Tibial intramedullary nail: egbɔkpɔnu si ŋu kakaɖedzi le na tibial fractures .

Tibial ƒe gbagbã, si gblẽa nu le shinbone ŋu, ate ŋu akpɔ ŋusẽ ɖe ʋuʋu kple gbesiagbedɔwo dzi vevie. Atike siawo dada bia be woabu nu vovovowo ŋu nyuie, siwo dometɔ aɖewoe nye gbagbã ƒomevi, teƒe si wole, kple dɔnɔa ƒe nɔnɔmewo. Amekoko ƒe mɔnu ɖeka si ɖee fia be ewɔa dɔ nyuie le ƒe ʋɛ siwo va yi mee nye tibial intramedullary nail zazã. Nyati sia ku ɖe viɖe, amekokomɔnu, afɔkuwo, kple hayahaya si do ƒome kple atikewɔwɔmɔnu sia ŋu.

Kpɔkplɔyiɖeme

Afɔkpodzi ƒe gbagbã ate ŋu ana ame nagbɔdzɔ, si ana ame nase veve, mali ke o, eye azɔlizɔzɔ nasesẽ. Seɖoƒe li na atikewɔwɔmɔnu deŋgɔwo, abe casting alo external fixation ene, si na be wokpɔ egbɔkpɔnu deŋgɔwo abe tibial intramedullary nail ene.

Nukae nye tibial intramedullary nail?

Tibial intramedullary nail nye atikewɔnu si wowɔ be wòali ke ahadoe ɖe ŋgɔ le lãkusi ƒe lãkusi me. Gati si wotsɔ dea ƒu ƒe titina si me do le mee le eme, si wɔnɛ be wòli ke eye wòdoa alɔe le dɔyɔyɔa me. Zi geɖe la, wotsɔa titanium alo gakpo si mexɔ dzo o wɔa lãgbalẽa eye woƒe lolome le vovovo be woawɔ dɔnɔ ƒe ŋutilã vovovowo.

Nusiwo fiaa tibial intramedullary nail .

Wozãa tibial intramedullary nails zi geɖe tsɔ daa tibial shaft fractures. Wowɔa dɔ nyuie ŋutɔ na gbagbã siwo hiã be woatsɔ aɖo wo nɔewo ŋu li ke, abe ƒu ƒe gbagbã siwo woɖe ɖa alo esiwo me wogbã le ene. Mɔnu sia hã sɔ na dɔléle siwo ƒe ƒuwo menyo o alo ne wodi be woalolo enumake.

Amekokomɔnu na tibial intramedullary nail .

Ðoɖowɔwɔ do ŋgɔ na dɔwɔwɔ na ame .

Ðoɖowɔwɔ nyuie do ŋgɔ na dɔwɔwɔ na ame le vevie ŋutɔ na afɔkpodzi ƒe lãkusi ƒe dɔwɔwɔ dzidzedzetɔe. Esia lɔ alesi wodzroa ƒu ƒe gbagbã ƒe ɖoɖoa me tsitotsito, dɔnɔa ƒe lãmesẽ bliboa, kple abi ɖesiaɖe si do ƒome kplii la me ɖe eme. Woate ŋu azã nɔnɔmetatawo ɖeɖe ƒe mɔnuwo abe X-ray, CT scan, alo MRI ene atsɔ ada ƒu ƒe gbagbã ƒe nɔnɔmewo kpɔ eye woafia mɔ amekoko ƒe nyametsotsowo wɔwɔ.

Dɔnɔwo ƒe Nɔnɔme .

Le amekokoa me la, zi geɖe la, woɖoa dɔnɔa ɖe amekokokplɔ̃a dzi. Wodzraa afɔ si ŋu wòku ɖo la ɖo eye wotsɔa dɔlékui si me dɔlékui mele o la blanɛ. Teƒe nyui nɔnɔ le vevie be woate ŋu age ɖe teƒe si wogbã la nyuie wu eye wòana ɖaƒoƒo nanya wɔ.

