre le agbenɔnɔ le ku megbe me.

Aleae wònɔ le ame kuku si woyɔna be Usermontu si ŋu woke ɖo le Tutankhamun ƒe yɔdo me, afisi wotsɔ ka si wotsɔ ka de akɔta kple afɔkpodzi dome be klo ƒe ƒunukpeƒea nali ke (abe alesi wòle le Nɔnɔmetata 2 lia me ene).

Tomenukulawo susui be menye Usermontu ŋutɔe nye ame kuku si le amekukuɖaka la me o, ke boŋ ame bubu aɖe si blema yɔdodalawo va xɔ ɖe eteƒe le ƒe 600 D.M.Ŋ.

Ƒe 2000 megbe la, Bernardino de Sahagun, si nye amegbetɔŋutinunyala si nɔ Hernando Cortes ƒe mɔzɔzɔa me, ka nya ta be wozã atikutsetse si wotsɔ ƒoa aɖuɖɔe zi gbãtɔ le dɔnɔ gbagbe aɖe ŋu le Mexico.

Le ƒe 1524 me la, ekpɔ Aztektɔwo ƒe ƒuŋutinunyala aɖe (si ŋkɔe nye 'Tezalo') tsɔ obsidian hɛ ɖe ƒumelãwo ɖa eye emegbe wòtsɔ resin-ti de ƒumeŋuɖui ƒe doa me be wòana ƒu gbagbãa nali ke. Le amekokomɔnu nyuiwo kple dɔlékuiwutikewo ƒe anyimanɔmanɔ ta la, kuxiwo sɔ gbɔ ɖe dɔ siawo wɔwɔ me eye wowua ame geɖe.

Ƒe 1800-awo: Afɔɖeɖe Gbãtɔwo

Le ƒe 1800 ƒeawo ƒe domedome lɔƒo la, atikewɔwɔ ŋuti magazine gbãtɔwo ka nya ta tso ɖaƒoƒo ɖe lãkusi me ŋu. Woka nya ta be Diefenbach, Langenbeck, Bardenheuer kple amekola bubu siwo doa Germanygbe zã nyiɖu ƒe ɖa siwo le ƒu didiwo ƒe ʋuka me tsɔ da ƒu siwo metso o.

Le ɣeyiɣi ma ke me la, Nicholas Senn si tso Chicago, si nye numekula kple asrafowo ƒe amekola veviedonula, wɔ dodokpɔwo le alesi woatsɔ aŋe atɔ te dɔlékuiwoe ŋu. Azã aŋe si me do le si wotsɔ nyitsu ƒe ƒu wɔ eye wòatsɔe ade lãkusia me atsɔ ada 'pseudarthrosis' le eƒe gbagbã megbe.

Le ƒe 1886 me la, Heinrich Bircher si tso Switzerland ƒo nu tso amekoko ƒe kpekpe aɖe me le alesi wotsɔa nyiɖu ƒe ɖawo dea lãkusia me be woatsɔ ada ƒunukpeƒetetedɔ sesẽwoe kpata (Nɔnɔmetata 3).

Ƒe ʋɛ aɖewo megbe la, Themistocles Gluck si le Germany wɔ nyiɖu ƒe ɖa gbãtɔ si me do le ɖaa ƒe nuwuwu, si wɔe be woto nukpɔsusu si nye be woatsɔ aƒo ƒu ɖe wo nɔewo ŋu vɛ zi gbãtɔ.

Le ɣeyiɣi ma ke me la, Julius Nicolaysen si tso Norway ye nye ame gbãtɔ si ŋlɔ nu tso biomechanical gɔmeɖose siwo nye intramedullary nailing of proximal femoral fractures ŋu. Ete gbe ɖe alesi wòhiã be woadzi ɖa si le lãkusi me ƒe didime ɖe edzi be woakpɔ viɖe geɖe wu le nugbagbeŋutinunya me eye wòana ƒu bliboa kloe nakpɔ ta.

