Aleke wowɔa atike na periprothetic fracture?

Taɖodzi

Afɔkpodzi ƒe gbagbã le akɔta ƒe akpa si le gota nye kuxi gã aɖe le akɔta ƒe ƒunukpeƒetetedɔ me. Nusi ŋu woka nya ta le be edzɔnae nye 3.5% le ƒe 20 le ƒunukpeƒedede gbãtɔ megbe eye wòdzina ɖe edzi ne ƒunukpeƒewo ɖɔliɖɔli ƒe dzɔdzɔ. Zi geɖe la, lãmekawo ƒe gbagbã le dɔwɔwɔ me do ƒome kple atikutsetse siwo wometsɔ siminti o. Zi geɖe la, ame tsitsi siwo gbɔdzɔ siwo dze anyi le amekoko megbe la ƒe gbagbã dzɔna. Togbɔ be vovototo le dukɔwo dome le atikutsetse siwo wotsɔ siminti wɔe kple esiwo wometsɔ siminti wɔe zazã me o hã la, kpeɖodzi si me kɔ aɖeke meli be ke ƒomevi ɖeka si wotsɔ siminti wɔe do ƒome kple afɔku si le gbagbãƒe si lolo wu evelia o. Amekolawo da asi ɖe Vancouver ƒe hatsotsowo me toto ƒe ɖoɖo si wozãna na afɔkpodzi ƒe gbagbã siwo le lãkusi godo ŋu le afisiafi eye wokpɔe be kakaɖedzi le eŋu.

Taɖodzinu vevitɔ si le numekuku sia ŋue nye be woanya ƒomedodo si le Vancouver ƒe hatsotso si me wotsɔ siminti wɔe kple esi wometsɔ siminti wɔe o ƒe ke ƒe gbagbã dome. Taɖodzinu eveliae nye be woaku vovototo siwo le dɔnɔ siwo ƒe gbagbã ƒomevi eveawo ƒe gɔmedzedze ƒe nɔnɔmewo me.

Nusiwo Wozã Kple Mɔnuwo

Dzigbɔɖi:

1. Dɔnɔ siwo kplɔ wo nɔewo ɖo siwo ƒe proximal periprothetic fractures kplɔ wo nɔewo ɖo.

2. Dɔnɔ siwo ƒe akɔta ƒe akpa aɖewo ƒe gbagbã gbãtɔ koe wotsɔ de eme.

3. Woɖe dɔnɔ siwo ƒe akɔta gbã le dɔwɔwɔ na wo me, akɔta ƒe gbagbã siwo wogbugbɔ gbugbɔ wɔ, kple akɔta ƒe gbagbã le ametia ƒe akpa vovovowo dome la ɖa.

   
   

Nyatakakawo ƒe nuŋlɔɖi:

1. Digitál radiography kple computed tomography si wotu ɖe elektrɔnik nuŋlɔɖiwo kple numekuku dzi.

2. Gɔmedzedze ŋuti nyatakaka siwo woŋlɔ ɖi dometɔ aɖewoe nye ƒe si woxɔ, ŋutsu alo nyɔnu nyenye, ŋutilã ƒe lolome ƒe dzesi, kple ʋuʋu dzi ɖeɖe kpɔtɔ hafi dze egɔme alo be dɔnɔdzikpɔla ƒe ŋuɖoɖo ɖe eŋu.

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Amekoko ŋuti nyatakakawo ŋlɔ be:

1. Wotsɔ ɣeyiɣi si woatsɔ ade ƒunukpeƒetetedɔ zi gbãtɔ, nusiwo fia be woawɔ ƒunukpeƒetetedɔ (ƒunukpeƒetetedɔ alo ƒunukpeƒetetedɔ), ke ƒomevi (si wotsɔ siminti alo esi wometsɔ siminti wɔe o), kple ƒunukpeƒetetedɔ ƒomevi (ƒunukpeƒetetedɔ bliboa alo afã kple afã) kpe ɖe eŋu.

2. Nɔnɔmetatawo ŋuti nuŋlɔɖi tsitotsito dometɔ aɖewoe nye Vancouver ƒe hatsotsowo me toto, varus ƒe akɔta ƒe nɔnɔme, kple Dorr ƒe hatsotsowo me toto.