Incision kple Access .

Woɖea lãkusi aɖe ɖe amekokoƒea dzi be woate ŋu age ɖe ƒu si gbã la me. Alesi lãkusia ƒe didime kple afisi wòle la nɔ te ɖe eƒe gbagbã ƒomevi kple afisi wòle le afɔkpodzia ŋu dzi. Lãmetsi falɛfalɛwo zazã nyuie le vevie ŋutɔ be woaɖe nuveviwɔame dzi akpɔtɔ eye woaɖe dɔlékuiwo xɔxɔ ƒe afɔkua dzi akpɔtɔ.

Nail ƒe tsɔtsɔ de eme .

Esi amekolaa wɔ teƒe si gena ɖe afɔkpodzi si te ɖe eŋu me vɔ la, etsɔa afɔkpodzi ƒe lãkusi si le lãkusia me la dea lãkusia me nyuie. Wozãa fluoroscopic mɔfiame tsɔ kpɔa egbɔ be woda wo ɖe teƒe ɖeka eye woɖo wo ɖe ɖoɖo nu pɛpɛpɛ. Wodoa ɖa la ɖe ŋgɔ to ƒu me, wogbugbɔa kakɛ ɖesiaɖe si woɖe ɖa la ɖoa ɖoɖo nu eye wògbugbɔa ŋutilã ƒe wɔwɔme ƒe ɖoɖo si sɔ la ɖoa anyi.

Locking screws ƒe ɖoɖo .

Ne wonya ɖo ɖa la ɖe teƒe nyuitɔ ko la, wotsɔa gavi siwo wotsɔna ƒoa gaviwoe la dea eme be woatsɔ abla ɖa la ɖe ƒu me. Gavi siawo nana woli kena ɖe edzi eye woxea mɔ na ʋuʋudedi ƒe kakɛawo ƒe tɔtrɔ alo axial ƒe ʋuʋu. Screw ƒe xexlẽme kple wo dada nɔ te ɖe eƒe gbagbã ƒe nɔnɔme kple amekolaa ƒe didi dzi.

abi ƒe nutsotso .

Ne wokpɔ egbɔ be wowɔ ɖoɖo nyuie ɖe wo nɔewo ŋu nyuie eye wole wo nɔewo ŋu bum vɔ la, wotsɔa sutures alo staples xea nusi woɖe la nu. Wowɔa abi ƒe nutsotso nyuie be woado gbedada ɖe ŋgɔ eye woaɖe dɔlékuiwo xɔxɔ ƒe afɔkua dzi akpɔtɔ. Wozãa atike si me dɔlékui mele o, eye wokpɔa amekokoƒea ta.

Viɖe siwo le tibial intramedullary nail ŋu .

Tibial intramedullary nail zazã naa viɖe geɖe le atikewɔwɔmɔnu xoxowo ŋu. Viɖe vevi siwo le eme dometɔ aɖewoe nye:

1. Fixation si li ke: Nail la naa fixation si li ke, si wɔnɛ be woate ŋu aɖo wo ɖe ɖoɖo nyui nu eye woawɔ ɖeka le fracture fragments la me.

2. Ameƒoƒo kaba: Nail la naa ameƒoƒo kaba, si wɔnɛ be dɔnɔwo te ŋu dzea kamedede siwo me wotsɔa kpekpeme ɖona kple esiwo me wogbugbɔa wo ɖona gɔme kaba ne wotsɔe sɔ kple atikewɔwɔmɔnu bubuwo.

3. Ʋu ƒe sisi takpɔkpɔ: To ʋuka si le ʋukaa me zazã me la, tibial intramedullary nail technique ɖea ƒu ƒe ʋuʋu ƒe tɔtɔ dzi kpɔtɔna, si nye nu vevi aɖe na ƒu ƒe gbagbã.