Eya hãe nye ame gbãtɔ si do susu si nye be nail/bone interlocking le proximal kple distal la ɖa be woatsɔ awɔ static locking. Agbalẽnyala aɖewo bua eŋu be eyae nye ame si ƒoa ɖa le lãkusi me fofo.

Kaka ƒe 1800 ƒeawo ƒe domedome naɖo la, mɔɖelawo abe Ignaz Philipp Semmelweis si le Vienna kple JosephLister si le Glasgow ene ɖo gɔmeɖoanyi na amekoko be woatsɔ awɔ vidzidɔe. Esia nye nu yeye aɖe elabena ena woto amekokomɔnu yeyewo vɛ le nɔnɔme siwo me dɔlékui mele o me.

Ƒe 1900-awo: Nɔnɔmetɔtrɔ

Le ƒe 1912 me la, Britaintɔ amekola Ernest Hay Groves ye nye amekola gbãtɔ si zã gakpo sesẽ aɖe abe ɖa si wotsɔna ƒoa ɖae ene eye wònye mɔɖela le mɔnu si wozãna tsɔ ƒoa ɖae si trɔna yia megbe la me.

Nuteƒekpɔkpɔ su esi le Xexemeʋa I me esime wòda dɔ na dɔnɔ siwo ŋu pseudarthrosis si ŋu dɔlékui le siwo medi be yewoatso woƒe abɔwo kple afɔwo o. Menye ɖeko wòƒo nu tso mɔnu gbãtɔ si wozãna tsɔ ƒoa ƒuwoe si na be ƒuwo te ŋu ƒoa ƒu to nuveviwɔame suetɔ kekeake me ko o, ke ebi ɖe ɖa siwo wotsɔ ƒoa ƒuwoe kple ɖa suewo zazã hã me tsɔ ɖɔa ƒu siwo gbã la ɖo.

Ete nusiwo wotsɔ dea ame me siwo wotsɔ aluminum, magnesium kple gakpo wɔe kpɔ eye wòkpɔ biomechanics ƒe vevienyenye le gbagbã ƒe dɔyɔyɔ me dze sii. Togbɔ be ele alea hã la, dɔlékuiwo xɔxɔ ƒe agbɔsɔsɔ gã aɖe ɖe fu na Ernest Hay Groves ƒe aɖaŋua eye le esia ta eŋɔlimetɔwo melɔ̃e nenema gbegbe o.

Le ƒe 1931 me la, Smith-Petersen, si nye Amerikatɔ ƒumeŋutinunyala, to gakpo si mexɔ dzo o si ŋu aʋala etɔ̃ le vɛ be woatsɔ ada akɔta ƒe kɔ ƒe gbagbã le ƒunukpeƒetetedɔ me. Ewɔ mɔnu aɖe si le ʋuʋu ɖi si lãa afɔkpodzi ƒe akpa etɔ̃lia si le ŋgɔgbe, gena ɖe dɔwɔwɔ ƒe teƒea to lãkusi gbadzaa ƒe ŋgɔgbekpa dzi, emegbe egbugbɔa teƒe si wogbã la ɖo eye wòzãa nusi ƒoa nu tsɔ ʋua gakpo si mexɔ dzo o ƒe gavi la yia afɔkpodzi ƒe ta me (Nɔnɔmetata 4).

Le Smith-Petersen ƒe dodokpɔa ƒe dzidzedzekpɔkpɔ ta la, amekola geɖe te ga siwo wotsɔ dea lãme na ame ƒe gbagbãƒewo dodo kpɔ. sven Johansson to ɖa si me do le si le lãkusi me vɛ le ƒe 1932 me; eƒe nu yeye si wòto vɛ la zã kerfing-aŋe si na woate ŋu ade ɖa si le lãkusi me si dzi wokpɔna si dzi wokpɔna to keklẽŋusẽ dzi. Mɔ̃ɖaŋununya ƒe akpa vevi siwo wòzã la gakpɔtɔ le zazãm egbea.

