Top 10 Distal Tibial Intramedullary Nails (DTN) le Dziehe Amerika na January 2025

Nu gbadzɛwo ƒe agbawo .

Nu vevi aɖe si gblẽ le lãkusi falɛfalɛwo ŋu, dɔlékuiwo ƒe agbɔsɔsɔ si sɔ gbɔ, hayahaya didi .

Antegrade ɖaƒoƒo .

Afɔku si le klo ƒe ƒunukpeƒe ƒe abixɔxɔ, fixation si mesɔ gbɔ o, si te ŋu trɔna bɔbɔe me .

DTN ƒe egbɔkpɔnu .

Mɔnu si me nu boo aɖeke mele o kple megbedede ƒe ɖoɖowɔwɔ

1Tibial ƒe gbagbã le didiƒe bɔ, eye seɖoƒe li na atikewɔwɔ siwo wowɔna le kɔnu nu .

Distal tibial fractures nye abɔ kple afɔ ƒe gbagbã ƒomevi si bɔ. Atikewɔwɔ siwo wowɔna tsã abe ʋuƒo siwo wotsɔ xea mɔ na nu kple antegrade intramedullary nails dometɔ ɖesiaɖe ƒe kuxiwo le wo dometɔ ɖesiaɖe ŋu ene. Plate plate ate ŋu ana dɔlékuiwo naxɔ ame le dɔwɔwɔ vɔ megbe alo lãkusi falɛfalɛwo ƒe kuku, si ana wòahaya ɣeyiɣi didi aɖe; Togbɔ be antegrade ɖawo megena ɖe eme boo o hã la, woate ŋu agblẽ nu le klo ƒe ƒunukpeƒea ŋu, ana woase veve, eye woatsɔ afɔku siwo nye be woagaɖɔ ɖo nyuie o alo woƒe lãme nagasɔ nyuie o, si xea mɔ na hayahaya.

2Egbɔkpɔnu Yeye: Distal Tibial Nail (DTN) .

Atikewɔwɔ ƒe mɔnu yeye aɖe—si nye distal tibial nail (DTN)—na nukpɔsusu yeye aɖe si dzi woato akpɔ distal tibial fractures gbɔ kple eƒe retrograde design tɔxɛa.

Fig. 1: DTN Retrograde Insertion Design .

1Dɔnɔwo ƒe Nɔnɔme Kple Wo Dzadzraɖo Ðe Wo Dzi Ðeɖe Akpɔtɔ .

Wotsɔa dɔnɔa dana ɖe akɔta ƒe nɔnɔme me. Ele be woate ŋu aɖe gbagbãƒe siwo woɖe ɖa la dzi akpɔtɔ kple asi; Ne ehiã la, zã reduction forceps nàtsɔ akpe ɖe eŋu hafi nàde DTN la eme. Ne ka ƒe gbagbã si kpe ɖe eŋu li la, ka ƒe ɖoɖo nyuie ate ŋu akpe ɖe tibial dzi ɖeɖe kpɔtɔ ŋu.

2DTN ƒe nudede eme ƒe ɖoɖo .

Woɖea 2–3 cm didi ƒe ʋuʋudedi le medial malleolus ƒe nugbɔ be wòaɖe deltoid ligament si le gota la ɖe go. Wotsɔa mɔfianu ƒe pin dea malleolus la ƒe nugbɔ alo le titina vie, si nye 4–5 mm tso articular surface gbɔ.

Fig. 2A: mɔfiame pin dede .

Fig. 2b: axadzinɔnɔmetata .

Fig. 2C: Reaming ƒe ɖoɖo .

Gbugbɔgaɖɔɖo ƒe ɖoɖowɔɖi .

• Afɔkpodzi ƒe ƒunukpeƒe ƒe dɔwɔwɔ dzea egɔme le amekoko vɔ megbe teti .

• Ƒo asa na kpekpeme tsɔtsɔ na kwasiɖa 4–6 .

• Trɔtrɔ vivivi yi kpekpeme dzi ɖeɖe blibo gbɔ le kwasiɖa 8–12 me .

• Kpɔkpɔ edziedzi le fotoɖeɖe me le hayahaya ƒe akpaa me .

1Dɔnɔ 10 ƒe dɔdamɔnu me tsonu .

Numekuku aɖe kplɔ dɔnɔ 10 ɖo. Kaka ɣleti 3 naɖo le OP megbe la, nya 7 ye da gbe le eŋu; Dɔnɔawo katã kpɔ dɔyɔyɔ le ɣleti 6 me. Varus kple recurvatum ƒe nɔnɔme madeamedziwo ƒe akpa ɖesiaɖe dzɔ. Womekpɔ dziɖeɖi, dɔlékuiwo xɔxɔ, kuxi siwo do ƒome kple wo nɔewo, alo abi siwo woxɔ le iatrogenic ŋu o.

1Biomechanical ƒe liƒo .

Retrograde nails ƒe axial kple rotational stiffness si de ŋgɔ wu ne wotsɔe sɔ kple medial locking plates kple antegrade nails. Greenfield kple exɔlɔ̃wo. Wowɔ biomechanical dodokpɔ si ɖee fia be to distal screws zazã le DTN me ɖo 60–70% ƒe compressive stiffness kple 90% le torsional stiffness me ne wotsɔe sɔ kple screw etɔ̃.

2Viɖe siwo le DTN ŋu .

Ne wotsɔe sɔ kple agba siwo wotsɔna ƒoa nui la, lãkusi siwo le lãkusia me megblẽa nu le lãkusi falɛfalɛwo ŋu boo o, vevietɔ wosɔ na dɔnɔ tsitsiwo kple amesiwo xɔ abi vevie le lãkusi falɛfalɛwo ta tso nuveviwɔame si me ŋusẽ geɖe le me. Dɔdamɔnua mehiã klonu o, si ɖea afɔku si le edzi ɖeɖe kpɔtɔ ƒe bublu me dzi kpɔtɔna eye wònana wòsɔna na dɔnɔ siwo ƒe klo ƒe ʋuʋu mede o.

3Dɔdaƒe ƒe tsɔtsɔ sɔ kple wo nɔewo .

Nonign kple malignment rates na antegrade nails nye 0–25% kple 8.3–50%, le wo nɔewo yome; Le ʋuƒo siwo wotsɔ xea mɔe gome la, 0–17% kple 0–17%. Le numekuku sia me la, nɔnɔmeawo katã ɖo ɖekawɔwɔ gbɔ, eye 20% koe ƒe nɔnɔme gblẽ >5°, si sɔ kple mɔnu xoxowo.

DTN ƒe adzɔnuwo ƒe ƒuƒoƒo .

Distal tibial intramedullary nail (DTN) .

Kpɔɖeŋu: T1100-59.

     Adzɔnuwo ŋuti nyatakakawo .    

Distal tibial intramedullary nail (DTN) dɔwɔnu ƒe ƒuƒoƒo .

Kpɔɖeŋu:1200-27

     Adzɔnuwo ŋuti nyatakakawo .    

Distal Tibial Intramedullary Nail (DTN) Dɔwɔnu Aɖaka .

Kpɔɖeŋu:1000-0139

     Adzɔnuwo ŋuti nyatakakawo .