3. Woŋlɔ ke ƒe nɔnɔme (conical alo compound na ke siwo wotsɔ siminti wɔe, dzɔdzɔe alo wedge-nɔnɔme na ke siwo wometsɔ siminti wɔ o) ɖe fotoɖemɔ̃ ƒe dzedzeme dzi.

4. Wotu Vancouver ƒe hatsotsowo nyanya ɖe nɔnɔmetatawo me nusiwo ŋu woke ɖo kple nusiwo ŋu woke ɖo le dɔwɔwɔ me le dɔnɔ siwo wowɔ dɔ na ŋu dzi.

5. Wowɔ akɔntabubuwo me dzodzro to tɔtrɔ siwo yia edzi T-dodokpɔ kple Fisher ƒe dodokpɔ si sɔ pɛpɛpɛ na tɔtrɔ siwo le hatsotsowo me tsɔ tsɔ gɔmedzedze ƒe nɔnɔmewo kple Vancouver ƒe hatsotso si me woda dɔnɔ siwo le ke ƒe ƒuƒoƒo siwo wotsɔ siminti wɔe kple esiwo wometsɔ siminti wɔe o sɔ kple wo nɔewo.

6. Dodokpɔawo katã nye akpa eve eye woƒe vevienyenye ƒe seƒe nye 0.05. Wozã GraphPad Prism ƒe tɔtrɔ 8.0.0 tsɔ wɔ akɔntabubuwo me dzodzro.

   
   

Metsonu

Dɔnɔwo ƒe xexlẽme:

1. Wode dzesi dɔnɔ 1181 to biabia tso kɔdzi ƒe nyatakakadzraɖoƒea me.

2. Woɖe dɔnɔ 978 siwo ƒe afɔkpodzi ƒe gbagbã si menye periprosthetic proximal femur fractures o la ɖa.

3. Le dɔnɔ 203 susɔeawo dome la, 8 ƒe lãme gbã le dɔwɔwɔ na wo me, 6 ƒe akɔta ƒe ƒunukpeƒe ƒe gbagbã siwo wogbugbɔ trɔ, eye 17 ƒe akɔta ƒe ƒunukpeƒetete ƒe gbagbã le mɔ̃ si wotsɔ léa akɔta ƒe ƒunukpeƒewo ŋu, siwo wogaɖe ɖa.

4. Wotsɔ dɔnɔ 172 de eme le wo ɖeɖeɖa vɔ megbe.

5. Gbagbãƒewo katã dzɔ le anyidzedze megbe. Femoral stem bone cement group gbagbã le ame 84 siwo me siminti mele o me

6. Ame 88 ye gbagbã le ƒuƒoƒoa me.

   
   

Gɔmedzedze ƒe Nɔnɔmewo:

1. Vovototo gã aɖe nɔ ƒuƒoƒoawo dome le ƒe si woxɔ, ɣeyiɣi si wotsɔ de lãme na ame zi gbãtɔ, dzesi siwo fia be woawɔ ƒunukpeƒetetedɔ na afɔkpodzi ƒe kɔ ƒe gbagbã, ƒunukpeƒe ƒe akpa gbãtɔ ƒe ɖɔɖɔɖo, varus ƒe ke ƒe ɖoɖo, kple ŋutilã ƒe lolome ƒe dzesi.

2. Vevietɔ le siminti ƒuƒoƒoa me la, wo dometɔ akpa gãtɔ nye ƒunukpeƒetetedɔ.

3. Vovototo gã aɖeke menɔ ƒuƒoƒoawo dome le gbɔdɔdɔ, Dorr ƒe hatsotsowo me toto, kple ʋuʋu do ŋgɔ na dɔlélea alo dɔnɔdzikpɔlawo ƒe ŋuɖoɖo ɖe ame ŋu dzi ɖeɖe kpɔtɔ gome o.