Esi Rush kple nɔviaŋutsu yi ŋgɔ wu afɔɖeɖe ɖeka la, woto nukpɔsusu si nye elastic intramedullary nail vɛ le ƒe 1937 me.

Wozã gakpo si mexɔ dzo o si te ŋu trɔna, si wobɔbɔ do ŋgɔ, si wotsɔ ƒoa ƒu ɖe lãkusi me eye wodze agbagba be yewoawɔ nusi wotsɔ léa nu ɖe ​​lãkusia me si me teƒe etɔ̃ le be woatsɔ atsi axadziʋuʋu ƒe nɔnɔme si ƒo xlã gbagbãƒea nu.

Le woƒe nukpɔsusu nu la, lãkusi falɛfalɛ si me gblẽ o la wɔa dɔ abe teteɖeanyi ƒe ka si tsi tre ɖe teteɖeanyi si ɖa si wotsɔ ƒoe do ŋgɔ la hena vɛ ene. Woƒe wɔwɔme seɖoƒe li na le esi gakpo si mexɔ dzo o ƒe teteɖeanyi ƒe nɔnɔmewo trɔna kaba tso elastic deformation dzi va zu plastic deformation. Mlɔetɔa ate ŋu ahe ʋuʋu evelia kple nɔnɔme madeamedziwo ƒe dɔyɔyɔ vɛ.

Tsɔ kpe ɖe eŋu la, ɖa siwo le ƒunukpeƒewo te ŋu dona le ƒunukpeƒea alo gena ɖe ƒu siwo le ƒunukpeƒewo me, alo doa do le ƒunukpeƒea gɔ̃ hã. Ke hã, Viennatɔ agbalẽnyala Ender yi edzi zã mɔnu sia abe gɔmeɖoanyi na Ender suku si nye be woatsɔ axe mɔ ɖe gbagbãƒewo nu eye wogazãnɛ egbea hena ɖeviwo ƒe gbagbãƒewo ɖɔɖɔɖo si te ŋu trɔna bɔbɔe.

Ƒumeŋuɖui ƒe ɖa

Le ƒe 1939 me la, Germanytɔ amekola Gerhard Küntscher, amesi tia Nobel Nunana la, to gakpo si mexɔ dzo o ƒe ɖa si wotsɔ dea akɔta ƒe lãkusi me vɛ be woatsɔ ada akɔta ƒe ke ƒe gbagbãwo.

Smith-Petersen ƒe gakpo siwo mexɔ dzo o siwo wozãna tsɔ daa akɔta ƒe kɔ ƒe gbagbãwoe ʋã Küntscher kple ame bubuwo eye woxɔe se be woate ŋu azã gɔmeɖose mawo ke le ke ƒe gbagbã hã ŋu. Intramedullary nail si woto vɛ la ƒe nɔnɔme nye V le gɔmedzedzea me le eƒe cross-section me eye eƒe didime nye 7-10 mm.

Esi wòsrɔ̃ nu tso ame kukuwo kple lãwo ŋu vɔ la, etsɔ ɖa si le lãkusi me kple amekoko ƒe mɔnu la ɖo amekoko ƒe kpekpe aɖe me le Berlin le ƒe 1940. Le gɔmedzedzea me la, eƒe dɔwɔhati Germanytɔwo ɖu fewu le eƒe nu yeyea ŋu, togbɔ be eƒe mɔnua va xɔ ŋkɔ le Xexemeʋa II megbe hã.

Hippocrates (ƒe 460-370 D.M.Ŋ.), blema Helatɔwo ƒe ɣeyiɣia me atikewɔla si woyɔna zi geɖe be atikewɔwɔ fofo, gblɔ ɣeaɖeɣi be, 'Ele be amesi di be yeawɔ amekoko la nayi aʋa'; nenema kee wònɔ le Küntscher hã gome.