4. Dɔwɔwɔ me tsonu siwo nyo ɖe edzi: Ne woɖo wo ɖe te sesĩe eye woƒo wo nu ƒu kaba ta la, zi geɖe la, dɔnɔ siwo wowɔa afɔkpodzi ƒe dɔwɔwɔ na wo le lãkusi me la toa dɔwɔwɔ me tsonu siwo nyo ɖe edzi eye wogatrɔna ɖe gbesiagbedɔwo ŋu kabakaba wu.

5. Afɔku si le lãkusi falɛfalɛwo ƒe kuxiwo me dzi ɖe kpɔtɔ: Ne wotsɔe sɔ kple gotagome fixation mɔnuwo la, ɖa ƒe lãkusi ƒe mɔnu si wozãna ɖe lãkusi me la bia be woaɖe lãkusia ƒe akpa siwo le sue wu eye woaɖe lãkusi falɛfalɛwo ƒe tɔtɔ dzi akpɔtɔ, si wɔnɛ be afɔku si le lãkusi falɛfalɛwo ƒe kuxiwo kple dɔlékuiwo xɔxɔ me dzi ɖena kpɔtɔna.

   
   

Kuxiwo kple afɔkuwo .

Togbɔ be zi geɖe la, afɔkpodzi ƒe lãkusi me dɔwɔwɔ le dedie eye wòwɔa dɔ nyuie hã la, kuxi siwo ate ŋu ado mo ɖa kple afɔku siwo ate ŋu ado tso eme la li. Ele vevie be nànya nu tso nu siawo siwo ate ŋu adzɔ ŋu hafi woawɔ atike nɛ. Kuxi siwo dona tso eme dometɔ aɖewoe nye:

Dɔdzedze

Abe alesi wòle le amekoko ɖesiaɖe gome ene la, afɔku li be woaxɔ dɔlékuiwo. Gake ne wozã mɔnu nyui siwo me dɔlékui mele o, dɔlékuiwutikewo ƒe mɔxexeɖedɔléle nu, kple beléle na ame le dɔwɔwɔ vɔ megbe la, woate ŋu aɖe afɔku si le dɔlékuiwo xɔxɔ me dzi akpɔtɔ.

Malignment alo nonunion .

Le go aɖewo me la, kakɛawo mate ŋu ahaya le ɖoɖo si wodi nu o alo mada gbe le wo ŋu kura o. Nusiwo nye dziɖeɖi si mesɔ gbɔ o, ƒu ƒe nyonyome madeamedzi, alo kpekpeme si gbɔ eme ate ŋu ana woawɔ nu wòagbɔ eme alo womawɔ ɖeka o. Woate ŋu alé ŋku ɖe eŋu nyuie eye ne ehiã la, ahiã be woawɔ nu bubu siwo woatsɔ awɔ dɔ na ame abe amekoko si me woagbugbɔ ŋku alé ɖe nu ŋu ene.

Kuxi siwo do ƒome kple ame ƒe lãmetutudɔ .

Togbɔ be kuxi siwo mebɔ o, siwo do ƒome kple wo nɔewo ate ŋu ado tso eme hã ate ŋu ado mo ɖa, abe ame ƒe lãmetutudɔ, eƒe gbagbã, alo dzikudodo ene. Nya siawo ate ŋu abia be woagade nu nyaa me geɖe wu hafi woate ŋu akpɔ wo gbɔ.

Lãmetsiŋusẽ alo ʋukawo ƒe abixɔxɔ .

Le amekokoa wɔɣi la, afɔku sue aɖe le lãmekawo alo ʋukawo ƒe abixɔxɔ me. Amekolawo wɔa afɔɖeɖewo be woaɖe afɔku sia dzi akpɔtɔ, gake ele be dɔnɔwo nanya nu tso alesi wòate ŋu adzɔe ŋu eye woagblɔ dzesi ɖesiaɖe si anɔ anyi ɖaa alo si le gbegblẽm ɖe edzi la enumake.