4. Le ƒuƒoƒo si wotsɔ siminti wɔe me la, ke akpa gãtɔ nye esiwo le tsɛ eye susɔeawo nye esiwo wotsɔ ƒo ƒui.

5. Le ƒuƒoƒo si me wometsɔ siminti wɔ o me la, ke akpa gãtɔ nɔa dzɔdzɔe eye susɔeawo nɔa abe aŋe ene.

   
   

Vancouver ƒe hatsotsowo:

1. Woma VancouverB2 ƒe gbagbãƒewo ɖe gbagbã ƒe nɔnɔme vovovo ene me: comminuted 'burst', clamshell, kple helical nɔnɔme siwo ŋu míeƒo nu tsoe va yi, kple 'reverse' clamshell ƒe nɔnɔme si wokpɔ yeyee. Woɖe X-ray ƒe dzedzeme si le tsitre ɖi na nusiwo kplɔ wo nɔewo ɖo kple nɔnɔmetata si sɔ kplii fia (Nɔnɔmetata 1).

2. Wokpɔe be gbagbã kple spiral ƒe gbagbã do ƒome vevie kple ke siwo wotsɔ siminti tu, gake flap gbagbã ya do ƒome vevie kple ke siwo wometsɔ siminti ɖo o.

3. Clamshell ƒe nɔnɔme si trɔna ɖe megbe la dzɔ le ke eveawo siaa me nenema ke.

4. Vancouver ƒe hatsotsowo ƒe hatsotso suewo, siwo dome B2 ƒe gbagbã ƒomevi ene siwo ŋu míeƒo nu tsoe le etame hã le, ƒe kadodo kple ke ƒe geometry ɖe alesi gbagbã ƒomeviwo le le goawo katã me fia.

Dzro eme

Vaseɖe fifia la, esiae nye numekuku gãtɔ kekeake si tsɔ ƒomedodo si le atikutsetse ƒe ƒuƒu siwo wotsɔ siminti wɔe kple esiwo wometsɔ siminti wɔe o dome sɔ kple Vancouver ƒe hatsotsowo dome tẽ:

• Vovototo gã aɖeke menɔ kadodo si le ke siwo wotsɔ siminti wɔ kple esiwo wometsɔ siminti wɔ o dome le Vancouver ƒomevi A, B, alo C ƒe gbagbãwo me o. VancouverB2 ƒe gbagbã ƒe dzɔdzɔ sɔ le hatsotso eveawo siaa me, si fia be ke siwo li ke kple esiwo meli ke o ƒe dzɔdzɔ ɖekae le periprothetic fractures me le hatsotso eveawo siaa me.

• To vovo na ema la, Fenelon kple exɔlɔ̃wo. wodzro periprothetic fractures me kple ke siwo wotsɔ siminti kple esiwo wometsɔ siminti wɔ o. Edze ƒã be dɔnɔ siwo ƒe lãme gbã le Vancouver B2 kple B3 ƒe xexlẽme sɔ gbɔ ŋutɔ.

• Phillips kple exɔlɔ̃wo. ɖɔ 'burst' ƒe nɔnɔme si wogbã ŋutɔ si nye conical cement stem segments kple 'crack' le siminti jacket la ŋu, si sɔ kple 'axe head'. Wokpɔe be gbagbã sia do ƒome vevie kple ke siwo wotsɔ siminti tu le numekuku sia me.

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• Alesi ƒu gbagbã siawo ƒe gbagbãƒe lolo la nana wotsia dzi ɖe ƒu ƒe dɔmawɔmawɔ ŋu, eye zi geɖe la, ebiana be woaɖe siminti ɖa nyuie eye woatsɔ ati si le didiƒe si le ƒuƒuie la ato wo ŋu.

• Capello kple exɔlɔ̃wo. ƒo nu tso 'flip-flop' ƒe gbagbã si do ƒome kple ke siwo wometsɔ siminti wɔ o ŋu, eye nusiwo ŋu woke ɖo ɖe nusi ŋu woke ɖo sia fia. Gbagbãƒea dzɔna tso lãkusi gãtɔ ƒe titina gɔme, ekekena yia titina ƒe lãkusi me, eye wòkpɔa axadzi ƒe lãkusi si le didiƒe ʋĩ tso lãkusi suea gbɔ la ta. Talar nuto ƒe lolome kple kea ƒe ɖiɖi nye radiographic dzesi siwo fia be kea meli ke o. Numekuku siwo wowɔ va yi ɖee fia be kadodo ɖedzesi aɖe le gbagbãƒe sia kple ke siwo wometsɔ siminti wɔ o siwo ƒe ŋutilã ƒe wɔwɔme kple esiwo ƒe nɔnɔme le abe wedge ene dome, eye numekuku sia ɖo kpe kadodo sia dzi.