Le Nazitɔwo ƒe ɣeyiɣia me la, Küntscher nɔ kɔdzi aɖe si le Finlandtɔwo ƒe aʋagbedzi. Le afima la, ete ŋu wɔ dɔ na dɔnɔwo kple aʋawɔla siwo woɖe aboyoe le nutoa me. Eto amekokomɔnu si wotu kple esi woʋu ɖi zazã me to ƒumeŋuɖui ƒe ɖaƒoƒo ƒe susu vɛ.

Le mɔnu si wotu nu la, etsɔa ɖa si le lãkusia me la toa lãkusi si lolo wu la me le mɔ si yia ŋgɔ nu eye wòtsɔnɛ da ɖe kplɔ̃ si dzi wogbugbɔa nu le si wotsɔa aŋe wɔ dɔe dzi. Wogbugbɔa ɖa si gbã la ɖoa teƒe bubu eye wotsɔa ta ƒe keklẽŋusẽ dea ɖaa ɖe yameʋu eve me. Le mɔnu si le ʋuʋu ɖi me la, wotsɔa ɖa si le lãkusia me la toa lãkusia me yia lãkusia me to lãɖeɖe aɖe si te ɖe fli si me wogbãe ŋu.Küntscher zãa ɖa si le lãkusia me tsɔ daa afɔkpodzi ƒe ke ƒe gbagbã kpakple afɔkpodzi kple akɔta ƒe gbagbã.

Esi wogbugbɔ Dukɔ Siwo Bla Nu ƒe aʋawɔgaxɔmenɔlawo ɖo wo de megbe hafi wova da asi ɖe Küntscher ƒe aɖaŋua dzi le dukɔwo dome.

To mɔ sia dzi la, Amerikatɔwo kple Britaintɔwo ƒe amekolawo va nya nu tso ɖa si le lãkusi me si Küntscher to vɛ ŋu eye wokpɔ viɖe siwo dze ƒã le eŋu le ɣeyiɣi sia si me wozãa ɖa si wotsɔ daa aɖuɖɔtoewoe me.

Le ɣeyiɣi kpui aɖe ko me la, amekola geɖe wu va nɔ eƒe mɔnua zãm le xexeame godoo, eye Küntscher ƒe ɖa si wotsɔ ƒoa ɖa si le lãkusi me la trɔ asi le alesi woda ɖa le lãmekawo ƒe gbagbã ŋu to ɣeyiɣi si dɔnɔa xɔna ƒe hayahaya dzi ɖeɖe kpɔtɔ ƒe ɖeka kloe me. Dɔnɔ siwo ahiã be woaxe mɔ na wo le atike si wotsɔna ƒoa ƒui me ɣleti geɖe hafi la ate ŋu azɔ azɔ le ŋkeke ʋɛ aɖewo ko megbe.

Vaseɖe fifia la, wobu Germanytɔ amekola la be eyae nye ame vevitɔ si to ɖa si le lãkusi me vɛ, eye eƒe nɔƒe vevi aɖe le amekoko si wowɔna le nuveviwɔame ƒe ŋutinya me.

Intramedullary Nail ƒe kekeɖenudɔwɔwɔ

Le ƒe 1942 me la, Fisher kple exɔlɔ̃wo gblɔ be: ƒo nu tso alesi wozãa nutunu si kekea ƒumeŋuɖui ɖe enu be woatsɔ adzi afisi ɖa si le lãkusia me kple ƒua dome kadodo ɖo ɖe edzi eye wòana ƒu ƒe gbagbãƒe ƒe ƒoƒo ƒe liƒo nanyo ɖe edzi ŋu.

Ke hã, Küntscher to reaming drill si wofia mɔe si te ŋu trɔna bɔbɔe si wogazãna egbea vɛ eye wòdoa alɔ reaming le ƒu ƒe ke ƒe medullary cavity ƒe didime bliboa dzi be wòana woate ŋu ade ƒumeŋuɖui me siwo ƒe didime lolo wu.