Gbugbɔgaɖɔɖo kple hayahaya .

Le tibial intramedullary nail surgery megbe la, ɖoɖo si me wowɔa dɔ bliboe le la le vevie ŋutɔ be woahaya nyuie wu. Ðoɖo si wowɔ koŋ be woagbugbɔ aɖɔe ɖo la ate ŋu ato vovo le alesi wòsẽe, eƒe nɔnɔme, kple amekola ƒe mɔfiafia nu. Kamedede kaba, kpekpeme dzi ɖeɖe kpɔtɔ vivivi, kple ŋutilãmedɔdada wɔa akpa vevi aɖe le dɔwɔwɔ gbugbɔgaɖɔɖo me, ŋusẽdodo, kple ƒu ƒe dɔyɔyɔ dodo ɖe ŋgɔ me.

Nudzɔdzɔwo me dzodzro kple dzidzedzekpɔkpɔ ŋutinyawo .

Dɔnɔ gbogbo aɖewo kpɔ dzidzedze le afɔkpodzi ƒe lãkusi me dɔwɔwɔ na wo me. Nudzɔdzɔ ɖeka si wowɔ le nudzɔdzɔa ŋu ku ɖe ame aɖe si xɔ ƒe 35 si ƒe afɔtiwo gbã la ŋu. Esi wowɔ dɔ na dɔnɔa vɔ la, wowɔ dɔ nɛ kple afɔkpodzi ƒe lãkusi si le lãkusi me vɔ la, dɔnɔa ɖo solid fracture union gbɔ, egaxɔ kpekpeme blibo ƒe ŋutete, eye wòtrɔ yi woƒe dɔwɔwɔ ƒe seƒe si nɔ anyi tsã le ɣleti ade me.

Tsɔe sɔ kple atikewɔmɔnu bubu siwo woate ŋu azã .

Ne wole atikewɔwɔ ƒe tiatia siwo woawɔ na tibial fractures ŋu bum la, ele vevie be woatsɔ viɖe kple seɖoƒe siwo le mɔnu ɖesiaɖe ŋu asɔ kple wo nɔewo. Togbɔ be afɔkpodzi ƒe lãkusi ƒe dɔwɔwɔ na ame ƒe afɔkpodzi ƒe dɔwɔwɔ naa viɖe geɖe, abe fixation si li ke, ʋuʋu kaba, kple lãkusi falɛfalɛwo ƒe kuxi siwo dzi ɖe kpɔtɔ ene hã la, ɖewohĩ masɔ na gbagbã ƒe nɔnɔme alo dɔnɔ ɖesiaɖe o. Woate ŋu adi mɔnu bubuwo, abe plating alo external fixation ene, le go aɖewo me. Tomeɖoɖo kple ƒumeŋuɖui ŋuti nunyala aɖe akpe ɖe ame ŋu woanya atikewɔwɔmɔnu si sɔ wu le ame ɖekaɖekawo ƒe nɔnɔmewo nu.

Nyanuwuwuw

Le nyataƒoƒo me la, tibial intramedullary nail surgery nye atikewɔwɔ ƒe mɔnu si ŋu kakaɖedzi le eye wòwɔa dɔ nyuie na tibial fractures. Mɔnua naa fixation si li ke, ɖea mɔ be woaƒo wo nu ƒu kaba, eye wònaa viɖe geɖe wu mɔnu xoxowo. Togbɔ be afɔku kple kuxi siwo ate ŋu ado ƒome kple dɔdamɔnua li hã la, ɖoɖowɔwɔ nyuie do ŋgɔ na dɔwɔwɔ, amekokomɔnu si sɔ, kple beléle na ame le dɔwɔwɔ vɔ megbe si sɔ ate ŋu aɖe dzimaɖitsitsi siawo dzi akpɔtɔ.