• Grammatopolous et al ɖɔ helical fracture patterns siwo kplɔ wo nɔewo ɖo le periprothetic fractures siwo me cemented stems le, zi geɖe la, wodo ƒome kple wedge fragments siwo ɖe wo ɖokui ɖe aga kple comminution sesẽ. Wodzi helical gbagbã siwo le ke si wotsɔ siminti wɔ me ƒe xexlẽme ɖe edzi ŋutɔ le nusiwo kplɔ wo nɔewo ɖo sia me, si ate ŋu aɖe alesi gbagbã siwo ƒo xlã tubular cemented stem la kaka le mɔ si sɔ kple dzɔdzɔme ƒu nu la afia.

• Le radiographic numekuku aɖe si wowɔ le periprothetic gbadzɛ gbogbo aɖewo ŋu me la, numekulawo kpɔ gbagbã ƒe nɔnɔme aɖe si ŋu womeƒo nu tsoe le agbalẽwo me va yi o. Gbagbãƒea dzɔna tso titina ƒe lãkusi si to axadzi ƒe lãkusi me, si wɔnɛ be titina ƒe lãkusia nɔa anyi. Woyɔa gbagbã sia ƒomevi be 'reverse' clamshell gbagbã, si numekukua bu be enye Vancouver B2 gbagbã si bɔ.

• Wotia ŋkɔ sia le susu eve ta: gbãtɔ, enye 'flip' ƒe ahuhɔ̃e me nɔnɔmetata, eye evelia, ewɔa nu abe reverse oblique proximal femoral fracture ene, kple abductor ƒe supralateral displacement ma tɔgbe si hea proximal fragment . Gbagbã mawo tɔgbe dzɔ le ke siwo wotsɔ siminti tu kple esiwo wometsɔ siminti wɔe o hã ŋu (Nɔnɔmetata 2).

• Togbɔ be menye taɖodzinu si le numekuku sia ŋue nye be woaku atikewɔwɔ me tsonu me o hã la, le numekuku sia me la, zi geɖe la, wogbugbɔ trɔa asi le reverse flip-flop fractures ŋu to arthroplasty na distal load-bearing stem eye wotsɔ cerclage ka alo plates bla proximal fracture fragments.

• Woɖe dɔnɔ si wotsɔ mɔnu sia da dɔe ƒe kpɔɖeŋu aɖe fia, si ɖe alesi wokpɔ dɔyɔyɔ ƒe dzidzedzekpɔkpɔ fia (Nɔnɔmetata 3).

Nɔnɔmetata 2 Trɔ flip-top gbagbã ƒe nɔnɔme.

Figure 3 Arthroplasty kple cerclage ka ƒe fixation na retrograde flap fractures.

Nyanuwuwuw

Le Vancouver ƒe hatsotsowo me toto ƒe ɖoɖoa nu la, ametia ƒe gbagbã ƒomevi siwo wotsɔa lãgbalẽ wɔe ƒe gbagbã le ametia ƒe akpa si wotsɔ siminti wɔe kple esiwo wometsɔ siminti wɔe o me sɔsɔe. Eyata ke siwo li ke kple esiwo meli ke o ƒe dzɔdzɔ le woƒe gbagbã megbe sɔ le hatsotso eveawo me. De dzesi VancouverB2 ƒe gbagbã ƒe nɔnɔme vovovo ene, siwo dome flip-flop ƒe nɔnɔme si wogbugbɔ trɔ si wokpɔ yeyee hã le, akpe ɖe amekolawo ŋu woade dzesi ke ƒe ke ƒe malikenyenye. Ehiã be woawɔ numekuku le etsɔme be woaku ƒomedodo si le lãmeka ƒe gbagbã ƒomevi kple atikewɔwɔ ƒe mɔnu dome me be woakpɔ vevienyenye si le nusiwo ŋu woke ɖo le numekuku sia me ŋu le dɔdamɔnu me.

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 .

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