Le gɔmedzedzea me la, wowɔ intramedullary reaming be wòana ƒu ƒe kadodo kple intramedullary nail nadzi ɖe edzi ŋutɔ be ƒu ƒe gbagbãƒea nali ke eye dɔnɔa naʋuʋu kabakaba.

Abe alesi Smith et al ɖɔe ene la, medullary ƒe kekeme milimeta 1 ɖesiaɖe dzia kadodo ƒe teƒe ɖe edzi 38%. Esia wɔnɛ be woate ŋu azã ɖa siwo lolo wu eye wosẽ wu le lãkusi me, si wɔnɛ be xɔa ƒe gbagbãƒe ƒe xɔtunua ƒe liƒo bliboa nyona ɖe edzi.

Gake togbɔ be Küntscher intramedullary nail kple eƒe intramedullary reaming drill si te ŋu trɔna bɔbɔe la va zu ememe fixation device tiatia si sɔ na ƒu ɖeɖeɖa hã la, agbalẽnyalagãwo megakpɔ ŋudzedze ɖe eŋu le ƒe 1960 ƒeawo ƒe nuwuwu o tsɔ da asi ɖe Arbeitsgemeinschaft für Osteosynthesefragen (AO) ƒe agbalẽvi yeye siwo woto vɛ dzi.

Ƒe 1960-awo: Viviti Ɣeyiɣiawo

Le ƒe 1960-awo me la, woɖe ɖa le lãkusi me vivivi ɖa kasia tsɔ do alɔ agbalẽ kple gavi ƒe gbagbã.

Togbɔ be Küntscher ƒe mɔnua wɔ dɔ nyuie hã la, amekola siwo le xexeame godoo gbe wo le esi dɔwɔwɔ vɔ megbe me tsonu nyui aɖeke o ta.

Tsɔ kpe ɖe eŋu la, amekola aɖewo te asiɖeɖe le keklẽŋusẽ zazã ƒe mɔnuwo, abe ta me fluoroscopy ene ŋu, le esi keklẽŋusẽ ƒe nugbegblẽ le ame ŋu la va nyɔ ŋu na amekolawo. Intramedullary nailing ƒe ŋgɔyiyi metɔ ɖe afima o, togbɔ be dukɔwo dome nukpɔsusu ɖeka le afisiafi be woazã plate internal fixation systems hã.

Küntscher, si nye Germanytɔ atikewɔla, de dzesi viɖe siwo le ƒoƒo ɖe wo nɔewo ŋu me eye wòwɔ clover-aŋgba ƒe nɔnɔme si wotsɔ bla ɖe wo nɔewo ŋu le lãkusi me, si wòtsɔ ŋkɔ na be 'detention nail'. Achilles ƒe afɔkpodzi si wotsɔ wɔ ɖa si le lãkusi me le ɣeyiɣi ma mee nye alesi womete ŋu na lãgbalẽ gbagbã alo gbagbãƒe siwo wogbã ŋutɔ siwo woɖe ɖe dzogoe gãwo dzi la li ke Kuxi sia gbɔ kpɔnue nye gavi siwo wotsɔ xea mɔ na woe zazã.

Kuxi sia gbɔ kpɔnue nye be woatsɔ gavi si xea mɔ na ɖa si le lãkusia me la nali ke.

To mɔ sia dzi la, nusi wotsɔ de ame me ate ŋu anɔ te ɖe ŋusẽ siwo le bɔbɔ kple esiwo le ʋuʋum nu nyuie wu esime wòle mɔ xem na abɔ kple afɔ ƒe kpuiƒe. Wozã susu siwo tso Küntscher, Klaus Klemm, kple Wolf-Dieter Schellmann gbɔ tsɔ wɔ ɖa si le lãkusi me la be wòana wòali ke wu to do siwo le gavi si te ɖe lãkusia me ŋu kple esiwo le didiƒe ʋĩ, si wotu ɖe gavi si wotsɔ de eme la ŋu la kuku do ŋgɔ me.

Le ƒe ʋɛ siwo kplɔe ɖo me la, ŋgɔyiyi siwo wowɔ le nɔnɔmetata siwo me kɔ nyuie le fluoroscopic me na wogate ŋu tia mɔnu siwo woatsɔ axe mɔ ɖe gbagbãƒewo nu ahaɖe wo dzi akpɔtɔ.

Ƒe 1970 kple 1980 ƒeawo: Gbugbɔgadzɔ

Le ƒe 1970-awo me la, wotsɔ ɖe le Germanytɔ amekola Küntscher ƒe nukpɔsusu si nye be woaƒo atitsoga le lãkusi me la me vevie.

Closed reduction intramedullary nail fixation for fractures, kple eƒe reaming kple interlocking nukpɔsusu siwo te ŋu trɔna bɔbɔe ƒe tsatsam kple fluoroscopic mɔnuwo ƒe eme kɔ nyuie wu, na amekokomɔnu nyui sia si ƒe dzesi enye be lãmeka falɛfalɛwo megblẽna boo o, li ke nyuie, eye dɔnɔa te ŋu ʋãna enumake la yi ŋgɔ eye wòkaka.

Ɣemaɣi la, nu yeye siwo kplɔ wo nɔewo ɖo siwo na woto dzidzime evelia si nye intramedullary nailing vɛ la xɔ agbalẽnyalawo ƒe xexeame.

Le ƒe 1976 me la, Grosse kple Kempf wɔ ɖa si ƒe akpa aɖe do le lãkusi me be woatsɔ akpɔ ɖa si le lãkusi me ƒe elastic modulus ƒe kuxia gbɔ. Womede do ɖe ɖa si le lãkusia me la me le nuto si te ɖe eŋu me o eye do aɖe nɔ eme na ɖa si wotsɔ ƒoa ɖae la, si wotsɔ dea eme le dzogoe si nye dzidzenu 45 dzi be wòana ɖa si le lãkusia me ƒe ememe fixation structure ƒe liƒo nadzi ɖe edzi.

Ƒe ʋɛ aɖewo megbe la, AO va kpe ɖe ɖa siwo le lãkusi me ƒe tsitsi ƒe nɔnɔmea ŋu to ɖa siwo wosusu nenema ke le lãkusi me toto vɛ me (Nɔnɔmetata 5) .

Le ƒe 1984 me la, Weinquist kple exɔlɔ̃wo gblɔ be: do mɔnu si me ŋusẽ le, si nye be woana gbagbãƒe ƒe nuwuwu ƒe dɔyɔyɔ nanyo ɖe edzi to do siwo lolo wu siwo wotsɔ xea gavi siwo wotsɔ xea mɔe la dede eme, gavi siwo wotsɔ xea mɔe siwo meʋãna o ɖeɖeɖa, eye emegbe woatrɔ asi le gavi siwo wotsɔ xea nu ŋu ƒe doawo ŋu woazu do siwo le abe ɖa ene le atsyã si sɔ ɖe egbegbe nu nu.

Taɖodzinu si le mɔnu si me ŋusẽ le ŋue nye be wòado ƒu ƒe gbagbã ƒe dɔyɔyɔ ɖe ŋgɔ eye wòaƒo asa na ƒu ƒe mawɔmawɔ le dɔwɔwɔ si tsi megbe ta.

Fifia la, intramedullary nailing dynamics bu eƒe taʋlilawo abe mɔnu si le eɖokui si ene eye fifia koe wozãnɛ abe egbɔkpɔnu si me ga menɔa anyi o wu ememe fixation system ɖɔliɖɔli keŋkeŋ le gbagbã siwo meda gbe le o dada me ene.

Le biomechanical numekuku aɖe me la, Gimeno et al. ka nya ta be tɔtrɔƒe si le ɖa si le lãkusia me ƒe akpa siwo me do mele o kple esiwo me do le dome la na nuteɖeamedziwo sɔ gbɔ ɖe lãme na ame eye amekoko me do kpo nusi wotsɔ dea ɖa si wotsɔ léa ememe la me.

Be woakpɔ kuxi siawo gbɔ la, Russel kple Taylor et al. wɔ ɖa gbãtɔ si me do mele o, si mekeke o, le ƒe 1986 me, eye emetsonuwo dze ame ŋu.

Le ɣeyiɣi sia me la, ɖa siwo le lãkusi me ƒe ƒoƒo ɖe wo nɔewo ŋu ƒe kuxia hã yi edzi nɔ ŋgɔ yim, eye abe alesi míenyae egbea ene la, Klemm kple Schleman ƒe aɖaŋu le Germany be woatsɔ gavi la aƒo ƒu to do si woɖe do ŋgɔ na ɖa si le lãkusi me la me. Woatsɔ asi si woate ŋu akpɔ le ablɔɖe me, si ana amekolaa nakpɔ keklẽŋusẽ geɖe atsɔ afia mɔ gavi la dede eme.

Egbea la, wokpɔ kuxi sia gbɔ to adzɔge taɖodzinu ƒe ɖoɖo aɖe si me wozãa elektrikŋusẽ ƒe mɔ̃ si léa ŋku ɖe nu ŋu, mɔ̃ɖaŋununya si wotsɔ fluoroscope fiaa mɔe le asi faa, kple mɔfiame si sɔ pɛpɛpɛ si wotsɔ dea ɖa le teƒe si te ɖe wo ŋu.

Ƒe 1990-awo: Titanium ƒe ɖa si le lãkusi me

Le ƒe ewo siwo kplɔe ɖo me la, Russel-Taylor ƒe ƒumeŋuɖui va xɔ ŋkɔ ŋutɔ le dukɔwo dome ƒumeŋutinunyalawo dome. Belélename ƒe dzidzenua va zu intramedullary nailing vivivi kple static locking of screws, abe alesi numekuku si Brumback et al.

Le numekuku sia si wowɔ le etsɔme me la, emetsonuwo ka nya ta be gaƒoƒo na nu nyuiwo do tso eme le go akpa gãtɔ me eye medo ƒome kple gbagbãƒea ƒe ƒoƒo ɖekae o.

Ŋgɔyiyi siwo wowɔ le gaŋutinunya me na wova do titanium intramedullary nails, siwo wozãna geɖe le atikewɔwɔ na nugbagbewo ƒe dɔwɔƒewo le woƒe ŋusẽ, tsitretsitsi nyuie na xɔxlɔ̃ kple nugbagbewo ƒe ɖekawɔwɔ ta.

Alta intramedullary nailing system ye nye titanium intramedullary nail gbãtɔ si li, eye atikewɔlawo do dzidzɔ nɛ ŋutɔ le titanium, si nye ga si sesẽ wu gake mesẽna o wu gakpo si mexɔ dzo o ƒe mɔ̃ɖaŋununya ta.

Gake agbalẽ siwo li fifia ke ɖi nenye be titanium nye nusi sɔ wu na ememe nuléle wu gakpo si mexɔ dzo o, vevietɔ le ga si wozãna ɖe titanium zazã ŋu si dzi ɖe edzi ta.

Gake viɖe aɖewo siwo le titanium ŋu, abe elastic modulus si te ɖe cortical bone ŋu kple magnetic resonance imaging ƒe ɖekawɔwɔ ene, na wònye tiatia si hea ame.

Tsɔ kpe ɖe eŋu la, titanium nye tiatia si hea ame ŋutɔ ne ehiã be woatsɔ ɖa siwo le lãkusi me siwo ƒe didime le sue wu.

Fifia ƒe Nɔnɔmewo

Le ƒe bla nane siwo va yi ƒe dzidzedzekpɔkpɔ kple kpododonu megbe la, ƒumeŋutinunyalawo kpɔ nuteƒe geɖe wu le ƒumeŋuɖui ƒe ɖaƒoƒo ŋu.

Intramedullary nail fixation of femoral, tibial and humeral fractures va zu beléle na ɖa ƒe gbagbã akpa gãtɔ kple gbagbã aɖewo siwo le ʋuʋu ɖi. Taɖodzinu kple teƒeɖoɖo ƒe ɖoɖo yeye na amekola siwo si nuteƒekpɔkpɔ mele o gɔ̃ hã ate ŋu awɔ dɔa bɔbɔe eye woate ŋu agbugbɔe awɔ.

Nusiwo do mo ɖa nyitsɔ laa ɖee fia be titanium kple gakpo siwo mexɔ dzo o ƒe ga siwo te ŋu trɔna bɔbɔe ŋutɔ eye be nuteɖeamedziwo doa viviti ɖe nuteɖeamedzi siwo doa dziku siwo hiã hena ƒuwo ƒe dɔyɔyɔ ŋu. Wole biomaterials yeyewo abe magnesium alloys, shape memory alloys kple resorbable materials dom kpɔ fifia le agbalẽnyalawo dome.

Intramedullary nails siwo wotsɔ carbon fiber-reinforced polymers siwo yia edzi ɖaa siwo ƒe elastic modulus nyo ɖe edzi eye ɖeɖiteameŋu ƒe ŋusẽ gã aɖe le wo ŋu la li fifia. Magnesium-kpewo ƒe ʋuʋudedi ƒe modulus sɔ kple cortical bone tɔ eye woate ŋu agblẽ nu le nugbagbewo ŋu.

Numekuku siwo Li kple exɔlɔ̃wo wɔ nyitsɔ laa. ɖe viɖe veviwo fia le ƒumeŋuɖui ƒe gbagbã dada me le lãwo ƒe kpɔɖeŋu siwo wogblɔ be magnesium kple zoledronate ƒe nutsyɔnu tsɔtsɔ ƒo ƒui hena ƒu gbagbãwo dzadzraɖo gbɔ, si nye mɔnu si ate ŋu ava zu ƒu ƒe gbagbãdɔ dada le etsɔme.

Nyanuwuwuw

Le ƒe siwo va yi me la, esi wowɔ ŋgɔyiyi gã aɖe le ɖa si le lãkusi me ƒe wɔwɔme, gaŋutiɖoɖo ƒe mɔnuwo, kple amekokomɔnu me ta la, ɖaƒoƒo ɖe ƒu me va zu beléle na ƒu didi akpa gãtɔ ƒe dzidzenu si li fifia eye wònye mɔnu si wɔa dɔ nyuie, si me womewɔa nu boo aɖeke le o, eye woate ŋu agbugbɔ awɔe.

Gake le ɖa gbogbo siwo wowɔ le lãkusi me ta la, nyatakaka geɖe meli ku ɖe woƒe dɔwɔwɔ le dɔwɔwɔ vɔ megbe me tsonu ŋu o. Numekuku geɖe hiã be woatsɔ anya intramedullary nail type size nyuitɔ, eƒe nɔnɔmewo kple radius of curvature.

Míegblɔe ɖi be nu yeye siwo woawɔ le nugbagbewo ƒe dɔwɔwɔ me ahe ɖa yeye siwo wowɔna le lãkusi me ƒe wɔwɔme vɛ.

Ale Si Nàƒle Ƒumeŋuɖuiwo Kple Ƒumeŋuɖui Dɔwɔnuwo?

Elabena CZMEDITECH , míekpɔa adzɔnuwo ƒe hatsotso si de blibo ŋutɔ si nye ƒumeŋuɖui ƒe amekoko implants kple dɔwɔnu siwo sɔ, adzɔnuwo 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 .

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